New FDA Ruling
1 Replies
Brenda - May 26

Hi
I have a few questions regarding the FDA ruling on tissue donation, regarding donor eggs. I understand from Dr. Smith, the FDA requires infectious disease testing on the donor 30 days after the egg retrieval.

Q1-What tests will be included in this panel?
Also we are preparing for a consult with our RE regarding our past donor egg cycle. We were only informed of the # of follicles during the donor stim part of the cycle and not the size nor the estradoil reading. It appears our donor did hyperstimulate according to the Donor Egg coordinator, not other information was forth coming from our clinic.

At the beginning of the donor's stim drugs she produced 27 follicles and the next 2 day report indicated she had only 10 follicles, and then 14 etc, to retrieval day.

On retrieval day, there were 18 follicles retrieved, 4 were post mature or immature, 4 did not fertilize and we were left with 10 embryos with less than desireable grade.

Our clinic uses the grading scale of a=best grade, then b+, then b, the b-. Out of the 10 embryos, 3 were only b grade, and the rest of the embroyos were b-

Q2-What would cause the poor grade and

Q3- also if the donor did hyperstimulate, what is reasonable estradoil readings on which day? I know that the stimulation protocols have to be adjusted to not risk over cooking the egg in the follicle, but when the clinic realized the donor was hyperstimulating, and decreased her meds, what should an appropriate estradoil reading been at that time and till the end of her stimulation protocol.

we do plan on asking our RE these questions and would like to know what are reasonable estradoil readings after the stims were decreased.

At the transfer of the embryos, it was very interesting bc it was the first time an RE never discussed how many to transfer and what the embryos looked like nothing, only the embryologist said it was an egg issue. That is all we know for now.


Q4----Also does PCOS increase the risk of hyperstimulation and what are the prescreening tests performed on the donor to rule out pcos.

I had inquired before the transfer and before the cycle if they use donors that have fertility issues such as PCOS and their reply was no.

Q5-My current RE says if I have pcos it does not increase my risk factors for miscarriage, do you agree or not agree with this statement. I have 2 prior miscarriage and the reasons were fibroids, immunological issues and potentially sperm chromatin

Q6---I know the fsh/lh ratio is one test, insulin to glucose fasting ratio test, glucose tolerance tests for PCOS but are there other tests you routinely evaluate?

also this was a proven donor that we had used and it was our RE recommendation to increase her stims or that is normally what she does on proven donors.
thanks for your insights as we prepare for our post failed donor egg consult.

Many thanks

Brenda Blankenship

 

Barry Jacobs, M. D. - May 27

I really do not have the information I would need to address your questions about a previous egg donor cycle. They really need to be put to the RE who did the procedure. The elevated risks of miscarriage for women with PCO seem to be reduced by using Glucophage. Glucophage als decreases the risk of gestational diabetes in women who are insulin resistant. Probably the most effective way to diagnose PCO is the ultrasound appearance of the ovaries.
Good luck

 

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