Dr, Could really use your advice

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Posted by on July 17, 19100 at 20:23:14:

We have no known problems contributing to our infertility - 6 years ttc #1 with 1 mc from naturally achieved pg in '91.

In Aug 95, we went through our first IVF. Both my husband and I were 27 years old at the time. Lupron and Metrodin was started right after menstruation. 13 follicles aspirated, 8 eggs, 5 fertilized, 1 arrested, 4 embryos were transfered on day 2. I'm not definate on the amount of cells of the embryos. I remember having a 3 day transfer and I could have sworn they were 8-celled but my official record say that it was a 2 day transfer, so I'm not sure what went on. No data about embryo size or quality is written down so I can't refer to that. ICSI was not used. Reguardless, it was a success and we now have 4 year old daughter.

Just completed IVF #2 with negative results. I was on the long Lupron Protocol 20u. Started taking 4 vials Humegon (from recalled batch). Lupron decreased to 5 units. On day 4 of stims my E2 was 264 and was told to decrease my Humegon to 2 vials. On day 7, US showed 4 or 5 lead follicles around 12-14 in size. E2 was 471. I was told to once again increase my medication to 4 vials/day because the E2 was lower than expected. By this time I had heard of the Humegon recall and opted to change to Pergonal for the last 3 days of stims. E2 on day 10 was 1151 and US showed 5-6 follicles over 14 in size.

Retrieved 9 eggs but only 2 fertilized. This clinic uses ICSI on all patients because they feel it increases your fertization rate. I'm not sure if I agree. Of the 9 eggs, 5 were ICSI'd. 2 fertilized, 1 fertilized abnormally (3PN), 1 had fragmented polar body, 1 was damaged during ICSI. The other 4 poorer quality (2 had large zona and 2 immature) eggs were left to fertilize on their own IVF, but of course had zero fertilization. Had a 3 day transfer with 2 embryos, but we were given slim odds of achieving pg. One embryo was 4 cell and the other 5-6 cell with fragmentation.

We were told it apparently was an egg quality issue. I just turned 32 last week. Could the Humegon have contributed since it was recalled? Would I necessarily have the same results next time? Could a change in protocol affect the quality of the eggs/embryos? We honestly don't know what we should do at this point.

Do you have any suggestions about what our next step should be? Thanks for your time. Carla

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