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Torrin - December 27th, 2006 10:36 AM

Dear Dr Smith

We changed drugs on our last 2 cycles from menogon to menopur and on both these cycles the %fertilisation was dire, the worst ever. We are using frozen TESE sperm, so I know we are starting off on the back foot. Previous cycles have had 60 - 90% fertilisation but on the last 2 only 45% and 27% respectively.

Is this just a fluke? Just wondered if the change of drug could have had any impact though Dr tells me that the drugs are the same with menopur more refined.

With the menogon the trigger drug was choragon and with the menopur one cycle used pregnyl and the last one ovitrelle. I'm guessing that these drugs are named differently in the states. I am in the UK. The only reason for the change was to make injecting easier as I struggle with the i/m injections myself when DH isn't around. Am I right in thinking that menogon and choragon are urine derived and menopur isn't?

We are planning another cycle and I'm trying to research whether we should revert to menogon/choragon.

Regards, Torrin

Dr Smith - January 8th, 2007 2:12 PM

I am not familiar with the medications you describe, so I have forwarded your question to Dr. Miller, an RE.

With regard to the poor fertilization, I think it is very likely due to sperm "quality" and not the stimulation medications. The use of testicular sperm results in highly variable fertilization results. So, what you desribe is within the normal variation expected using testicular sperm. Testicular sperm are very immature, as they have not undergone the 2-3 months it takes for sperm to mature. It is surprising we can achieve fertilization at all using testicular sperm.


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