Any way to improve egg quality?

[prayforprincess]

Hi Dr. Potter-

I am going into my 4th IVF/PGD cycle. I really hope this works as it will be our last attempt trying high tech.
I am 29 and my husband is 37. I have always gotten pregnant on my own very easily, within the first month or two trying to conceive.
For whatever reason, I have not had embryos that are that great. I respond well to the stims and get a good amount of eggs (roughly 12-20). We have had 70-100% fertilization each time. But for whatever reason, on my day 5 transfer's we only have maybe 1 blast (not even a hatching blast) and the rest are all pre-blast and none look really great. They don't look bad, but are not A quality -- they are B quality at best.
I would think at my age, with good fertility my embryos would be in great condition. All my tests and blood work have come back perfect.
I am taking a pre-natal with fish oil. I eat very healthy. This cycle I am starting to take 1 low does aspirin daily (in hopes it can only help not hurt).
What, if anything else can I do to try to improve my egg quality?

[lisvna]

Pfp i have the same question!!! Im in a similar situation. All my eggs are looking great too. First time 10 out of 12 fertilized en second time 12 out of 12. But my embryos develop poor. They are highly fragmented and never a grade. The dr things it can be endometriosis but I have no symptoms at all, so it looks likes a bit strange to me.....am I infertile now? Or can we do something about egg quality next time? Tomorrow I will have a transfer if we have some left.......

[prayforprincess]

I know it is soooo weird. I have always gotten pregnant first month trying with my all my boys, barely trying at all. Then I try the ivf/pgd thinking it is a slam dunk, and well...it was not.
I don't get it -- I get pregnant so easily on my own yet have such a tough time having a good healthy embryo that sticks doing ivf. No sense!
My husband and mother think that "the drugs just might not agree with my body". My RE assured them that was not the case.
My 1st IVF round we had 8 eggs, 7 fertilized and made it to pgd. We had 1 normal xx and 2 normal xy. Transfer 1 xx and bfn. The 2 xy were not even good enough to freeze. 2nd cycle we got 7 eggs, 7 fertilized and made to pgd. 3 normal xx. Transfer 2 and bfp. Miscarried at 6 weeks. FET with the 1 xx and bfn. 3rd cycle (switched RE's) had 17 eggs, 12 fertilized and 10 made it to pgd. 2xx and 4 xy. Transfer 2xx and bfn again! Out of the 4 xy we had left, only 1 looked really good and could freeze but we did not.
Now here I am about to start my stims for cycle 4 in 2 weeks. I just really want 1 (though 2 would be so nice) amazing looking xx to transfer. I would LOVE twins! Though not to be greedy, I would be very happy with only 1.
Why have my embryos been such crap?? I don't get it!

[peterpan]

did dr potter ever reply to this?

[Dr. Potter]

Hi Dr. Potter-

I am going into my 4th IVF/PGD cycle. I really hope this works as it will be our last attempt trying high tech.
I am 29 and my husband is 37. I have always gotten pregnant on my own very easily, within the first month or two trying to conceive.
For whatever reason, I have not had embryos that are that great. I respond well to the stims and get a good amount of eggs (roughly 12-20). We have had 70-100% fertilization each time. But for whatever reason, on my day 5 transfer's we only have maybe 1 blast (not even a hatching blast) and the rest are all pre-blast and none look really great. They don't look bad, but are not A quality -- they are B quality at best.
I would think at my age, with good fertility my embryos would be in great condition. All my tests and blood work have come back perfect.
I am taking a pre-natal with fish oil. I eat very healthy. This cycle I am starting to take 1 low does aspirin daily (in hopes it can only help not hurt).
What, if anything else can I do to try to improve my egg quality?This is a very important question. The information that would help me help you would be: (1) What is your ovarian reserve and how and when was it checked last? (2)What stimulation protocol was used? How many days of stim? What type of trigger? (3)Do you have insulin resistance? (4)Does the facility you are using do a lot of PGD and blast culture? (5)What type of PGD was used?

Somethings that you can consider in addition to the above would be (1)Co-enzyme Q10 400mg per day (2)Acupuncture (3) adding hGH (4) using either BCPs, estrogen priming or DHEA if not already doing so (5)Have your husband take Cyvita 3 tablets twice per day leading up to his collection day to decrease DNA fragmentation and optimize sperm quality (6)Consider that maybe the endometrial receptivity might be better in your case with an all freeze cycle followed by a FET

I hope that this helps.
Dr. P

[lisvna]

What does HGH exactly do to improve embryo quality? As I understand it's a growth hormone right?

[Louby]

I have cycled with you twice and other than adding in the human growth hormone nothing else was mentioned. Even on my follow up, none of the above was mentioned. I took co-enzyme Q10 and did acupuncture but you didn't advice. A girl i cycled with was told by you that her husband should take Cyvita 3 but again I was never told. After 2 failed cycles, i think that these should have been mentioned and esp, freezing and doing a FET, was never an option offered by you. Upsetting!

[Dr. Potter]

I have cycled with you twice and other than adding in the human growth hormone nothing else was mentioned. Even on my follow up, none of the above was mentioned. I took co-enzyme Q10 and did acupuncture but you didn't advice. A girl i cycled with was told by you that her husband should take Cyvita 3 but again I was never told. After 2 failed cycles, i think that these should have been mentioned and esp, freezing and doing a FET, was never an option offered by you. Upsetting!
Lubby, I am sorry that we have not had success for you yet. It depends on how you fail and what the endometrium looks like. Freezing has its risks. Even with vitrification. I have had one patient fly in for a vitrified embryo that did not survive, I will never forget that and as such recommend 'all freeze' in selected cases only. All freeze will not help poor embryo quality. Co-enzyme Q10 is a pretty recent thing in my practice. It is cheap and may help. We are considering having all patients take it but are waiting for data to further support it's broader use.