Quality vs Quanity of Donor eggs?

[50/50]

Hi All,

I asked my RE if he planned to do an agressive protocol on our donor cuz I am hoping for a lot of eggs. He told me he is hoping to get 5-10 eggs and it's quality not quanity that he is after. He said he does not want to be too aggressive as he does not want overstim her and make her sick. Which I can understand I don't want that either, but I was very disappointed about the # of eggs he is counting on as if this first cycle doesn't work I'd like to do FET.

Anyone ask their RE about this prior to start of cycling? and anyone know the count of their donors? My donor is 23 yo. and I realize everyone will stim differently but geez 5-10 eggs? That's the range they retreived out of me at 41.

thanks
50/50

[hildes]

Yeah, me too. But I know someone whose donor only got something like 4 and only ONE made it to transfer - and they have a 4 month old boy now...

So, hang in there (not like I take my own advice though!)

Hilde
(44)

[Emily'sMom]

Well we haven't gotten to that point yet but during our last consult with the RE in October I asked him how many he thought we'd get and he said probably an average of 10-15 eggs. I keep telling myself it's quality not quantity but lets face it, I think we're all more comfortable when we're told we have lots of eggs to work with. I know my clinic is going to hate me when we actually cycle because I like details and ask lots of questions. I'm curious how many amps they'll put your donor on to start. Do you know? The only thing my RE said is that he can always increase the donor meds if the response is less than expected. He said a steady slow stim is better.

If you don't mind me asking, where are you in your cycle? (i.e. on lupron, donor has started stims, etc.)

I think one of the most difficult things with doing a donor egg cycle is not having control of everything. I'll be interested to see other responses to your thread.

Good luck,
Ellen

[50/50]

Thanks for your repsonses. At least I now feel as though I'm not the only one thinking the same thoughts.

Hilde-thanks for the success story, I will try to keep that in mind.

Emily-My donor just had her med/psych eval last week and passed. She is now going to get her legal counsel and then to our RE for blood screens. I'm currently going through a mock cycle so we won't even start cycling until the middle of April. I don't know what protocol she will be on but I beleive he mentioned Lupron. She is a first time donor so I'm guessing they will be cautious with her? I don't know?

Yes, the control issue is really becoming annoying. I think I have become a pest to our donor agency, but I figure we are shelling out all of this money so I have some right to call and ask questions?

I am going to Coastal Fertility in Orange County for my DE cycle.

Thanks again for the support and info!

[hildes]

We are HOPEFULLY getting close to retrieval, although the clock is ticking s - l - o - w - l - y while I wait for call from nurse with results from donor's b/w and u/s this a.m. It was supposed to be yesterday but donor was sick and rescheduled. Her E2 was high at baseline, and first monitoring didn't show anything, so I am terrified we will be cancelled! The nurse doesn't tell me a lot of details re: how donor's cycle is going, but at least some general info. I just hope the news is good... I am sooo nervous. Originally I was hoping/wishing for a ton of eggies - but now I'll be happy with anything (even a BFN) other than a cancellation. I'll post later regardless.

Good luck to both of you!

Hilde

[50/50]

Hilde- I hope your cycle doesn't get cancelled either. I know how it must seem like forever to hear any news at all. I'll be thinking of you and will be watching the bb's for your posts. Best of luck!

50/50

The problem with overstimming is that you might get 30 eggs, but the majority of them will probably be immature or of poor quality. That said, 5 to 10 does sound a bit low. Our RE retrieved 24 eggs from our 23 year old donor and 18 fertilized (ICSI). I had one fresh cycle and 2 frozen and still got "only" one child.

Maybe a good question to ask your doctor is what his success rate is for donor cycles. That might give you a better idea of your odds. You can also go to the CDC.gov website and see the stats for yourself for your clinic.

Diana

[BC-MAV]

Yea, IMO, I think that's what the RE's from large clinics aim for in the general population... donor or yourself! I guess RE's figure they are doing pretty good if they get a handful of eggs since a lot of infertile women respond very poorly and get less than 5 eggs and a few of those 5 eggs are probably immature. I was disappointed too to hear this when we went to CA for a 5th IVF because my RE here in our state had always gotten 10-15 eggs with my FSH under 3 and a fairly low dose of 1-2 amps of FSH meds. I think aiming for 5-10 eggs is lame considering the expense we are going through and there is not likely to be frozen if all eggs aren't mature and if all eggs don't fertilize.

The difference, IMO, is that the larger IVF clinics have a standard protocol and they just give that standard dose of 2 amps of Gonal-F and 1 amp of Pergonal or Repronex to everyone... whether donor or you. I had reams of records with the dose of what med I had taken for each cycle and it was generally the same with a bit of tweaking of the dose, had my E2, my progesterone, my linings, and all the records for the previous 4 IVF cycles with my RE. I don't think the other RE with the big clinic out of state took 1 look at any of the records for the cycles!!!

The RE did what he always does with every patient and the 5th IVF he only retrieved 5 eggs and just 3 were mature so we only had 3 embryos to transfer to our SM. What a bummer and it was the poorest cycle I ever had so I went back to our hometown RE!!! The next cycle with the hometown RE he retrieved 20+ eggs. He knew how high my E2 could get without the Progesterone affecting the egg quality and he tweaked the dose and trying to get the most amount of follicles and having them all be a mature size.... like "baking a cake"... trying to get the best darn cake he could and not going by the book-LOL!

I was really surpised when we did egg donor and our "proven egg donor" at the clinic in CA was put on 3 amps... just like I had the "standard" protocol with my awful cycle! The 2nd egg donor who was "not proven" and had no records of how she responded was put on 2 amps since she was young but then they upped it a bit mid-cycle. I have done about the same or better in terms of quality and quantity than both egg donors, but I had no pregnancies with me and it was 2 years before a pregnancy with a SM using our gametes, so that was part of the reason to do egg donor... to change a variable... and perhaps change the success rate.

The RE in CA put me on different meds and I questioned why since I had such good results with my previous retrievals in terms of number and quality on a certain med and a certain dose. He said they found that these certain meds produced better quality eggs than just doing plain FSH like Gonal-F.

RE also did a short stim cycle of 9 days and I had always done meds at least 12 days before HCG so I don't understand why he changed that either. He explained that their research showed longer stim cycles could affect egg quality. (I think it's different for each woman.) If that RE bothered to look at my records he would have SEEN that longer stim cycles for me resulted in a nice quantity of eggs and a nice quality. This may not hold true for everyone, so the RE's gotta look at the records. My eggs fertilized great too.

Also that other RE's clinic seemed to have a cut-off E2 level... not wanting it to get above a certain number...1500 comes to mind. My E2 with my hometown RE averaged 3,000 to an all time high of 6,000 before HCG and directly correlated to the amount of follicles I had and the size and maturity.

The other RE didn't want follicles over 18 mm. With my hometown RE I had follicles that were all 18 mm (considered mature follicle) and then some were of course much bigger at 20+ and a few at 30+. The CA RE explained that if the follicles were too big in size the eggs inside could become "overipe". I thought eggs were either mature or immature....

My hometown RE did lots of ultrasounds and tweaked the dosage going from 3 amps in the beginning to 2 amps, then 1 amp, sometimes coasting. The other RE just kept things at 3 amps so it was like he was using this "standard" recipe for baking a cake instead of adding more flour if the dough was sticky or baking things longer if the cake wasn't done, KWIM?

Another thing is that when we did surrogacy my E2 didn't really matter because getting pregnant in itself can cause OHSS so since I was just going through the egg retrieval and our surrogate was going through the transfer and hopefully getting pregnant, it was not a big risk for ME to get the E2 high. So, IMO it is not a big risk for egg donors to have a high E2. I NEVER had to go in the hospital or anything like that with those high E2/s ranging from 3,000 to 6,000. Sure I felt a bit bloated, had to hydrate myslef, got a little dizzy, but nothing major.

Also the amount of follicles you start out with is the amount you'll have in the end. So it is better to start with a higher does of meds in the beginning and you can always taper off.

I am rambling but having been through so many IVF's and in different states with different RE's, I've learned a lot. Hope I haven't confused you.

[flicka7]

My RE gives young donor 3-4 amps per day. He said they were looking for a dozen eggs.

Please remember that quality IS the most important thing. Who cares if you get 30 eggs and none of them are any good??

I was told before retrieval that my donor had about 14 follicles. Turned out they got 28 eggs!! I was so thrilled. Only 21 were mature and 14 fertilized. Only 3 were grade 1 and 8 cells at time of transfer. I transferred 2 and got a BFN and had 5 blasts to freeze which I was happy with. I was hoping to have a couple of children from this one retrieval and have them be genetically the same.

Anyhoo, I hope you get some good quality eggs with a few to freeze. Good Luck!

[Laenae]

more so than the quantity. I do understand your concern however. When I went for my IVFs I was on 3 amps follistim in the AM and PM as well as Repronex. I stimmed well and had around 15 follies and generally transferred 5 or 6 embies. I do feel the quality is more important than the amount. You would think that Clinics would want the donor to stim well seeing that the recipient is paying for it and most likey the recipient has already exhausted all other avenues of getting PG and spent a lot of money on treatments.

I hope the estimate your RE gives you is just an estimate and that your Donor produces a lot of little eggies for you.

Please keep us posted.

Love,
Laenae