QuestionQUESTION: I stimulated with lupron, menopur and triggered with ovidrel. Had 11 follicles which turned out to be 2 cysts and 9 empty follicles at retrieval this saturday. I am 44 years old, have 4 children ages 20, 19,13, 9 and have had 4 miscarriages one being twins at age 40. Last miscarriage was aug. 2007, pregnant with IUI. My question is, since this attempt yielded no eggs at retrieval, should we attempt ivf again? No signs of menopause hormonally except have had a shortened follicular phase and spotting in luteal phase within the past year. All day 3 labs were better than doc expected for my age.
ANSWER: Hello Allison,
This cycle showed that your ovaries could be stimulated, however, one of the problems seen with advanced reproductive age is an increase in "empty follicles", just as you have experienced. Despite you successes in pregnancy in the past, and most recently, your chances are significantly reduced because of your age. The take home message is, if you want to have a genetic child, then you will have to keep trying with the hope that one of these cycles will yield a good egg and be successful. That chance, however, is pretty low. The other option would be to use Donor eggs, in which case your chances would be very high. My recommendation would be to pursue Donor eggs, unless you have the fortitude to endure multiple failures before being successful.
Sincerely,
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.
---------- FOLLOW-UP ----------
QUESTION: Just wondering if there is anything I can do or take to diminish the heavy period I have been warned to expect due to this failed attempt. my estrogen was very high at retrieval as I had 11 follicles that fell in line with my estrogen level.
AnswerHello again,
I'm sure you are on Progesterone, which should diminish the amount of flow. It can be increased to reduce the endometrial lining. The other option would be to use a birth control pill that is a progesterone only pill like "Micronor" to reduce the bleeding.
However, I would not necessarily expect you to have a real heavy period. Maybe more than usual but not super heavy.
Sincerely,
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.
