# Good egg quantity but bad egg quality?



## Gribbie (Apr 19, 2010)

Hi

Don't know if anyone can help me - I have just had my first ICSI which was a  BFN   

Had a follow up meeting at the hospital.  They said that on day 3 lots of the embryos  were very good quality (about half were grade 1-) but by day 6 they were all 2+ or  worse - some had completely collapsed.  I  ended up having 2 grade 2+'s put back.  They have suggested that next  time I take steroids for the 2 weeks the eggs are growing and some extra  vitamins etc for both me and DH.
  
Does anyone have any idea what might have caused such a marked degradation?  Anything you can suggest to improve things  for next time?  I'm looking at DHEA but I  have PCOS so not sure if I should...


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## Belbs (Aug 3, 2009)

Hi Gribbie,

Sorry about your bfn.     

This is something my DP & I had problems with. For our last cycle of ICSI my DP (who donated her eggs to me) was diagnosed with PCOS and our consultant prescribed Metformin which helps improve egg quality. I took the steroids, prednisolone, which help with the implantation as they reduce the natural killer cells in your uterus. I would certainly recommend asking for the metformin and taking the steroids as I am convinced they gave us the positive outcome.

Good luck.

Belbs xxx


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## Gribbie (Apr 19, 2010)

Thanks so much for replying.  I'm on metformin already.  Prednisolone is a new one for me - will investigate    I will keep my fingers crossed that the steriods help too.

Thanks for the info - greatfully accepted - and congratulations on your BFP


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## livity k (May 19, 2009)

Hi Gribbie, 

I thought it was after day 3 that the sperms role kicked in more, so make sure your DH takes lots of vits too, 

Good luck,

Livity x


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## Gribbie (Apr 19, 2010)

Ooo - interesting - thanks Livity


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## kdb (Apr 9, 2009)

Hi Gribbie - I have PCOS and Dr Saab put me on Metformin to help with egg quality. He also said I would take dexamethasone during stimms to improve egg quality, as PCOS can expose your eggs to too much testosterone. I am guessing this is what you will be on too?

Unless you have elevated NK cells (or another autoimmune disease) I don't think they would prescribe prednisolone for you.

DHEA is an interesting one... I talked to my endocrinologist about it and he said that there is _some _evidence (ie, one small study) that showed DHEA gave a better outcome, however clinics tend to prescribe steroids rather than DHEA, even though there haven't been any studies done on steroids!

Have you had your DHEA levels tested? Your GP should be able to do this for you.

As Kate says, vits for DH are really impt even if his numbers are good. At a minimum I would have him taking a good quality multi-vitamin, Selenium, and CoEnzyme Q10. At night (assuming he took the multi-vit in the morning) he should take Zinc and Vitamin C. (Vit C helps the absorption of Zinc, while some of the other minerals in the multi-vit can hinder absorption - eg, zinc / iron compete.)

We are all wishing you tonnes of luck for cycle #2 

xoxo


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## KiaKaha (Aug 4, 2008)

Hi,

Sorry about your BFN  .  I had a similar situation to you, lots doing brilliantly on day 3 but only two left on day 5, although I was very lucky and both my embies stuck.  Just a few thoughts - what drug did you stimm with?  I think Menopur is supposed to be best for PCOSers.  Also, how long you stimm for effects egg quality which can be an issue with PCOS - longer is better, even if you coast for a few days - and fast growing follies are not supposed to be so good.

I also heard the thing about sperm effecting development after day 3 - there is a test you can do which I think is a FISH test.  The problem with sperm is that apart from diet, vitamins etc, there is not a lot that can be done so it might just be worth concentrating on those and not worrying about the test.

Any reason why they waited until day 6 to transfer?  Just being nosy really, not heard of it a lot before.

Big hugs to you     

PS re vits - another one for men which my DH took is Pycnogenol.  I also took apimist, lots of the girls on my clinic thread take royal jelly (which apimist contains).


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## Gribbie (Apr 19, 2010)

Fab fab fab!  Just the kind of info I need - thank you all so much!     

I will talk to Dr Saab about DHEA - might not need it if I'm having steriods?  And get hubby on a whole load of good stuff   

KiaKaha - I had a genetic test done on each embryo before they were popped back to eliminate a muscle disease I have - the tests were done in Rome so getting the results back took until day 6.  I will try and see if we can speed this up.

I was on Gonal F and Menopur - low doses of both - for 12 days - eggs collected on day 14.

Thanks everyone - you lot are brill!


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## KiaKaha (Aug 4, 2008)

Sorry, like I said I was just being nosy!  The clinic I was at routinely take embies to day 6 to see if they are good enough for freezing, and will sometimes do it if they still can't see clear leaders on day 5 so I'm sure it is fine - I was just wondering if they were moving to day 6 now.

Good luck


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## niccad (Apr 28, 2009)

Gribble - sorry to hear your news. Agree with the others that day 3/4 is supposed to be when DH sperm really makes a difference. I put mine on a load of vits and he stopped all drinking and no aspartime. He also dosed up on blueberries etc. He also tested for fragmentation and aneuploidy so we knew what % of his sperm had chromosome issues.... 
I took royal jelly and bee propolis and a whole host of other vits for my egg quality. 
Steriods are really used to help implantation rather than egg quality.. the 2 most common are prednisolone and dexymethazone. I've tried both in the past. Dex is better at not causing issues with egg quality and pred is better post ET (although I'm still on Dex and I'm 12 weeks!). A lot of clinics will put you on dex from about day 5 of stimms and then swap you over.

Best of luck next time xxx


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## kdb (Apr 9, 2009)

Hi Niccad - congrats on reaching 12 weeks    That is v interesting about switching steroids part way through.  My original protocol incl dex (for egg quality I was told   ) but since then have been dx with autoimmune hypothyroid so I'll be taking pred instead.  I think I've read that dex is less likely to cross the placenta?  Also Dr Beer prefers dex, though UK clinics seem to prefer pred (for immune issues).

Fab idea re; the Royal Jelly - I always forget to mention that because I am allergic to bee stings so cannot take it   

KiaKaha - are you a fellow Kiwi in London?  Your little boys are gorgeous, congratulations!

Gribbs - we may be cycling together - do you have any timings?  Sept / Oct maybe?


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## Gribbie (Apr 19, 2010)

KiaKaha - you're very welcome to be nosy   

niccad - congratulations on your BFP   The doc suggested Dexamethasone 1mg day1-13 of simms.  He also suggested <10 units of alcohol, 1000mg vitamin C and 2x400ui vitamin E for hubby.  Off to get that for him today - I've started on Pregnacare + omega 3 (instead of my basic tesco vits).

kdb - that would be great if we are!  I'm on AF at the mo so will start down regging next one (end Aug?) so starting simms mid/end Sept   

I have emailed my PGD nurse to ask if trying to get the DNA results back quicker will help at all.  Also if DHEA will help me.


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## KiaKaha (Aug 4, 2008)

Gribbie - sorry I have been meaning to reply again, but have been v. busy!  12 days sounds like a good amount of time stimming, although the clinic I used now apparently has a new protocol for those likely to overstimm, where they take you up to the limit of your bloods which they are happy with, then coast for a few days.  

Do you have the Zita West book?  You can probably get it in the library, it is really good for info about vitamins.  Because I had a few issues I went through and made notes about what was recommended, then kind of did an overview of what I needed.  I never too her vitamins as they were so expensive but had an array of things I took .

You're sounding remarkably positive after your failed cycle, hope you are looking after yourself    .  

KDB - yup we're both Kiwis, and would love to take our little Kiwi men home but unfortunately its not happening this year.  Hopefully next year!  Loads and loads (or should I say heaps and heaps!) of luck for your cycle


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## Gribbie (Apr 19, 2010)

I was completely devastated for a few days - I'm such an optimist that I just assumed it would work because everything else had gone so well   

I have been reading about coasting and might suggest it for next time.  I have ordered Zita Wests book too.

Thanks


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## Gribbie (Apr 19, 2010)

Just a quick update - far better quality this time!  I was on Dex and growth hormones, plus lots of vits for me and hubby.  Don't know if it has worked yet but we had a hatching blast and a morola to put back.


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## KiaKaha (Aug 4, 2008)

Great news!  Loads and loads of luck for your 2ww   

We had a blast and a 'somewhere between a morula and a blast' put back too!


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## Gribbie (Apr 19, 2010)

Thanks - I hope my two do as well as your two!


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## KiaKaha (Aug 4, 2008)

me too! xx


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## keyno1 (Aug 30, 2009)

Bookmarking


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## Gribbie (Apr 19, 2010)

Well at least one has decided to hang around


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## KiaKaha (Aug 4, 2008)

That's fantastic news    
Huge, huge congrats to you and your DH!


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## Gribbie (Apr 19, 2010)

Thank you so much.  I'm still a bit shocked really.  Scan in a couple of weeks to see if it's one or two


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## Belbs (Aug 3, 2009)

I am so happy to read your news.


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## niccad (Apr 28, 2009)

Gribbie - many many congratulations. Please let us all know how the scan goes xxx


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## Gribbie (Apr 19, 2010)

Thank you both so much!  Whether it was the £500 growth hormone or the 50p steroids who knows!


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## star27 (Apr 27, 2010)

Hi Gibbie,

Congrats!!! I had a similar situation to you and am going to cycle again soon - what is the growth hormone that you mentioned and what exactly is it for.

Quick one on vits - I'm taking Q10 - Should my hubby be having this too??

Thanks
Sx


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## Gribbie (Apr 19, 2010)

Q10 - I think it is ok for you both to take but my hubby refused saying it was "woo"    

The growth hormone was sprung on me by the doc as I seemed to be slow getting my oestrogen levels to rise -I can't remember what it was called!  I think it is shown to improve egg quality in some studies.

Best of luck


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## kdb (Apr 9, 2009)

Hi Star - I had DH on the Co Q10 as well (we both took 60mg / day).  I *think* Zita West rec'ds it for DHs.

I think if you mention 'human growth hormone' to your clinic they will know what you mean


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