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Unexplained fertility question

Posted: Tue Nov 13, 2018 8:23 am
by gneu0407
Hello,
I am 35 years old, and was recently diagnosed with stage III endometriosis after my first retrieval. Even though my sister also has endo, I had no symptoms, my AMH was very good for my age and my RE just didn't think a lap. was necessary. After they discovered it, I had a successful surgery and went right in for another retrieval, per their advice. My husband and I elected to do PGS testing. We received no normal embryos. I feel a little lost. According to drs. I am "great on paper", and all blood work looks perfect for my age (FSH, AMH) and they do not know why I did not respond well, and that all eggs were abnormal. I was put on 450 IU of follistim, cetrotide and HCG shot. In the meantime they put me on Orilissa to help clear remaining endo. Do you have any idea about what might be causing all embryos to be abnormal at my age, when ovarian reserve looks good? Could it have been too close to my surgery? Would you suggest any changes to protocol? I ordered DHEA and will be taking that for the next few months. We are just pretty devastated and concerned about spending $ for another round if my eggs quality is poor. Any advice would be great.

Re: Unexplained fertility question

Posted: Tue Nov 13, 2018 12:52 pm
by Dr. Ambartsumyan
I’m so sorry for the outcome you have had. While it’s unusual for someone in your age group to have all abnormal embryos, it is not unlikely. Ultimately, it becomes about number of embryos that need to be tested before finding a normal embryo (your age group I would expect 1 out of 2 or 3 to be normal). I think taking some vitamins and antioxidants is a good idea. In cases like this I would usually sit down with the patient, review the past protocol and talk about what can be done differently to improve outcomes. I would advise sitting down with your RE to discuss some of the changes that can happen with your next stimulation. There are always some changes and adjuncts that one can do to try to improve outcome. Best of luck and don’t give up. :-)

Gayane Ambartsumyan MD, PhD
Reproductive Partners Medical Group, Inc.