# Is poor egg quaility the same as poor overian reserve?



## baby777 (Apr 6, 2011)

Hi,

I wonder if anyone can shed any light...

I just had my follow up after my BFN in October and I was told that the main reason the doc could give was that the egg quality was poor. We did ICSI due to male factor but it now looks like i also have some issues. We got 5 eggs at EC and they were of poor quality, even though the scans showed approx 10 eggs.. I did the short antagonist protocol and have been told that I will be doing antagonist again but this time instead of Gonal f and cetrotide i will be using Puregon with Menopur and Orgalutran.

My main question is that does this mean I have a poor ovarian reserve or just bad egg quality? Can my egg quality be improved? Or is this just how its going to be? 

My doc is always very positive and is happy to try different protocols and meds etc to get the right combo but I cant help but having a negative feeling insideand feeling that I just have crap eggs and thats the end of it.

If any one has had poor egg quality and them improved it somehow please let me know how and what changes you made.

Thank you
Baby777


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## Han72 (Feb 15, 2007)

Hi hon and  for your BFN.

Poor egg quality and poor ovarian reserve aren't the same thing, you got a good crop which indicates that your reserve is fine, but (according to your doc) the quality was bad. Obviously I'm not a doctor but I think it might be worth getting a second opinion. OK, maybe there IS a problem with egg quality, but if you had 10 follies but only got 5 eggs then IMO, they messed up the trigger injection timing. Either it was too early and some of those eggs weren't ready to be collected yet, or it was too late and you'd already ovulated and lost some of them. The fact that you were on cetrotide makes me suspect it was the former, but as I say that's just my inexpert opinion.

Also you may find that if there is a problem with quality, then the change of meds may help.

It is definitely worth getting your DH's sperm DNA Fragmentation checked, if it hasn't been done already. ICSI is all well and good but the process won't show up problems with the DNA in the sperm. The result is that the embryologist picks the best looking sperm for ICSI and the embies start developing ok in the lab but then stop developing either just before or soon after transfer. These issues can be remedied with your normal male fertility vitamins if I recall correctly so it's probably worth getting your man to start taking these now, if he isn't already

Finally, over here is a list of the tons of hits and supplements that you and DH can take to improve egg and sperm quality:
http://www.fertilityfriends.co.uk/forum/index.php?topic=226042.0

Good luck hon 

xxx


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## baby777 (Apr 6, 2011)

Hi Han,

Thanks for your usefull post. Its funny you should say that i may have ovulated early as I actually was convinced that i did on the day before my trigger shot. I felt like i was ovulating and i drove my DH crazy about it. I then got over it, but i was convinced. TMI - I could feel a lot of watery CM and i was convinced about it. I'm also convinced that i am an early ovulator and that my fertility window is short. 

I will ask to doc to monitor me every day next time instead of every other day. Maybe this will help.

I actually asked another doctors opinion on line and he said that it couldn't of been an early ovulation due to the cetrotide etc.

Do you know other people who have ovulated early with cetrotide? I'm not using it next time anyway but still its good to know.

Thanks
Baby777


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## Han72 (Feb 15, 2007)

Hi hon

early ovulation with cetrotide can happen but it's rare... I've been on here for years and spoken to loads of people doing IVF and I only know of 2 people who had that problem and both of them were poor responders, like 1 or 2 follies per cycle on the highest possible stims (600 iu   ).  


As you approach EC you will notice changes in cervical mucus as your body prepares for ovulation but it doesn't follow that you ovulated early. The annoying thing is it's just one of those things that you can't possibly know unless they're monitoring LH levels daily like they do at the ARGC for example....  I would seriously consider using cetrotide again though, particularly if there is even the slightest possibility that you might ovulate early.  The only real issue with it is that it makes your E2 levels look lower than they are so the doc will need to scan regularly during stimulation to make sure that your follies are growing properly rather than just relying on blood tests.


Hope this helps hon!


xxx


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## catie_s (Jul 24, 2011)

Hi Baby777
I just read your post and I wanted to say that the same thing happened to me on my first attempt at icsi. I was on the short protocole with puregon, had 12 eggs collected and then was told that 10 were not good enough quality to inject. I was so shocked as all throughout the scans the Dr was so pleased with how the follicules were growing. It turned out that the 2 good eggs fertilised but I got a BFN. I was so upset and convinced that my eggs were bad and combined with DH poor sperm nothing would work for us!
Anyway, at my review my DR was really positive and said (just as the other lady mentioned) that some people need to delay the trigger shot and take puregon for a little longer as the eggs need to spend a little more time in the fluid inside the follicule to help them mature. She said she was confident and I left (still feeling a bit sceptical) with a prescription for the same protocole but just for a few days longer.
Well.... this time round they got 13 eggs at collection which turned into 7 embryos!! I couldnt believe it, I burst into tears when they told me! 2 were transfered and 4 were able to be frozen. Best of all.......  I am now nearly 6 weeks pregnant! It's very early days but hoping and praying all goes well.
I just wanted to say that it is worth discussing this option with your clinic, I honestly thought like you that my eggs were bad but I got my BFP.
Good luck!!!!!!
Catie xx


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## baby777 (Apr 6, 2011)

Hey Ladies,

Hon - I was also on a very high dose of Gonal f. Started on 350iu, then, 450iu for a few days, then 500, 550, 600, 650 and 700 on the last day. Maybe my dose was too high? I don't know anymore. I'm just confused as on the scan i could see good eggs which were growing very well and most were over 15 and 2 or 3 were even 17 or 18. Next time I'm going to record the whole conversation so i don't forget. I wont be using cetrotide as the doc has changed my meds, so he obviously feels that i didn't respond that well to them. I hope it works this time! I am also trying to loose a stone as i have put weight on since my last ICSI. This should help also i think.

Catie - Thanks for your post. It sounds very similar to my situationbut my doc actually told me I had poor egg quality. He was also very positive through out the whole thing. I think that my issue was, like you say with the trigger and maybe stimms etc. I'm going to keep an eye out for everything next time round. I don't want to have to suggest my ideas to the doc as i don't want him to think that I'm telling him how to do his job as i really do trust that he wants the best for me. Its hard but i think the best option is to stick with the same doc as he knows me now and my reactions. I will menton the extra trigger time to him and hope that he agrees if he doesn't suggest it himself.

I'm so pleased for you for your BFP and thank you so much for sharing and giving me hope.

Thanks ladies
baby777
xxxx


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