2 failed IVFs
1 Replies
emily - August 28

Dr. Jacobs,
My husband and I were just notified that our second IVF failed - the one embryo that we got did not develop past the 2nd day.
We have unexplained infertility. I just turned 34 with FSH < 6, and E2 and LH levels normal. I ovulate regurlary on my own.
I would like to get your opinion on the protocol that I have been on and whether you have an idea of what the problem might be and if I should be put on a different protocol:
supression:Lupron 10units 7 days after ovulation.
stimulation:Gonal-F 150am/pm, lupron 5units. On day 4 of stim Gonal-F was increased to 225am/pm because E2 levels not high enough.
HCG on day 12 of stimm (E2 was about 1700 then).
17 follicles were observed, but only 3 eggs were retrieved. none fertilized (my RE almost cancelled my cycly then, but decided to keep going b/c my age and day before retrieval E2 was 1994).

Supression: lupron 10units 7 days after ovulation.
stimulation: Gonal-F 300am/pm, lupron 5units.
I stimmulated better now, getting to E2 2208 on day 12, and on that evening HCG shot.
21 follicles were observed this time. quite a few of them >20 at time of HCG.
This time 7 eggs were retrived.
1 was fragmented, 4 died, one fertilized but 1pn and the other fertilized to 2pn, but stopped developing at day 2.

How do you explain my low response to the stimms? would you prescribe a different protocol? Do you think there is any way that more eggs can be extracted? Do you think it's a problem of egg quality, the wrong protocol, or bad luck?

My RE is very reputable and we really like him. We haven't had a post-IVF meeting with him yet, but if you can advise me on what I should be asking him, I'd be very greatful.



Barry Jacobs, M. D. - August 28

For my "poor responders", I use a microdose flare protocol. You may be overly suppressed by the Lupron for a week prior to stimulation. As to poor embryo developement, it could be an egg problem, or a lab problem. After day 3, genes from the sperm play a role in embryo growth and developement, so I cannot identify a sperm problem from the data you provided.
Good luck.



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