25 year old First Attempt with IVF

Discussion forum for those particularly interested in IVF and embryo transfer including frozen embryo transfer.
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Bubby101
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Joined: Sat Jul 29, 2006 1:27 am
Location: Freehold, NJ

25 year old First Attempt with IVF

Post by Bubby101 »

I was wondering If anyone is in the same situation as I am and has any words of wisdom or good advice. I am 25 and my Husband is 34. After all the testing we have been through they have come to the conclusion that I am fine and my husband has a low sperm count and low mobility. We are going to do IVF In a few months. I am really nervous. If anyone is in the same situation as I am in and it was successful or not would you please tell me your story. We basically have only two shots at this cause of the cost. It would help ease my mind to hear from all of you.

Kristin
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gigi
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Location: United States

Post by gigi »

i'm significantly older than you but only have a few shots at IVF as well. Your age is a good thing. your eggs should be very good and with icsi your chances of fertilization are good too. plenty of my friends had good eggs, were young like you, and had icsi done and have beautiful children as a result. I think your chances are excellent! Keep positive.

gigi
gigi
me 42dh 40
1st ivf july:bfp 8/7/06: dd born 6/07
miscarried natural pregnancy 6/08
next ivf 9/08; bfn
miscarried natural pregnancy 3/09
ED 8/09 (last attempt)
JustinesBaby
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Post by JustinesBaby »

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Last edited by JustinesBaby on Thu May 15, 2008 2:24 pm, edited 1 time in total.
patientIVFpatient
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Joined: Fri Jun 30, 2006 4:42 am
Location: USA--Missouri

Post by patientIVFpatient »

I am 25, my husband is 27. All my test came back "picture perfect" and our only prob is my husband has poor sperm quality, and super low count. Less than 3 mil. per mL.

My doc said that noone wants to be in an IVF situation, but if anyone had to be, that we have the best one to be in.

I just did my test on Wednesday and had a LOW LOW LOW LOW positive. So low that I cried because they basically said it wasn't going to last. I retested today and my numbers doubled, so now I retest on MOnday.

My RE was even hesitant about putting 2 embies in because of our situation. He only wanted to do one. It just doesn't always work though.

But I'm sure you guys have a great chance, as my RE was very positive about our situation which is VERY similar to yours. I would have a lot of confidence going into your situation.
Amanda
26, DH--28
Married & TTC 3 yrs.
severe male factor
First IVF July--low BFP that didn't stay that way:(
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Kabillion
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Location: New Jersey

Post by Kabillion »

Hi! I am also from New Jersey. Are you going to the IVF clinic in Freehold? I went there and they are awesome. I am 36 and had an FSH of 13 but I am now pregnant w/ twins on my first attempt. If you are going elsewhere I urge you to reconsider. This clinic is rated 2nd in the country. If they can get me pregnant, they will definately work for you.
1st IVF July 2006 BFP!!!!
Twin Boys : )

Check out my cuties! www.gaudtwins.com


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Ghost
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Post by Ghost »

Since you are 25, which is unusually young for autologous IVF, I have two pieces of advice. Both relate to selection of your clinic.

1. At your age, you will probably produce an abundance of eggs (oocytes). This will probably lead to an abundance of embryos, more than you can use in the fresh transfer cycle. Since most fresh cycles fail, the frozen embryo cycles make a handy and inexpensive backup plan. Many new to IVF greatly under-rate the value of frozens. They are safe and can be reliable, moreso than fresh embryos, especially in young and highly fertile patients. That is, the abundance of follicles and corpora lutea in young "high responders" produce lots of estradiol and progesterone, and the theory holds, these will diminish the chance of implantation in the fresh cycle. There are certainly publications of diminished pregnancy rates at the high end of ovarian response. This problem goes away in frozen embryo transfer (FET) cycles, and in donor cycles too. That is, the ovarian stimulation that produces the eggs is also what can temporarily compromise your endometrium in that cycle. My advice: Make sure your clinic has a strong record with frozen embryos (>30% delivery rates, preferably even higher). You don't want to go through stimulation again if you don't need to, and clinics vary a lot in frozen embryo success.

2. The greatest risk to the patient comes from a complication called ovarian hyperstimulation syndrome (OHSS). You don't want this. Patients can be hospitalized for days, and have more than 4 liters of fluid drained from their abdomen in each of several paracenteses. Then doing it again 2 days later, and again, and again. This tends to occur in young patients with many follicles. With fewer than 20 follicles, the chance of severe OHSS is low, probably less than 1%. But young patients frequently have more than 20, and 30 or 40 is not unusual (I've seen 50+). OHSS is a potential consequence of giving hCG "trigger" to a patient with many follicles.

This part may get complicated: If they "down regulate" you (suppress your pituitary gland to prevent premature ovulation) with a GnRH agonist (e.g. Lupron), the only "trigger" option they will have is hCG. If your response is very high (many follicles), they might even cancel the cycle to avoid OHSS rather than administer the hCG. You don't to go through all that stimulation and then get your cycle canceled with no eggs retrieved.

If they down regulate you with an antagonist (e.g. ganirelix acetate), then they will have the option of using either hCG or a GnRH agonist to "trigger ovulation" (technically, they induce final oocyte maturation). The agonist trigger is associated with greatly decreased risk of severe OHSS. In fact, it almost eliminates the risk and, to date, nobody has published a report of a severe case after agonist trigger. The downside is that, to date, the agonist trigger is associated with lower ongoing pregnancy rates in the fresh cycle. The embryos are great, and they will implant just fine, but they won't stay, apparently because of some problem with the endometrium (note the corpora lutea I mentioned above are not functioning after agonist trigger). What this means is a high rate of early pregnancy loss following agonist triggers, and this has been published in the two main prospective randomized trials of agonist vs hCG triggers. But the embryos work great in frozen embryo cycles, with no elevated early pregnancy loss rate. My advice: Seek a clinic that knows about agonist triggers (>50 cycles experience) and, again, has a strong FET program. That way you won't have to get your cycle canceled before egg collection and you'll still have a great shot at a successful pregnancy after FET. You can even omit the fresh transfer and go straight to FET. That's up to you and your physician of course, but why go through a pregnancy that would likely fail (emotional cost, not to mention those progesterone injections and the D&C)?

Some sources:

Eliminating OHSS with agonist triggers:

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

Early pregnancy loss in fresh cycles with agonist triggers:

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

Best of luck with whatever you do.
Last edited by Ghost on Sun Jul 06, 2008 3:21 pm, edited 1 time in total.
shelton
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Joined: Mon Jul 24, 2006 7:27 pm
Location: Georgia

Ia m 24 and my husband is 35

Post by shelton »

I am starting my first IVF/ICSI right now. They are hoping my retrieval date will be in October. My husband had a failed vasectomy reversal, so in order for us to get pregnant, this is our only option. I have no idea what to expect. I am scared to death it wont work. I just have so many emotions right now.
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