Question:
A bit of history...2 miscarriages in the last 2 years. We were referred to an RE who did testing and found that my husband has a balanced translocation. We were advised to do IVF with PGD - I had no apparent problems. Our IVF cycle resulted in 10 eggs, 7 fertilized, 3 made it to day 3 for pgd and stopped dividing later that day. The PGD revealed very abnormal embryos with multiple trisomies and some chromosomes with only 1 copy.
The dr said I must have bad eggs - he indicated he was very surprised because all my levels were normal and I'm only 29. he has suggested donor eggs. I'm wondering if I should try another protocol or just go along with the donor eggs. I feel like I'm too young to have bad eggs but since no embryos lived there must be something wrong right?
Any advice would be greatly appreciated!
Answer:
Your history is a little odd, because for someone your age, I would have expected a better outcome in terms of the number of embryos to test. It is most likely that the abnormal embryos are coming from your husband. Not you. I think, unless finances is a problem, I would continue trying. You will eventually have a good embryo, and hopefully, a subsequent cycle will give you more embryos to test. You were not stimulated very strongly and could be. Because of the poor embryo development, I would try to get you to produce 15-20 eggs. That will probably require more medications. PGD can be done to check the embryos with subsequent cycles to see if they are chromosomally normal or not. Keep in mind though, that recent studies have shown decreased pregnancy rates with PGD, probably due to embryo injury or affects from removing one of the blastomeres. In other words, you may harm a potentially "good egg".
If you go another 2-3 tries and still no normal embryos, then I would suggest you consider donor sperm with IUI. You could do IVF but that would be much more expensive. I would think that if you persist in having abnormal embryos it is because of the abnormal sperm. That is why I suggest donor sperm. If you are dead set on having a genetic child from your husband, then you will just have to keep trying using IVF.
I don't agree that your outcome in the first cycle is a sign of bad "eggs", especially at your age.
Good luck and try to keep in mind that you do have options.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.
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