Saturday, October 24, 2015

Poor Egg Quality- Is IVF the Only Treatment Option?


When patients come in for a consultation and want to know why they can’t have a baby despite trying so hard, I typically start with explaining the basics of making babies . Of course, some of my patients are well-informed and have an arsenal full of information and a barrage of pointed questions, that I’m more than happy to answer. But there are a number of patients who know how babies are to be made in the bedroom , but aren’t too well-versed about what the reasons not being able to conceive are.

The Basic Tests

And so, it’s back to the basics for them; it takes 3 things to get pregnant- good sperm, open fallopian tubes and ovaries that produce good eggs working. When a couple goes in for IVF treatment, some basic tests will be carried out.  However, for some women , even though the ovarian reserve tests are normal( normal antral follicle count, normal AMH, normal Day 3 E2 and FSH levels ), when the IVF cycle fails, her doctor tells her that the reason for the failure was poor egg quality – and this is the reason for her infertility.


Poor Egg Quality Facts

Now this can come as a shocker –especially for a young woman with regular cycles? The first thing you need to do is to get photos of your eggs and embryos. One of the commonest reasons for poor quality eggs is a poor quality clinic. For example, the doctor may not have superovulated you properly; or the IVF lab may have damaged your eggs while handling them in vitro. It’s important to get a second opinion, and repeat your IVF treatment in a better IVF clinic.

What happens if your worst nightmare comes true, and your eggs are of poor quality again ? What exactly is poor egg quality and what can be done about it? Here are some things you should be aware about:

•    Most women who are told that they have poor egg quality feel that it is the end of the road and that they won’t ever be able to get pregnant; but this is not the case. Based on your individual situation, all it means is that it will be more difficult for you to get pregnant. In certain situations, it may mean that these women may have to consider using donor eggs. It’s important to understand that poor egg quality doesn’t necessarily equate to can’t get pregnant.

•    Women are born with all the eggs they will ever have and each month, there are a set number of eggs that try to win the race to reach the fallopian tube. Only one will emerge the winner and will ovulate; the rest of them simply die and can never be used again. Regardless of how old you were when you first started your menstrual period, the number of times you have been pregnant or the length of time you have been on the pill, it is a cruel fact of nature that your ovaries will run out of eggs as you get older.

Every woman loses eggs at a different pace, and you just can’t compare how many eggs could have been retrieved in your egg retrieval process compared to someone else who was doing IVF. The other factors which can have a negative impact on egg quality include history of prior ovarian surgery, endometriosis, cancer treatment, and smoking as well as some genetic conditions such as FragileX.
•    It’s possible for you to try to improve the quality of your eggs, but it’s not possible for any doctor to guarantee that he will be able to make you  get pregnant as there really is no concept of “controlling your fertility”. It’s important that you lead a healthy lifestyle and consult the best IVF specialist; however it’s also important to view the fact that no one can guarantee you will get pregnant with your own eggs (no matter how many different treatments and techniques you try), if you have been told  that the quality of your eggs might be poor.

The Treatments

The simplest way to think about it is that if the quality of your eggs is poor, it means they just don’t have what it takes to actually turn into a normal pregnancy.
IVF is a treatment option where poor egg quality is the cause for infertility in the couple. If the quality of eggs is too poor, donor eggs can also be used. The treatment course and its effectiveness will be determined by your specific condition and will differ from one patient to the next.

Has your doctor told you that you have poor egg quality ? Need a second opinion ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better!






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