Questionhello, i am 28 years old and have gone through 7 unsuccessful rounds (1 miscarriage) of fertility treatment and now have to resort to ivf. my pcos sympotoms are elevated androgens and irregular periods but no insulin/weight issues.
my clinic tells me that the success rates for ivf are 40-50% for under 35's however i have been told many different figures. i need puragon 75 to to get any follicles to grow but they havent gone any higher as i have 60+ small follicles there each month and they are scared of over stimulating me. what is your opinion of my chances with ivf? also does having pcos bring my success rate down?
AnswerHello Krystal from Australia,
Pregnancy rates with IVF are very dependent on the clinic that you attend. In women under the age of 35, PR can range from 45% to 79% (it is 79% in my clinic in 2010).
PCOS can certainly affect your chances of pregnancy but IVF is the best treatment. The difficulty is the stimulation because PCOS ovaries tend to be very very sensitive to the fertility medication and OHSS is certainly a risk. PCOS patients need to be cared for very carefully and watched closely. There is no reason you can't use more than 75IU of medications. There are specific protocols that have been developed for PCOS patients. You should ask your doctors if they use a different protocol for PCOS that their regular patients. As an example, I use a low-slow (starting from the lowest dose of FSH and increasing slowly) with the antagonist Ganerelix protocol with a Lupron trigger instead of HCG. If needed, I will also use drifting/coasting if there are more than 30 follicles and the Estradiol level reaches 4000 before the follicles are ready to harvest. With this protocol I have been able to not have any OHSS for the past 10+ years with my PCOS patients. There are other protocols out there as well. You certainly want a doctor that is well experienced in this area.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
