WTF appt. What do you think?

AmberB75

sometimes I think my RE is full of it. What do you guys think? Our diagnosis is MFI. There are no known issues on my end. We've done 2 ivfs. One had zero fertilization with icsi and the second resulted in a pregnancy that ended somewhere around 6 weeks. My RE says she would essentially do things the same the next time and sees no need for additional testing. I think our cycles have been less than optimal but she disagrees. Cycle 1: I had 27 follies with 10 eggs retrieved. 8 were mature and none fertilized. RE calls this a fluke. No explanation. Cycle 2: I had 28 follies and 15 were retrieved. Only 2 were retreived from my right ovary, which had 12 follies. Only 8 were mature and only 4 fertilized. RE says this is a normal fert rate with male factor but it seems low to me. Then, of the 4 fertilized only 2 divided normally. RE admits this is low but offers no explanation why. Both cycles were antagonist protocol with lupron trigger. I am a very robust responder so her focus has always been on avoiding OHSS. I sort of wonder if they have a crappy lab or if we have egg or sperm issues. RE is optimistic about another cycle. I fear having nothing to transfer again. How do our numbers look to you gals? I just think the results seem sucky for how well I seem to be responding to the stims. Thanks ladies. I appreciate all of your help!!

AmberB75

Crap...I didn't realize posting from my phone would result in one giant paragraph. How annoying. Maybe I should repost later

Faith722

I'm no expert, but we are MFI, too.  0% fert on IVF 1 doesn't sound normal to me.   50% fert for IVF 2 sounds a little more likely.  We had 62% fert with ICSI and my RE said that was "decent" for MFI and ICSI, but we were also using frozen sperm.

I don't understand why you have so few mature eggs out of all those follies.  Maybe it's an egg quality issue.  Maybe they need to stim you differently.  If you've done both cycles with the same RE, I think it's time for a 2nd opinion.  That doesn't mean that you have to leave your RE, but I think having a fresh set of eyes look at your case is a good idea.

theworms

i would get a second opinion.

i am confused as to why so many eggs are not mature.

what meds are you stimming with?

 

 

vanessagorc

theworms:

i would get a second opinion.

i am confused as to why so many eggs are not mature.

what meds are you stimming with?

 

 

I agree w worms...and zero fert seems odd too.  GL!!!

STL34

I agree with PPs, I would get a second opinion.  It sounds like you might be better off with a different protocol.  Like PPs said, getting a second opinion doesn't mean you have to leave your RE.  I got a second opinion and am still doing IVF #3 with my original RE.

patchen30

I agree - I would get a different opinion, and also try a different protocol.  Also, I wonder if triggering w/ Novarel or Pregnyl would result in a higher maturity rate.

ecleptic

I'd also go for a second opinion. We're MFI primary (since my lack of ovulation doesn't matter for IVF) with ICSI and had a very solid fertilization rate.

I guess my first question would be- of the 27/28 follicles were they all of a size where they would reasonably have mature eggs? I had 18 follicles but there were some big ones and some small ones- we only had 11 retrieved, 9 mature. So about half of the follicles had mature eggs- and my RE would tweak the stimming to keep them better grouped for a second try- I started too slow and some of the little ones couldn't catch up.

 My second question would be- did they change your stim doses? 28 sounds awesome but if they could stim you a little slower, grow a few less eggs, and trigger you with a traditional trigger- might you have a better maturity ratio and wind up with more mature eggs to work with?

We wound up with 6 blasts out of 9 mature which is admittedly above average- but I'd be asking a lot more questions about sperm/egg quality and lab procedures if we'd wound up with only a quarter (or none) of the embryo's dividing normally. And I'd be pretty unhappy if the doctor didn't have at least a guess.