@gorgeousgeorge fabulous post!
Makes a lot of sense... It doesn't sound good in my case but I'd rather know what I'm dealing with...
You put things into a different perspective for me. Thanks for taking the time to explain all this! X
QUOTE=gorgeousgeorge;8534356]@pingc383 i agree with @Maxwellsmum about poor egg quality/poor responder.
Just because you get good "grades" it doesnt mean the embryos actually are any good. The grades measure how well the embryos progress, i.e. have they divided during the timeframe normally - right number of cells for each day, are the cells similar sizes and % of fragmentation. But these 3 things are the only things they can "see" with a microscope and unfortunately these 3 measures cant tell you whether the embryos are chromosomally normal. So really, they can look great and be graded AA but still not be any good.
So the way they tell you have poor egg quality is even if you have transferred lots of "good looking-good graded" embryos or "poor graded" embryos but whatever they looked like under the microscope, they didn't result in pregnancy. HOWEVER they never really know, its not like they can test for it without doing pgd, in any definate way. They just conclude, if youve transfered lots of embryos but they never work, then your eggs overall arent likely to be good or get better. Yes, there may be a good few eggs in there somewhere but the drs are basically saying it could take a long time, many cycles and lots of money if you want to keep trying to find a good one. I transfered 6 embies from 4 full cycles, 2 were average graded and 4 were graded good/very good. But none took and if they were chromosomally normal, youd think after 6 tries that at least one of them would have made a baby.
Being a poor responder means no matter what doses of stim or type of stims you take, you dont get many eggs. 'Normal' responders should produce 10-12 eggs. Poor responders consistently get less. In my last 3 stim cycles i only got 4 eggs each cycle, so 12 eggs in 3 full stim cycles. A normal responder could get 12 eggs just by doing 1 cycle. So they problem with being a poor responder is that your not getting good chances each time you do a cycle. If you have 12 eggs the odds of getting a good 1 are much higher.
There seems to be a correlation between poor egg quality and a poor response. Many ladies have both. So, it makes it even harder to succeed. 1) you have less good eggs overall and 2) its harder to find them because your only pulling out 4 eggs at a time.
Someone explained it like this once and it helped me understand:
Looking for the golden egg is like if you have 100 fish in a barrel. The fish are your eggs. If you have good quality eggs there would be 20 golden fish in there. The other 80 are no good. This is same as normal fertility. I.e. 20% chance.
If you have poor egg quality, there might be say only 1 - 5 golden fish in there. I.e. 1-5% chance.
So you will have less chance of having a golden egg overall.
A round of ivf is like scooping a net into the barrel and collecting a batch of the fish. Normal responders can scoop out 10 fish at a time. So they can find the golden egg faster (less ivf cycles) because after 10 scoops, getting 10 fish each time, thats the whole 100 fish- you would have found the golden egg for sure. Poor responders, only scooping out 5 fish at a time would have to put the net into the barrel 20 times, with 5 eggs each time to scoop out the 100 eggs.
If that makes sense? The more % of good eggs and the more you can scoop out, the more likely you are to find the golden egg.
I think of myself as having a small percentage of good eggs in the first place because i have tried naturally for 20 cycles and they got 20 eggs in ivf. So out of 40 eggs, they didnt fertilise or died off in days 1-5 and the 6 embryos i transferred didnt take. So im like none from 40. 40 eggs and not one of them resulted in pregnancy. I dont have blocked tubes so all my natural cycles had no reason not to work. So when i think, in a barrel of 40 fish, ive scooped them all out and not one of them was golden. My other problem with ivf is being a poor responder getting 4 eggs each ivf (which is $$$ and mentally and physically awful) its going to take so much money and pain to keep trying.
I have endometriosis and the drs say often ladies with endo tend to have poor egg quality. Unfortunately im a poor responder too.
There is a correlation in that its not usual for a woman to have great quality eggs and be a poor responder. If you are a poor responder, your more likely to have poor egg quality too.
Wow, what a long posts. I just wanted to try and explain about how the grading system doesnt really tell you much in terms of your egg quality. Only doing lots of transfers and failing will indicate poor egg quality. And only doing lots of cycles and not getting many eggs will indicate poor response. xox[/QUOTE]