Comments on IVF Authority: Egg/Embryo Quality: A Critical Consideration in IV...

Hi Dr, I had IVF cycle and we have 4 embryos of po...

2011-04-07T19:10:39.238-07:00

Hi Dr, I had IVF cycle and we have 4 embryos of poor quality and 1 of high quality. According to our PGD results the high quality embryo is a polyploid but according to our embryologist that is best we have and she recommends transferring that. According to her, this particular embryo can be termed "normal" by a different lab. We are concerned about any birth defects if we transfer the polyploid embryo. Please advice

Hi, Dr. Sher. I had 2 ivf cycle failed. the first ...

2011-01-18T13:24:11.897-08:00

Hi, Dr. Sher. I had 2 ivf cycle failed. the first one i had 10 eggs which 3 were fertilized , and 2 transfered with no sucess. the second i had 11 eggs and 5 fertilized but only 2 survived , my MD said i had fragmentation, and poor quality eggs, do you think it is possible to have a better outcome?how?

Hi Dr. Sher, I am 34 years old and my husband is ...

2010-09-20T18:36:24.841-07:00

Hi Dr. Sher,

I am 34 years old and my husband is 35. I have had 3 miscarriages at 10 weeks or earlier and 2 chemical pregnancies (both following IUIs using follistim). I produced 4 follicles using 150 units of follistim a day and 5 follicles using 225 units. My day 3 FSH is 12.8, and my RE feels that explains our poor outcome so far. She feels that we should do microdose flare IVF as our next step.

After reading about your thoughts on the MDL protocol, I'm uncertain as to whether or not this is the best course for us. We're 100% self-pay, and I'd hate to waste our hard-earned cash on a protocol that's unlikely to give us a good outcome.

Thank you very much for your thoughts,
-Sarah

Dr. Sher, I am a healthy 37 year old and conceive...

2010-09-20T09:00:33.239-07:00

Dr. Sher,

I am a healthy 37 year old and conceived for the first time at 35 with a trisomy 18 baby that I carried until 17 weeks (D and E). Since then I have conceived 2 more times both ending in early miscarriage. We just got back from my first IVF cycle. I had 11 eggs retrieved of which 8 were mature. ICSI was used on all 8 and 5 fertilized. On day 3 all were dividing normaly and biopsied for CGH testing. On day 5 all came back with chromosomal abmormalities (some with multiple). We were told by doctor that we should not try IVF again due to bad egg quality. I have been told that my reserve is excellent and all my pre IVF testing came back great, so there was no reason to expect such a poor outcome. We were told that our best option is egg donor. Can you give me any other information? I am a healthy 37 year old and dont understand why eggs are bad.

Respectfuully, I cannot conceive of that explanati...

2010-09-07T11:28:25.056-07:00

Respectfuully, I cannot conceive of that explanation being correct. This could have to do with the fine tuning the protocols for ovarian stimulation.

Please read elsewhere in this blog on this issue.

Also consider calling 800-780-7437 for a free medical telepgone consultation to discuss indepth.

Geoff Sher

Dr. Sher 5 IVFs have resulted in an average ferti...

2010-09-07T06:44:07.352-07:00

Dr. Sher

5 IVFs have resulted in an average fertilization rate with ICSI of about 30% with only two cycles making it to Day 5 (2 blasts and one morula). I am a good responder (no less than 15 eggs per cycle). Last cycle, 9 fertilized out of 18 and all but one arrested before Day 5. One poor grade morula was transferred. My current doctor says my husband (35 - low counts) and I (33 - PCOS) are genetically "incompatible" and are incapable of success through our own gametes. Do you ever come to this conclusion after such repeated failures?

So sorry. First the chances at 44 with dimiished o...

2010-06-29T13:11:55.960-07:00

So sorry. First the chances at 44 with dimiished ovarian reserve are poor. You really need an egg donor.

However, if in spite of this you want to try again, then in my opinion, the last protocol I would recommend is a flare protocol. Women over 40 and women with reduced ovarian reserve do poorly on this. You need an agonist/antagonist conversion protocol with estrogen priming (LA10-e2v).Please see the relevant article on this, elsewhere on this blog.

If you wish to discuss further with me, feel free to call 702-619-7437 for a free consultation.

Geoff Sher

I will be 44 in about a month. I have completed 9...

2010-06-28T19:20:27.430-07:00

I will be 44 in about a month. I have completed 90% of pre-IVF screens and results are normal. My current cycle day 2 FSH was 18 and 2 months ago had to cancel a flare-micor dose Lupron IVF cycle due to lack of follicles. Based on yours and SIRM's experiences, what would be my chance of having a life birth with my own eggs with IVF? Thank you.

I am afraid not! Geoff Sher

2010-06-16T16:54:55.538-07:00

I am afraid not!

Geoff Sher

Is it possible to retrieve any left over eggs from...

2010-06-14T14:27:28.363-07:00

Is it possible to retrieve any left over eggs from a post menopausal women?

I'm am 26 years old. After one laparascopy to ...

2010-04-24T14:45:52.946-07:00

I'm am 26 years old. After one laparascopy to remove my left tube for an etopic pregnancy, fallowing after that I had two more laps and numerous blood work, and procedures done to determine the cause of my infertility. They didn't find nothing and said it was unexplained and it could be because of my long periods 28-39, and hence I don't make quality eggs. I am going through IVF and supposed to transfer in two days. My ER retrieved 19, 8 mature, 6 fertilised, and ONLY 2 are growing. My nurse told me "It's an egg quality problem". I always new this in my heart that I had this. I have been trying for 6 years now. Why is this happening to me?

That is really a relatively poor yield of embryos ...

2009-07-02T22:25:47.552-07:00

That is really a relatively poor yield of embryos on 17 eggs. Something sounds wrong...possibly relating to the protocol of ovarian stimulation. Read my blog on ovarian stimulation and nthen perhaps go to the SIRM discussion board at www.havaababy.com and communicater with me from the SIRM-Las Vegas board, there.

Geoff Sher

I am 38 and my AMH is 25. I have undergone one IVF...

2009-06-21T22:47:13.910-07:00

I am 38 and my AMH is 25. I have undergone one IVF cycle. 17 eggs retrieved, 9 kept for normal IVF and on 8 ICSI was done. Out of 8 ICSI only 2 embryo formed with 2 and 3 cells on 2nd day. Embryologist told us there is a little hope to conceive.
How should we proceed for the 2nd IVF cycle?

One polar body (PB) is normal. In fact all mature ...

2009-06-14T08:36:51.774-07:00

One polar body (PB) is normal. In fact all mature eggs have 1 polar body. However, simply because an egg has 1 PB and is thus mature, does not exclude aneuploidy.

Geoff Sher

When eggs have >1 polar body it is a chromosoma...

2009-06-14T08:27:24.165-07:00

When eggs have >1 polar body it is a chromosomal aberation called polyploidy...not much you can do about that.

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So if the cycle was managed well, most of the eggs were mature and fertilized, then the problem we face seems to be genetic. Is there a chance that one or two of my eggs could be normal. We've done two cycles to date and all eggs appear off.

Under 35 ..about 40% are normal. At 40, probably 1...

2009-06-13T08:13:00.654-07:00

Under 35 ..about 40% are normal. At 40, probably 15%-20% and by the mid 40's..... below 10%.

It is usually age that is the predominant factor and also the metod used for ovarian stimulation....See Part 2 of the article, "Embryo quality..." (posted on Friday on this blog)

Geoff Sher

When eggs have >1 polar body it is a chromosoma...

2009-06-13T08:10:07.176-07:00

When eggs have >1 polar body it is a chromosomal aberation called polyploidy...not much you can do about that.

The most important way to optimize a woman's egg quality is to optimize the ovarian protocol of stimulation. (see Part 2 of the "egg quality" blog posted on Friday!

Geoff Sher

Hello Dr. Sher, In a typical IVF cycle, what perc...

2009-06-13T03:08:21.094-07:00

Hello Dr. Sher,

In a typical IVF cycle, what percent of a woman's eggs are typically 'normal', and how does this change with age?

How do you know if a poor result is due to age, genetics or poor care?

Thank you

thank you adding this blog on egg quality! any se...

2009-06-12T06:05:10.164-07:00

thank you adding this blog on egg quality!

any sense for why eggs would have many polar bodies and appear obviously abnormal?

anything i can do/not do to improve the quality of my eggs, i'm 36, and a good responder but most are abnormal and don't grow past day 3.