tag:blogger.com,1999:blog-7481750454508390979.post668870195386776752..comments2010-03-17T12:25:57.706-07:00Geoffrey Sher, MDhttp://www.blogger.com/profile/04400321044974355125noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-7481750454508390979.post-83424273345194101802010-03-08T11:57:37.621-08:002010-03-08T11:57:37.621-08:00Dear Dr. Sher, <br /><br />I am 34 year old, my husband is 37. We just finished the second IVF (after 2 IUIs), which failed. We know of a male factor infertility (low count, low motility, and fragmented), but now we are told we need better eggs. First IVF - 6 eggs, 5 matured, transfer of all 3 fertilized (all grade B, two 8-cell and one 7-cell). Second IVF - 9 eggs, transfer of all 3 fertilized (2 grade A 8-cell and one grade B 6-cell). We now also learned of an ovarian resistance so next cycle will be without the lupron and 325 units Gonal-F (last time 725 units but with lupron). Any suggestions?shellyhttp://www.blogger.com/profile/10394433907783835315noreply@blogger.comtag:blogger.com,1999:blog-7481750454508390979.post-25279322313546993892009-11-26T04:00:33.667-08:002009-11-26T04:00:33.667-08:00There nare 2 issues nto be considered here. The first is the protocol of ovarian stimulation needs adjustment to try and avoid egg quality issues and the second is your husband&#39;s sperm function. This needs to be carefully evaluated and, if possible improved. While helpful, the information provided is insufficient to base advice on. To address these requires that we communicate by way of consultation.<br /><br />Geoff SherGeoffrey Sher, MDhttp://www.blogger.com/profile/04400321044974355125noreply@blogger.comtag:blogger.com,1999:blog-7481750454508390979.post-31785414869411865102009-11-25T09:50:40.527-08:002009-11-25T09:50:40.527-08:00hi<br />thank you very much for your detailed writings<br />my wife is 32 year old and we tried 4 time IVF<br />first 2 ivf tries were 4 years ago and long time agonist step down protocol they use.third time they tried antagonist protocol.this time it is 4th and doctor tried low dose long protocol<br />all ivf tries happened as : low quality embryos<br />and I am 33 years old male and I have very severe olygospermia and we have male factor<br />my wife is high responder and always over than 15 eggs are happening..third try (antagonist cycle ) was 34 eggs.last was 16<br />here is our question<br />we want to try one more<br />what is your suggest ?<br />antagonist or agonist ?<br />long or short protocol ?<br />what should be the dose of FSH analogues ? ( 75 U ? 100 U ? 150 U =)<br />should we use oral contraceptives before cyclus ?<br />how can we stop high responding ?<br />our E2 levels always higher than 3500 Iu on tenth day after mens <br />we have never faced early OHSS<br />and we appreciate what you answer <br />regardsmurathttp://www.blogger.com/profile/12111699607742882379noreply@blogger.comtag:blogger.com,1999:blog-7481750454508390979.post-63656431732330432752009-11-15T12:44:04.883-08:002009-11-15T12:44:04.883-08:00Dr. Sher,<br />I have one more question. Another hormone level just came back high. 17 oh progesterone? I&#39;ve never heard of this before. What does it do? What are the causes? Is it treatable? I know it can also be a cause of infertility, but was hoping you could tell me more.Auntie Kerihttp://www.blogger.com/profile/17779916398848046884noreply@blogger.comtag:blogger.com,1999:blog-7481750454508390979.post-65923321109623214012009-11-11T21:16:41.034-08:002009-11-11T21:16:41.034-08:00Respectfully, in my view IUI is not the right aproach.The success rate is too low nad you are about to run out of time. You need IVF ASAP and with what refer to as an agonist/antagonist conversion protocol with estrogen priming (LA10-E2V). Read up on this elsewhere on this blog. You mkight not respond sufficiently but it is your BEST hope. If you don&#39;t respond to this protocol you will need donor egg. Don&#39;t expect to produce many follicles, but because you are young, and aside from the protocol of ovarian stimulation used, age is the main determinant of egg/embryo quality, you might have a chance...but you won&#39;t get there with IUI.<br /><br />Feel free to set up a free medical telephone consultation to discuss this with me. Just click on to the appropraiter link at the top right hand corner of this page.<br /><br />Geoff SherGeoffrey Sher, MDhttp://www.blogger.com/profile/04400321044974355125noreply@blogger.comtag:blogger.com,1999:blog-7481750454508390979.post-47208602239934036282009-11-11T17:56:14.649-08:002009-11-11T17:56:14.649-08:00Hi Dr. Sher. I&#39;m hoping you can help me. I just turned 28 and was told I have high fsh. I only had it tested once and it came back at 27. The thing that bothers me the most was our RE immediately said donor eggs &amp; adoption. He wasn&#39;t willing to work with me. Our second opinion appointment with another doctor went slightly better, but he still wasn&#39;t hopeful. He did an ultrasound of my ovaries to check things out. Said my uterus and lining looked excellent. He saw that my right ovary was small in volume, but to his surprise my left ovary looked great and actually had 4 follicles.<br /><br />Is there something to help me? RE #2 said possible IUI with injectables, but wasn&#39;t 100% I thought IVF was better for women with high fsh??<br /><br />Can you please give me some more information and hope??Auntie Kerihttp://www.blogger.com/profile/17779916398848046884noreply@blogger.com