Post failed donor egg cycle consult
1 Replies
Brenda - June 2

Hi Dr. Jacobs
We have just had our post failed donor egg cycle and reviewed the donors stimulation protocol. It appeared the donor had quite a few follicles and the RE blocked out the donor initially had 27 follicles. At retrieval there was some follicles that were at a size 14 but the majority was at 16 -21 mm. There were 18 follicles retrieved and her estradoil levels were only 2238 and we thought that was low.

Should estradoil Readings be at 200 pg/iui per follicle before retrieval.

Is there a day in the stimulation that the estradoil readings reach their peak and do you keep the patient at those levels until retrieval or should the estradoil readings gradually increase on stims and the last day before retrieval is the day with the highest estradoil readings?

Also the normal embryologist was on medical leave and she used her staff of old embryologists that she had used in prior years.

Our embryos which resulted in 10 and only 4 were b rated embryos and the rest of the embryos were b-. She is recommending to unthaw all 10 of the embryos to see if they make it to blastocysts and my thoughts is they will not make it to blast bc they would of taken them to blast at day 3.

We are definitely getting a second opinion bc our RE is standing firm there is not an egg issue even though the embryolgist stated there was an egg issue. We requested the report on the eggs before the fertilization report.

We used my husband sperm sample that had been corrected for dna and was a frozen sample.

Our RE stated she increased dosage on the donor bc hopefully it will produce more eggs and if there is a male factor it will be overcome, and produce more viable embryos. We did not have a male factor and icsi was performed and our donor was proven. So we know in a prior donation she had good egg quality and by increasing the donors meds, it compromised egg quality.

any thoughts would be appreciated.


Barry Jacobs, M. D. - June 2

I am unable to answer questions specific to your donor or the stimulation protocol used. As a rule of thumb, we expect an esrradiol concentration in serum of 250 pg/ml to 350 pg/ml per mature follicle.
Good luck.



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