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Change in protocol to improve egg qualit

IVF meds

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#1 california55

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Posted 02 August 2012 - 05:28 PM

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

#2 Heregoesnothing

Heregoesnothing

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Posted 02 August 2012 - 06:28 PM

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.

"Courage doesn't always roar. Sometimes, courage is the tiny voice at the end of the day saying, 'I will try again tomorrow'"

Me: 33 - DH: 34
Dx: Male Factor


IVF #1 - March 2012
Egg Retrieval: Only 5 wee-guys - 3 fertilized - None of them survived... cycle cancelled.


IVF #2 June 2012
Retrieval: 13 eggs - 5 fertilized - transferred two grade A embryos on Day 3.
One blast at day 6 - but not good enough quality to freeze - th_abfn.gif


IVF #3 - August 2012
Retrieval - 15 eggs retrieved, 14 fertilized - Transferred 2 blasts. None to freeze -
Aug. 27th: BFP
May 6th, 2013
Our baby boy is born with 10 fingers and 10 toes!


(See my profile page for more details)

______________________________________________________________________________________________________

IVF 2.0 - The Quest for Sibling Begins

IVF #4 - March 2014
Egg retrieval: 4 eggs - 3 fertilized
Day 3: 2 left - 1- 6 cells - 1 - 8 cells
Day 5: Cycle cancelled. Both embryos have stopped developing.


IVF #5: June 2014
Retrieved 9 - 8 mature.
Day 3: 4 embryos ranging from 5-7 cells. Not very hopeful at this point.
Hoping for a day 5 blast to transfer...

Day 5:  Embryologist called - there are no embryos of high quality to transfer.  Cycle is once again cancelled.


#3 rokgerl

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Posted 02 August 2012 - 06:45 PM

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.

#4 TammyO

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Posted 02 August 2012 - 09:11 PM

Just want to mention to you ladies that I have read CoQ10 helps to improve egg quality.
  • Metco likes this
Me: 35
DH: 44
TTC Since 1999
Adopted DD October 2003 (direct placement)


IVF #1 March 2012 BFN :(
No frosties...back at square one!





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#5 LateBloomer27

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Posted 02 August 2012 - 10:47 PM

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.
Me: 42; DH: 45
IVF/ICSI #1 (9 weeks before my 40th B-day): April 2010; DD born 1/7/2011.
FET#1: Oct 2011; BFN
IVF/ICSI #2: Nov 2011; chemical
IVF/ICSI #3: Jan/Feb 2012 - eSET
2/15/2012 - BFP!!! 276!!; 2/17/2012 - Beta didn't double :( 445.
2/24/2012 - gestational sac! measuring perfectly!
3/2/2012 - strong heart beat, CRL measuring perfectly.
3/9/2012 - strong heart beat, CRL measuring perfectly.
3/19/2012 - graduate to OB.
4/4/2012 - bleeding - subchorionic hematoma (small, OB not worried)
4/10/2012 - NT scan / 1st trimester screen - risk of downs 1/1,300; risk of other trisomies lower. NEGATIVE.
5/15/2012 - amnio - genetically normal. It's a boy!!!
10/17/2012 - Baby Boy born at 39w0d!!! Already loved beyond words!! 8lb 4oz, 21 inches.

#6 Heregoesnothing

Heregoesnothing

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Posted 03 August 2012 - 06:39 AM

Latebloomer: What is HGH? When is it given?

"Courage doesn't always roar. Sometimes, courage is the tiny voice at the end of the day saying, 'I will try again tomorrow'"

Me: 33 - DH: 34
Dx: Male Factor


IVF #1 - March 2012
Egg Retrieval: Only 5 wee-guys - 3 fertilized - None of them survived... cycle cancelled.


IVF #2 June 2012
Retrieval: 13 eggs - 5 fertilized - transferred two grade A embryos on Day 3.
One blast at day 6 - but not good enough quality to freeze - th_abfn.gif


IVF #3 - August 2012
Retrieval - 15 eggs retrieved, 14 fertilized - Transferred 2 blasts. None to freeze -
Aug. 27th: BFP
May 6th, 2013
Our baby boy is born with 10 fingers and 10 toes!


(See my profile page for more details)

______________________________________________________________________________________________________

IVF 2.0 - The Quest for Sibling Begins

IVF #4 - March 2014
Egg retrieval: 4 eggs - 3 fertilized
Day 3: 2 left - 1- 6 cells - 1 - 8 cells
Day 5: Cycle cancelled. Both embryos have stopped developing.


IVF #5: June 2014
Retrieved 9 - 8 mature.
Day 3: 4 embryos ranging from 5-7 cells. Not very hopeful at this point.
Hoping for a day 5 blast to transfer...

Day 5:  Embryologist called - there are no embryos of high quality to transfer.  Cycle is once again cancelled.


#7 judes

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Posted 06 August 2012 - 05:08 PM

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!

Me: 34 Him: 35
Married since 2006 TTC ever since
Diagnosis: PCOS 

 

For complete history, see about me.

 

2012

 

IVF 1.3
12/26 - Mackenzie born 7:54 am, 6 lbs 3 oz

wFsTm5.png

 

2013 - Project sibling

 

IVF 2.1

4/17 - consult - Project sibling is a go.  same protocol as last time pending bloodwork and sonohysterogram. 

Projected beginning of cycle - August 2013.

 

5/8 - sonohysterogram: tubes clear, no residual placental tissue, ovaries still polycystic. Green light to cycle when ready.

 

8/9 - baseline scan. begin meds, 150 puregon, 50 menopur

8/13 - add orgalutran

8/18 - trigger half ovidrel, half hcg

8/20 - ER - 17 retrieved. 8/21 - 8 mature, 7 fertilised

8/23 - ET - One 8-cell grade 2 embryo transfered

8/26 - One embaby made it to the freezer!

9/1 - HPT - BFP!!!!

9/5 - Beta - 295!

9/9 - Beta - 1550!

9/18 - we have a heartbeat. Little Shrimp is 4.5mm and heart is beating at 109 bpm

10/25 - Turns out Little Shrimp is actually Little Shrimps! We had identical twins! Twin A 174 bpm, Twin B 183 bpm. Both measuring 11wks + 4 days

 

11/1 - NT scan. 1.5 and 1.6mm. Twins both measuring 12wks + 5 days, 2 days ahead.

 

Week 24 - put on modified bed rest due to softening of the cervix

Week 27 - hospitalised with pre-term contractions

Week 29 - put on strict bed rest

 

Seamus and Ronan born March 13 at 31 weeks and 2 days

 

Ronan came home April 7 and Seamus came home April 11.

 

SFCBm4.png
 

My blog - Geeky.Mama.Life

 

My YouTube channel - Geeky Mama Life

 

My day in the life vlog - Geeky.Mama.Vlogs

 

 

 


#8 KittenB

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Posted 02 December 2012 - 10:16 AM

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
Age: 37
TTC: 1 year w/ previous DH, 16 months w/ current DH
Oct. 2012: first observation cycle, large cyst on left ovary, right ovary looks fine, O normal
Nov. 2012: DH test results - poor count, motility, etc.
Dec. 2012: more DH tests ???


"Is there really a vas deferens between my sperm and donor sperm?"

- anonymous male poster

#9 onetencat

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Posted 19 July 2013 - 03:19 AM

Change in protocol made a world of difference.
Lupron, bcp and lots of drugs = poor egg quality for me.
Mini ivf= baby girl for me.

Consider less drugs .
FYI I have moderate egg reserve and fsh highes reading ever was 9.
Baby dust to all!





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