[Dee]

Hi Peter

Before I begin, just want to say that I hope you are settling in Canada well ... good luck.

We had our review appointment today and I am hoping that you can give me some quick advice/clarity on a few things. I have requested a full copy of all my notes but obviously it will take them some time to copy them ... Dr seemed to find it strange that I'd asked for them and wanted to know why I wanted them. I said "just because I do!"

Anyway, here goes....

1st cycle IVF ... stims used 3 amps menogon per day. Poor response and cycle converted to IUI. Failed.

Today's info ...

2nd cycle IVF ... stims used 4 amps menopur per day. Poor response - 3 follies.
3 "good quality" eggs collected. (clinic seem surprised to get an egg from each follie) "Easy" EC
"Good quality" sperm
All 3 eggs fertilised. (clinic seem surprised at 100% fertilisation) "Easy" ET
3 "poor quality" embryos. (grading system is done in % and ours were around 33% .... 70%+ is classed as good apparently)
FSH level is around 7
Cycle failed.

Clinic have agreed to arrange a womb x-ray as I haven't had any tubal tests.

My questions/issues :

Dr seems to think that I should be looking at donor eggs? Based on the quality of the embryos produced and my poor reponse to stims. What do you think?

Dr says change of drugs (to say Gonal F) won't make any difference to my response to the stims? What do you think?

Clinic does not carry out immunology testing and says there is no proof that this is valid? Your thoughts?

Clinic does not do blastocysts or assisted hatching?

And I think the main crux of my questions to day is ... Why good eggs + good sperm = poor quality embryos?

Thanks for your time Peter - I just need some early advice. I feel absolutely gutted and deflated.
Obviously, when I get the copies of my notes we may be able to tell more?

Dee
x

 

[peter]

Hi Peter

Before I begin, just want to say that I hope you are settling in Canada well ... good luck.

Yes thanks, so far so good!

We had our review appointment today and I am hoping that you can give me some quick advice/clarity on a few things. I have requested a full copy of all my notes but obviously it will take them some time to copy them ... Dr seemed to find it strange that I'd asked for them and wanted to know why I wanted them. I said "just because I do!"

Anyway, here goes....

1st cycle IVF ... stims used 3 amps menogon per day. Poor response and cycle converted to IUI. Failed.

Today's info ...

2nd cycle IVF ... stims used 4 amps menopur per day. Poor response - 3 follies.
3 "good quality" eggs collected. (clinic seem surprised to get an egg from each follie) "Easy" EC
"Good quality" sperm
All 3 eggs fertilised. (clinic seem surprised at 100% fertilisation) "Easy" ET
3 "poor quality" embryos. (grading system is done in % and ours were around 33% .... 70%+ is classed as good apparently)
FSH level is around 7
Cycle failed.

Clinic have agreed to arrange a womb x-ray as I haven't had any tubal tests.

My questions/issues :

Dr seems to think that I should be looking at donor eggs?

No, it is far to early to be getting into things like this

Based on the quality of the embryos produced and my poor reponse to stims. What do you think?

I would want to see a revised stimulation protocol and a bit more imagination on the embryologyt side.

Dr says change of drugs (to say Gonal F) won't make any difference to my response to the stims? What do you think?

I don't agree but there you go!

Clinic does not carry out immunology testing and says there is no proof that this is valid? Your thoughts?

Immunology data can be useful but information such as sperm DNA fragmentation is more useful.

Clinic does not do blastocysts or assisted hatching?

Go to someone who is experienced in blastocyst work.

And I think the main crux of my questions to day is ... Why good eggs + good sperm = poor quality embryos?

More detailed andrology is needed

Good luck!

Peter

Thanks for your time Peter - I just need some early advice. I feel absolutely gutted and deflated.
Obviously, when I get the copies of my notes we may be able to tell more?

Dee
x

 

[Dee]

Hi Peter

Thanks for your reply .. pleased Canda is going well so far.

Just need some clarification, please. I don't understand .. why do you think more detailled andrology is needed, what would this involve and what might this tell us?

Thanks again
Dee
x

 

[peter]

Hi Peter

Thanks for your reply .. pleased Canda is going well so far.

Just need some clarification, please. I don't understand .. why do you think more detailled andrology is needed, what would this involve and what might this tell us?

Thanks again
Dee
x

It's just that 'good qaulity' sperm is very vague and more detailed information would be informative.

Good luck!

Peter