Thursday, December 08, 2016

Patients with poor ovarian reserve: is there any point in flogging a dead horse?

Women with poor ovarian reserve who have regular cycles are extremely difficult to treat. Because they have regular cycles , they expect that they will have good quality eggs.  This belief is reinforced when they do IVF and their eggs fertilise and the doctor gets embryos.  They feel that these should implant, because this was their only problem. Since their uterus is normal , and since IVF has helped them to make embryos from their eggs, they think success is assured.

However, when their embryos fail to implant, they go to pieces. With repeated IVF failures, they start getting even more desperate , and are advised to explore options such as surrogacy.  This is bad advice.

The problem is that their major bottleneck remains their poor egg quality. Just because an egg forms an embryo doesn't meant that that embryo is good enough to become a baby . This is something patients with poor ovarian reserve need to understand .

However, because they are so desperate to transmit their own genes to their child, they often pursue treatment which is futile , and ends up wasting a lot of time as well as money. Sometimes it's better to cut your losses and accept that you need to move on to plan B, which is using donor eggs. Yes, this is a hard decision, but it's the one which gives them the highest chance of becoming a mother.

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