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RICHMONDTB - August 7th, 2006 1:09 AM

Hi
My husband and I did a donor egg cycle that I need some additional information. Unfortunately, we have found out recently that I have ashermans syndrome that was caused 7 years ago after a myomectomy and we were never disclosed this condition. We also were approved to do 1 ivf cycle, and 2 donor egg cycles. There were 3 uterine surgeries and the scar tissue was visiable to the RE who did the surgery.
With those 3 cycles, we miscarried twice and now we are in the process after many battles of moving forward with an entire new staff of 3 RE. bc of the Ashermans syndrome.

We have frozen donor egg embryos, that are severly fragmented. My hubby sperm was ok on the SA, and sperm chromatin tests.

When and how would you know if there is a sperm issue. of 14 embryos, 10 embryos fertilized but there is a fragmentation issue, and I think it is in the range of 20%.
The RE are trying to say the reasons for the miscarriages could be sperm related and I said It was the ashermans. The scar tissue has been there in both of the miscarriages. the first miscarriage was an older egg, but on day 3, it was an 8 cell top grade embryo from a 41 year old patient.
the other miscarriage the donor egg was 8cell top of the line embryo.

What role does fertilization play in all of this, is that part of the sperm contributions? if there is poor fertilization what is that from?
thanks for all your help through the years.
Brenda

Dr Smith - August 8th, 2006 12:20 PM

The sperm's contribution doesn't really come into play until the embryo is between the 4 and cell stage of development. So, fragmentation prior to the 8 cell stage is entirely due to egg issues. Unfortunately, there's no way to know if an egg donor has good eggs until you fertilize them and culture the resulting embryos. We have had similar cases in the past. You always assume that because a donor is young, she will have good eggs. Although this is generally true, some egg donors have crappy eggs. 20% fragmentation isn't terrible, but its not a good sign either.

As to the miscarriages: It is possible that the miscarriages were caused by the sperm, but with normal semen parameters and a normal SCSA, I think this is extremely unlikely, especially in view of the Asherman's Syndrome.

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