14 replies to this topic

[Tonya5]

Hello,

I had a follow up yesterday for an unsuccessful FET. My RE told me that for my age (currently 31) I have poor embryo quality. A little fragmentation and a brown tinge to them (should be glassy). He didn't tell me about this after my IVF follow-up and wouldn't go into too much detail with me about it. I asked about Estrace (heard many girls talk about it on here) and he said you can't get it in Canada and it isn't proven that it works.

I was wondering if I have poor quality eggs:

• can somebody explain this a little better (maybe why or how tis could occur)
• how did I get 4 grade 4 quality embryo's with little frag then
• how can I fix this

I have quit smoking, eating a lot healthier, and been seeing a Naturopath who has been giving me vitamins that supposedly help to get people PG. Since there are so many of you knowledgeable people out there, I was wondering if anybody has run into it and what you did.

Thanks for your help.

Tonya

[Sandibeach]

Hi Tonya,

Unfortunately I don't know much how to improve egg quality, but I can tell you Estrace is avaiable in Canada. Both clinics I saw could prescribe it - but from what I understand it's to deal with estrogen levels, not sure if that improves egg quality. I also have egg quality issues - none of my 17 embies during my 2nd IVF made it to transfer. For my 3rd cycle, eggs were slightly better (not much)and I got a BFP this time. There was both a change in protocol and clinic. Maybe seek a second opinion. All the best!

[Springroll]

Hi Tonya,

Sorry to hear that you are struggling - I was also told that I had "serious egg issues" (as per embryologist following retrieval for first cycle) and thus our first transfer did not work out. I can also agree with Sandi - Estrace is absolutely available in Canada and I have been on it for all both IVF cycles...

The thing with egg quality is that the eggs themselves cannot be improved, but the environment that they grow in can be. If the environment is improved, then egg performance is maximized. This is the belief behind the protocol that I am currently on - Antagonist/Agonist Conversion Protocol with Estrogen Priming. It really, really made a difference. The estrogen component prevents one egg/follicle from growing too quickly, so that there is a chance to get more even growth and subsequently more eggs.

Protocols aside, I have also been seeing an acupuncturist for 6 months, and taking Royal Jelly and 200 mg of coenzyme q10 a day for the last five months. Big difference in egg quality this time around -

Good luck - I am sure that there will be others who will respond and share their stories!!

All the best,
Springroll

[TOGirl]

Hi Tonya,

After my 2nd cycle I was also told that I had poor eggs and the RE recommended moving onto donor eggs. We tried one last time with 3 months prep of DHEA and coenzyme Q10(you can buy the coenzyme at costco). We ended up with much improved quality and a BFP. I'd ask your RE about both of these supplements. Good luck!

[Tonya5]

Hi Tonya,

Sorry to hear that you are struggling - I was also told that I had "serious egg issues" (as per embryologist following retrieval for first cycle) and thus our first transfer did not work out. I can also agree with Sandi - Estrace is absolutely available in Canada and I have been on it for all both IVF cycles...

The thing with egg quality is that the eggs themselves cannot be improved, but the environment that they grow in can be. If the environment is improved, then egg performance is maximized. This is the belief behind the protocol that I am currently on - Antagonist/Agonist Conversion Protocol with Estrogen Priming. It really, really made a difference. The estrogen component prevents one egg/follicle from growing too quickly, so that there is a chance to get more even growth and subsequently more eggs.

Protocols aside, I have also been seeing an acupuncturist for 6 months, and taking Royal Jelly and 200 mg of coenzyme q10 a day for the last five months. Big difference in egg quality this time around -

Good luck - I am sure that there will be others who will respond and share their stories!!

All the best,
Springroll

Sorry I think I meant DHEA. Can you get that perscribed in Canada? I too have been doing acupuncture for over a year and I love it. It is so relaxing. I thought it was an implantation problem, but I guess I was wrong.

Springroll, what is Royal Jelly and can you explain the Antagonist/Agonist Conversion Protocol with Estrogen Priming? I ahve never heard of these things (as I have tried almost everything). Looks like I am going to go out and buy the coenzyme q10 right away. Gotta love Costco. I have nothing to lose by taking it and I have just over a month and a half before the next retrieval. So hopefully it will help. Even a little bit. If this doesn't work out we will be tryint one more time so at least the benefits will kick in by then.

It is good to hear that there are people with this problem that do get pregnant and have had success.

[Lisa1995]

Hi Tonya,

I am sorry to hear your RE told you that. I think I mentioned this on our June FET buddies page but from what I understand they cannot be sure about egg quality after just one cycle. You could do a fresh IVF and get very different results. Here is a link to a RE's blog from NYU. Scroll down to the November 6th entry about need for donor eggs and read to the bottom where he says: One failed cycle of IVF is not completely predictive of future cycles.
http://infertilitybl...01_archive.html
You can also use the search feature for his blog in the upper left corner and search for "poor quality" and more references he has made about it will also come up.

I was on DHEA for a little while last fall but went off of it when I realized I would have to wait months for my septum surgery and then would be doing a FET so I did not want to stay on it for more than 6 months unneccesarily. My RE at Lifequest wrote me a prescription since they were actually doing a study to track the results and I agreed to participate. The DHEA capsules had to be made by a special compounding pharmacist (they only gave me 3 names in Toronto that do this).

Lisa

[Springroll]

Hi again,

I totally agree with Lisa's statement that one failed cycle does not poor quality make! My RE also jumped to the "donor egg" talk immediately following our last failed cycle, and I had to convince him to look at other protocols and different ways of stimming me...although he was pessmistic, he agreed to do it and I am glad that he did!

Here is something that I have copy/pasted from my blog to explain what royal jelly is: "Royal Jelly is an extremely nutrient-rich product that is said to improve fertility. It is a milky substance, generated by bees - the pollen that is fed by the worker bees only to the queen bee, whose job it is to produce lots and lots of infant bees. It's rich in amino acids, vitamins and enzymes, and can be considered nature's fertility drug. Royal Jelly helps the queen bee lay millions of eggs and live a much longer life than the poor old worker bee. Dr. Randine Lewis, a reknowned Traditional Chinese Medicine practicioner who specialized in infertility, recommends supplementing one's diet with Royal Jelly to improve fertility." I learned about it from reading this thread and figured I had nothing to lose! I asked my RE before starting it, and he said that it would do no harm.

The agonist/antagonist conversion protocol with estrogen priming was pioneered by Dr. Geoffrey Sher from SIRM down in the States. You can read about it here. One thing - it involves a lot of drugs. I was on 600 iu of gonal f, estrogen patches, vaginal estrace, and cetrotide. I started by taking 21 days of bcp. The end result did not give me more eggs, but I think the eggs I ended up with were much better quality (see signature).

Sorry about the long post - but I'm a huge proponent of gathering as much information as possible. I wish you the very best of luck and if you need any more info, just pm me.

Take care,
SR

[Tonya5]

Wow, this is some amazing info and thanks for sharing. I am going to take this to my doctor next time I see him (on day 3 of my prior cycle). As my FSH levels were a little high last time and he wants to check them again before going on BCP.

[Tonya5]

Here is something that I have copy/pasted from my blog to explain what royal jelly is: "Royal Jelly is an extremely nutrient-rich product that is said to improve fertility. It is a milky substance, generated by bees - the pollen that is fed by the worker bees only to the queen bee, whose job it is to produce lots and lots of infant bees. It's rich in amino acids, vitamins and enzymes, and can be considered nature's fertility drug. Royal Jelly helps the queen bee lay millions of eggs and live a much longer life than the poor old worker bee. Dr. Randine Lewis, a reknowned Traditional Chinese Medicine practicioner who specialized in infertility, recommends supplementing one's diet with Royal Jelly to improve fertility." I learned about it from reading this thread and figured I had nothing to lose! I asked my RE before starting it, and he said that it would do no harm.

Take care,
SR

Also, is Royal Jelly easy to get and where can I get it (organic food stores?)?

[Tonya5]

Could my poor egg quality be due to early Menopause? The reason I ask this is because my mother, grandmother and great grandmother all went through early Menopause, about mid 30'ies.

I told my doctor about this 3 years ago and he brushed it off. It seems like everything I try to come to him with he brushes off, now that I think about it.

Anyways, hope everyone has a wonderful and dry weekend.

T

[TOGirl]

Tonya- if you are thinking about another cycle, I would suggest considering switching clinics if you don't feel your current clinic is proactive enough. I switched after my second cycle and it was the best decision I have ever made. My second clinic (hannam) tried a bunch of new things that I know the first clinic would not have done and I am sure that is why it finally worked for us. We also had a much better result using the antagonist protocol. At least a consult with another clinic might put your mind that you are doing all you possibly can. It doesn't cost anything for a second consult- just pop into your family doctor and ask for a new referral. People get second opinions all the time so you might as well take advantage of it. Good luck!

[OliveO]

Tonya5 - I go to the same clinic as you and have been prescribed estrace. I have high fsh as well and am currently trying it instead of bcp before my next cycle.

It sounds like I go to a different RE than you but I have had some experience with a few of the RE's there.

I wanted to PM you but can't for the life of me figure out how to activate my account. If someone could guide me on how to do this I will gladly give you a bit more info.

[pathgirl]

I am on CoQ10 and DHEA as well. I thought I would post this info here on CoQ10 - I thought more people knew about this!

For women with DOR - diminished ovarian reserve (a.k.a. premature ovarian failure or pre-menopause or whatever you want to call it) - i.e. women with high FHS, CoQ10 has been shown to be quite beneficial.

I quote the abstract of the original article here:

CO-ENZYME Q10 SUPPLEMENTATION IMPROVES OVARIAN RESPONSE AND MITOCHONDRIAL FUNCTION IN AGED MICE.

Eliezer Burstein[F](1)(2), Alla Perumalsamy (2), Yaakov Bentov (1)(2),Navid Esfandiari (1), Andrea Jurisicova (2) and Robert F. Casper (1)(2).
(1) Toronto Center for Advanced Reproductive Technologies (TCART), (2) Samuel Lunenfeld Research Institute (SLRI).

Background and Objectives: Evidence exists that mitochondrial defects may in part be responsible for the decline in fertility as women age. Increased maternal age is accompanied by accumulation of mitochondrial DNA (mtDNA) mutations, changes in mitochondrial membrane potential (MMP) and overall metabolic activity of oocytes. As mitochondria are exclusively maternally inherited, alterations in their activity or abundance may severely compromise future embryo development. The objective of this study was to compare the effects of maternal treatment with CoQ10, resveratrol or R-alpha lipoic acid (ALA) on MMP, and reactive oxygen species (ROS) in oocytes from aged ICR mice and compare these parameters to placebo treated (aged control) or 10 week old (young) mice.

Methods: Retired breeder (8 month old) ICR female mice (n = 10 per group) were randomized to receive coQ10, resveratrol, R-ALA or vehicle alone for the period of 18 weeks. Upon completion of treatment, mice were subjected to hormonal stimulation and obtained oocytes were analyzed for mitochondrial localization, membrane potential (JC1) and accumulation of ROS (H2 DCFDA). The fluorescence of both dies was analyzed using a deconvolution microscope and the amount of fluorescence was recorded using the Delta Vision software package (Silicon Graphics). All obtained values were compared to oocytes obtained from young mice of identical genetic background.

Results: Compared to aged vehicle treated controls, CoQ10 treatment significantly improved the number of ovulated oocytes (11.7 vs 19.2) while R-ALA and resveratrol had no significant effect. In addition, mitochondrial membrane potential (JC 1 red to green ratio) as well as ROS levels were significantly affected by the treatment and reached levels comparable to those detected in the young oocytes. Neither of these parameters was affected by the maternal treatment with the resveratrol or R-ALA.

Conclusions: CoQ10 appears to improve ovarian response and mitochondrial function in old female ICR mice.

There is currently a clinical trial out of TCART for women 38+ where you either get put in the treatment (CoQ10) or placebo group (but you don't have a choice which and won't know it either). In compensation for participating in the trial, they cover the cost of the drugs (injectables for ovarian stimulation), but not other cost of the treatments.

I would also like to add that one should not count out alpha lipoic acid (one of the supplements used in the above study where they did not see an effect). In many other studies alpha lipoic acid was FAR more effective when used in conjunction with carnitine - 100 to 1000 times. Here it was used alone. It is possible, that like in many other organ systems, if they L-carnitine and alpha lipoic acid are used together they might be effective. (If you want more info on this, just let me know, I have researched this stuff extensively, this being my only hope!)

The dosage to take is 800 mg/day, preferable in 2 doses of 400 mg each. CoQ10 does not absorb well on its own, and should be taken with a fatty meal. I take it with my omega-3/salmon oil supplements as that is fat anyway. Vitamin B6 also helps its absorption.

Another option is to take the CoQ10 precursor "ubiquinol", which is water soluble and thus absorbs much better, so you only need half the dosage (i.e. 400 mg a day).

Lastly - where to get pills that have a lot of CoQ10 - assuming you don't want to eat a whole bottle of pills for breakfast (it would take 27 pills if each only contained only 30 mg! )

One option is to go order from www.iherb.com - they've got very good prices. I've ordered a bunch of stuff from them in the past and service has been good and quick. (note: make sure they ship via US Postal because courier companies will charge you upwards of $30 in brokerage fees in *addition* to duty while US Postal charges only $5 for brokerage.)

An online retailer in Canada that I've used is http://www.nationalnutrition.ca/
No duty and brokerage fee as they are in Canada. Again, shipping was quick and fast. Plus, if you order over $70 worth of products (or there abouts), shipping is free!

Another Canadian company is www.aor.ca
They have very high quality products, but tend to be on the pricey side. Their products are even more expensive if you buy them in the local natural/supplement stores (which will slap on 10-20% on the price tha AOR charges). I have bought stuff from them, but no free shipping unless you order something like $300 worth of products

My local nutrition/supplement store occasionally has these amazing sales where they beat or match the prices of these online sites.
There might be other good ones out there, these are just the ones I've found!

If you want to know where to get DHEA, just message me.

Any other questions, just ask!

P.S. I don't own stocks in any of these companies or receive any commission. (maybe I should though)

[lynn001]

I'm sorry for your result - I remember how distraught I felt when they found this in me after my first IVF.

On my first IVF a few years ago, my eggs appeared grainy/dark in the centre. This puzzled the doctors, and there was little optimism, but they thought to change my protocol to antagonist for the next IVF to see if it made a difference. It apparently did (there has been no sign of deteriorated egg quality in any subsequent cycle), and what it may indicate is that I may have had a sensitivity to one of the meds (Suprefact?) on the agonist cycle. But still, I sometimes worry about it, as I've never been able to get pregnant yet. We have severe male factor (morphology), but I always wonder if there is something else preventing this from working.

It is a possibility to be pre-menopausal, but that is a very rare occurance. What was told to me is that it either could be the meds, or I might have poor quality eggs from the time that they were formed in my body during infancy.

[wonder]

Hi Pathgirl,

Wow, this sounds great! I would really like to know more about L-carnitine and alpha lipoic acid (how much to take how often) and DHEA.

Thanks!

Wonder