good eggs slow development
3 Replies
Scott - December 17

Dr. Jacobs-

We need advice. Have failed 2 IVF cycles.
Our history:
A son conceived naturally (first month trying)
2nd pregnancy conceived 2nd month. 20 week ultrasound borderline nuchal fold thickening, amnio showed no chromosome problems, stillbirth 32 weeks(unknown cause).
Decided to do IVF due to severe hyperemesis used proven surrogate and proven donor (due to family medical history) retrieved 16 eggs 8 went on to early blasts on day 5, transfered 2 bfn. Surrogate carried twins before us and since us. Egg donor had a few successful donations with twins and singletons.

FET embies did not do well in thaw so had to transfer all 6 bfn
2nd cycle proven surrogate different egg donor (age 24)retrieved 11 eggs none made it to expanded blasts even by day 5 1/2. Transfered 1morula and 2 early blasts. Ended up with chemical pregnancy. Egg donor cycled again for another couple and they had LOTS of expanded blasts. On day 6 we froze 2 but they weren't expanded blasts either.

Embryos are dividing normally on day 3 and somewhere after slow down. Husband has had karyotyping and everything is normal and also fathered a healthy child. Help, what should we do?? Our RE seems baffled. If any clinic could give us better advice we'd travel anywhere.

Thank you.
Kim


 

Barry Jacobs, M. D. - December 17

It is hard to kow what the problem(s) may be. Doing a karyotype on the provider of sperm or eggs does not assure normal karyotype of the embryo produced. Eggs and sperm may have problems, even if the person providing them does not. Also, there could be a problem in the lab. I am sorry I do not have a better answer for you, but I do not have enough information. There are times in our program when we think the embryos we transfer look perfect, but we do not get a pregnancy.
Good luck.

 

Scott - December 19

Dr Jacobs,

Thank you for taking the time on the weekend to get back to us. I would be happy to supply any additional information we know that could shed light on this. Although we do not have current year statistics, our clinic appears to be having outstanding success and has a good reputation. Although lab problems are possible, that appears unlikely. In fact, they had at least one other successful pregnancy that transferred the same day we did.

With regards to your comment on karyotyping, assuming for the moment that abnormal karyotyping of the embryos has been the cause of slow development in both cycles, is there any other way of determining the cause of that. If my sperm has been analyzed as normal through karyotyping, is there something else that can or should be tested to determine whether or not I am the source of the problem. Or, based on our previous natural conceptions and my normal karyotyping, is it more likely that we have simply had bad luck?

How common is it to see slow developing embryos in young successful egg donors? As Kim pointed out, in neither of our cycles did we have expanded blastocysts on day 5. Our RE described the blastocysts in positive terms both times, but we have read how slow development is often an indicator of a problem, and that would appear to be the case with us.

Is there any significance to the fact that the embryos seem to progress at a normal rate through 3 days, then slow down?

We are trying to decide what to do next and are baffled and disappointed by what has happened. We would welcome any suggestions you might have.

Thanks,
Scott and Kim

 

Barry JUacobs, M. D. - December 19

Only half the genetic material in an embryo comes from the egg. The genes from the sperm do not play a role in embryonic growth and developement until after day 3. It is possible to biopsy embryos for either chromosome studies. or for molecular genetic problems. The latter will not be of benefit to you. Molecular geneetic studies are only useful for couples who have a known genetic disease. I do not know that chromosome analysis of your embryos would be beneficial, either.
Good luck.

 

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