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update: I have all of my immunity testing done...positive for MTHFR(compound hetero for 2 mutations), borderline positive for one APA. Nks at 12.9. Anti-thryoid antibodies elevated. All of the immune issues will be treated. But I am still concerned about our low fertilization. My new RE thinks an addition of a little LH should help! (left my previous RE because he does not believe in immune issues or change in protocol) New RE says the sperm has to be pretty severe to affect the fertilization...what is your opinion? |
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I agree completely with your new doc. It is very likely that the addition of LH will improve the cytoplasmic maturation of the eggs and, in turn, improve fertilization results. For sperm to cause fertilization failure, the sperm have to be really, really bad. For example, we see this when we use grossly immature testicular sperm, but it is extremely rare with ejaculated sperm and in those cases, all the eggs fail to fertilize. |
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Thanks for your response!! It is nice to hear something positive...I hope and pray we get better results this time!!! Will let you know how it goes!! |
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hello- |
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Yes, fetilization rate following ICSI is usually in the 70-80% range. However, you can't make a bad egg good by sticking a sperm inside. As I mentioned before, it is unlikely that the sperm was the cause of the lower fertilization rate. Some eggs are duds and even with ICSI, they fail to initiate development. Is this related to poorer development of the eggs that did fertilize? Yes and No (sorry to be vague). It really depends of the cycle and the indivual. In your case, the addition of LH to the stimulation protocol resulted in improved egg maturity (14/17; 82%) and to some degree improved fertilization/activation of development. However, it may not just be the stimulation on the previous cycles that was a problem. There may also be an egg "problem". We will find out as the embryos develop. Poor development and excessive fragmentation during Day 1 and Day 2 of development indicate a problem with the eggs. If the embryo fails to develop beyond the 6-8 cell stage, this is indicative of a genetic problem with the embryos (usually traced back to a problem with the genetics of the egg). Developmental arrest after the 8-cell stage could be caused by the egg or the sperm or both. We'll just have to play it out and see what happens. |
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since we had improved fert rates from 30% from my first two cycles IVF/ICSI improved to 60% with addition of LH during stimms....is this a good sign? It is still not at the expected 70% but I am hoping we get better embryo growth with the improved fert rate since with the 30% rate the embryos were just about average quality.... |
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today is day 3 and our embryos look excellent. 2 8 cell grade 1. 10 cell grade2, 2- 9 cells grade 2, a 7 cell grade 2 a few others not doing as well. |
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The consesus opinion is that LH is necessary for a successful stimulation. There are still some hold outs that continue to use FSH-only protocols. I'm glad that the embryo development was improved. It rules out an "egg problem". Best of luck. |
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Update: |
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Congratulations.! Glad to have been of some help. Its always nice when someone posts that their cycle was a success. Otherwise, you'd get the impression every cycle's a bust by reading the posts on this board. Again, congratulations and Happy Holidays. |
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