Embryo quality / chromosomes

[chattymonkey]

Hi Carole
Some other members have suggested I ask your help – hope you can answer! I have just cycled with the following results:
- 21 eggs removed, 15 mature, 11 fertilised via ICIS
- 10 to day 5 aCGH biopsy
- 1 normal male = NT
- Overall results:
1. +4, +17, +20 - female HB, ab
2. -21 - female HEB, ab
3. +16 - male HB, bb
4. -18 - male HB, bb
5. -16 - female XB, ab
6. Normal - male HEB, bb
7. +21 - male HB, ab
8. +18 - female HB, bb
9. +20 - female HB, bb
10. +15 - male HEB, ab

I am 39 and DH is 41 – is there anything you can suggest we can do to help improve my chances? We both took all the recommended supps (plus I took metformin) and my pre-testing was normal and perhaps better than expected for my age.

My understanding is that the quality of the eggs is good, however I have an issue with chromosome defects. Is there anything you can recommend that could improve the number of normals that we make? For example – is it better to try and increase the number of eggs I make and therefore increase my chances by numbers or reduce the number of eggs I make and therefore potentially increase quality of just a few?

Should I be doing anything different/special in preparation for my next cycle?
MTIA,
Chatty x

[wantingonemore]

my cycle has just resulted in all abnormals and I am aged 38 so am following this to find out more!

[Carole]

my cycle has just resulted in all abnormals and I am aged 38 so am following this to find out more!

Hello ChattyMonkey and Wantingmore,
This is a common question. Here is a link to an Ovascience sponsored article on the Resolve website that discusses this issue The Effect of Egg Quality on Fertility RESOLVE: The National Infertility Association (http://www.resolve.org/diagnosis-management/infertility-diagnosis/the-effect-of-egg-quality-on-fertility.html) Their answer is a rather bleak "no". I think there are some caveats though. A poor stimulation protocol can affect egg quality by either over- or under-stimming. But even assuming that the stim is perfect, there will be fewer high quality eggs around to recruit when you are older. This is a side effect of simply living into your late thirties; being exposed to a background of environmental exposures that most of us are not even aware of and can do nothing about. The only thing in general that you can do is to take good care of yourself nutritionally- try to stay at a normal weight. Eat healthily. Keep chronic health conditions like hypo- or hyper thryoidism clinically managed etc. But, unfortunately, there is no magic pill or supplement. Ovascience is trying to develop a product to "rejuvenate" old eggs by injecting additional mitorchondria from the patient into their own egg at the time of ICSI but it is in the early pre-clinical trial stage. Here is more info about the science behind their work Science and Technology | OvaScience - Improving Fertility Through Science (http://www.ovascience.com/technology/) At some point, they will be recruiting for clinical trials. I don't know when that will be. Anyway, I wish that there was something more to do on your own right now, but there is hope for new treatments on the horizon. Best wishes, Carole

[chattymonkey]

Carole - many thanks for your quick and informative reply.

[ocean]

Carole - After reading that article, from your experience is age the only meaningful factor? (Amd general healthy living). Do you believe there's any benefit from supplements or low carb eating?

[Madison]

This is interesting for me to read too as I am 38 and due to cycle when I am 39:)

[Carole]

Carole - After reading that article, from your experience is age the only meaningful factor? (Amd general healthy living). Do you believe there's any benefit from supplements or low carb eating?

I think age is a major factor because it is the one we can presently do the least to get around as an obstacle. That's why the Ovascience research is so intriguing. If it is proven effective in clinical studies, that would be a really big deal in combating the effects of aging. Low carb eating may be beneficial if it is necessary for good carbohydrate control. There is evidence that obesity and poor glucose control (extreme form is diabetes) and metabolic disorders can lead to poor fertility. Metformin, a drug used for diabetics, is prescribed to some patients in order to normalize the process of egg maturation to improve egg quality. It is a very complicated metabolic picture so simply cutting out all carbs is NOT the way to achieve better fertility. If your doctor is also a reproductive endocrinologist, he should be able to advise you regarding whether this might have any effect. Supplements are problematic, because they are not regulated and "effective dose" may vary from manufacturer to manufacturer--and it is not at all proven which supplements might be beneficial--since they are not required to jump through the same clinical testing required of prescription drugs. Supplements can interact with stim drugs and reduce their effectiveness.

The best advice is to be most ready for good fertility is to:
g
Get to as normal a weight as possible, neither severely under or overweight.
Eat nutritiously so that you have all the vitamins you need for optimal health- a daily vitamin or doctor prescribed supplement may be helpful if diet is not enough.
Try to get sufficient and regular sleep- regulate your sleep cycles --naturally, not with sleep drugs--because chronic jet lag type sleep disorders also affect our hormonal system.
Find a mechanism to deal with stress so that it does not become overwhelming.
Regulate an over- or under-active thyroid so that it is functioning in the normal range.
Find a qualified reproductive endocrinologist who understands your entire hormonal picture and can treat underlying conditions before offering IVF.

I hope that helps. All the best, Carole

[willtherebe4]

Very informative. Thankyou :)

[ocean]

Thank you again Carole for this clear response, I've read it many times since then and am following your guidance - thank you.

[Carole]

Thank you again Carole for this clear response, I've read it many times since then and am following your guidance - thank you.

My pleasure. I am glad you find the info helpful. :) Carole