Posted by Larry Grunfeld, MD on July 31, 19100 at 09:29:43:
In Reply to: ? for Dr: egg quality and length of time on stimulants posted by Kelly on July 29, 19100 at 13:31:00:
Ovulation induction with PCOS is very challenging. High rates of pregnancy can be achieved only if there is a high chance of multiple pregnancy. This is why many RE's are quick to recommend IVF if you are a high responder. A high number of eggs can be examined and the only the best embryos are replaced.
The decision between day 3 and day 5 is based upon the experience of the lab. Day 5 ET has a lower multiple pregnancy rate, but may reduce the overall rate of success in some cases. This is because in some patients there is poor survival to day 5.
Larry Grunfeld, MD
: I am pcos and have been ttc for over 2 yrs. We are in the middle of our 6th and final IUI (I ivf and 2 fet in past yr as well). Last 5 were with current dr. With past dr 1 iui was converted to an ivf after hperstimulating. That resulted in enough emryos for 2 fets. Nothing took. Current dr is better at managing pcos. For all preceeeding iui's I took 1 1/2 amps night of gonal-f. I usualy stimulated very slowly, for 11-13 nights, and would end up with 1 or 2 dominant follicales. For this cycle I switched to repronex for financial reasons. I ended up responding really quickly and triggered last night day 8 of my cycle with iui on sunday. I already had an 18mm and a 14mm with about half a doxen at 11 and 12 so he triggered before e2 rose to much. My question since the follicles developed so quickly - does that mean that the eggs are of even less quality than usual. I am on met but am concerned that this cycle is doomed even more than usual. What effect does length of stimulants have on egg quality? I go on to ivf in sept if this does not work so I am keeping my fingers crossed.
: Another question. I told that the primary reason I am not getting pg is low egg quality associated with pcos. For my ivf, if it comes to it, dr has sorta left it up to me on whether I want to do a day 3 or attempt to go to blast. We are predicting I will have a large number of eggs retrieved. My question is - if my eggs have more a tendency of being low quality do I have a better chance of doing day 3 and having the rest to freeze or will going to blast sort out the bad ones so that I do not wast time transferring low quality eggs?
: Thanks in advance
: Kelly