Wednesday, March 08, 2006
Clarification. . .
Thank you again for all of your kind comments and emails. My situation seems to have elicited a bunch of questions and I feel like I should take a minute to answer some of them. Keep in mind that our problem seems to be a failure to mature not a failure to fertilize. I do not think I was clear about that in my previous post.

1. Why no ICSI?
ICSI was not performed because the eggs that were retrieved were not mature at retrieval and did not mature enough over the weekend for fertilization.

Before an ovum can be fertilized it must undergo a process of maturation or ripening. This takes place previous to or immediately after its escape from the follicle, and consists essentially of an unequal subdivision of the ovum (Fig. 4) first into two and then into four cells. Three of the four cells are small, incapable of further development, and are termed polar bodies or polocytes, while the fourth is large, and constitutes the mature ovum.

ICSI will not work if you are dealing with immature eggs.

The embryologist is still confident that HAD my eggs been mature Husbands swimmers would have been able to do it on their own.

2. Why the pessimistic response from my RE?
The condition (average to high retreival number and ZERO maturation) is not seen that frequently especially in someone my age with absolutely no other apparent issues. I would say that the doctors are being realistic and not pessimistic. I actually appreciate that they are not playing games with us. They truly and honestly do not know whether the condition is permanent, but if it is there is really no way to fix it.

3. Why a diagnostic IVF cycle?
The doctors are not willing to confirm their hypothesis based on one failed cycle. 'Diagnostic' is the term that I am using to help keep it real. IF we decide to go through another IFV it will be for diagnostic purposes. However, IF the doctors hypothesis is wrong and my eggs are able to mature and subsequently fertilize then by all means we will put two back!

4. What next?
We have a re-group with the RE and the Embryologist on the 28th. The RE is not sure what he would do differently if we did another cycle. This cycle he actually pushed me one day further than he ordinarily would with the hopes that a couple of the smaller follicles I had at my Wednesday ultrasound would be ready by Saturday. He is going to do some research and hopes to be able to present us with at least one option at our meeting. He is considering increasing my HCG trigger to try to force the eggs into the final stages of maturation and he is considering taking me longer (higher E2 levels and bigger follicles) than he would ordinarily.

Does that help explain it?


Blogger Mellie said...

Oh P. I'm sorry for not getting the difference right away. Now I understand. I hope the research your RE does turns up a good alternative. Do you know what your E2 level was and what size most of the follicles were on the day of trigger?

Blogger Donna said...

You didn't owe us an explanation but you did a good job of it anyway. I hope you get some good options when you see your RE again.

Anonymous thalia said...

Thanks for the explanation. I hope the research is helping you and you're not just doing it for our benefit! Hoping that the doctor's research is helpful.

Blogger Larisa said...

I hope your RE is able to find something that may offer hope. Thinking of you.

Blogger ninaB said...

Someone has probably already suggested this and if so, I apologize for wasting your time with useless suggestions.
But have they suggested IVM?
There are a few clinics that have gotten pretty good at maturing eggs post-retrieval.

I am so sorry for your troubles. How frustrating and saddening it must have been to go through the whole long annoying process and nothing.....

I hope it does work out..

Anonymous Amy said...

I just found your blog from a link and don't have anything helpful to add. But I wanted to say I'm sorry you're going through this and hope your RE can find some helpful research.

Anonymous Wavery said...

I'd like them to let your follicles grow a little more. But I guess I don't get a say in this (nor do I deserve one).

How confusing and frustrating though. I hope you get some solid answers from your appointment.

Blogger Beth said...

How frustrating. I am so very sorry.

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