Question for those with more than 20 eggs retrieved (quality vs quantity?)

[Egg Factory]

Hi all,

I just had a failed cycle and while waiting for AF to show, I'm gathering some questions to ask my RE when I next meet him, and wondering how we can improve things for the next fresh cycle if this last FET doesn't work.

I had 25 eggs retrieved, 23 mature and 15 fertilized with ICSI. Out of these, we had 5 blasts. I am not sure what to make of these numbers, but I had expected a better fertilization rate with ICSI.

I was on the short protocol and my E2 levels went up to 1000+ pg/ml after 6 days of stimming. My RE's only concern was OHSS but I am wondering if the over-stimulation had affected the egg quality as well, especially when I read this article:

Is there an ideal egg number for IVF? - Conceive Online

"The “live birth rate” (LBR) rose, not surprisingly, with the number of eggs a woman produced – but only up to a point. At 15 to 20 eggs the live birth rate plateaued. And after 20 eggs, the rate steadily declined."

So my question is, should I aim for fewer eggs next time, or would that decrease my chances even further? I don't know of many people with this many eggs retrieved, and if someone here has got similar experiences I would love to hear about the results of your cycles, if tweaking the number of eggs made any difference, etc. I would like to add that I do not have PCOS, my LH/FSH ratio is normal, my AMH is over 20 - good ovarian reserve.

[tenseintexas]

HI- I am so sorry you had a failure. i have the opposite problem and usually get around 7....so I dont have much info but what I have learned, from 4 IVF's, is that everyone is different...just because you have a lot of eggs does not mean the quality is all good or all bad....i dont think if you had less eggs that would automatically mean the quality was better.
This forum will be great- i feel like there are lots of people on here who makes lots of eggs and will be able to help you.
Great luck to you! I am always jealous of yall that make lots of eggs

[WhitneyAtFertilityAuthority]

egg factory: well I guess at least you are true to your moniker. I have a close friend who made as many follies and after two failed rounds decided to do PGD. The genetic testing uncovered stuff that just made her worries greater, but in the end she has two perfect children from following rounds. Good luck and I know more experience will find you on these boards to impart wisdom.

[milo]

Yes, I think if the eggs develop too quickly they may not be of the best quality. I had a similar situation - initially with 20+ follicles and fear of OHSS, but then they coasted me for several days until my E2 came down and some of the follicles died off. I had 16 eggs retrieved in the end, and 9 fertilized. Only 3 were deemed worthy of transfer on day 3.

From what I understand, the REs prefer to have a "controlled" stimulation so that the eggs/follicles mature at a steady, predictable rate.

I do not have a diagnosis of PCOS either, but based on my hyper-vigorous response and mild cystic-appearing ovaries, they think I am "PCOS-like," if that makes any sense.

[Egg Factory]

tenseintexas: thanks for your reply and I'm sorry to read that you've had such a rough time with IVF... I hope you have success in your new clinic. you're right - everyone is different and even in the same person, every cycle is different. To further add to the confusion, every RE does things differently! Please don't be jealous - I spent a bomb freezing all these embryos and yet I end up with only 2 tries.

whitney: I'm happy for your friend. Are you undergoing IVF at the moment? PGD isn't allowed where I live, so I guess I'll have to rely on divine power.

milo: Ah I see... yes maybe I need a change in protocol for more controlled stimulation. I'll bring this up to my RE when I meet him. Thanks and good luck for your next cycle. I'm sure they'll be able to find a protocol that suits you.

[tenseintexas]

egg- Thank you. i wish you luck as well!!!PGD isnt allowed!?? really?? I didnt even know that was possible.....i dont agree with people who do it for gender selection but i have a balanced translocation ( ie 66% of my eggs WILL miscarry) so that is what i look for....

[TypinginTexas]

*Mention*
I make huge amounts of eggs, 25 last time, ICSI fertilized 14 of those. Put back a 5day blast and a morula and one stuck. Zero to freeze. FF 3yrs or so and I'm back with an antral follicle count of 58+ and the news that I skimmed cancellation by a hairs breadth last time. The decision has been to use the antagonist protocol with a lupron trigger (instead of the long lupron of the first round) The hope is I'll get less eggs (maybe) of better quality without tipping me into OHSS. we may also freeze all and try an FET instead but I'm not sure I quite grasp the reasoning behind that yet.

[BC-G36]

58?? Good God! Antagonist protocol worked well for me last round (more eggs - 22 - yet less fertilized via ICSI) but not great quality. It really is a crapshoot, depending on the IF cause (ours is severe male factor). I've done both with mixed results.