Was told i have poor eggs... any hope?
3 Replies
MsBail - September 7

Hello,
I am a new member. I just failed my first IVF cycle and need your advice. I am 35, 7.6 FSH, Estradiol 21, with mild endometriosis that was removed in March. My RE implied yesterday that they've learned through this IVF that i have "multiple egg issues" which translated to me as bad eggs. A week ago, when I only had 5 follicles, he encouraged us to cancel this cycle and said he thought I'd have a better chance at "follicular recruitment" if I had a higher dosage of Gonal F during the first 5 days. (They had upped my dosage this time on day 6 to 600iu per day when I wasn't producing enough follicles). I was stimmed for 13 days total and produced 6 follicles that grew to 21,19,19,15,14,7mm, two days before retrieval. My E2 at trigger (two days before retrieval) was 474. I also had a cyst that was millimeters at baseline and grew (painfully i might add) to 5 x 5.5 cm by day 8. I was told the cyst would not effect the cycle. All this said, we decided not to cancel and see what we got in hopes we might learn something that, if anything, might improve our odds for next time. 4 eggs were retrieved, 3 mature. All 3 were considered poor quality with slightly dark cytoplasm and thick outer shell. 2 fertilized with ICSI but they divided much too slowly and were only 2 and 3 cells, by day 3. No transfer was done because it was believed they'd arrested. I was shocked to hear that the assumption is already being made that my eggs are bad after only one try at IVF... Especially when I was encouraged to cancel and told that "the Microflare protocol would produce better results for us!"

My question to you is, how much of egg quality is controlled by the stimulation process itself (correct timing, # of days and dosage)? Do you think we have a chance at getting better eggs by changing the protocol or will my eggs always look like they did on this first IVF round? Could the rapid growing cyst have effected egg quality? I am only 35 and again, my 3 day FSH is 7.6! I find it hard to believe that donor eggs is our next step.

I appreciate your feedback very, very much.
Thank you,
Karen

 

B. Jacobs, M. D. - September 7

Cysts do effect follicle recruitment in the ovary where they ar located. If you had a cyst of any kid on your baseline, I would have delayed cycle start. I learned that the hard way (or 1 of my patients did). If it turns out you are a poor responder, I would use a microdose flare protocol.
Good luck.

 

MsBail - September 7

Thank you very much for your reply. So it is my understanding then that you think the cyst had a lot to do with this failed cycle... I was very worried the cyst was affecting it, mainly due to the excruciating pain of it growing to that size so quickly! (and i am no baby!) My other good ovary only had 3 follicles. Can the influence of the cyst take away from both ovaries during the recruitment phase? They still do not know if it is a corpus luteum or an endometrioma, though my RE tends to think it is a CL because of how quicky it grew. He tried to aspirate it at egg retrieval. Not much came out and there were white areas within it, that he said made it seem like it was starting to resolve itself. He suggests doing nothing and to see if it goes away on it's own. My concern is, by starting another round right away (back to back cycles), are we not leaving enough time for the cyst to completely go away? I truly appreciate your thoughts and thank you for your time.

Karen :)

 

B. Jacobs, M. D. - September 8

If your cyst were a luteal cyst, it would be secrteing hormones, and would effect the other ovary, too. The white areas on ultrasound, and the inability to aspirate material from the cyst makes me think of a possible dermoid (benign cystic tumor).
Good luck.

 

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