Ask Our Doctors – Archive
Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.
I’m going through ivf and have two embryos that had trophectoderm cells tested by CooperGenomics and came back high level mosaic. I’m trying to decide if I should transfer them (my doctor’s recommendation) or if I should do a second round of ivf and hopefully get a normal embryo to proceed with. I’m 29, had two unexplained miscarriages at 26, and had a healthy baby born at 27.
The first embryo has impacted chromosome: del(8)(pter-p23.1). The second embryo has impacted chromosome: dup(6)(q22.31-qter) +20.
I’m trying to understand the likelihood of having a viable pregnancy with significant genetic abnormalities. I’d be fine with transferring embryos that have a binary result – where a normal could implant but abnormal would not implant or would miscarry early. I’m trying to avoid a situation where I end up at a 20 week ultrasound discovering significant abnormalities or having an amnio come back with inconclusive results.
Would you move forward transferring these embryos? Which would you prefer of the two? I won’t do them together as I definitely couldn’t handle twins.
Thank you!
I do not think that I can give you a definitive answer. However, i would transfer these two blastocysts and then do CVS/amniocentesis later in the pregnancy.
Geoff Sher
I am a 39 year old woman with good ovarian reserve but multiple RIF with one extraction ( 19 eggs and 9 blastocysts, no pregnancy; but no PGS done). I have been in touch with two Clinics to decide the protocol for the next extraction. The main difference between the two clinics seems to be whether or not to use the human growth harmone (HGH).
Clinic 1 is against use of HGH( Omnitrope) in extraction saying the use in older women is not proven well in the scientific literature. Clinic 1 wants to use low dose HcG with lupron and follistm.
Clinic 2 wants to use HGH.
My question: Does HGH have any benefit for older women with good ovarian reserve as part of the stimulation protocol? Does use of HGH have benefit on good egg quality?
Also my mom passed away few years ago from harmone receptive breast cancer? Does use of HGH increase cancer risk in women
Thanks
I do not think the use of HGH would increase the risk of Breast Cancer for you.
The answer to whether HGH definitely helps women with normal ovarian reserve. The answer is that “I don’t know that there is any concrete data available on this”.
Geoff Sher
Dear Dr Sher,
Thank you for your response. I understand what you say about a medicated cycle being able to control hormones, etc better, but I am trying to wrap my head around the fact that my ovary still recruited a follicle despite taking all of my estrogen doses, as prescribed. My cycles over the last four years have varied between 23 and 29 days. Is it possible that I didn’t start taking the estrogen early enough? How early do ovaries begin recruiting follicles? Does it occur before menstruation?
Also, I don’t know your opinion on BBT, but I noticed that my temperatures were much lower while taking estrogen and that my temperatures decreased several days before my period came when I was on estrogen and it seemed to delay the start of my period. My BBT pattern usually shows a decrease in temperature only for one or two days max before my period comes (it has been very helpful for anticipating the start of my period since I have a bit of variation in my cycle length). What do you think?
I appreciate your input. Thanks!
Whitney
In my opinion, the taking of estrogen makes it very unlikely that you would conceive in that cycle.
Geoff Sher
Dear Dr.Sher.
Following my question about estrogen priming. Does estrogen priming can be performed at exactly the same time with agonist down regulation ( Synarel), a week before expected period ? Or estrogen priming should start after downregulation completed?
Thank you
In my opinion….after down-regulation is completed.
Geoff Sher
Dr. Sher,
Soon, my pgs normal embryo should get implanted. I am wondering what must be done in advance? (which tests, which vitamins, which drugs)?
Thanks, Selin
That is a very broad question and definitely something you need tom discuss with your treating RE.
Good luck and G-d bless!
Geoff Sher