|
|
|
|
|
|
Dear Dr. Smith.
History: Normal FSH- unexplained infertility
IVF #1 (Age 31) - only 5 eggs retrieved. 3 fertilized. 1
8- cell fragmented and 2 6 -cell fragmented. Transferred all three. Became pregnant with my son, now 2 years old.
IVF #2 (Age 33) same protocol although I felt 5 eggs was not enough last time! RE disagreed. Only 2 eggs retrieved! One fertilized- grew to only 4 cell. Negative cycle. RE felt I was too suppressed on Lupron.
Moved Clinics.......New clinic agreed with Lupron suppression idea.
IVF #3 (Age 33) Antagon Protocol. Retrieved 15 eggs! 7 fertilized. On day 3- 1 (moderately?) fragmented 8 cell, 3 6-cells, and 2 4-cells. Transferred the 1 8-cell back. We wanted to do blast transfer, but obviously results were too poor to consider this.
I'm thinking I have a serious egg problem and shouldn't attempt IVF again and that my son is just a pure miracle- 1 in a million shot.
However, could it be that my eggs are fragmented and that this is normal for me? Could my fragmented eggs be "good eggs" and should I try again?
The slow growing problem bothers me too. Clinic said they will continue to grow the remaining eggs and see if any make it to blast, but they are not confident.
Your thoughts are much appreciated!
Thanks,
Tracy
|
|
|
|
|
|
|
|
A small amount of fragmentation is within normal limits of human embryo morphology. However, moderate or excessive fragmentation coupled with slow embryonic division cycles and only a small percentage of the embryos reaching the 8-cell stage by Day 3 is not encouraging. It shows that the eggs have both nuclear (genetic abnormalities that prevent division beyond the 8-cell stage) and cytoplasmic (slow division, excessive fragmentation) problems. Since this occurred with two different stimulation protocols, two different docs and two different labs, it looks like it will be consistent and only get worse with age. Since you are still relatively young, there may be some "good" eggs left in your ovary, but, realistically, it could take several cycles to get "the one". I'd say the odds are pretty slim, but I would still recommend trying one more time on the Antagon protocol. If the results are the same, then I give up at that point.
Best of luck.
|
|
|
|
|
|
|
Thanks, Dr. Smith. I think that's great advice.
Do you have any opinion on diet improving egg quality? I have a pretty awful diet and lots of digestive issues. I am on a new kick of eating very healthily...kicking diet soda etc....
I know it's the right way to eat for my health....have you ever seen a difference in egg quality when someone drastically changes their diet for the better?
Thanks,
Tracy
|
|
|
|
|
|
|
I am not aware of any published scientific studies that directly link diet to egg quality. However, there is a lot of evidence to suggest that there is an optimal weight for pregnancy (as a separate issue from egg quality). So, if you are overweight or under weight, diet can impact your chances of a successful pregnancy provided you get a "good" egg to work with.
|
|
|
|
|
|
|
Dear Dr. Smith,
I am totally perplexed now and hoping you could give me some advice. My pregnancy test was negative (we transferred one fragmented 8 cell as mentioned before in thread) and the clinic was not optimistic that any of my remaining embryos would grow to blast.
However, I just received a letter in the mail telling me that 2 embryos made it to blast. I go to RMA of NJ, so I am assuming that they only freeze high quality blasts. That's certainly a question I will have to ask them.
I am hopeful now that I might still have a chance...but I would like your input for my follow up:
1. Are blasts only "high quality" or could I have fragmentation issues at this stage too?
2. Does the fact that my eggs did make it to blast mean that my egg quality could be ok afterall?
3. What questions should I ask the RE when I go for my follow up and arrange for a FET?
4. Are stats generally much lower for frozen blast transfer?
Thanks very much,
Tracy
|
|
|
|
|
|
|
I am not sure of RMA's current policy for freezing blastocyst stage embryos. There is considerable variation in blastocyst quality, depending mostly on the number of stem cells present. You'll have to ask them if they only freeze high quality blastocysts or not.
As I mentioned before, a small amount of fragmentation is of no consequence. These embryos develop to the blastocyst stage regularly. When the blastocyst "hatches" out of the protective protein coat (zona pellucida), the fragments remain behind inside the coat. No worries.
It is always a good sign when some of your embryos reached the blastocyst stage. It confirms what I posted before; you have some eggs left that are developmentally competent.
Ask your RE about the quality of the embryos (i.e. grade) and whether they were frozen on Day 5 or Day 6 (Day 5 is slightly better than Day 6). The pregnancy rate for frozen-thawed blastocyst stage embryos is good. Each embryo has about a 20% chance of developing to a term pregnancy. Two embryos = about 40% chance of taking home a baby.
|
