Dr. Yuliya Blazhko, fertility specialist & obstetrician-gynecologist at Gryshchenko Clinic-IVF, is discussing how repeated Controlled Ovarian Stimulation can influence the number of oocytes obtained in the consecutive cycle.
As I have already mentioned, we don’t see any bad influence on all of the repetitive stimulation, and the fact that she confirmed pregnancies from 4 of your previous donations, it’s a good predictive factor that her oocytes have good quality, and that’s why it seems to me that it will not have a bad effect, and for the 5th time there will be the same good result.
PGT- A is a procedure that is widely implemented in our clinic, and in spite of donors having a rather low risk of genetic abnormalities of embryos, there is still a risk. The risk is about approximately 30- 40%, but this technology led us to determine normal embryo structure and to avoid implementation failures or to minimize the risk of miscarriage.
No, this data is relevant not only for donor eggs, as I’ve mentioned, we decided to compare this result with patient simulations, but I have to say that AMH level and the ovarian result decreases with age. It’s not connected with repeated ovarian stimulation, the quality of the oocyte becomes lower every year. That is why if you provide several simulations from year to year, this is quite predictable that in 4 years, you will get fewer oocytes quantity then f.e. at first simulation.
Actually, I agree with you that 2 good embryos from 10 or even 15 eggs are a very, very low number. Especially, in a donor who is 28 years old, her egg quality should be good enough, and her level has to be at least 50-60%, and out of 10 -15 eggs should give more than 2 good embryos.
I would advise you not to give up and to continue your journey to motherhood. I should say that you can try with your eggs as long as you can, but understanding that the chances of pregnancy reduce with age, and at the age of 40 years old, the chances are up to 10%. Using donor eggs your chances increase up to 60 or 70%. If you try with your own eggs, I will advise you to do genetic testing of embryos, but still, you have both options.
Your outcome with your previous simulation was rather good, from 19 to 20 eggs and the euploid embryos rate was also very good and your age actually, it’s very perspective, that is why it seems to me that the 3rd time sure the outcome will be as good as it was already. About the vitamins, we advise to use folic acid in a dosage of zero and eight milligrams per day and nowadays we all have an insufficiency of vitamin D, that is why it will be useful to do an analysis for this vitamin in case she has insufficiency. What about maximizing the outcome, this might be a question to your doctors and your clinic, we guarantee to all the patients an indefinite number of oocytes and if we get fewer eggs from the donor, we can take the oocytes from our egg bank, and we can provide the necessary quantity of the oocytes to the patient.
An AMH level does not depend on the day of the cycle, and the LH level is necessary to know of the day of egg retrieval initially, we just check the LH level day-3 or day-4, actually, every day between day -1 and day- 5 is a good day to determine this hormone. About the scans we provide, and I would suggest doing a uterus and ovaries scan at the beginning of the cycle to have good visualization of antral follicles and to have an antral follicle count.
It seems to me that this number is quite normal, actually, we expect a good answer to controlling through a simulation when we get from 8 to 15 or 16 oocytes, that’s why 10 mature oocytes is a good result. I don’t think that after thawing, you will get more than 10 mature eggs because, at the moment of freezing, it was 10 mature eggs, but it still a good quantity.
We recommend our donors to take vitamins before they donate. If you can request it, I would say that depends on a clinic but actually, they can give you full information about the preparation of donors, and this is not a secret that’s why it seems to me that it won’t be any problem to ask the clinic what medications and what preparation they provide to the donor.
Yes, it is that possible and, it is called the individual donation program so you can provide your individual donor, we can do a stimulation for you and then fertilize donor eggs and to do an embryo transfer to your uterus. The process can take from 1 to 3 months, we need to get the oocytes, it will take about 2 weeks, and it all depends on your plan. We can freeze the eggs and do genetic testing and then put it through back to the uterus on your second cycle, or we can do it without genetic testing. On average, it takes about 1 up to 3 months.
We don’t really like those guarantee packages because these procedures are never 100% successful. That is why to guarantee something like this, is not very true, and usually, all those guarantee programs include several IVF attempts, and the price of this guarantee programs is sometimes 3 times higher than just the usual IVF program. That’s why at the moment, we don’t have such a program, but maybe in the future, we will