Hi Ghost - I'm hoping you may be able to give some insight on my recent IVF failure. I just had my follow up appointment with my RE and reviewed all the details of my cycle.
My RE retrieved 23 oocytes and 17 were mature for ICSI. The quality distribution prior to fertilization was 4 good, 11 fair and 2 poor. My RE said that he would have liked to see at least 7 oocytes in the good range. 11 then went on to fertilized and 2 were then transfered on Day 5. There was significate drop off in both grade and quailty by Day 5, thus nothing to freeze.
I am going to attempt IVF #2 in December and the only thing they are changing with my meds is to start the menopur/ganirelix injections earlier in combination with follistim. My RE thinks that the boost in LH might positively effect my oocyte quality. He mentioned that it could have a negative effect for some women. He said everything in my cycle was perfect except for the surprise in oocyte quality distribution for my age and FSH (6.9).
Have you heard of additional LH boosting egg quality? Is there anything else I can do - accupuncture, diet..? I thought we were only dealing with male factor (low count, low morphology), now it's egg quality too!
Your comments are much appreciated.
Angie
Egg Quality Question For Ghost
Your clinic might use an unusual system. I've seen grading oocytes as M2 (mature eggs, the best), M1 (not so good, but some still might fertilize) and GV (germinal vesicle). Perhaps those 17 that were "mature for ICSI" were the M2 grade. I don't know of any grading we do within the M2's, so I don't know what those 11, 4, and 2 represent.
23 oocytes is great. Only two viable embryos is not so great, especially from 23. It is good they are modifying the protocol a bit. But even if they left it the same, there is much randomness involved, so you might do a little better anyway. (Randomness just means we don't know what caused the variation.)
There are research papers arguing both ways on LH. Here is one that argues in favor:
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum
Here is one arguing against:
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum
I have the impression that added LH is beneficial, based on the practice of the docs i work with, at least for some patients. But I have never studied it. Somebody asked me about low-dose hCG the other day. It mimics LH, and is used in very low doses during stimulation for the same purpose. A large dose, of course, triggers "ovulation" (final oocyte maturation).
The acupuncture papers I've seen did not look like good science. I don't know what else you can do. My standard advice: relax, follow instructions.
23 oocytes is great. Only two viable embryos is not so great, especially from 23. It is good they are modifying the protocol a bit. But even if they left it the same, there is much randomness involved, so you might do a little better anyway. (Randomness just means we don't know what caused the variation.)
There are research papers arguing both ways on LH. Here is one that argues in favor:
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum
Here is one arguing against:
http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum
I have the impression that added LH is beneficial, based on the practice of the docs i work with, at least for some patients. But I have never studied it. Somebody asked me about low-dose hCG the other day. It mimics LH, and is used in very low doses during stimulation for the same purpose. A large dose, of course, triggers "ovulation" (final oocyte maturation).
The acupuncture papers I've seen did not look like good science. I don't know what else you can do. My standard advice: relax, follow instructions.