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cal - April 1st, 2008 4:18 PM

HI Dr., May I have your opinion please? I had 2 failed IVF cycles. The 2nd cycle was on suprefact, Gonal-F 300iu + Luveris 75iu (11days), 7500iu hcg triger.
18 follicles: 17 eggs, 12 matured, only 6 of them fertilized healthily. They're 4-5 cells on day 3.
The leading follicles' size: 1.8, 1.85, 1.9, 1.9, 1.9, 1.95.
E2 was 19038(can) on the day of the trigger.
- what could be the cause of the low fertilization rate in the 2nd cycle?
- would you think the E2 is too high? what affect do you think it had on the implantation?

thanks so much

B. Jacobs, M. D. - April 1st, 2008 5:27 PM

Apparently very high estrogen levels or very rapid rise of estrogen levels is associated with lesser quality eggs. Typically the estradiol levels I like to see are arround 3500 pg/ml
Good luck.

cal - April 2nd, 2008 1:00 PM

Thanks very much for your prompt response.

Could the protocol be part of the blame for low fertinized rate(low quality eggs, high E2)?
the first IVF I had 70% fertinized rate, I was on suprefact, Gonal-F 225iu (11days), 7500iu hcg trigger. 17 follicles: 10 eggs, 6 matured & 7 fertilized.

Any suggestion or adjustment of the protocol would you recommend to improve the outcome?

We went through tests and no adversary found. But I'm 45.

Thanks!

B. Jacobs, M. D. - April 2nd, 2008 5:22 PM

Since I have not been a participant in your care, and cannot truly evaluate you or your stimulatioin response, I cannot make meaningful medical recommendations. If you are not comfortable with the practice which has been providing your care, Please seek a formal second opinion.
Good luck.

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