Poor Egg Quality
8 Replies
corbella - May 14

Hi,
We just went through our 2nd Failed IVF. My DR thinks I may have an Egg Quality Issue.

I am 32 years old & DH 28 yrs old. We had the DNA done on his sperm and it came back good.

As for me, I have 2 small fibroids at the back of my uterus, and a cyst on my cervix which makes the transfer a little tricky (causes an "S" shape to get past & into the uterus)

First cycle was Pure FSH. Day 21 Lupron & then Puregon. Stimmed for 7 days. 10 Eggs retrieved, 7 mature & 6 Fertilized. At retrieval, my DR retrieved 1 Huge Egg (abnormal) and from the 6 that fertilized 2 of my eggs allowed too much of my DH sperm in. From 4 eggs on Day 3: 2-8cell, 1-6cell, 1-5cell. Transferred 1 Blast and 1 Morula. BFN. Nov/04

April/04-IVF#2. This time FSH & LH. 21 Day Lupron, Puregon(reduced the amount) and Added Repronex. Stimmed for 10 days.
9 eggs retrieved, 8 Mature, 6 Fertilized.
No abnormal eggs this cycle.
Day 3: 1 Morula, 2-8 cell grade 1&2, 2-6 cell grade 2&3, and 1 4-cell grade 1 (grade 1 the best)
We transferred 1 Blast and 1 Morula again but they were a better grading then the cycle before.

From your experience do you think that I might have an Egg Quality Issue?
Could a 3rd IVF with a different drug procotol make for a successful cycle.
What drug protocol is recommended for someone who has an Egg Quality Issue?
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Dr Smith - May 16

The egg problems observed in the first cycle could be attributed to the short stimulation period (i.e. less than 9 days of stimulation). In other words, not an egg problem [i]per se[/i].

The second cycle was managed better and the resulting embryo development reflected this. There is always attrition of the embryos when performing extended culture to Day 5. I would have expected you to have a couple of good quality blastocysts, but one good quality blastocyst and a morula on Day 5 isn't that bad. Again, doesn't really look like an egg problem.

What strikes me is that, in both cases, they transferred reasonable embryos and nothing implanted. If you have a cervix which is difficult to negotiate for embryo transfer, this may have been a contributing factor. If the transfer is traumatic to the cervix or endometrium, the chances of pregnancy are significantly reduced. Have they considered cervical dilatation to "straighten out" the path?

Alternatively, there may be a problem with implantation (i.e. immunological problems or clotting factors). I would suggest that you discusss this possibility with your doctor and have additional testing.

 

Corbella - May 16

Thank you Dr.Smith!

Our 1st cycle transfer with my DR I had spotting right after the transfer for about 2 days. On that transfer my DR noticed a polyp on my cervix which he removed right after the transfer. I questioned him about our failed cycle and if removing the polyp had anything to contribute to the negative result, but he said no
(and was offended by the question)

My 2nd cycle transfer with my DR's college went better. She had a hard time getting around the cervix and had to change the clap from a normal one and a much bigger one (wow that was uncomfortable) but then she had no problem getting around the cervix.

If we do another cycle, What would you recommend to be a good procotol for us ?(drugs & stimmulation time)
Can the cyst on my cervix be removed? What is cervical dilatation?

I have emailed my DR about Immune/Anitbody testing and he is open to testing for that but I'm not sure what tests they do. What are the most important tests to have done for Immune/Antibody Testing? His comment to me was, "although your eggs are not the Best, you could theoretically have an Immune problem"

One last question. We had the DNA on my husband sperm done almost a year ago, does each sample vary in results? I've read that the sperm can impact egg quality so I was wondering if we should get another DNA sample done?

Thank you so much for your honesty and advice! My follow up appointment to discuss our failed cycle and what we are going to do next is on June 21st. I haven't had a Laparscopy done. Should I?

Again, I greatly appreciate your advice! Thanks so much!!

 

corbellla - May 16

Oh, I forgot to mention that my E2 for 1st cycle was 5800 and 2nd cycle, last day of repronex was over 6000 so the day before I triggered he had me just do the lupron injection with no meds which brought my E2 down to 5700 when I triggered. Is that E2 level o.k? and by dropping my E2 the day before triggering, did that have any impact on my eggs? Thanks Again!! :)

 

Dr Smith - May 17

Most of your questions are of a medical nature and Dr Jacobs message board would be a better place to ask them (I'm not a physician).

The immunological and haematological testing information can be found on www.repromedix.com or www.millenova.com

Unless there has been a large change in the semen parameters in the last year, I would say additional DNA testing is unecessary.

E2 values over 6000 pg/ml can be associated with diminished egg/embryo quality, so that may be part of the "egg problem" your doctor referred to. However, slowing the stimulation down by "coasting" (1-4 days without medication) keeps the E2 in line and does not adversly affect egg quallity. This is what they did for the second cycle. Perhaps thats why the embryo quality was better.

 

corbella - May 17

Thanks again for your help!

 

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babydust30 - February 18

hi there im 30 and my dh is 36 with low sperm count . 1st icsi cycle transferred 1 6 cell day 3 embie and none to freeze and second attempt got 16 eggs and had ohss so couldnt transfer neither did any make it after day three. what do you think the problem could be is it egg quality ?

 

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