Ghost : Fragmentation

[summit]

HI Ghost,
I just had my 3rd unsuccessful IVF cycle. In each cycle I have always had between 29 - 16 eggs retrieved, there has been significant fragmentation in our embryos, but we have always had 2-3 high quality embryos to transfer on day 3. However, after day three the remaining embryos pretty much stop growing and we have never had any viable to freeze. My doctor has shared that the issue is the quality of my eggs and it is likely that the transferred embryos have also stopped growing. She has said that if we continue to pursue IVF we are likely to see the same results in each cycle.

During my follow-up appointment my doctor discouraged me from further pursuing IVF unless I wanted to use donor eggs (which is not for my husband and I). I trust my doctor and she works for a reputable clinic and honestly I do not want more of the same in regards to treatment.

Would you recommend a second opinion or given my situation would your clinic recommend the same?

many thanks,

[Ghost]

HI Ghost,
I just had my 3rd unsuccessful IVF cycle. In each cycle I have always had between 29 - 16 eggs retrieved, there has been significant fragmentation in our embryos, but we have always had 2-3 high quality embryos to transfer on day 3. However, after day three the remaining embryos pretty much stop growing and we have never had any viable to freeze. My doctor has shared that the issue is the quality of my eggs and it is likely that the transferred embryos have also stopped growing. She has said that if we continue to pursue IVF we are likely to see the same results in each cycle.

During my follow-up appointment my doctor discouraged me from further pursuing IVF unless I wanted to use donor eggs (which is not for my husband and I). I trust my doctor and she works for a reputable clinic and honestly I do not want more of the same in regards to treatment.

Would you recommend a second opinion or given my situation would your clinic recommend the same?

many thanks,

Yes, I recommend a 2nd opinion when a clinic recommends oocyte donation for a 34 year old who produces many eggs.

My clinic would not really recommend donor IVF, but they would advise you of the greater chance of success with it.

What was your stimulation protocol? (In detail, if you don't mind).

[summit]

Hi Ghost,
My doctor also says she is surprised by my egg quality due to my age and that I am a non-smoker. Lab reports show my eggs are slightly darker in color. Doctor says that I am likely just genetically pre-disposed with poor egg quality. Here are the basics for cycle 1 & 2 and more details for most recent cycle. If you want more details for the first 2cycles let me know.

As always many thanks!

During our first cycle we did the typical Lupron, menopur, and follistim and during retrieval we had 24 eggs.

Cycle# 2 Antagonist Follistim, Menopur, Ganerelix 16 eggs retrieved

Cycle # 3 Antagonist 29 eggs retrieved
Day 1 to Day 5:
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 6
150 Follistim AM
75 Follistim PM
75 Menopur PM ** reduced

Day 7
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 8
Start Ganirelix AM
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 9
Ganirelix AM
150 Follistim AM
75 Follistim PM
75 Menopur PM ** reduced

Day 10
Ganirelix AM
150 Follistim AM
0 Follistim PM **
75 Menopur PM ** reduced

Day 11
Ganirelix AM
75 Follistim AM **
HCG Trigger PM

[Ghost]

Hi Ghost,
My doctor also says she is surprised by my egg quality due to my age and that I am a non-smoker. Lab reports show my eggs are slightly darker in color. Doctor says that I am likely just genetically pre-disposed with poor egg quality. Here are the basics for cycle 1 & 2 and more details for most recent cycle. If you want more details for the first 2cycles let me know.

As always many thanks!

During our first cycle we did the typical Lupron, menopur, and follistim and during retrieval we had 24 eggs.

Cycle# 2 Antagonist Follistim, Menopur, Ganerelix 16 eggs retrieved

Cycle # 3 Antagonist 29 eggs retrieved
Day 1 to Day 5:
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 6
150 Follistim AM
75 Follistim PM
75 Menopur PM ** reduced

Day 7
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 8
Start Ganirelix AM
150 Follistim AM
75 Follistim PM
150 Menopur PM

Day 9
Ganirelix AM
150 Follistim AM
75 Follistim PM
75 Menopur PM ** reduced

Day 10
Ganirelix AM
150 Follistim AM
0 Follistim PM **
75 Menopur PM ** reduced

Day 11
Ganirelix AM
75 Follistim AM **
HCG Trigger PM

Thank you for the detail. I was wondering if you were coasted or triggered differently. Looks like you got a mix of some pretty standard protocols. Do you recall the size of your follicles on the day of your trigger? Were you on BCP before the cycle?

[summit]

Follicles were measuring 18 to 20... and I did take BCP all three cycles.

What would be other possible protocols to ask about?