Welcome to IVF Authority - World Renowned Resource for IVF Information

Welcome to IVF Authority Blog

Search by Topic

Search by Date

<< Back to IVF Page

Egg/Embryo Quality: A Critical Consideration in IVF (Part 1)

Dr. Geoffrey Sher Recommends

Loading ...

Phone:
702-892-9696

Fax:
702-892-9666

Pin It

When receiving a report of “poor embryo quality” the first inclination is often to point an accusatory finger at the embryology laboratory. This is grossly unfair because the truth of the matter is that while the In Vitro Fertilization (IVF) embryology laboratory plays a pivotal role in the success of an In Vitro Fertilization (IVF) program, it is the IVF doctor that selects the ovarian protocol that drives egg development and, regardless of expertise, no embryologist can make “poor quality eggs” develop into “good quality embryos”.

The potential for a woman’s eggs to undergo orderly development and maturation, while in large part being genetically determined can be profoundly influenced by the woman’s age, her “ovarian reserve” and proximity to menopause. It is also influenced by the protocol used for controlled ovarian stimulation (COH) which by fashioning the intra-ovarian hormonal environment, profoundly impacts egg development and maturation.

In this post, we’ll discuss age related factors that contribute to egg quality. Tomorrow’s post will discuss ovarian stimulation related factors. Age & Egg/Embryo Quality: A woman is born with all the eggs she will ever have.

After the menarche (age at which menstruation starts) a monthly process of repeatedly processing eggs continues until the menopause, by which time most eggs will have been used up, and ovulation and menstruation cease. When the number of eggs remaining in the ovaries falls below a certain threshold, ovarian function starts to wane over a 5 to10-years. This time period is referred to as the climacteric. With the onset of the climacteric, blood Follicle Stimulating Hormone (FSH) and later also Luteinizing Hormone (LH) levels begin to rise…. at first slowly and then more rapidly, ultimately culminating in the complete cessation of ovulation and menstruation (i.e. menopause).

One of the early indications that the woman has entered the climacteric and that ovarian reserve is diminishing, is the detection of a blood FSH level above 9.0 MIU/ml (in association an estradiol level of

Prior to the changes that immediately precede ovulation, virtually all human eggs have 23 pairs (i.e. 46) of chromosomes. Thirty six to forty hours prior to ovulation, a surge occurs in the release of LH by the pituitary gland. One of the main e purposes of this LH surge is to cause the chromosomes in the egg to divide n half (to 23 in number) in order that once fertilized by a mature spermatazoon ends up having 23 chromosomes) the resulting embryo will be back to having 46 chromosomes. With ovulation induction using fertility drugs, the administration of hCG (the hCG “trigger”) mimics the LH surge. A “competent” mature egg is one that has precisely 23 chromosomes, not any more or any less. It is largely the egg, rather than the sperm that determines the chromosomal integrity of the embryo and only an embryo that has a normal component of 46 chromosomes (i.e. euploid) is “competent” to develop into a healthy baby. If for any reason the final number of chromosomes in the egg is less or more than 23 (aneuploid), it will be incapable of propagating a euploid, “competent” embryo. Thus egg/embryo aneuploidy (“incompetence”) is the leading cause of human reproductive dysfunction which can manifest as: arrested embryo development and/or failed implantation (which often presents as infertility), early miscarriage or chromosomal birth defects (e.g. Down’s syndrome). While most aneuploid (“incompetent”) embryos often fail to produce a pregnancy, some do. However, most such pregnancies miscarry early on. On relatively rare occasions, depending on the chromosome pair involved, aneuploid embryos can develop into chromosomally defective babies (e.g. Down’s syndrome).

Up until a woman reaches her mid thirties, only about 2 in 5 of her eggs will likely be chromosomally normal. As she ages beyond her mid-thirties there will be a a progressive decline in egg quality such that by age 40 years only about 15%-20% of eggs are euploid and, by the time the woman reaches her mid-forties, less than 10% of her eggs are likely to be chromosomally normal. While most aneuploid embryos do appear to be microscopically abnormal under the light microscope, this is not invariably so. In fact, many aneuploid embryos a have a perfectly normal appearance under the microscope. This is why it is not possible to reliably differentiate between competent and incompetent embryos on the basis of their

Microscopic Grade alone. Even when turning to conventional chromosomal evaluation of embryos by way of Preimplantation Genetic Diagnosis (PGD) using fluorescence in-situ hybridization (FISH) it remains impossible to differentiate between “competent” and “incompetent” (euploid and aneuploid) embryos reliably. This is because at best, PGD/FISH can only access 12 of the 23 pairs of chromosomes. Thus, even when an embryo tests FISH-“normal,” there remains about a 40%-50% chance that the diagnosis is erroneous. The recent introduction of comparative genomic hybridization (CGH) could change all this. By allowing access to all the chromosomes CGH permits a much more reliable assessment of embryo “competence”. Our research has shown that the transfer of even a single CGH-normal embryo yields better than a 60% chance of a healthy baby. This represents a several-fold improvement over prior methodologies.

The process of natural selection usually precludes most aneuploid embryos from attaching to the uterine lining. Those that do attach usually do so for such only a brief period of time. In such cases the woman often will not even experience a postponement of menstruation. There will be a transient rise in blood hCG levels but in most cases the woman will be unaware of even having conceived (i.e. a “chemical pregnancy”). Alternatively, an aneuploid embryo might attach for a period of a few weeks before being expelled (i.e. a “miscarriage”). Sometimes (fortunately rarely) an aneuploid embryo will develop into a viable baby that is born with a chromosomal birth defect (e.g. Down’s syndrome).

The fact that the incidence of embryo aneuploidy invariably increases with advancing age serves to explain why reproductive failure (“infertility”, miscarriages and birth defects), also increases as women get older.

It is an over-simplification to represent that diminishing ovarian reserve as evidenced by raised FSH blood levels (and other tests) and reduced response to stimulation with fertility drugs is a direct cause of “poor egg/ embryo quality”. This common misconception stems from the fact that poor embryo quality (“incompetence”) often occurs in women who at the same time, because of the advent of the climacteric also have elevated blood FSH levels. But it is not the elevation in FSH that causes embryo “incompetence”. Rather it is the effect of advancing age (the “biological clock”) resulting a progressive increase in the incidence of egg aneuploidy, which is responsible for declining egg quality. Simply stated, as women get older “wear and tear” on their eggs increases the likelihood of egg and thus embryo aneuploidy. It just so happens that the two precipitating factors often go hand in hand.

Stay tuned for tomorrow’s post on factors relating to the effect of ovarian stimulation with fertility drugs on egg/embryo quality.

Egg/Embryo Quality: A Critical Consideration in IVF (Part 2)

Tags: Age and Fertility, Controlled Ovarian Hyperstimulation, egg quality, embryo quality, FSH, IVF Authority, LH

20 Responses to “Egg/Embryo Quality: A Critical Consideration in IVF (Part 1)”

Anonymous says:

June 12, 2009 at 6:05 am

thank you adding this blog on egg quality!

any sense for why eggs would have many polar bodies and appear obviously abnormal?

anything i can do/not do to improve the quality of my eggs, i'm 36, and a good responder but most are abnormal and don't grow past day 3.

Reply
coco says:

June 13, 2009 at 3:08 am

Hello Dr. Sher,

In a typical IVF cycle, what percent of a woman's eggs are typically 'normal', and how does this change with age?

How do you know if a poor result is due to age, genetics or poor care?

Thank you

Reply
Geoffrey Sher, MD says:

June 13, 2009 at 8:10 am

When eggs have >1 polar body it is a chromosomal aberation called polyploidy…not much you can do about that.

The most important way to optimize a woman's egg quality is to optimize the ovarian protocol of stimulation. (see Part 2 of the "egg quality" blog posted on Friday!

Geoff Sher

Reply
Geoffrey Sher, MD says:

June 13, 2009 at 8:13 am

Under 35 ..about 40% are normal. At 40, probably 15%-20% and by the mid 40's….. below 10%.

It is usually age that is the predominant factor and also the metod used for ovarian stimulation….See Part 2 of the article, "Embryo quality…" (posted on Friday on this blog)

Geoff Sher

Reply
coco says:

June 14, 2009 at 8:27 am

When eggs have >1 polar body it is a chromosomal aberation called polyploidy…not much you can do about that.

————-

So if the cycle was managed well, most of the eggs were mature and fertilized, then the problem we face seems to be genetic. Is there a chance that one or two of my eggs could be normal. We've done two cycles to date and all eggs appear off.

Reply
Geoffrey Sher, MD says:

June 14, 2009 at 8:36 am

One polar body (PB) is normal. In fact all mature eggs have 1 polar body. However, simply because an egg has 1 PB and is thus mature, does not exclude aneuploidy.

Geoff Sher

Reply
debjani says:

June 21, 2009 at 10:47 pm

I am 38 and my AMH is 25. I have undergone one IVF cycle. 17 eggs retrieved, 9 kept for normal IVF and on 8 ICSI was done. Out of 8 ICSI only 2 embryo formed with 2 and 3 cells on 2nd day. Embryologist told us there is a little hope to conceive.
How should we proceed for the 2nd IVF cycle?

Reply
Geoffrey Sher, MD says:

July 2, 2009 at 10:25 pm

That is really a relatively poor yield of embryos on 17 eggs. Something sounds wrong…possibly relating to the protocol of ovarian stimulation. Read my blog on ovarian stimulation and nthen perhaps go to the SIRM discussion board at haveababy.com and communicate with me from the SIRM-Las Vegas board, there.

Geoff Sher

Reply
Carolina says:

April 24, 2010 at 2:45 pm

I'm am 26 years old. After one laparascopy to remove my left tube for an etopic pregnancy, fallowing after that I had two more laps and numerous blood work, and procedures done to determine the cause of my infertility. They didn't find nothing and said it was unexplained and it could be because of my long periods 28-39, and hence I don't make quality eggs. I am going through IVF and supposed to transfer in two days. My ER retrieved 19, 8 mature, 6 fertilised, and ONLY 2 are growing. My nurse told me "It's an egg quality problem". I always new this in my heart that I had this. I have been trying for 6 years now. Why is this happening to me?

Reply
Cathy says:

June 14, 2010 at 2:27 pm

Is it possible to retrieve any left over eggs from a post menopausal women?

Reply
Geoffrey Sher, MD says:

June 16, 2010 at 4:54 pm

I am afraid not!

Geoff Sher

Reply
mamaisbjorn says:

June 28, 2010 at 7:20 pm

I will be 44 in about a month. I have completed 90% of pre-IVF screens and results are normal. My current cycle day 2 FSH was 18 and 2 months ago had to cancel a flare-micor dose Lupron IVF cycle due to lack of follicles. Based on yours and SIRM's experiences, what would be my chance of having a life birth with my own eggs with IVF? Thank you.

Reply
Geoffrey Sher, MD says:

June 29, 2010 at 1:11 pm

So sorry. First the chances at 44 with dimiished ovarian reserve are poor. You really need an egg donor.

However, if in spite of this you want to try again, then in my opinion, the last protocol I would recommend is a flare protocol. Women over 40 and women with reduced ovarian reserve do poorly on this. You need an agonist/antagonist conversion protocol with estrogen priming (LA10-e2v).Please see the relevant article on this, elsewhere on this blog.

If you wish to discuss further with me, feel free to call 702-619-7437 for a free consultation.

Geoff Sher

Reply
The Mystical and Practical Lawyer says:

September 7, 2010 at 6:44 am

Dr. Sher

5 IVFs have resulted in an average fertilization rate with ICSI of about 30% with only two cycles making it to Day 5 (2 blasts and one morula). I am a good responder (no less than 15 eggs per cycle). Last cycle, 9 fertilized out of 18 and all but one arrested before Day 5. One poor grade morula was transferred. My current doctor says my husband (35 – low counts) and I (33 – PCOS) are genetically "incompatible" and are incapable of success through our own gametes. Do you ever come to this conclusion after such repeated failures?

Reply
Geoffrey Sher, MD says:

September 7, 2010 at 11:28 am

Respectfuully, I cannot conceive of that explanation being correct. This could have to do with the fine tuning the protocols for ovarian stimulation.

Please read elsewhere in this blog on this issue.

Also consider calling 800-780-7437 for a free medical telepgone consultation to discuss indepth.

Geoff Sher

Reply
hopeful says:

September 20, 2010 at 9:00 am

Dr. Sher,

I am a healthy 37 year old and conceived for the first time at 35 with a trisomy 18 baby that I carried until 17 weeks (D and E). Since then I have conceived 2 more times both ending in early miscarriage. We just got back from my first IVF cycle. I had 11 eggs retrieved of which 8 were mature. ICSI was used on all 8 and 5 fertilized. On day 3 all were dividing normaly and biopsied for CGH testing. On day 5 all came back with chromosomal abmormalities (some with multiple). We were told by doctor that we should not try IVF again due to bad egg quality. I have been told that my reserve is excellent and all my pre IVF testing came back great, so there was no reason to expect such a poor outcome. We were told that our best option is egg donor. Can you give me any other information? I am a healthy 37 year old and dont understand why eggs are bad.

Reply
Sarah says:

September 20, 2010 at 6:36 pm

Hi Dr. Sher,

I am 34 years old and my husband is 35. I have had 3 miscarriages at 10 weeks or earlier and 2 chemical pregnancies (both following IUIs using follistim). I produced 4 follicles using 150 units of follistim a day and 5 follicles using 225 units. My day 3 FSH is 12.8, and my RE feels that explains our poor outcome so far. She feels that we should do microdose flare IVF as our next step.

After reading about your thoughts on the MDL protocol, I'm uncertain as to whether or not this is the best course for us. We're 100% self-pay, and I'd hate to waste our hard-earned cash on a protocol that's unlikely to give us a good outcome.

Thank you very much for your thoughts,
-Sarah

Reply
Andrea says:

January 18, 2011 at 1:24 pm

Hi, Dr. Sher. I had 2 ivf cycle failed. the first one i had 10 eggs which 3 were fertilized , and 2 transfered with no sucess. the second i had 11 eggs and 5 fertilized but only 2 survived , my MD said i had fragmentation, and poor quality eggs, do you think it is possible to have a better outcome?how?

Reply
5c0cbb68-6185-11e0-89be-000f20980440 says:

April 7, 2011 at 7:10 pm

Hi Dr, I had IVF cycle and we have 4 embryos of poor quality and 1 of high quality. According to our PGD results the high quality embryo is a polyploid but according to our embryologist that is best we have and she recommends transferring that. According to her, this particular embryo can be termed "normal" by a different lab. We are concerned about any birth defects if we transfer the polyploid embryo. Please advice

Reply
- Geoffrey Sher MD says:
  
  April 5, 2012 at 2:28 am
  
  Respectfully, I would NOT advise that this embryo be transferred. It is abnormal, no matter how “good” it looks!
  
  Geoff Sher
  
  Reply

Case Study: Hydrosalpinx (Blocked/Fluid Filled Fallopian Tubes) and IVF Failure

RL, a 31-year-old woman, presented with a 7 year history of inability to conceive, in spite of 2 prior fresh and 1 frozen IVF ... Read more

Loading ...

Why IVF Pregnancies Are “Higher Risk”

While many IVF pregnancies will progress normally and without any increased risk to mother or baby, there is little doubt ... Read more

Loading ...

Recurrent Unexplained IVF Failure with “Good Quality” Embryos

The following is a case study of a recent patient that came to me for treatment. CJ, a 34 year old, and her husband RJ ... Read more

Loading ...

Karmann and Ryan’s Journey – My Approach to Their Treatment

Please refer to last week's blog post, where Karmann tells in her own words her struggles with recurrent miscarriage - nine ... Read more

Loading ...

Top Search Terms for In Vitro Fertilization

Dr. Geoffrey Sher Recommends

Embryo Quality & Embryo “Competence” – Part III – Testing the Seed

This is the third and final post in three part series on embryo quality. In the prior two posts, I outlined the intrinsic/physiological factors and the clinical factors that can impact embryo “competence”. In this post, I will discuss the rol... more

Loading ...

Embryo Quality & Embryo “Competence” – Part One: Planting a Good Seed

“At 45 years of age the incidence of aneuploidy is likely to be nine in ten.” Several weeks ago, I posted an article about endometrial receptivity and its effect on IVF success. This, as I noted, was the “Soil” component of the “See... more

Loading ...

The Needle vs. the Dish: Should ICSI Be Used in All IVF?

The introduction of Intracytoplasmic Sperm Injection or ICSI has made it possible to fertilize eggs with sperm derived from men with the severest degrees of male infertility. What’s more, pregnancy rates achieved by this method of fertilization are... more

Loading ...

Embryo Implantation: What Farmers Can Teach us About Growing Healthy Babies

I often refer to the conception process in terms of a “seed/soil” relationship. Just as a plant can’t grow and thrive without first assuring that both seed and soil are good, neither can a pregnancy be successful without both the seed (e... more

Loading ...

Acupuncture and IVF: Does it Improve Success?

Acupuncture involves the insertion of thin needles into the skin along so-called meridians (energy channels). It has been used in China for centuries to regulate and treat many health disorders including ailments involving the female reproductive sys... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #17: Why Didn’t I Get Pregnant When I Used a Young Egg Donor and Had Good Quality Embryos?

This is #17 in a series of answers to common questions about failed IVF. For women whose advancing age and/or ovarian resistance make having a baby with their own eggs unfeasible or unlikely, IVF using donated eggs from a young donor (under 35 years)... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #15: Might My Mental State Have Played a Role?

This is the 15th in a series of responses to common questions about failed IVF There is little doubt that stress and emotional lability plays a role in the normal physiological/hormonal regulation of the menstrual cycle.After all, Eskimos often stopp... more

Loading ...

Understanding Immunologic Implantation Dysfunction Part 1: Setting the Stage for Selective Immunotherapy with Intralipid and IVIg

It is an unfortunate reality that many IVF programs attach little importance to factors that affect embryo implantation in general, and immunologic implantation dysfunction (IID) in specific (see below). Perhaps the lack of attention given to evaluat... more

Loading ...

IVF: Coping With the Emotional Roller Coaster Ride

Procreation – and with it the ability to achieve immortality by living on through one’s children – is one of the most insatiable human needs. This strong natural urge exerts tremendous pressure on couples unable to have a baby. And ... more

Loading ...

DQ alpha/HLA Sharing: Does It Always Lead To Reproductive Failure?

It is not unusual for couples who share DQ alpha/HLA similarities to first give birth to a healthy baby only to subsequently develop infertility, recurrent IVF failure or recurrent pregnancy loss. Such couples find it hard to comprehend how after hav... more

Loading ...

Dr. Geoffrey Sher Recommends

CGH Embryo vs. Blastocyst vs. Cleaved Embryo

IVF Success Rate Reporting – Are We There Yet?

Please join me on Wed, February 6 at 8:30pm Eastern for a live webinar where I’ll discuss this topic in detail and take your questions. For more information or to register, click HERE ————- I have, for many years, tak... more

Loading ...

IVF Success Rate Statistics: The Time Has Come to Revise the Present Reporting System

IVF programs currently report their outcome statistics in a number of categories: a) Number of IVF cycles initiated in a given year b) Number of single and multiple pregnancies that occurred c) Number of cycles that res... more

Loading ...

Mother Gives Birth Using Daughter’s Eggs: Was It “Ill Conceived”?

I wish to share a very interesting case with you; one that I’m pretty sure will meet with the approval of some and evoke criticism by others. Before I even tell you about it, let me say that I and my team thought long and hard before going ahead wi... more

Loading ...

Gender Selection in IVF: What Is Its Place?

Couples have for centuries sought to influence the gender of their offspring. More than seven centuries ago the ancient Chinese developed a birth calendar said to be able to predict gender on the basis of when conception occurred. Later, the ancient ... more

Loading ...

Acupuncture and IVF: Does it Improve Success?

Loading ...

Understanding Immunologic Implantation Dysfunction Part 2: A Rational Basis for Selective Intralipid & IVIg Immunotherapy in IVF

ALLOIMMUNE VS. AUTOIMMUNE DYSFUNCTION Alloimmune Implantation Dysfunction Every human being has two DQ-alpha genes. One is contributed by the father and the other by the mother. In a small percentage of patients undergoing IVF, paternal-maternal DQ-a... more

Loading ...

Understanding Immunologic Implantation Dysfunction Part 1: Setting the Stage for Selective Immunotherapy with Intralipid and IVIg

Loading ...

DQ-alpha Matching in IVF: The Controversy, How It Affects Outcome, & How to Treat!

IVF patients, especially those who find themselves inexplicably repeatedly failing treatment after treatment are no longer willing to blindly accept platitudes from those who would ignore the role of immunologic causes of IVF failure while unable to ... more

Loading ...

Unexplained Infertility: True Diagnosis or Cop Out?

For about 10% of all infertile couples, the cause of the infertility cannot be readily determined using conventional diagnostic methods. Such cases are often referred to as “unexplained infertility.” The truth, however, is that in most su... more

Loading ...

Egg Banking of Genetically (CGH)-Tested Eggs Could Change The Face Of IVF-Ovum Donation

For more than a quarter century, medical scientists have attempted to defy the biological clock by freezing a woman’s eggs to preserve her fertility. Most of these efforts have failed. Consider the fact that since the birth of the world’s 1st “... more

Loading ...

Case Study: Hydrosalpinx (Blocked/Fluid Filled Fallopian Tubes) and IVF Failure

RL, a 31-year-old woman, presented with a 7 year history of inability to conceive, in spite of 2 prior fresh and 1 frozen IVF attempts, where a total of six good quality blastocysts had been transferred to her uterus. Her husband PL, had normal spe... more

Loading ...

Recurrent Unexplained IVF Failure with “Good Quality” Embryos

The following is a case study of a recent patient that came to me for treatment. CJ, a 34 year old, and her husband RJ (age 35) presented to me with a six-year history of infertility. Based on semen analysis, RJ, who had initiated two pregnancies i... more

Loading ...

Karmann and Ryan’s Journey – My Approach to Their Treatment

Please refer to last week’s blog post, where Karmann tells in her own words her struggles with recurrent miscarriage – nine miscarriages to be exact – and her long journey of heartbreak, disappointment, and finally – hope.... more

Loading ...

Karmann and Ryan – Nine Miscarriages, Then Hope!

In observation of National Infertility Awareness Week (NIAW), I wanted to share the touching story of a couple that I first met last year – after they had already experienced 8 years of heartbreak and frustration. Their story is representativ... more

Loading ...

IVF in a Same-Sex Male Couple: A Case Study

Background: About two years ago, I received a call from a gentleman that I will call “John”. John was a movie producer who stated that he and his partner “Brian” had been in a monogamous same-sex relationship for 7 years and each wanted to si... more

Loading ...

Recurrent Molar Pregnancy Treated By “IVF Genetic Chess”

Background: Maria (fictitious name), a childless 34-year-old Hispanic lady, presented with a history of having had five (5) successive spontaneous pregnancy losses at 7 weeks gestation, all due to hydatidiform moles. Four (4) of these losses were �... more

Loading ...

Case Study: Donor Egg IVF in a Post Menopausal Woman

Mary (fictitious name), a 54 year menopausal woman, presented at SIRM-Las Vegas for IVF using an egg donor. She had been menopausal for 7-plus years and had NOT been on any hormone replacement therapy. Mary gave a history of having undergone IVF with... more

Loading ...

Case Study: Endometriosis Presenting as “Unexplained Infertility”

I consulted with a 36 year old lady (whom I will refer to as “Sandra”) and her partner, about 18 months ago. She and her husband of 5 years had been having regular unprotected intercourse throughout this time and had been unable to conceive. Sand... more

Loading ...

Case Study: Pelvic Tuberculosis, Hypothyroidism, and Immune Implantation Dysfunction

About 18 months ago I saw an Asian Indian couple who presented with a very interesting history. The female partner (whom I will refer to as DB) had regular menstrual cycles and normal ovarian reserve, was ovulating regularly and had a fertile male pa... more

Loading ...

Dear Dr. Sher: A Healthy Baby Followed by Multiple Miscarriages

This is the second in a series of posts taken from questions that have been submitted to me via email, website, or discussion boards. This question is from a patient who had a healthy baby from her first pregnancy, but then went through a period of... more

Loading ...

Karmann and Ryan’s Journey – My Approach to Their Treatment

Loading ...

Why Did My IVF Fail? Part 2 – Uterine Receptivity and Transfer Technique

This is the second part of a two-part post on IVF failure. In my January 22nd post, I discussed what I often refer to as the “seed” variable in the “seed/soil” relationship – the embryo. This week’s post will address the “soil” variab... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #19: Why Do I Keep Having Chemical Pregnancies and Miscarrying?

This is the 19th in a series of answers to common questions about failed IVF. Early pregnancy loss – whether due to miscarriage or chemical pregnancy – is due to two major factors. In more than 70-80% of cases the cause is attributable to... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #18: My Fertility Clinic Reports a High Success Rate – How Could I Have 2 Failed Cycles In A Row?

This is no. 18 in a series of answers to common questions about failed IVF. While it is true that IVF failure can be due to preventable factors, it is as important to understand that optimal medical care does not always equate with an optimal outcome... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #17: Why Didn’t I Get Pregnant When I Used a Young Egg Donor and Had Good Quality Embryos?

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #16: Why did my hCG levels stop rising properly?

This is the 16th in a series of answers to common questions about failed IVF. Immediately following implantation, the root system (trophoblast) of the embryo begins to release the pregnancyhormone, human chorionic gonadotropin (hCG) into the surround... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #15: Might My Mental State Have Played a Role?

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #14: Could it Have Been Due to Inadequate Hormonal Support After the Egg Retrieval & Embryo Transfer?

This is the 14th in a series of answers to common questions about failed IVF. In vitro fertilization establishes an abnormal hormonal environment in the uterus.In some cases (especially older women and those with a diminished ovarian reserve), high o... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #13: Did the Number of Embryos I Had Transferred Play a Role?

This is the 13th in a series of answers to common questions about failed IVF. Virtually everyone recognizes that pregnancy with multiples (especially triplets or greater) is associated with a high incidence of premature delivery that has serious cons... more

Loading ...

My IVF Cycle Failed – What Went Wrong? Question #12: Might the Timing of Embryo Transfer – Day 2-3 (Cleaved) vs. Day 5-6 (Blastocyst) Play a Role?

This is the 12th in a series of answers to common questions about failed IVF. (Note: I’ll be hosting a live video chat on Aug. 2 on the topic of Failed IVF where I’ll discuss the issues addressed in this series of posts and take your ques... more

Loading ...