7 replies to this topic

[california55]

Hello,
I just had my first IVF cycle with a Lupron protocol (bcp, lupron, Gonal-F, menopur and HCG trigger shot.) 24 eggs were retrieved, only 1 fertilized, but it didn't divide after day 2. When I talked to Dr, he said I was a good responder and that if we try again he suggests the same meds protocol but try ICSI this time ( we didn't have ICSI the first cycle.)

I have found contradictory information regarding how the protocol can affect egg quality. So, what is your take on that? Can a change in the protocol reduce the number of eggs produced, but improve the quality of the eggs?

Thank you

[Heregoesnothing]

I don't have any answers for you, but I would also love to know. ICSI will certainly help improve fertilization rates (70% successful fertilization) but will do nothing for egg quality. ICSI is used when Male Factor is an issue. Good luck! Looking forward to hearing what the others have to say about this.

[rokgerl]

Personally, I have heard that if you are looking at an egg quality issue then a change in protocol would be warranted. I would not be comfortable using the exact same protocol as the cycle before that yielded poor results. I am facing an egg quality issue and all research I have done also points to changing protocol as the meds can affect results. On IVF #2, we switched everything - protocol, meds, etc. even though my RE said that we had a good response for my age (just very poor quality embryos). I would not have gone through it if he would have suggested the same protocol.

Is there a reason why they are thinking that ICSI is going to help you? Are they thinking that poor egg quality is resulting in low fertilization rates (ie: you have very thick shell that is not allowing sperm to penetrate)?

I found an article that talks about ICSI (what it is, why it's used) and in it they state "ICSI is generally unsuccessful when used to treat fertilization failure that is primarily due to poor egg quality.". You can find it here: http://www.ivf-infer...om/ivf/icsi.php

I'd ask more questions. Do a little bit more research and go in armed with questions. I know it can be overwhelming to get news at the RE's office, especially when it's news that you're not expecting to hear. My RE always tells me to make sure that I go home, let it digest, and if I have other questions (or even find things on the internet) make as many appointments as I need (and make sure that you print out and give the web address of information online). It's your dime (or rather 100,000 dimes), so make it count!

Let us know what you find out! Good luck.

[TammyO]

Just want to mention to you ladies that I have read CoQ10 helps to improve egg quality.

[LateBloomer27]

I had ICSI for all 3 of my IVF cycles. (See my signature). Male factor is our main issue. I was considered a good responder.

In IVF#1 (which was with ICSI); They retrieved 12 eggs from 18 follicles; 9 fertilized and 3 made it to day 5 blastocyst.

My RE suggested that in his older patients, he uses Human Growth Hormone (Saizen or Omnitrope) to improve egg quality. In the US, where I had my treatments, this drug is considered experimental in IVF and not an FDA approved use. My RE said his experience is that it does improve quality.

In IVF/ICSI#2: I had 18 follicles and 18 eggs. (I won't mention the number that fertilized because there was a lab error).

In IVF/ICSI#3: I had 23 follicles and 23 eggs; 16 fertilized and 9 made it to day 5 blastocyst.

[Heregoesnothing]

Latebloomer: What is HGH? When is it given?

[judes]

California - I can't comment on protocol as ours never changed, but we also had fertilisation issues the first time around. I can only tell you how our situation was handled.

During our first IVF we retrieved 9 eggs and only 5 were mature. None fertilised. Our RE believed it was either an egg issue where there was a hard zona or it was a sperm issue. Most likely it was an egg issue according to him. He suggested we go ahead with ICSI the next cycle.

Our second IVF, we retrieved 12 eggs and 8 were mature. 5 were fertilised via ICSI. However, I did not have any grade 1 embryos. We did a day 3 transfer of a 10 cell grade 2 embryo back. That was a BFN. I can't say whether it was the embryo or something else that did not work out, cause I bled out 2 days after the transfer. The embryo, had it been viable, would not have even started implanting yet at that point.

For our third IVF, we got 13, 8 were mature and all 8 fertilised via ICSI. We had much better quality this time around. We had some grade 1 and grade 2 and 1 that was a grade 4. One made it to blastocyst and we transfered on a day 5. It stuck. We are now 18 weeks along.

In every instance my protocol remained unchanged except for the trigger. We did puregon, menopur, orgalutran. In IVF 1, we triggered using ovidrel. In the last 2 cycles, we did a trigger cocktail of buserelin and hCG.

Hope everything works out for you. Good luck!

[KittenB]

Hi! I am 37 (almost 38) and doing a lot of research on all of this (protocols, mini vs. standard IVF, ICSI, etc.). We have male factor issues, plus probably egg quality issues because of my age. Though since we haven't started IVF yet, I can't be sure on that second one. My RE did suggest mini IVF as a lower cost option, and after researching it, I've found that egg quality might be improved over standard IVF, since there are fewer eggs produced. There are threads about that very topic on this forum, though I don't remember exactly where.

Wishing you all the best!!

~KittenB