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Topic: immature eggs (Read 2159 times) |
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ali-d
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Hi
My husband and I have been trying to conceive for five years and have been diagnosed 'unexplained infertility'. Three attempts at IUI have failed and we have just failed on our first cycle of IVF. 11 eggs were collected but none fertilsed. We were so shocked. A phonecall the day after to our clinic mentioned something about immature eggs - could this have been avoided? They scanned me twice and tested my blood on the friday and said I should be ready by Tuesday...i clearly wasn't. Is there anything I can do to boost the speed with which my eggs mature? Is it possible that they made a mistake? Is it possible that my eggs don't mature at the same rate as my follicles? Is it possible that some of them were released already? What does all this mean?
Thanks
ali
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Dr Smith
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First, you try to get a straight answer out of your doctor. I can only suggest what might have happened.
The hCG shot induces the final phase of egg maturation and renders them "fertilizable" (not necessarily developmental competent, but at least they can be fertilized). When an embryologist says the eggs didn't fertilize because they were imature, it is usually related to the timing of the hCG shot, the hCG dose or the way the shot was administered. Go over exactly how you did your hCG shot with your doctor to see if that's where the problem occurred.
If the stimulation phase was less than 9 days, or the follicles were too small (i.e. <16mm in diameter), that could be a problem as well. If the eggs have not been allowed to mature in the follicles for a sufficient period, they do not respond to the hCG shot. The result is the same, immature eggs that fail to fertilize.
You can't (and don't want to) try to speed up the maturation prcess of the eggs. You can't hurry love. Some patients need extra time for the eggs to mature and the doc should wait until the follicles are a bit bigger before giving the hCG shot.
If your egg retrieval was within 35-37 hours after the hCG shot, it is extremely unlikely that you ovulated prior to the egg retrieval.
Finally, you should seriously consider treatment at a program that is willing to perform blood tests and ultrasounds on the weekend. When you reach the end of the stimulation, it is crucial that your progress be evaluate every day. They dropped the ball by not seeing you on the weekend.
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ali-d
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We have now had a follow up appointment where it has been explained to us that my eggs were ready to be released from the follicles, so all follicles were ready etc etc, but the eggs were still immature. Apparently this can happen but is very rare and is not related to the HCG injection...otherwise they wouldn't have been able to get the eggs out so easily. Is there anything I can do to help my eggs mature? Can this be stress related? Is it possible that they can be immature this time and be okay the next? They seem to be saying that my eggs may never be mature enough and that might be why I'm not getting pregnant. Any advice? please....
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Dr Smith
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We take blood sample the day before the egg retrieval to determine the level of hCG in the patient's blood. Values under 100 mI.U./ml usually indicate a problem with the administration of the hCG. Was your hCG level evaluate the day before the retrieval? If it wasn't, there's no way to know for sure if low hCG was the cause.
Although it is very rare (I've seen 1 case in almost 20 years), some patient's follicles/eggs do not respond to hCG. To troubleshoot this, a different type of hCG can be used (a urinary derived product versus a recombinant protein product) or by using true LH (the naturally occurring hormone that hCG immitates). Don't give up yet. Get a second opinion from another RE about how the stimulation was managed. The answers that you were given clearly put the blame on you (and away from the doc and lab), but I think there is more to the story. A second opinion may shed some light on what happened.
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wendyhubbert
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Hi - I am having this same problem. Have had a retrieval 3 times. All three times, I did the HCG shot exactly as instructed; retrieval was exactly 36 hours later. Of 10 follicles sized 18 - 22 mm, there were only 3 that were mature. My levels were evaluated every day before the retrieval, and everything looked absolutely perfect. I am trying, as a layperson, to learn more about this problem with immature eggs which doesn't seem to have anything to do with a failure in the stimulation process. My doctor said something about "poor blood supply to the follicles" which is not fixable. I understand that - but I need to understand more about the science of this in order to feel resolved. Is this a syndrome? Is it an autoimmune problem? What is it?
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Michele
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I just had my first failed IVF. I responed extremely well to all meds and E2 levels were great. Follicles were all between 16 to 22. I gave my HCG 35 hours prior to retrieval. They were able to retrieve 11 eggs. All of them were immature. I was told this is not very common but could not seem to get any answers as to why this would happen. Were you able to get any further information?
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