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red17 - February 26th, 2009 2:27 AM

Dr.Jacobs,
I am 36yo with PCOS and my husband 38yo. Presently about to start our third IVF cycle. My FSH 7. 1st 2 cycles were on Lupron, Gonal-F and Menopur.

IVFcycle #1 - 16 eggs retrieved, none fertilized on their own so ICSI 24 hrs later. 10 fertilized. 3 implanted on day 3 (1 good quality 4 cell, the others fair quality 5 & 7 cell). BFN

IVF Cycle #2 - same protocol. 17 eggs retrieved, all ICSI'd, 10 embryos, none great quality. Again 3 implanted on day 3 (1 good, 2 fair). BFN

About to start cycle 3. Plan is to not use Lupron and instead use Ganirelex during cycle (& continue Gonal-F and Menopur).

Wondering if you had any thoughts on possible causes for poor embryo quality and any potential suggestions you had regarding further testing and/or protocol variences.

Thanks.

B. Jacobs, M. D. - February 26th, 2009 6:30 AM

embryo quality depends on egg quality, sperm genetics and laboratory issues. WE find we get better quality eggs if we do not add LH, which is in Menopur.
Good luck.

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