Ovary inaccessible

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Mtntn
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Ovary inaccessible

Post by Mtntn » Sat Sep 01, 2018 12:09 am

Dear Dr. Wisot,

Firstly, thank you for providing such a valuable support to so many of us and being so generous with your time answering all our questions.

I turned 40 in Feb and have never tried for children before. My question relates to my first cycle earlier in the year (May) which didn't end so well.

While I have never had any symptoms of PCOS, during my consultation I was diagnosed with PCOS.
I was put on an antagonist cycle and by the end stims, I had approx 35 follicles with approx 27 which were seemingly in the appropriate size range, which is when I did the trigger. My estradiol was quite low for the number of follicles, however, my RE wasn't too concerned. I had my egg collection and unfortunately, my RE was only able to retrieve 12 eggs as she was not able to access one of my ovaries. I was quite disappointed as given my age and PCOS, I felt I would have had a greater chance of success if whatever eggs that were there were retrieved. Six of my embryos made it to blast stage (4 x day 5, 2 x Day 6), however unfortunately after PGS it was determined they were all abnormal. There was no consistent abnormality so they think it was just very bad luck.

I spoke with my RE about my ovary not being accessible and she said that as my ovary had grown due to the number of follicles, there was no space, so it moved above my uterus making it inaccessible during EC.

1. I was wondering if this is quite common? I can't seem to find much on the internet.

2. Are ovaries at that stage of stims very mobile? I would have thought that given the size of my ovary (13+ follicles on that side) it would have been visible at the last scan (morning of trigger) that my ovary had moved above my uterus.

As I'm planning another round I'm so nervous of the same outcome. I wonder if I should ask my RE about a scan the morning of egg collection just in case the same thing happens and at least they may be able to make an alternative plan?

Thank you again Dr. Wisot for your opinion,
Brianna,
Boston, MA

Dr. Wisot
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Re: Ovary inaccessible

Post by Dr. Wisot » Sat Sep 01, 2018 8:15 am

This is unusual but it happens. It's a shame when an ovary with so many promising follicles floats up and out of reach.

The first egg retrievals were done laparoscopically until our Dr. Meldrum did the first ultrasound guided retrieval in the U.S, that resulted in a pregnancy. So I would suggest that they set you up in an OR in which they could do the ovary that is inaccessible by laparoscopy. If it does not become inaccessible then they just do both by ultrasound guidance. Another option is to do it by abdominal ultrasound but there are very few REs who have that skill.

Let us all know how it turns out.

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

Mtntn
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Joined: Fri Aug 24, 2018 4:32 am

Re: Ovary inaccessible

Post by Mtntn » Mon Sep 03, 2018 11:51 am

Dear Dr. Wisot,

Thank you for your reply.

That makes a lot of sense about doing the procedure in an OR, at least that way there are options! I will speak to my RE and see what she says. Fingers crossed this one proves more successful :)

I will let you know how I get on!
Thank you,
Brianna

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