Question IVF from Buenos Aires
1 Replies
caschere - November 29

Dr Jacobs
I am 34 yrs from Buenos Aires Argentina. Normal day 3 FSH (6) LH (3) and actually I have all the blood test normal (estradio, LH, FSH day 3 and day 13) I have normal u/s and I am normally ovulating every month arround day 13. My husband had a varicocelle and low motility and was surgeryremoved 3 yrs ago. I did 5 IUI negatives.
1st IVF Oct 2003- Long Lupron and 150 Gonal-F, follicles grown very slowly so they did 300 gonal from day 7.
9 oocytes retrieve, 7 were mature but none fertilization by ICSI (cytoplasm inmature).
2nd Jan 2004. During my natural cycle without any meds when my own follicle reached 17mm HCG shot. 1 oocyte retrieved, ICSI 1 3day 7cells embryo transfer. Normal pregnancy my baby borned in Oct 2004.
I am trying to have a 2nd baby, but with natural cycle in 4 oportunities they could not obtained the oocyte during the retrieval procedure. They did several washes and the oocyte did not come.
I did last month IVF 300gonal-F in day 7 we added 75 Menopur. During the first days with gonal-F only, the oocytes did not grown very much and in day 7 were less oocyte than in day 5. When we added Menopur the oocyte started to grow incredible and much more follicles appeared. HCG shot when at least 4 follicles 18. We got 12 oocytes, 9 mature, ICSI 6 fertilized, only 2 good embryos were transfer. !st beta 106, 2nd 163, 3rd 224, 4th 224. Stop meds. Beta is 7 days later in 150 so is comming down slownly ( may be It was ectopic I do not know).
Questions:
Why we could not get the oocyte from my natural ovulating cycle when is the best day to do HCG shot ( once I did later and I ovulated).
Why I do not have good results with stimulations IVF. Is something related with protocole, oocyte quality. Do you think I could try an stimulation just with Menopur (It was very noticeable the follicle size and number when we added menopur).
Suggestions
Kindly
Carolina

 

B. Jacobs, M. D. - November 29

It is not uncommon to not retrieve an egg from even a large follicle after stimulating ovaries. I do not do "natural cycle" IVF. It is even less predictable than IVF stimulating ovaries. I do not us any LH in my stimulation protocols. We seem to get better quality eggs and embryos if we use straight FSH to stimulate ovaries.
Good luck.

 

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