bad eggs in younger women
6 Replies
holly-co - May 11

I have currently just finished my 3rd IVF w/ ICSI (for mf) and AH cycle (neg result). I think at this point it is safe to say that despite my young age (32 now but 29yo when we started IVF), nl fsh levels, good response to stims, healthy etc. that their is some sort of egg issue going on with me as we have seen some "unusual" things about my eggs in all 3 cycles (dark, grainy cytoplasm, inclusion bodies in cytoplasm etc.) and our embryos, while they are very good grade wise (no fragmentation, even cell size etc.) are slow to develop. These findings have been present at 2 clinics (last two cycles have been with Dr. Schoolcraft at CCRM) and with different stim protocols. We were lucky on our 2nd attempt and currently have a 15mo daughter so our 3rd cycle really has been our 1st in our attempt to conceive a 2nd child. Anyways, my doc still is somewhat optimistic of our chances since I am young and respond well and it has only been 2 years since we were successful. We are aware that it may take several cycles to find another good egg though but hope that it can happen and feel that my daughter has to be a fairly good prognostic sign (obviously better than if we had never conceived and had a live birth).

Anyways, for me it is a VERY frustrating diagnosis since it is unexpected, uncommon and not easily explained as to why. I understand some of the possible causes of poor eggs in younger women (esp. w/ nl fsh levels) such as genetic, inherent, endometriosis (which I have what they call a very mild case of), and PCOS (I don't have). What are other known or hypothesized causes (toxins, viruses etc.). Did I recently see that there was some data that linked second hand smoke to poor egg quality (same effects as if you yourself smoked)? Any info would be appreciated.

Thank you for your time and I am sorry for the lengthly post.

 

holly-co - May 11

I just want to add that my 29yo sister also had troubles conceiving. They failed 2 IVF's (no mf) and have since moved on to adoption. Although, they did make some good embies, they didn't make as many as one would expect for someone her age. Although there are also some differences between us (she has elevated fsh but good response, has had surgery for a teratoma on her ovary, has an endometrioma etc.), I think it is rather suspicious that there is a link and that we both might have an egg issue (although I guess could just be incredibly bad luck too). I am not aware if they saw any of the similar egg findings as me (they told her they looked normal). Our mother had no problems conceiving but did so at a younger age (22).

Do you think I have reason to be overly concerned about this egg issue being passed on to my daughter or any other offspring we may have? I guess the real answer is that we just don't really know. Hopefully if that is the case, IF treatment will be incredibly different in 25 years as will diagnostic testing (esp. for egg quality).

 

meridithhasfaith - May 16

Holly,
I hope you don't mind my barging in here. I am sure the doctor will answer your medical questions in this post but I wanted to share something about egg quality.

I had ICSI done in 1997 when I was only 29. After fertilization, we were told that the embryos were very poor quality. They wrote that my eggs were brown and thick and any other ugly word you might think of. We ended up with an 8 lb. boy from that cycle.

He is 7 yr. old now, in 1st grade and doing grade 3 level math. Hits a mean baseball in little league and get this...he "knows everything"! Okay, those were his words, not mine.

Just saying that sometimes appearance doesn't tell the whole story especially since you had a healthy child yourself. As far as implications for offspring, as my new RE commented regarding my past cycle, "Well, your eggs were obviously good enough to create a healthy human being, they couldn't have been that bad."

Meridith

 

Holly-CO - May 16

Thank you Merideth! I really needed that and I agree that at least 1 of my eggs was good since my daughter is PERFECT :D! I just believe that it can hopefully happen again. Congrats on your amazing miracle too! Good luck in your quest as well!

 

Dr Smith - May 16

The short answer is "I dunno". I just returned from a conference devoted almost entirely to the diagnostic evaluation of sperm, eggs and embryos. After sitting through two days of lectures, the take home message was that we need to develop much better tools to evaluate the "quality" of sperm, eggs and embryos. Our current methods of just looking at embryos with a conventional microscope or measuring a few stray chemicals floating around in the culture medium came up sadly lacking as a way to determine the developmental potential of embryos. Unfortunately, we don't know what we should be looking for and we don't have the tools to measure it even if we did know what we were looking for. Soooo, our visual descriptions of eggs and embryos (i.e. dark and grainy) are pretty meaningless.

There may be a genetic link associated with diminished egg quality akin to the Y-chromosome deletions associated with some types of sperm problems, but no one knows what they are or how to test for them.

Do not be discouraged. I think you should consider trying again.

 

holly-co - May 17

Thank you for your time. I really appreciate it!

Have you seen women with "abnormal" looking eggs (dark, grainy cytoplasm) get pregnant at your clinic? If so, have you seen any of those women go on to get pregnant a 2nd time when the same egg findings are consistently present cycle after cycle?

 

Dr Smith - May 17

Yes and Yes. Good luck.

 

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