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Welcome to IVF Authority - World Renowned Resource for IVF Information
Micro IVF – An Affordable and Successful Alternative to IUI
Dr. Geoffrey Sher Recommends
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Phone:
702-892-9696
Fax:
702-892-9666
702-892-9696
Fax:
702-892-9666
There has been a lot of buzz in the media lately about what is known as “Mini IVF“. Some practices have even made these cycles the mainstay of their business. On the surface, an IVF cycle for around $6,000 is very appealing. But let’s focus for a minute on the cost of a baby rather than just the cost of an IVF cycle. In an effort to keep the cost low, these “mini-IVF” cycles are generally performed using oral medications such as Clomid, rather than expensive (but more effective) injectable fertility agents (gonadotropins). As a result, they typically produce birth rates per cycle of at best 15-20% per attempt.
We recently introduced an IVF package that we call Micro IVF which differs from “Minimal Stimulation IVF” in that it involves the use of injectable gonadotropins which are far more effective than Clomid. Micro-IVF represents a scaled-down IVF treatment cycle that includes all the fundamental steps of the IVF process. When used in younger women (under 36 years) and in the absence of male infertility, it is likely to yield better than a 30% birth rate success rate per IVF cycle. This is about twice as effective as “Mini-IVF” and about three times as successful as a cycle of intrauterine insemination (IUI). Again, when viewed in terms of the cost of a baby rather than the cost of treatment, “Micro-IVF” becomes a much more efficient approach.
In reality, Micro-IVF was devised to serve women who otherwise might be regarded as candidates for IUI treatments. At a cost of $6,250,which includes monitoring, egg retrieval, embryo transfer and embryo freezing/banking but excludes medications, this is only slightly more than an IUI cycle using injectable gonadotropins.
Few people recognize that IUI is relatively unsuccessful in women over 35 (and it gets progressively worse after age 40). This is also the case with moderate to severe male infertility, endometriosis (regardless of its severity), and in women (of any age) who have diminished ovarian reserve. In all such cases IVF is far more likely to succeed.
67 Responses to “Micro IVF – An Affordable and Successful Alternative to IUI”
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Dr. Geoffrey Sher Recommends
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Dr. Geoffrey Sher Recommends
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Ask Our DoctorsA Question
Just wondering how Micro IVF can be so much less expensive than regular IVF – especially with injectable medications. Are there differences that aren’t mentioned here?
See elsewhere…to you!
Thanks for the questions.
Geoff Sher
Micro-IVF is indeed regular IVF but very simplified. Unlike regular IVF we reserve eligibility for Micro IVF to non-male cases and younger women who do not need ICSI. Candidates are under 36Y and must be regularly menstruating ovulating women who have a normal FSH/AMH/AFC etc) and will be normal responders (PCOS type women who are at risk of OHSS and may need coasting, are excluded ). Micro-IVF candidates will not require supplementary treatments. By hormonally deferring CD1 we can insure that all hands-on reatments are almost always done on weekdays and so Micro-IVF is not time or human resource intensive. We have no qualms about achieving an adequate stimulation response in these predictably normal responders.
Hope that answers the question!
Why are you against using Clomid in Micro-IVF? I know some programs use Clomid alone in Mini IVF or use it in combination with injectable medications.
In my 30 years of experience I can tell you that any use of clomid (alone or in combination with gonadotropins) in IVF, is relatively disadvantageous. It has been known since the 80′s and early 90′s when clomid alone and in combination was used alot….that the results were poorer, probably due to an adverse influence on egg quality. Thus clomid alone or in combination with gonadotropins was supplanted by gonadotropins only. I am convinced that using clomiphene alone or with gonadotropins is a retro-step and as such we do not advocate its use in IVF.
The only clear motivation of using clomid is to cut costs. In my opinion this is not a good enough reason to do so given the reduced success rates when used in IVF.
In response to the question about about IVF being simplified, the question as to why it’s cheaper isn’t really answered. How would the IVF be any less involved that a 41 year old with 1 egg who went to retrieval on Monday? This begs the question, why isn’t IVF cheaper for low responders. The medications are different but the service provided would not be. Also would 5 more eggs make that much more work if there was nothing to freeze at the end?
Similar to any field of commercial endeavor, providers package services differently, as an incentive.This is what micro-IVF is about.
As with the SIRM First-Responder Program which significantly discounts our services to Teachers/military/Nurses/Fire-fighters/Police, Micro-IVF simply discounts services to another specific group of individuals……those who otherwise would require IUI but for whom IVF although not mandated will provides a 3 times greater chance of success with very little (other than the addition of ER and ET) to what otherwise would be provided through IUI (using injectables). The Micro-IVF patient will by and large require less intensive scrutiny, less medications and in the absence of male or egg factors ICSI will not be mandated. Also a single micro-IVF attempt is several times morte likely than IUI to give a positive pregnancy test. Simply stated, it is far less hassle , being easier to conduct, oversee and manage.
Best wishes,
Geoff Sher
These are philosophical questions that we could discuss when/if we were to talk.I have however addressed some of these issues elsewhere.
Geoff Sher
Lets take your 41 year poor responder (1 egg produced)as an example. This woman would require a much higher protocol of stimulation, she would probably take much longer to stimulate needing more monitoring, including repeated blood tests, her age would be a medical indication for ICSI, (which alone adds more than 2,000 dollars to the cost of IVF etc.
If such a woman were to use the protocol we comfortably use with Micro-IVF in a well defined category of young, low-risk patients, her chances of success would be much diminished.
As for the 2nd example (the 5 egg woman), the decision to do Micro-IVF is made in advance of treatment. Of course there will be some women who start off as eligible for Micro-IVF but later will through their response be found to need additional services. If that happens,they would have to convert to “fee for services rendered”. Since we do not wish to lure unsuspecting couples into IVF on the basis of a “false promise”, we have elected not to include categories of patients who are at risk of having treatment changed midway.
Also remember, as with all package plans, we are deliberately discounting our services with Micro-IVF in order to make it more affordable and offer it as an alternative to lesser treatments such as IUI where couples would pay almost the same, and have one third the chance of success per treatment.
What other limitations are put on the micro-IVF? Can you have gone through IVF before? Using injectibles, what number of eggs are considered within range before the “fee for service” is added on? Can micro-IVF be used in combination with IVIg/Intralipids for immune issues? And, finally, is it continued on the same IVF schedule start dates within in the clinics? Thank you for always offering choices for your patients.
Yes…IL/steroids/Lovenox etc can be added to micro-IVF and we do operate under the same calendar start dates.
Geoff Sher
1.Yes, the number of prior IVF’s is not a factor.
2.I expect aan aveage of 4-10 eggs per case.
3. Yes, Yiou ca use Intralipid with micro-IVF. We do not recommend IVIG any longer. Intralipid has supplanted IVIG.
4. Yes, Micro-IVF is done in the regular SIRM cycle batches.
Geoff Sher
If almost all the procedures between a normal IVF and the micro IVF are same, why is it not possible to do an ICSI with micro IVF? I understand that it would be $2500 more. But is it not more advantageous?
Also if some people have coverage for medications in their insurance, is it possible to increase their medications to simulate more eggs in a micro IVF? (almost to the same levels of normal IVF)
Thank you for your continued support to the community, and for your patient responses
There is no getting around the fact that Micro-IVF is an intentionally discounted service that addresses the difficult economic times. In providing Micro-IVF we needed to avoid 2 things: 1) having to perform unanticipated additional services and therefore make Micro-IVF unaffordable for us to provide and, 2) we did not want there to be additional add on costs that might lead some to criticize it for being a “switch and bait” situation.
The manner in which the Micro-IVF package is offered was our decision to make and we decided that it would address younger women who were likely to be straight forward, uncomplicated IVF cases.
Most Micro-IVF candidates might otherwise be considered to be ideal candidates for IUI. This was intentional because there can be little doubt that Micro IVF would be much more successful than IUI , and that at a comprehensive cost of $4950 per treatment.. is price very competitive with gonadotropin IUI(especially when one considers per baby).
Geoff Sher
Dr. Sher,
Do you think I would be a candidate for Micro-IVF? I am 32 years old, have given birth to 2 children already – the youngest is 11 years old. I would like to have another child but was diagnosed with Stage IV endo a few years ago. Since then I’ve had surgery to have the endo removed – both my tubes are opened according to my last two HSGs. I’ve undergone 1 IUI cycle with clomid which was unsuccessful. Do you think I have a chance with Micro-IVF?
It certainly sounds as if you would be a candidate for Micro-IVF, provided that you are a normal responder with normal ovarian reserve (Highest cycle day 3-FSH of less than 9.0MIU/ml in assocuiation with a blood estradiol level of under 70pg/ml).
Geoff Sher
Dr. Sher,
I, too, would like to know if you think I would be a good candidate for Micro-IVF. I am 31 years old and have a 16 month old boy. We did two IUIs before we conceived him (100 mg Clomid). Now that we’ve began trying again I am not having as much luck. I recently had a laparoscopy (they thought I had a blocked left tube via HSG) but turns out that everything looked good (no endo and no blocked tubes). I found out today that I’m not pregnant, and this was our 7th IUI since trying to conceive #2. I am currently on 200 mg Clomid CD 3-7 and Repronex/hcG (generic brand?) CD 5-11 (although this month I had to keep taking the shots all the way through CD 17!). My husband’s counts are fine. They said his total motile was 58 million, and he’s had uppwards of 350 million in the past. Please let me know if there is something out there for me! I desperately want my son to have a sibling since I hated being an only child. Thanks so much!
Indeed…you might be an ideal candidate for IUI.
Give us a call and perhaps Skype with me to discuss (800-780-7437).
Geoff Sher
Yes Indeed, on the face of it is sounds as if you also would be a candidate for Micro-IVF.
Geoff Sher
I am 31 years old and have in the past for all 3 IUIs and 1 IVF been a good responder. Only the IVF was successful in the past. I feel that I would be a good candidate for Micro-IVF though the problem is that my husband's counts are very low so we needed ICSI in order to have a successful IVF. In light of this need for ICSI does this rule out Micro-IVF for us?
Unfortunatel the presence of any degree of Male Factor Infertility precludes paricipation in Micro-IVF.
Sorry!
Geoff Sher
Dr. Sher,
As long as a womans FSH is less than 9, can she still participate in Micro-IVF?
I will be 38 soon, FSH is 7.2 and normal estrogen, I had 2 normal PG 5 & 7 years ago, but now I've had 4 unsuccessful clomid IUI's trying to get pg again. (this makes me upset now after reading your piece about how clomid should not be given to women over 35!!! agh!)
Other than my age, I think both me and my husband are very fertile. thank you
Unfortunately criteria for acceptance at SIRM for Micro-IVF exclude women of 36 years of age or older.
This having been said, I agree that you are a candidate for IVF with a good chance of success provide you do not delay too long in getting the treatment.
Good luck!
Geoff Sher
After testing to ensure fertility for both my husband and myself, our only issue is that I had tubal ligation in 2001 after my 3rd successful pregnancy. Would this make us a good match for Micro-IVF?
How do somewhat irregular menstral cycles affect this procedure? (mine vary from 28-40 days and maybe once a year 60+ days)
How many embryos are transferred during a Micro-IVF cycle? My husband and I would really like twins but don't want to transfer over 2 embryos.
If you are under 36Y of age and your husband is fertile, you probably would qualify and your sligjhtly irregular periods shoul not necessarily be a factor.
You could go to www,haveababy.com and set up a free medical; consultation to discuss further.
Geoff Sher
I am 29 years old and my husband and I have male factor infertility. We are on our 3rd try of doing IUI's and I am wondering if Micro-IVF would be a possibility. Because of my husbands condition we would be using donor sperm. So, is micro-ivf possible with donor sperm?
Thank you
Indeed you would be.
Geoff Sher
I am 33 years old and had both tubes removed due to ectopics. My FSH is 6.5, no male factor, and have not yet tried any ivf treatments. My cycles are always 30 days long. However, I have polycystic appearing ovaries (but not PCOS). Would I be a good candidate for micro? Thank you for offering this new treatment!
Indeed you likely would!
If you wish, you can set up a free telephone consultation to discuss this. Just go to the top of this page and click on the applicable link.
Geoff Sher
I noticed that sirm says that pcos patients are not good candidates for micro-ivf. Since they are high responders, why wouldn't lower doses of meds be the ideal protocol for them?
PCOS women need much more intensive management than is available through our Micro-IVF program. This includes: a)the fact that PCOS women are the ones who are the most susceptible (of all IVF candidates) to develop severe ovarian hyperstimulation syndrome (OHSS), a life endangering condition. The avoidance and/or treatment of OHSS requires a degree of intensive, skilled management that is outside the scope of what is provided through Micro-IVF (see the article on PCOS and "Prolonged coasting" elsewhere on this blog), b) there is usually ba need for ICSI (an expensive and high tech fertilization procedure) because of a thickening of the egg's envelopment (zona pellucida), c) the same zonal thickening often also requires making a rent in the embryo's envelopment (assisted hatching) prior to embryo transfer… to try and improve the chance of successful implantation and, c) compromized egg quality (egg "incompetence" , probably due to an increased incidence of chromosomal issues (aneuploidy)is much more common than in non-PCOS women of the same age. This can only be addressed through the strict neticulous and intensive implementation of highly customized ovarian stimulation protocols….etc
What all this translates into is that PCOS patients can hardly be considered straight forward…and thus by our criteria, are ineligible for "watered down" IVF as constitutes "Micro-IVF".
Geoff Sher
Dr. Sher,
Can you address how many shots needed to be used for Micro IVF such as how many shots per day and for how many days or per cycle?
With Mini IVF, there are only oral meds and about 3 shots all together per cycle?
I'm trying to avoid shots.
Thanks
Trying to compare oral meds ("mini-IVF) with well structured low dosage injectible gonadotropins (Micro-IVF) is like comparing apples with oranges. With oral meds the success rate is 2-3 times lower than with injectibles.
This having been said, the stim with "Micro-IVF" usually involves about 8-10 days of daily low-dosage gonadotropin injections.
Geoff Sher
Dr. Sher,
With the Mini IVF, there are only 3 – 4 shots per cycle according to one clinic in NY (posted on their website). How many shots are there for the Micro IVF per cycle at SIRM?
Yes, I understand that Mini IVF has lower rate than Micro IVF. However, I'm fear of needles.
Thank you.
About 7-9 shots with gonadotropins.
Geoff Sher
Dr. Sher-
I had a tubal ligation in 2002 my kids are 7 and 9. I am 29 years and now remarried for 2 years. My husband is 26 and no kids. We are both healthy, no smoking, no drinking, not overweight, my periods are regular and like clock work. Paps are normal. We were looking into tubal reversal, then IVF…now we find Micro IVF- we are really thinking this is the right way for us to go-presuming all our tests look good. What tests should I ask my PCP to order so I can ensure we are candidates for this. WE have the money, We have the time- we just need the right place, the right dr. and a definant answer if we are candidates for this. What fertility medications are required for this procedure and where we purchase these? Also- how many transfers can we do per cycle? We to do at last two to make sure one takes. Thanks and we are excited to have found this procedure!
You certainly sound like an ideal candidate for Micro-IVF. Why don't you go to the top of this page and set up a free medical telephone consultation so we can discuss.
Geoff Sher
I am 26yrs old. I lost both tubes due to ectopics. I currently have uterine polyps and haven't had them removed yet. I am concerned that removing them may cause additional scar tissue that would prevent a successful treatment. I have no male factor. Am I a good canidate? If so how long does the overall procedure take for those traveling from out of town? Thanks
Hi Dr. Sher,
I am only 27, have normal FSH levels, and we have 3 babies (triplets) conceived through IVF/ICSI. My husband's counts require ICSI. My question is about ICSI and its effect on micro-IVF process. I don't want a high stim protocol. We were lucky on IVF #1, and I don't want excess embryos, so I'd rather get fewer eggs, a lower chance for OHSS, etc…All my husband has to do is provide sperm on the day of transfer. (When he has last time, after spinning, everyone remarked at how good the morphology and motility was, so the embryologist didn't spend much time at all performing ICSI). I understand that ICSI takes time for the embryologists, but in terms of the monitoring needed over the cycle, it requires no extra work from the RE. We only have a transportation issue (i.e. not enough sperm to get to the eggs), so ICSI is really the major cure for our situation. I'm pretty sure I am an easy patient to monitor, but it we just require that extra step at transfer due to MF. I'm not quite sure why MF infertility is excluded from micro-IVF as younger women with no fertility issues would be the ideal candidates. Thanks!
Unfortunately the existence of MF is an exclusionary criterion for Micro-IVF at SIRM.
Perhaps if you call 800-780-7437 and set up a free telephone consultation we can discuss what we do have available and how I could best address your other concerns.
Happy Holidays!
Geoff Sher
Dear Sher,
I m 33 yr old . i have 3yrs old son. now we are trying for baby since last 6 months.my husband's motility is low n one of my tube is slightly blocked. what are my chances of conceiving naturally n do i perfect for Micro ivf
Thanx
At present your situation cannot as yet be defined as "infertility". You need at least 1 year of trying first. Then, since you have conceived in the past, if no pregnancy occurs you would be categorized as "secondary" infertility and a specific work-up would be needed. Depending on the ensuing findings and the the cause of the problem, treatment would be advocated. If so, should IVF be indicated then based upon your history,it is quite likely that you would qualify for Micro-IVF.
Happy New Year!
Geoff Sher
Dear sher,
Thanx for ur advice. but my husband's sperm motility is 29,n morphology is 80 . do i still have good chances of get pregnant naturally? what are my chances for conceiving.
thanx
That is good , but there is a lot more that needs to be assessed . Read my new blog that will be posted today on "unexplained Infertility".
Geoff Sher
Hi Dr Sher
I am 31 yrs old, i have lost my left tude due to ectopic and right side is block. i wanted to know if i was a candidate for micro-ivf? I have 3 children and no infertility problems. i had 2 of my children before my tubes were block.
You sound like an IDEAL CANDIDATE for Micro-IVF. Feel free to call my office at 800-780-7437 so we can talk.
Geoff Sher
I am 34 years old. I had my last infertility treatment in 2006, in which my ex husband and I underwent 4 treatments of Iui without success. We were diagnosed as "unexplained infertility, Pcos varient, and male factor infertility." As far as my infertility, all of my labwork was normal, hysterosalpingogram normal, but I had polycystic appearing ovaries. Would I be a possible candidate for micro IVF? Also, I take seasonique for birth control. Will that affect my chances after I get off of it? How long does that take?
Since you are <36Y and if you have have regular periods and have "unexplained infertility" then you probably are an ideal candidate for Micro-IVF.
Call 800-780-7437 and set up a phone consultation if you wish to discuss.
Geoff Sher
P.S. Please read my article on this bog pertaining to "unexplained Infertility".
I am 35 years old, a non-smoker,
120 pounds. I have a history of severe endometriosis and cysts and fibroids.
I had laparotomy to have it all removed 1 1/2 years ago. I conceived naturally 5 cycles after the surgery healing period, but I had an early miscarriage at 5 1/2 weeks. That was one year ago almost, and I have been trying to conceive since then with no luck. I have regular cycles (approximately 26/27-day cycles) and ovulate on my own every cycle
approximately day 12/13. I have a few days of spotting prior to onset of my periods.
I tried 4 cycles of Clomid this past fall to see whether it would help. I had 5 follicles develop one cycle on just 50 mg of Clomid, and my Dr. reduced my dose to 25 mg for the remaining 3 cycles. I didn't conceive,though. During that time, I did one unsuccessful IUI. My RE strongly recommends I move to IVF now and mentioned she would put me at the higher dose of drugs due to my having endo, which confuses me given my response to the small dose of Clomid.
My lining is good, my progesterone is always good, and as far as I know all other blood work I've had has been normal. I've not had ovarian reserve testing yet, though.
I should mention that since my surgery, my right ovary is apparently stuck behind my uterus. My current RE did not seem to think that would cause a problem for egg retrieval, though a previous RE I saw wasn't sure.
Would I be a good candidate for Micro-IVF? I'll be 36 in August, so would need to move on it relatively soon…
Thanks!
I forgot to mention that my husband's sperm count/motility was excellent.
No! You would likely be better off with conventional IVF since you are probably a poor responder who would need aggressive stimulation and monitoring.
Geoff Sher
Why would I probably be a poor responder? I ovulate on my own and responded extremely well to stimulation with Clomid. I don't understand.
Just curious why women over 35 but under 40 excluded? At 38, my FSH, estradiol & AFC are the exact same as they were at 33. Thanks in advance…
Egg quality declines after 35 and there is an increased likelihood of diminished ovarian reserve. Both require more intensive stimulation, monitoring and often ICSI.
Geoff Sher
We attended the seminar last night in Touro University and would like to thank you and Dr. Fisch for sharing very informative information for free.
I am 41 and my husband is 35 and we never had any test done on infertility. We’ve been married for almost 5 years now. I am working in Caliornia since we got married so technically we only see each other on a weekly basis. I asked my OB/GYN why I cannot get pregnant since we don’t use any contraceptives and she told me that it’s a timing issue since we don’t see each other everyday.
What if we are eligibile for Micro-IVF after all the tests; can you still recommend it despite of my age and/or can you still give it to us if Micro-IVF is our choice?
Hi Dr. Sher,
I am 27yr old. I have complex ovarian cysts in my both ovaries (left is small cysts 3cm and right is big 5.5cm). I have endometriosis but not critical. I have unwanted hair growth in my body which may indicate PCOS. But never proved as I have PCOS. My Hormone levels are not perfect. My period is irregular. Before I took Clomid 100mg X 3months. It increased the size of my right ovarian cyst 7cm from 5cm. Now again it is 5.5cm after Provera10mg. No pregnancy so far. As my age is 27 and few follicles have been found in my both ovaries recently, can I be successful with MICRO IVF (I have no insurance coverage for IVF). Please advise as I want to get treatment as soon as possible.
hi, i am 34 and had a tubal reversal in nov of 09, with only left tube repaired at 4 cm. I've been pregnant twice in 2010 and both ended in early mc. I'm now taking prometrium 400mg a day 2 days after ov. I came across this micro ivf and and very interested, I am emotionally burnt out taking this hormone not even knowing if my fixed side is releasing. I also have 2 healthy sons which I conceived naturally prior to the ligation. would this be a good option for me?
I had never heard of micro ivf before and I want to know if I would be a good candidate. I am 25 years old, been trying for 3 years. I was diagnosed with pcos, have tried clomid and 3 fsh iui cycles with successful ovulation but no pregnancy. Had a laparoscopy and hysteroscopy and tube
Check and all was fine. My current dr. (at the care clinic) Said she didn’t think I should do ivf because based on what I have I shouldn’t need it, but I am really tired of unsuccessful treatments and no baby’
You could be a candidate. Call 800-780-7437 and set up a free video-conference call with me to discuss your case in detail.
Geoff Sher
Hello, Is there a minimum sperm count that is required to be a candidate for micro IVF? Thank you.
We require a count of >20 million per ml and a motility of >50%
Geoff Sher
702-892-9696
Hello Dr. Scher
Thank you for answering all of our questions!
A little backgroud on me.
I am 35yrs old, amh .56, normal estrogen but no fsh testing done
7 conceptions, 1 live birth, 1×8 week loss and 5x chemical pregnancies (natural, iui, & ivf)
Basically everytime I try to get pregnant I conceive only to lose the pregnancy due to “poor egg quaity”
IVF- Retrieved 6, 1 immature, 4 fertilized, transfer 2×8 cell 3dt, froze 1 blastocyst Miscarriage #6
Is there something wrong other then my eggs??? No one person should conceive this often! uggggg
And would Micro-IVF be an option for me
Thanks!
AJ
You need to consider the possibility that the early losses could be due to an implantation dysfunction. The fact that you had a live birth makes autoimmune implantation dysfunction unlikely but it does not exclude an alloimmune cause or an anatomical (lining) issue. Please go to the home page on this blog (www.IVFauthority.com) then find the “search bar” in the right hand column. Type in the following subjects into the bar and it will take you to all the relevant articles I posted there.
“Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
“Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
“Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
“IVF success: Factors that influence outcome”
“An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
“Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
“Agonist/Antagonist Conversion Protocol”
You might consider calling 800-780-7437 or 702-699-7437 to arrange a telephone or Skype consultation (free of charge to those who reside in the United States or Canada), so we can discuss your situation in detail. While an audiovisual (Skype) interaction is much more personable and preferable than a discussion by telephone, either will suffice.
Geoff Sher
Hi Dr Sher
I tried to find the previous post but I couldn’t. My background – i am 32 years old, had a regular cycle (until the ivf saga started), all blood work ok, laparascopy, HSG all seemed normal. We had 6 IVFs in total. 4 with my husband’s sperm until we changed RE’s & country with the last IVF where we could try to get to day 5 blastocysts. The first 3 IVF were done in the home country where IVF is still a taboo subject where freezing and injecting all retrieved eggs is not possible. The 4th cycle we did PGD with all non-viable embryos where we found deragments in a number of chromosomes. We then opted for donor sperm with IVF cycle #5 and #6. Husband had a hernia operation when he was a toddler and in a nutshell the operation was botched in such a way that we needed to have TESE on IVF1 till IVF 4. Back to IVF #5 and #6. We used donor with suprefact for down regulation and Merional 375. We had good embryos, some with slow progession but each time we transferred 3 very good grade embryos with little or no fragmentation. IVF#6 we could freeze the 3 frozen embryos which the RE was 99% certain that these were not viable as it their rate of progression was not normal. we decided to do CGH on these 3 frozen embryos with the hope of some answers. in the meantime we were already thinking of donor eggs thinking that my eggs for some reason are not of good quality considering the slow and erratic progression of the embryos which happened on both ivc #5 and IVF #6, surprise surprise.. the results came out and all 3 were chromosomal fine! The RE is advising on a low stimulation cycle next time. On the basis that during the last IVF, I had OHSS which was managed by dostinex, but had also an element of ovarian torsion ( was in great pain for a day or two). Do you think considering my background micro-ivf is a good idea? Are Merional and suprefact the correct medication?
Looking forward to your very helpful insight
many thanks
hopeful
When a woman of your age has as many ET’s as you have had (even with chromosomally normal blastocysts) and still has failed to achieve a viable pregnancy, it strongly points to an implantation dysfunction (anatomical or immunologic).Please go to the home page of this blog, (www.IVFauthority.com). When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
2. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
3. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
4.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
5. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a telephone or Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.
Geoff Sher
Hi I am 33 year old.when I was 26 I gave birth to a boy. After that I was pregnant for 2 times,but I aborted as my son was very young. My husband forced me for tubal ligation . I have mild pco. However my hormones, blood tests are fine. I am 136 lbs and my height is 5.4 my hubby has no male problems. He is 33. I did ultrasound and my ovaries has 20 follicles each side . Can I be a candidate for micro ivf? Otherwise how about tubal reversal ? Thank you in advance
Absolutely you can. Do not do a reversal…I suggest you go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Previous tubal ligation”
4. “Micro-IVF”
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher