Quality vs Quanity of Donor eggs?

[BC-MAV]

I totally agree that QUALITY is so much more important than QUANTITY. But with my hometown RE I had BOTH!! I think with proper dose of medication, careful monitoring of your E2 and progesterone, frequent ultrasounds to make sure all follicles are 18 mm and mature (small follicles have to catch up to the bigger which means some folllicles will be bigger), and tweaking of the dose, you CAN get both!!! It does take more effort and is more costly so smaller clinics can do this as opposed to larger clinics, IMO.

I just think aiming for 5-10 eggs is not great. 8-10 eggs is good and 12 eggs is certainly a nice number. 5 is lame, at least for the way I've responded in the past. The CA RE said if you have under 10 eggs they don't recommend trying to grow to blast because of the QUANTITY. Sure we all want a ton of eggs, but if they aren't good quality it is of NO GOOD. My hometown RE retreived 20+ eggs on TWO occasion, 90% of which were mature so those were really good retrievals for me and good protocol. However none resulted in a pregnancy for me.

The last IVF I did the CO RE retrieved 20+ eggs and only 10% were mature. Not a good retrieval/IVF. The protocol was very different from what my hometown RE did.... more meds, different meds, a short stim cycle of 9 days vs 12, follicles of varying sizes instead of the majority 18 mm, my E2 wasn't allowed to go high enough to let the follicles grow to maturity, etc..

Anyhows from those 26 eggs there were ONLY 3 mature eggs!!! ALL the OTHER eggs were IMMATURE and unfertilizable. It was a one shot try and from those 3 eggs we got 3 lone embryos and transferred all 3 lone embryos to our SM and she got pregnant with 1 singleton... our miracle DS!!!!

If you had more eggs than follicles then the ultrasound technician could have just been reporting the mature follicles and not counting ALL of them. Or if you were stimulating very well and your ovaries were touching and you had a lot of follicles sometimes the follicles squish together and hide behind each other so it is not possable to see ALL follicles on the u/s!

My hometown RE's u/s technician counts ALL the follicles and measures the dimensions of EACH follicle for BOTH ovaries EVERY time I had an u/s. So pretty much the amount of follicles equated to the amount of eggs retrieved, give or take a few.

I really was hoping for more eggs with each egg donor but the quantity and quality was up there with that 5-10 average. I think we got 12 eggs from each donor and the eggs were mature and things fertilized well. The embryos resulting from the proven donor as I said before resulted in 0 pregnancies for 2 different surrogate Moms. The unproven donor did similary in terms of quantity and quality with her ER and our FOURTH and first time surrogate mom got pregnant the 1st try.

I know that this is more ART than science!

[50/50]

Thank you all for your responses. I know logically quality is what I want but I'd rather have 15 high quality eggs than 5 high quality eggs. I don't see why I can't have both like you did Mav? This is a new RE that I'm seeing so I'm gonna ask him about his 5-10 qty. Cuz 5 is very LAME especially for the amount of money that we are paying. What if 5 are retreived and none of them are of high quality? I would be really upset. I was thinking the same thing about the 3 day transfer vs the 5 day blasts. With this little qty I don't wish to go 5 day and lose my embryos. I guess I am jumping the gun here....I don't even know how well my donor will respond to the meds. She may stim better than what he is hoping for?

He has given us a 50-75% success rate.

Thanks again!

[BC-MAV]

I had both QUANTITY and QUALITY but none of those embryos resulted in a pregnancy in me so it didn't matter, but then again I don't think ANY embryos would implant in me.... unexplained infertility here!

Yes, I agree that 5 is very lame to expect from a young egg donor considering the financial and emotional costs. Of course no one knows how the egg donor will do if she has never done this before. Even when the donor has donated before it's no guarantee that she'll get similar results.

You have to be realistic and take into account ATTRITION too! Take those 5 eggs... not all are going to be mature... say 4/5 are mature so you are left with 4 eggs. Then with those 4 eggs.... you would likely get 60-70% fertilization (which I heard is supposed to be good, 100% would be very lucky, possable, but not likely). So you may have 2-3 embryos to transfer. If you are conservative you transfer 2 and freeze 1. (60-70% survival that the 1 embryo survives). Of course the fertilization rates and the thaw rates depend on the clinic so ASK!!!

The not knowing how the donor is doing would really bug me if I was paying good $$$. Of course we did pay good $$$ but since we had an open relationship with our 1st donor I could talk to her directly and she had donated before a few times so she would tell me what was going on-LOL! The 2nd donor never donated before but again we had an open relationship and talked on the phone so when she said they upped her dose I figured that she wasn't responded as they had expected. That was ALL the news we got until the retrieval day. We got the number of eggs, no indication of maturity just a general "Most were mature." And then we got a fertilization report and on the 3rd day we got a report of how many embryos were left. (our RE here checks every day to see what the embryos are doing... out of state RE's don't ~ logic was the ebmryos need to be in the dark)

Ok, I have definitely gone on LONG enough... just hope something I said helps someone out there.

[BC-KarenS-MI]

It's really, really tough, but honestly, you don't want to get a ton of eggs & have them all be stinky eggs that don't get you anywhere. Average is really only around 10-12 eggs retrieved. More than that is not all that common. Also, just because you get 20 something eggs, it doesn't mean that you'd end up with all/most of them. I see ladies who get 20 some eggs & only end up with 12-14 fertilizing & by transfer, they only have 6-8 left. Having a lot of eggs is NOT a guarantee that you'll have good fertilization, or growth & it will not guarantee that you'll have any left to freeze. Out of 3 cycles & 23 eggs retrieved, none ever made it to be frozen for us.

Hopefully if I share my story with you, it will give you a little hope that you don't have to have a lot. With my 2nd & 3rd cycles, we used the same anonymous donor. Previous to her first donation to us, she had 18 eggs retrieved. For our 2nd cycle, we only got 6 eggs from her. 5 of the 6 fertilized, we transferred 3 very good, healthy looking zygotes & I got pregnant with twins but lost 1 at 8w. For our 3rd cycle we only got 5 eggs. This time they all fertilized & again we trasnferred 3 very good, healthy looking zygotes & I got pregnant with a singleton. My point in sharing this with you is to encourage you that quality IS most important & that quantity doesn't mean much.

Also, if you don't get a lot of eggs, personally, I would refuse to do a 5dt. There's too much risk of losing all of your little ones if you don't have quite a few. Your little ones will do MUCH better inside you than they will growing in an artificial environment such as a petri dish.

Good luck!! Keep us posted on how things go with your cycle, ok?

Karen

[Janie-OR]

Yes, quality reigns over quantity! And fresh cycles are definitely the ones to optimize.

My first RE stimmed our young donor. Retrieved 25 eggs. Only 9 fertilized. Embryos of so-so quality. No pregnancy on either fresh OR FET cycle. More than a little disappointed. Moved onto another clinic and RE. New donor a bit older than the first, but proven. Retrieved 15 eggs. Only 3 fertilized (not sure why, but likely due to issues with DH this time). Best quality of embryos ever. Got pg. The light of our lives just turned 2 and 1/2.

Good luck!

Janie

[50/50]

Thanks all! I just saw my RE this morning and he told me to relax. haha. He is not "trying" to only retreive "5-10", he will prob get more than that cuz she is a young donor. Just doesn't want to overstim her and land her in the hospital. But still pushing "quality" over "quanity". I can hardly wait to start. I'm done with mock cycle today and he said my lining could be used for a poster cuz it looks so perfect! ha!

[Emily'sMom]

Congrats on finishing your mock cycle and also for that picture perfect lining of yours. Remind me, did you already start your acupuncture? I'm really excited for you and can't wait to hear your cycle is underway.

What exactly do they have you do for your mock cycle? My clinic said they don't do them b/c it gets too expensive. She comforted me when I asked what the heck happens if my donor is ready for retrieval but my lining isn't there yet. She said they fatten up my lining before the donor ever starts stims and then just keep me there. Curious if any other clinics do it that way.

Are you still thinking middle of April to really get rolling? Wishing you tons of luck!

Ellen

[50/50]

Thanks Ellen! Basically I was on estrogen patches for 2 weeks and had 2 blood tests to check my E2 levels and the final check was with the ultrasound to see my lining. The cost for the mock cycle was under $600. I saw another RE that does the same as yours does...gets your lining ready before they even start the donor on meds.

My donor went in today for her blood work and infect. diseases. One of which takes 2 weeks to get results back. They are still thinking it will be around the middle of April. But I'm not sure if that is when the retreival will be or when she starts meds. I'm thinking it will be when we do the retreival cuz by the end of March she should be ready to go since they put her on bc's today.

When will you start cycling? Has your donor already been through all of her testing?

Thanks 50/50

[Laenae]

50/50

Glad your visit with the RE went well. Given that your donor is young as is mine who is 22, I think you will get lots of embryos. Good that your mock cycle is over and that things are moving along. Two weeks is not too bad to wait for the medical tests to come back. In my case, the donor testing took a long time -- almost 4 weeks for me. They check everything including the kitchen sink. They test the donor's blood to see if they are a carrier for neurological diseases and my first donor was cancelled as she was a carrier for Tay-Sachs disease! I am glad the clinic was so thorough as they were! My current donor has no issues.

Look forward to your updates.

Love,
Laenae

[Emily'sMom]

Well I suppose $600 isn't too terrible. I wonder if my EDC thought I meant a mock cycle including the donor. I'm okay with not doing one now that I know they'll make sure my lining is where they want it before she starts. We're planning on using a donor from our clinic's pool. They completely pre-screen all of their donors. Which is kind of nice because then you aren't delayed by having to run their testing and you know they've already passed everything. We're not allowed to preview profiles though until our testing is complete. And unfortunately we're a little behind my original goal We should have our screening completed by the end of the month. I'll actually be starting bcp with my next period (in about 1 1/2 weeks) to help prevent further delays. I expect to be previewing profiles early April but probably not transfer until May or early June.

Sounds like you're really close. Mid to late April certainly sounds like a reasonable time frame given your donor started bcp today. IF you don't mind me asking, is this an attempt for your first child?

Ellen