anyone else notice this? (MFI/IVF/m/c)

kthappy76

I realize I have too much time on my hands to be cooking up completely non-scientific theories, but I was wondering if anyone else noticed this?

It seems the m/c risk is higher for those who are dealing w/MFI (and have done IVF w/ICSI)?  It seems like MFI folks get pg w/IVF/ICSI at a higher rate than others, but then seem more likely to suffer a loss?

But for female IF/egg issues it seems harder to get pg w/IVF, but then when they do, they seem more likely to stick?

Just thought I'd throw it out there (feel free to tear apart if you wish) but I just look around the board and see a trend...

scooterq

I have noticed this too.  I've also seemed to notice that PCOS ladies seem to get PG (with IF treatments) more quickly than others also.  I may be completely wrong with this though.

SLPMel

It is definitely more of a chance of m/c with MFI.  They put the sperm directly into the egg-which decreases the selection process.  They can't tell the chromosomal aspect of it-and it may not be the "strongest" sperm.  A S/A only shows the look of the sperm (morphology) and movement-nothing about the internal aspect of the sperm.

When we got our MFI dx, we were told "IVF with ICSI will fix it".  And it's not that easy.  It doesn't necessarily equalizes the playing field for people with MFI.  For us, we still had cruddy sperm.  We had a low fertilization rate and then even though we had two "good" embies at our 3DT, none of the other two made it to be able to freeze and I got a BFN.  With our high FSH in DH of 13.5, it impacts the sperm that is in his sample, as well as the quality of the sperm they got from the mTESE.  So even though there was sperm-the quality was still not good at all.  We know even if we were able to get pregnant with an embie from DH's sperm-we would have a much higher rate of miscarriage than someone else.

That's why I think the SCSA test can show so much-even though people can get pregnant even with fragmented sperm, the higher your rate of fragmentation, the less likely it will lead to a healthy, successful pregnancy.  

A good friend of mine with MFI had BFN of her first IVF, her first FET, and then her IVF#2 was a m/c with no heartbeat at 8 weeks.  You have to wonder.  

SLPMel

scooterq:

I have noticed this too.  I've also seemed to notice that PCOS ladies seem to get PG (with IF treatments) more quickly than others also.  I may be completely wrong with this though.

Do you think it's because of the increased amount of eggs to fertilize?  Thus being able to push it to a 5dt, and increasing the chance of a healthy embryo?

Ginger71

I have noticed the same thing. Add me to the list....MFI + AMA so it's extra tough. I have been pg 3 out of 6 times with IVF.....but I have no baby. We really delved deep into DH's issues so we know what we are dealing with. We did try DS+ my eggs and it didn't work for our last cycle but I think if we did DS when we started 3 years ago I may actually have a baby by now....so does my RE. I actually do really well with stims for being almost 40.

I don't believe that ICSI fixes everything from what I have seen in my own experience. My DH has an elevated level of issues with chromosomes 16 and 18....both trisomies are not compatible with life and the M/c we had tested was due to trisomy 16. DH'e Uro did give us lower odds based on this info. He said the only fix is ICSI (or DS) but it won't make the odds any better....ICSI is all they got but it won't help everyone from what he told us.

((Hugs)) I hate that you are going through this because I know exactly what you are going through.....

Faith722

This is really interesting!  Maybe we should do a little research poll to test your theory?

KDR1979

True for us. With IVF #1, we got 12 eggs, 8 fertilized with ICSi and we got 5 blastocysts.

IVF #1 = c/p

FET #1= All 3 survived thawing, but twin m/c

IVF#2= only 4 eggs retrieved...still in the 2WW. But only had a 2 day transfer, so not too hopeful.

 

vanessagorc

This theroy has support from my RE.

Here is how he explained it to me, at my m/c.  MFI IVF cycles have a higher rate of pregnancy, bc in a lot of cases there is no reason the woman can't implant the embie (become pregnant).

When they ICSI the assesment of the sperm quality is crude (do they look ok?).  There is no real way to guess if they are genetically normal.

A lot of these genetic flaws take weeks to develop, so the pregnancy seems normal in the early months. Hence the m/c.

He said MFI patients have a higher rate of pregnancy, but also a higher rate of m/c.

vanessagorc

SLPMel:

scooterq:

I have noticed this too.  I've also seemed to notice that PCOS ladies seem to get PG (with IF treatments) more quickly than others also.  I may be completely wrong with this though.

Do you think it's because of the increased amount of eggs to fertilize?  Thus being able to push it to a 5dt, and increasing the chance of a healthy embryo?

We did get pushed to 5dt, bc our embies looked good at day 3.  Day 4 and 5 they went south (RE and URO sited poor sperm quality).  I got a bleh blast and a morula...when they all looked decent at day 3.  I had a m/c, so in my case...i say no.

Maybe this would be a good idea to really see what ur dealing w though.  Just how good or bad the sperm quaility is...

Our uro said the embie development is a better indication of sperm quailty than the SCSA.  ie, now we know DH's quaility is poor now.  Our cycle told us

CallMeAl

I have kind of a related question, because I have noticed that trend just from lurking and observing on the board. Do most couples with MFI that require IVF/ICSI have genetic testing done? 

Our RE suggested that we have genetic tests done before our IVF/ICSI due to what a PP described (it was Vanessa maybe?) about ICSI bypassing the natural selection process. DH was tested for X chromosome translocations and a whole bunch of other stuff. I guess my question is just whether this testing is part of a usual MFI IVF cycle? 

kthappy76

CallMeAl:

I have kind of a related question, because I have noticed that trend just from lurking and observing on the board. Do most couples with MFI that require IVF/ICSI have genetic testing done? 

Our RE suggested that we have genetic tests done before our IVF/ICSI due to what a PP described (it was Vanessa maybe?) about ICSI bypassing the natural selection process. DH was tested for X chromosome translocations and a whole bunch of other stuff. I guess my question is just whether this testing is part of a usual MFI IVF cycle? 

From my experience and what I've seen w/others, no PGD is not a routine part of doing IVF/ICSI for MFI, unless you already know that you are carrying some recurring genetic problem.

CallMeAl

kthappy76:

CallMeAl:

I have kind of a related question, because I have noticed that trend just from lurking and observing on the board. Do most couples with MFI that require IVF/ICSI have genetic testing done? 

Our RE suggested that we have genetic tests done before our IVF/ICSI due to what a PP described (it was Vanessa maybe?) about ICSI bypassing the natural selection process. DH was tested for X chromosome translocations and a whole bunch of other stuff. I guess my question is just whether this testing is part of a usual MFI IVF cycle? 

From my experience and what I've seen w/others, no PGD is not a routine part of doing IVF/ICSI for MFI, unless you already know that you are carrying some recurring genetic problem.

Thanks for responding KT! We aren't doing PGD, but we did have DH's chromosomes tested. I guess my question was more about whether most of the girls' DHs get genetic testing to know whether or not PGD would help anything. I've seen a few siggies here and there that talked about it, but I hadn't seen much. 

Mr. & Mrs. Woodtick

CallMeAl:

I have kind of a related question, because I have noticed that trend just from lurking and observing on the board. Do most couples with MFI that require IVF/ICSI have genetic testing done? 

Our RE suggested that we have genetic tests done before our IVF/ICSI due to what a PP described (it was Vanessa maybe?) about ICSI bypassing the natural selection process. DH was tested for X chromosome translocations and a whole bunch of other stuff. I guess my question is just whether this testing is part of a usual MFI IVF cycle? 

We will be doing IVF with ICSI and it is not a a part of our cycle. If our first cycle doesn't work I think I might talk to my RE about it though.

vanessagorc

CallMeAl:

kthappy76:

CallMeAl:

I have kind of a related question, because I have noticed that trend just from lurking and observing on the board. Do most couples with MFI that require IVF/ICSI have genetic testing done? 

Our RE suggested that we have genetic tests done before our IVF/ICSI due to what a PP described (it was Vanessa maybe?) about ICSI bypassing the natural selection process. DH was tested for X chromosome translocations and a whole bunch of other stuff. I guess my question is just whether this testing is part of a usual MFI IVF cycle? 

From my experience and what I've seen w/others, no PGD is not a routine part of doing IVF/ICSI for MFI, unless you already know that you are carrying some recurring genetic problem.

Thanks for responding KT! We aren't doing PGD, but we did have DH's chromosomes tested. I guess my question was more about whether most of the girls' DHs get genetic testing to know whether or not PGD would help anything. I've seen a few siggies here and there that talked about it, but I hadn't seen much. 

We opted to do every genetic test out there.  We have even done karotyping (i saw it in our records). The problem is, there is NO way to test every gene.  Genetoc testing just tests for a few select situations.  So with MFI, the sperm can have the correct chromosomes (it did in our case) but still  be poor. 

Our m/c was not do to any abnormal chromosomes, it was due to a genetic flaw in the embryo.  Our track record indicates that it was a poor quality sperm.  There is just no way u can test for that.  Sadly the true test, is if the pregnancy survives.  Hence the higer rate of m/c.

Again, this is what my RE and URO told us....so I'm just passing it along.

KDR1979

Our RE didn't suggest genetic testing until we had the 2 losses. We both had karyotypes drawn then...which just told us that we have normal chromosomes (46xx and 46xy). I don't think this looks deeper into his Y chromosome though (where I think fertility defects are found).  I think there can still be genetic issues not found with a simple Karyotype. We paid $525-550 for each karyotype and I think it costs a couple grand to get full DNA testing done.

I still worry about this b/c we did have some success with IVF...but ended in c/p and m/c.

My RE said the extra sperm checks (Not sure exactly what this means other than checking for fragmentation) aren't routine anymore. He said he used to do them and sperm that seemed "terrible" would result in a healthy pregnancy and "better" sperm didn't produce a good pregnancy.

I'm so worried that we'll get further down this IVF road and find out we need donor sperm.

Sometimes I just want to use DS though b/c I think it'll work and result in a healthy BFP sooner...

IF is so hard.

 

vanessagorc

KDR1979:

Our RE didn't suggest genetic testing until we had the 2 losses. We both had karyotypes drawn then...which just told us that we have normal chromosomes (46xx and 46xy). I don't think this looks deeper into his Y chromosome though (where I think fertility defects are found).  I think there can still be genetic issues not found with a simple Karyotype. We paid $525-550 for each karyotype and I think it costs a couple grand to get full DNA testing done.

I still worry about this b/c we did have some success with IVF...but ended in c/p and m/c.

My RE said the extra sperm checks (Not sure exactly what this means other than checking for fragmentation) aren't routine anymore. He said he used to do them and sperm that seemed "terrible" would result in a healthy pregnancy and "better" sperm didn't produce a good pregnancy.

I'm so worried that we'll get further down this IVF road and find out we need donor sperm.

Sometimes I just want to use DS though b/c I think it'll work and result in a healthy BFP sooner...

IF is so hard.

 

I've felt this way too.  how many IVF's can i do...will i even have any eggs left if we  have to move on to DS.  It's SOOOO  hard.

kthappy76

CallMeAl:

Thanks for responding KT! We aren't doing PGD, but we did have DH's chromosomes tested. I guess my question was more about whether most of the girls' DHs get genetic testing to know whether or not PGD would help anything. I've seen a few siggies here and there that talked about it, but I hadn't seen much. 

Post-m/c they are doing karyotyping on me and the baby.  Not sure what other testing we will do before cycling again based on those results.  Our testing will look at the chromosomal level, not at the gene level.

SLPMel

vanessagorc:

SLPMel:

scooterq:

I have noticed this too.  I've also seemed to notice that PCOS ladies seem to get PG (with IF treatments) more quickly than others also.  I may be completely wrong with this though.

Do you think it's because of the increased amount of eggs to fertilize?  Thus being able to push it to a 5dt, and increasing the chance of a healthy embryo?

We did get pushed to 5dt, bc our embies looked good at day 3.  Day 4 and 5 they went south (RE and URO sited poor sperm quality).  I got a bleh blast and a morula...when they all looked decent at day 3.  I had a m/c, so in my case...i say no.

Maybe this would be a good idea to really see what ur dealing w though.  Just how good or bad the sperm quaility is...

Our uro said the embie development is a better indication of sperm quailty than the SCSA.  ie, now we know DH's quaility is poor now.  Our cycle told us

I was thinking about it from a PCOS side-they have more antral follicles.  They have more eggs retrieved.  Even if some arrest-they usually have way more to choose on day 5-not just two.  

 

Isn't/wasn't there someone who chose to fertilize half her eggs with her DH's sperm and half with Donor sperm?  I always thought that was interesting.  We brought that up with our RE-and she said they would do that if we wanted-but they would only transfer from one set (so we couldn't transfer one of DH's and one of the DS embryos).