Tengo muy muy baja ovárica. He realizado 4 tratamientos FIV, el primero con letrozol y pergoveris (225 cada dos días) en el que obtuvimos 2 ovocitos maduros de dos folículos, llegaron a embrión los dos, implantamos uno pero acabó en aborto a las 7 semanas.
Desde entonces (7 meses más tarde) hemos hecho 1 FIV más en ciclo natural, en la que el folículo estaba vacío. Y dos tratamientos más seguidos (doble fiv) con progesterona y Meriofert 225 diario. El primero, de 3 folículos, 2 vacíos y 1 atresico. Y la última vez de dos folículos, los dos ovocitos atresicos.
Mi pregunta es si estos ovocitos atresicos se debe a que la calidad ha empeorado considerablemente o si ha podido ser por la medicación, el tipo y la cantidad. ¿Merece la pena intentarlo otra vez?
Muchísimas muchísimas gracias.
Ask Our Doctors
Supporting Your Journey
Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.
-
Dear Patients,
I created this forum to welcome any questions you have on the topic of infertility, IVF, conception, testing, evaluation, or any related topics. I do my best to answer all questions in less than 24 hours. I know your question is important and, in many cases, I will answer within just a few hours. Thank you for taking the time to trust me with your concern.– Geoffrey Sher, MD
Fill in the following information and we’ll get back to you.
Atresia ovocitos
Name: Carmen N
I would be happy to respond but I don’t speak Spanish. So, could you re-post this in English please!
Geoff Sher
Donación de ovulos
Name: María de los Ángeles 1
Cómo hago para donar ovulos
Please post in English!
Geoff Sher
Endometrioma Sclerotherapy
Name: Anusha F
Hi,
I have a 5cm endometrioma on my right ovary. Do you perform sclerotherapy of these?
Thanks
I used to, but no longer have access to the sclerosant!
Sorry!
Geoff Sher
702-533-2691
___________________________________________________
Venta de óvulos
Name: Natalia S
Quisiera más información sobre vender mis óvulos
Please re-draft in English!
Geoff Sher
‘Empty’ follicles
Name: Ruth A
Hello Dr. Sher,
I just had an egg retrieval cycle where despite my follicles growing nicely and the clinic expecting to collect 15 eggs, they only retrieved 6 eggs, two of which have fertilised. Apparently, the ‘empty’ follicles contained cumulus cells but no eggs.
This is my sixth retrieval cycle and I have never encountered this issue before. Normally I am able to predict quite nicely how many mature eggs I will get compared to my follicles. My last cycle I got 22 eggs and ultimately four euploid blastocysts – this was four months ago. The protocol was pretty much the same – just a different clinic.
I have had other issues with cycles, such as a cycle where 20 eggs were retrieved, 18 mature but only one fertilised. I have had a difficult journey but I have not had this issue before.
I am 37, nearly 38. My AMH tends to measure low (around 1) although the last two times it was tested were not at optimal times. I normally have around 20 or more follicles. I also
Have been diagnosed through a lap with mild endometriosis. I am banking embryos due to failed transfers and miscarriages resulting from six untested embryo transfers.
I’m planning to do another retrieval but I am so worried about this happening again.
Thank you.
Ruth
Empty Follicle Syndrome” is a misleading term because follicles always contain eggs. However, some eggs may have difficulties detaching and being retrieved. This is more likely to happen when multiple attempts are needed to retrieve an egg from a follicle, indicating the egg may have chromosomal abnormalities.
The hormonal environment created during controlled ovarian stimulation plays a significant role in egg development. In certain cases, follicles may not release their eggs during retrieval, leading to the misconception of “empty” follicles.
This situation is most commonly encountered in older women, those with diminished ovarian reserve (DOR), and women with polycystic ovarian syndrome (PCOS). To address this problem, personalized protocols for controlled ovarian stimulation and careful administration of the hCG trigger shot are important.
The hCG trigger shot is given after optimal ovarian stimulation to initiate the process of reducing the number of chromosomes in the egg. It also helps the egg detach from the follicle’s inner wall. This allows for easier retrieval during the egg retrieval procedure.
Women with increased LH activity, such as older women, those with DOR, and women with PCOS, are more susceptible to the negative effects of LH-induced ovarian testosterone. Excessive LH activity can compromise egg development and increase the chances of chromosomal abnormalities. Medications like clomiphene and Letrozole can stimulate LH release, and certain drugs containing LH or hCG can have negative consequences.
Individualizing the controlled ovarian stimulation protocol, determining the correct dosage and type of hCG trigger, and administering it at the right time are crucial. The recommended dosage of urinary-derived hCG products is 10,000 units, while for recombinant DNA-derived hCG, the optimal dosage is 500 micrograms. A lower dosage of hCG can increase the risk of chromosomal abnormalities in the eggs and negatively impact the outcome of IVF.
Understanding the role of LH activity, the effects of medications on hormone release, and the importance of personalized protocols are vital. By optimizing these factors, the risk of failed egg retrieval and “empty follicle syndrome” can be minimized, improving the chances of successful IVF outcomes.
_______________________________________________________
PLEASE SHARE THIS WITH OTHERS AND HELP SPREAD THE WORD!!
Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)……. for your reading pleasure:
- From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; https://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link ;https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
I invite you to visit my very recently launched “Podcast”, “HAVE A BABY” on RUMBLE; https://rumble.com/c/c-3304480
If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or email her at concierge@sherivf.com\
Embrión mosaido
Name: Maria L
Buenos días Dr,
Soy de Madrid, España. Me acabo de transferir un embrión mosaico de Bajo Grado (30%) para trisomía del cromosoma 6. Me ha implantado, pero por mas que intento buscar información y casos que hayan ido bien, no encuentro nada. Qué probabilidad tengo de que salga bien?
Gracias
Please post in English!
Geoff Sher