Large drops in # of eggs mature and # fertilized..??s

km0426

Hello,

We are in the midst of IVF 2.2 - did one cycle in Dec 2009 with no success and attemted IVF 2 in Jan 2011 but coverted to IUI because of low response to meds.  Back in 2009 and in our current cycle I produced about 12 measurable follicles.  Not a terrible number.  However, both times they retrieved around 12 and then only some are mature - in 2009 only about 5 were mature and now only 7.  Of the 5 mature in 2009 and the 7 mature in 2011 only 3 fertilized successfully with ICSI.

Our RE has offered no explanation for why we have such significant drop off in terms of maturity and fertilization and so far we have had so many tests and been diagnosed with unexplained infertility.  Yet I feel like there has to be something regarding this small number of mature eggs or fertilization issues, or even my sub-par response to IVF meds. Has anyone had similar results and had their doctor provide some sort of an explanation for it?

We are hoping these three embryos are all we need.. but just wondering if anyone else has gone through this.

Thanks!  

Edwina.McDunnough

What size follicles? Measurable does not necessarily mean mature, and they could also be overmature. I had a lower fert rate for IVF 2, where I had a couple of lead folles, and a huge spread of sizes in the cohort. EP remedied that for me.

3 of 7 is not an abnormal fert rate.

Delta04

First of all, GL with this cycle - 3 is not a bad number from the 7.

As to your question about a decrease, it could be related to a number of things including your age and egg quality.  Have you had an AMH done recently?  I have never responded well to stims and I have been on maximum dosages each time.  However, my low/poor response is do to a low ovarina reservie and crappy eggs at my age.

I would recommend that you ask your RE about the changes - hopefully he can give you some additional info and maybe even recommend a different protocol.  GL to you.

Delta04

...also, it is not uncommon to respond differently with a new cycle.  Having a relatively high number of follies and fertilization does not necessary mean that subsequent cycles will be similar.  Again, I wish you luck.

km0426

Edwina.McDunnough:

What size follicles? Measurable does not necessarily mean mature, and they could also be overmature. I had a lower fert rate for IVF 2, where I had a couple of lead folles, and a huge spread of sizes in the cohort. EP remedied that for me.

3 of 7 is not an abnormal fert rate.

There was a small one at 12, and a big daddy around 32 that we knew we were sacrificing, but the others on day of trigger were between 15 and 23 - maybe this is just too big a spread?  There were at least 5 others below 10 that obviously we didn't expect anything from.  In 2009 our RE suggested that the number maure vs  number retrieved was a substantial and atypical drop off.  When you only look at the fert rate, you are right it doesn't look too bad.  Did EP help you to have your follicles grow together?

Edwina.McDunnough

Yes, EP kept the sizes much closer. My new clinic wants to do EP w/ step down stims to achieve more of the same effect, trigger when the lead is 18-19mm rather than in the mid-20s. My issue is egg quality.

EP works on suppressing your ovaries, so it's not always the best protocol for everyone. It can be executed in a number of ways, and combined with a variety of stim protocols, so there is no one method. Anyway, something to discuss with your RE, and if they think it can help you.

What protocol have been on for your two cycles? What is your age? Would you consider going to blast to see what happens to your embies?

Anyway, I've sen plenty of people with fewer than 3 embryos have successful cycles. I know it's disappointing, but you have a great chance this time around.

patchen30

I think the other ladies gave you good advice.  It could be a result of the protocol you're on (sounds like there wasn't that much even growth across the cohort) or a result of egg quality.  I would ask your RE about changing protocols and maybe get a second opinion.

stei8086

What is EP???

 Can you tell me about the protocol?? 

km0426

Thanks everyone! We are going in for a 3dt tomorrow and then we will sit tight and hope and pray for these 3 to be the ones we needed.

You all made some good points and definitely gives me somethings to look into and discuss with my RE if/when the time comes.  But for now I am trying to just have positive thoughts.

Thanks again and good luck to everyone on their journeys.