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holly-co - March 9th, 2006 10:53 AM

I saw in another thread ( I think? it was the one about slow embryos) that you mentioned that a select group of women seem to have poorer embryo development with Lupron (so I am assuming you mean they do better with like an Antagon protocol). Why do you think this is? What is the impact on embryo development?

I have posted to you many times before so you may remember me. I am one of those younger women, nl fsh, good response to stims, not PCOS, non smoker healthy etc. who has dark and grainy eggs (cytoplasm), thicker than normal zona pelucida and then embryos that are slow to divide (have had a couple 8 cells but rest 6 cells or less on day 3 but with minimal frag and even cell sizes). I did have a successful IVF cycle (#2) at a "top clinic" but then have had 2 failed cycles since then. We have tried different protocols (bcp's, no bcp's, all fsh, fsh +fsh/lh drugs etc.) but all have been with the long Lupron protocol. I know you are not an RE but from an embryology standpoint would you recommend for someone like me to try a no Lupron protocol once before throwing in the towel or is a situation like mine where we feel pretty confident egg quality is the prob (although unexplained) just a matter of being lucky and finding another good egg and that stim (when done appropriately whether with Lupron or not) won't make a difference.

Thanks for your time

Holly
P.S. And yes, I know my best odds lie with DE but we can't give up quite yet.


Dr Smith - March 10th, 2006 11:30 AM

I was referring to the ovarian response to the stimulation with and without Lupron, not embryo development. Some women have a better ovarian response (i.e. more follicles) without the Lupron down-regulation. More follicles can translater to more eggs and perhaps better odds simply because there are more eggs to start with. The down side to Antagon is that there is more dissynchony in the rate of follicle growth. A few big ones, then a bunch of small ones. This dissynchony on growth translates to problems with the maturity of the eggs at the time of retrieval. Some mature, some borderline, some immature - you get the picture. I don't think an Antagon cycle is the answer to your problem. I think its just a matter of getting a good egg, if you have one.

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