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  1. #1
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    Default pcos and immature eggs - what can we do better next cycle?

    Hi ladies, as the title states I have pcos and both stim cycles have resulted many immature eggs.

    Oct 2009: long down reg with 83iu puregon, 18 eggs, 10 immature, late onset ohss resulting in my DD .

    Jan 2012: 12 eggs, 7 immature, low quality resulting in only 2 embryos and at day 5 they were well behind schedule (6 and 8 cell).

    Any ideas? We did a long down reg cycle starting off at 75iu puregon, upped it to 83 as I was responding too slow then upped it again to 91iu for the last few days.

    I think we started off too slow. But i am scared of getting ohss again....

    Fs has mentioned DHEA, stimming for longer (even tho we slimmed for what seemed ages), or using add back.

  2. #2
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    Hi Nicole,

    I know we discussed IVM (maturing eggs in the lab) in the other thread but here is some more info for you.

    IVM and IVF are quite similar: Both involve the retrieval of eggs from a woman’s ovaries, followed by fertilization in a lab, and then implantation of one or more fertilized embryos back into the woman’s uterus. The crucial difference is the state of the eggs at retrieval: With IVF, the eggs are matured inside the ovaries, while in IVM doctors remove immature eggs and then mature them outside the body.

    As such, IVM requires no hyperstimulation of the ovaries, meaning the daily shots are almost entirely eliminated. IVM patients do need to take three to five hormones prior to surgery, and may also take estrogen for 12 days following their period to stimulate uterine development.

    Once they are removed, the immature eggs are placed in a petri dish and exposed to a combination of luteinizing hormones and follicle stimulating hormones. The eggs are typically left in this medium for 24 to 48 hours; if they've reached maturation, they're then inseminated. The newly formed embryos are then transferred back into the uterus within four days. The fertilization and transplantation processes are generally the same as in IVF.

    Driven by Economics, Embraced by Doctors


    Like IVF, IVM was originally developed on cows and other domesticated animals. The technique has been used in countries like Taiwan and Canada for years, but only recently, after some significant improvements, did it start getting attention from American doctors.


    It tends to be reserved for women who have PCOS. “IVM has been around for years and years—we’re just getting better at it,” says Jared Robins, an assistant professor of OB/GYN at Brown University and the director of the Center for In Vitro Maturation Excellence at the Woman and Infants Hospital of Rhode Island. His clinic has been offering IVM for women with PCOS for the last year. “The maturation rates [of eggs] are 40 to 50 percent, whereas they used to be 10 percent. The pregnancy rates are also a lot better. We understand how to handle the eggs a lot better now.”

    The probability of the procedure resulting in pregnancy is key: While the success rates for IVM are better than in the past, they’re still lower than those for IVF. Pregnancy rates for both treatments vary based on a number of factors, the most important being a woman’s age. A typical 35-year-old woman with no major health problems can expect around a 40 percent success rate for a single cycle of IVF—a number that falls to around 32 percent with IVM.


    Hope that gives you a bit more info Nicole. Hopefully some of the other ladies will come up with more suggestions too.

  3. #3
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    Thanks summer sunshine. I forgot to ask my fs about that but read somewhere else maybe it's only in WA atm?

  4. #4
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    Yep I'm pretty sure it is because I remember my FS saying that they have people from over east coming to do it.


 

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