poor egg quality?
4 Replies
crash - December 3

I am 35, have never been pregnant (was always on BC). DH is 34. When I was 32 my DH and I started having unprotected sex with no results for a year. Testing revealed that DH had a very low count (200K) which was attributed to a varicocele and Robertsonian Translocation of chromozones 13 and 14. All my testing showed I was normal, low FSH, regular periods (26 apx.), etc. Two varicocele surgeries improved DH numbers to 5 to 6 million, but 4 (2 with clomid) IUIs were unsuccessful.

Finally this year in July (when I'm now 35) we decided to do ICSI with a respected/reputable clinic (same that did IUIs). Long protocol was used, 150 Gonal F am & pm. Good number of follicle development and grouping. On day 11 triggered for a day 13 retrieval. Had 15 eggs, 2 of which were immature, 10 fertilized. All looked good through day 3 with 9 still developing, but on day 5 only 2 had continued to develop to blast/morula. Two were transferred in a difficult transfer (took 20 mins and required moving embryos to second cath. because couldn't get through cervix). In early August, pregnancy result negative. Dr. said at post-cycle follow up that results were "average" and were likely the result of the translocation. Dr. said there was no reason to think there was anything wrong with me (because we definetely asked those questions and whether I should undergo further testing).

In September we started a second ICSI cycle with the same protocol, same trigger date. Only difference was midway through cycle Gonal F in pm was reduced to 112.5 because estrogen was higher than last time at same point. Same good development with lots of folicles and good grouping.

About halfway thru the retrieval (which was much more painful than the prior cycle and was with a diff. Dr. at the clinic) the egg count was at 10, before Dr. even started on the other ovary. At end of retrieval, Dr. said he thought we would have 20 eggs. However, the end result was only 11 eggs. During the procedure Dr. kept commenting that he was sorry it was taking so long but the suction on the machines was lower than they use to be. Midway through retrieval and during the second ovary the nurse/assistant said "somethings going on here". We were told later that she was only saying she needed more vials because she was running low. She did in fact say that she needed more vials, but not in conjunction with that comment.

As for the eggs, 2 were immature, 5 disinegrated during "stripping", 5 were injected and only 1 fertilized. Day 2 transfer. Blood test was BFN. Dr. told us at the transfer that maybe there was a previously "undetected egg problem" which caused the problem with the eggs this time....

Is it possible that within only 3 months that we should have such a different result with the eggs? Is it possible that I have an "egg problem"? Is it possible something went wrong in the cycle or the retrieval? We wonder whether we should give up or get a second opinion. The idea that there is an "egg problem" is doubly distressing because our next step if this cycle was unsuccessful was IUI with donor sperm.


Mbre - December 3

I am not a doctor just a member and if you read some of my posting they are simliar in a sense as ar as the transfer, and I know with a community like this sharing experiences is always a great thing.
I am 27 my dh is 32, he has a child from a previous relationship. So he is not the prob, I have endo. I any event I went to one doc only produced 5 eggs ( i was taking the meds wrong, this clinic had too many patients and not enought doctors) needless to say, I only produced 5 eggs after gonal f 300 for 7 days. I had 3 retrieved and 2 fertilized and only 1 made it to blast. I had such a painful transfer took 30 min! 10 days later BFN. Went to another clinic who does not believe in heavy stims so I was on clomid to make follies made only 2( which was normal) 1 ferilised and made it to blast and the transfer once again was soooo painful. 10 days later BFN. Now after having such painful tansfers I started asking different doc "what cld it be y i am not conceving". Dr. Jacobs told me that it sounds like I have a stenonic cervixe(very narrow) and whith the painful transfers that the poking could have irritated the uterus and embies will not implant in an irritated uterus. Therefore on my next cycle i will have to get my cervix dialated. As for your follicules. I was also told and I am sure Dr. J will say the same thing is that the mans sperm has nothing really to do with you growing to blast, from what I was told it is an egg issue. Have you ever made it to blast? Mayb the next time around ask you doc can they see if you make it to blast. Keep me posted if you dont mind. Good Luck


B. Jacobs, M. D. - December 3

Without having more detail than you can provide, I cannot provivde an answer to the problem with your second IVF cycle. By way of speculation, if estrogen levels rise too fast and are too high, egg quality tends to be poor. As far as thefirst cycle, genes from the sperm start to participate in developement of the embryo after cycle day 3. The degenerating embryos were probably a sperm problem. If your husband has a chromosomal translocation, 1/2 of his sperm will have the wrong genetic makeup. I would suggest having day 3 embryos biopsied for chromosomal analysis to try to find embryos with the correct chromosome make up.
Good luck.

Just because your husband has a child from a previous relationshi;, do not assume there is no male factor problem. Things can change in the male. Please do not use Clomid for IVF. It is cheaper, but the pregnancy rates are poor. There are a number of issues cotributing to developement of blastocysts or failure. Sperm do play a role. Laboratory conditions are critical. As far as paionful transfers, if you have uterine contractions during or immediately after transfer, pregnancy rates are poor.
Good luck.


Mbre - December 5

Dr. J

We tested his sperm and results came back great. Also the clomid was done at New Hope in NY, and the doc believed in minimal stimulation, but I will never do that again. I am at SIRM now. Thanks
Also when is it that tye egg does most of the work without the sperm?

Good luck Crash!


B. Jacobs, M. D. - December 5

Genes from the sperm begin to play a role in embryo growth and developement after the 3rd day.
Good luck.



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