1st Cycle IVF - No PGS Normal

zoey1019
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1st Cycle IVF - No PGS Normal

Post by zoey1019 »

Good Evening,

Some background information on me, my husband has 0% morph, everything else is good (motility and volume). My LH is 7.7, FSH 5.3, AMH 4.5, these are all from the last round of CD3 testing.

We did our first round of IVF with antagonist protocol with Lupron trigger (80 units), I had 21 follicles and they only retrieved 11 eggs, the other sacs were "empty". Of the 11 eggs only 9 were mature. I was quite concerned with that number, because from my research follicles are never "empty" it is just that the egg failed to mature and drop from the follicle wall. After doing some reading on Lupron trigger, this can occur when the lupron doesn't produce the appropriate response in the brain. I ended up with 3 day 5 blasts, BX and send for PGS with natera. None came back normal (one had XXX). My MD first said that he thought the issue could have been the lupron trigger didn't mature my eggs completely, which may have caused some issues, this is what I leaned towards.

The next appointment he said something else that was concerning, he said that "this is why you haven't been getting pregnant" because you have abnormal eggs.

Is this even an actual diagnosis? Or have you seen a similar issue with lupron trigger in any of your patients? If so what is your recommendation on HcG?

Thank you for your opinion!
Dr. Wisot
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Re: 1st Cycle IVF - No PGS Normal

Post by Dr. Wisot »

If you look back at past posts you will see that this issue of no normal PGS blasts is very common. The most usual scenario is that you do another cycle and may do much better. Just rotten luck.

The Lupron issue can be overcome by using an hCG co-trigger and double checked by getting a progesterone level the day after trigger and a urine LH test. That was probably not related to the PGS results but should result in a better retrieval.

I notice that you cleverly left out your age which could be a factor despite your encouraging numbers.

You can likely do much better.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
zoey1019
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Joined: Tue Jan 31, 2017 1:18 pm

Re: 1st Cycle IVF - No PGS Normal

Post by zoey1019 »

Thank you for your response! It was very helpful and encouraging. I didn't even realize I forgot to include my age, I am 31!
Dr. Wisot
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Re: 1st Cycle IVF - No PGS Normal

Post by Dr. Wisot »

At 31 with your numbers you would seem to have a chance to do much better.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
optimistic
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Re: 1st Cycle IVF - No PGS Normal

Post by optimistic »

Hi,

I am a male 35 and my wife is 33. We could easily conceive two healthy daughters with single intercourse session each time. We wanted to balance our family and wanted a son. Recently, we tried IVF with ICSI and PGD.

Out of the 14 embryos that fertilized, 9 of them went to the blastocyst stage (Grade 1 and Grade 2).
After PGD, we came to know that there were six male embryos but all of them had some chromosomal abnormality (-8,-18,+21,+9,-3,+15)and there were 3 female embryos with no abnormality.

Can you suggest how could this happen. How could all male embryos become abnormal and how could all female embryos be normal?

Should we go for this technique again? OR do you think we cannot conceive a boy?

Regards,
Dr. Wisot
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Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: 1st Cycle IVF - No PGS Normal

Post by Dr. Wisot »

To the best of my knowledge there is no factor which would make all the girls chromosomally normal and all the boys abnormal especially since all the abnormalities were different.

So what is comes down to is bad luck and that's very distressing. If you read all the previous posts relating to abnormal embryos you will see that there is no rhyme or reason to the abnormalities.

So, I would try again. When you read those posts you will also see in couples where the woman was young (<40) that in the cycle after the disaster many did fine and hopefully so will you.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
optimistic
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Posts: 2
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Re: 1st Cycle IVF - No PGS Normal

Post by optimistic »

Thanks. In how much interval should we try again?
Dr. Wisot
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Joined: Fri Oct 14, 2005 11:16 am

Re: 1st Cycle IVF - No PGS Normal

Post by Dr. Wisot »

You can start whenever your doctor thinks you will have a good response.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
zoey1019
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Posts: 4
Joined: Tue Jan 31, 2017 1:18 pm

Re: 1st Cycle IVF - No PGS Normal

Post by zoey1019 »

Really?? I know you can ask questions anywhere, but this question is entirely offensive and upsetting to me, I cannot believe you piggy backed off of my post about my completely failed IVF cycle. I really really hope you understand what a huge blessing you have. It is really sad to think of how unwanted your female embryos are at this moment when there are people dying to get ONE normal embryo.
optimistic wrote:Hi,

I am a male 35 and my wife is 33. We could easily conceive two healthy daughters with single intercourse session each time. We wanted to balance our family and wanted a son. Recently, we tried IVF with ICSI and PGD.

Out of the 14 embryos that fertilized, 9 of them went to the blastocyst stage (Grade 1 and Grade 2).
After PGD, we came to know that there were six male embryos but all of them had some chromosomal abnormality (-8,-18,+21,+9,-3,+15)and there were 3 female embryos with no abnormality.

Can you suggest how could this happen. How could all male embryos become abnormal and how could all female embryos be normal?

Should we go for this technique again? OR do you think we cannot conceive a boy?

Regards,
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: 1st Cycle IVF - No PGS Normal

Post by Dr. Wisot »

I can understand why this would be upsetting to someone who is struggling just to get one normal embryo, regardless of sex.

I try not to make value judgments here; just answer questions and do not delete posts unless they are totally offensive. The fact is that people do IVF for family balancing and most of the specialty sees that as ethical

I hope that you are successful in getting that embryo that gets you the child you are longing for.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
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