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First IVF with ICSI cycle almost a success :(

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  • First IVF with ICSI cycle almost a success :(

    Dr. Roseff,

    Hello. I am a 34 year old woman, about to be 35 in less than a month. I have two children from a previous relationship. I am now married to the man of my dreams and have tried to get pregnant for a few years now. We found out that he has a very low sperm count. The IVF clinic we used said that with his numbers, the only solution would be to do IVF with ICSI.

    We began the process September of '10. In October, we did the transfer, and two weeks later, I was pregnant. I was extremely happy that it worked on the very first try!

    Unfortunately, almost 14 weeks later, I went for my routine checkup and I was informed that there was no heartbeat. I was devastated. We had lost our baby without any explanation. My OBGYN said it happens very often, and that testing later on would reveal if there were any chromosomal or genetic issues in either my husband and I. Which later on after testing we found out it was not a genetic issue.

    I needed to get a D&E. I had my DNE January 15th, 2011, then I went for my check up with my OB\GYN, he told me everything looks great and that I should wait 2 cycles before I start the IVF process again. My question to you is, is this a good amount of time to wait, or should I wait longer; I am very eager to start the process again.

    Another question, since suffering this lost, I began to look into the success rates numbers of different IVF clinics, I am looking at specifically the percentage of tranfers resulting in live births, and while looking i found out that the IVF clinic that we used had very poor numbers in this category. I am torn on whether I should use them again, because they already know my history and my story or look elsewhere, at another clinic with better percentage of transfers resulting in live births. Does this really matter?

  • #2
    Hi,

    I'm SO sorry to hear about your loss. Have you both had chormosome testing done? Did the chromosome test come back normal from the D&E? Are you sure they did ICSI on all eggs?

    My patients wait one menstrual cycle after a loss to try and conceive again.

    Regarding clinics, if you concieved on the first cycle with this center, I would say that is pretty good, wouldn't you?

    Dr. Roseff in Florida
    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
    PERSONALIZED/SUCCESSFUL Specialty care....

    Comment


    • #3
      Hi Doctor, thank you for responding so quickly; I really appreciate that. They did do chromosomal testing on both of us, and we are good. The clinic only retrieve 2 good eggs from me, because at first I was not responding to the meds. # of Oocytes=5 fertilized (2 Pronuclei Visualized)=2, #Embryos 2; this is the info from the report, they told us one embryo was a 6 cell and the other was an 8 cell. The clinic is not bad, but their success rate are not that good. does the percentage of tranfers resulting in live births matter when choosing a clinic? That is my concern, because I do not want to go through a miscarriage again.

      Comment


      • #4
        Yes, the percentage leading to live births is critical. Telling me they only got two eggs is of great concern to me given your age. Bad eggs/sperm can lead to embryos that aren't very good, leading to possible pregnancy failure.

        Your embryos were 6 and 8-cells, but what were the GRADES?

        What was your AMH? Antral follicle count?

        Dr. Roseff in Florida
        Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
        PERSONALIZED/SUCCESSFUL Specialty care....

        Comment


        • #5
          I have the records here with me and was trying to interpret them. The information I got was AMH: 0.8, I could not find the Antral follicle count. As for me only having two good eggs, at first the clinic that we were using was going to cancel the cycle, because I was not responding to it, so maybe this could be a reason; don't know. What determines the number of eggs or the quality of eggs that you have?

          Comment


          • #6
            An AMH is on the low side - Did they discuss that with you? Did they tell you in advance of your IVF cycle there was a potential egg problem?

            The number of eggs retrieved depends on several factors, including, and not limited to, one's age, your cycle day 3 FSH/E2, AMH, antral follicle count, and stimulation protocol.

            What stim protocol did you receive (drugs, doses, etc.)?

            Dr. Roseff in Florida
            Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
            PERSONALIZED/SUCCESSFUL Specialty care....

            Comment


            • #7
              The clinic did not discuss any potential egg problems with us before the IVF cycle, during the first stage of the cycle they were going to cancel our cycle because I was not responding to the treatment. At the beginning they had me on 20 units of Lupron for 10 days and on the 11th day I would decrease dosage to 10 units and remain on that until I got my menstrual cycle. I was on Lupron, Bravelle(2 Bravelle) and Menapur(1 Menapur mix). The indications were: start Lupron 20 units SQx10days, then on day 11 of Lupron-decrease lupron to 10 units SQ QD, call with menses. 3 FSH 15.1, E2 211, PGN 1.8.

              Comment


              • #8
                Hi,

                If you meant that your cycle day 3 FSH was 15.1, E2 was 211, and Progesterone was 1.8, then that is NOT normal (and indicates a potential egg problem). Please let me know....

                Dr. Roseff in FL
                Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
                PERSONALIZED/SUCCESSFUL Specialty care....

                Comment


                • #9
                  Hello,
                  I don't know if I am giving you the correct information... I'm having trouble reading my own records. I have the paper from day 3 and the info is FSH 4.6, Estradiol <32, Progesterone 0.9, don't know what these numbers mean. This is the first time that I go trough an IVF process. Wouldn't the clinic stop all process if there was an egg problem?

                  Comment


                  • #10
                    I can't say whether a clinic would stop or not if there's an egg problem, but you should STRONGLY consider a second opinion from a board certified RE before trying again....

                    Dr. Roseff in Florida
                    Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
                    PERSONALIZED/SUCCESSFUL Specialty care....

                    Comment

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