improving egg quality

[Sophie Baby Makes 3]

Hi

My Mhx includes endo (stage 3, laparoscopy check), female antisperm antibodies) and a bit of PCOS type 2.

I have had 6 completed ICSI cycles and 2 cancelled cycles (over stim prior to pick up AND eggs released prior discovered at pick up).

My Doctor gets me to do 5 day blastocyst then transfers.

With going to mild stimulation and I beleive diet changes (apparently I am sensitive to carbs) my egg numbers have dropped from 25 to 5, of course this means nothing does it when they still don't take. The closest think I have got to being pregnantwas a blighted ovum (exactly like that scene out of Marley and Me).

I am staring down the barrel of donor egg and it is not what I had imagined.

• I tried accupuncture then my FS said it was detimental. I think he means certain alternative therapies as the article he gave me did not say accupuncture specifically.
• I have heard of invitro maturation however my clinic doesn't do this.
• I have heard of screening eggs however my clinic doesn't do this and would it be of any use anyway, if it just meant they thought my eggs all looked dodgy?

What should I be asking my FS at my next appt?

Can someone explain please whether i should be focussing on reducing carbs, or just going Low GI?

Also how do I not know it is my lining that is the problem? Should progesterone be monitored? I have done the pessaries and the gel, and my clinic doesn't do the injection. If you have your period when it is due is that sufficient to say that it held together appropriately and it was the egg problem?

thanks

[butterfly_warrior]

Another one with PCOS here. I'd had two full cycles that ended up being freeze all due to OHSS and ended up with crap eggs all around.

When I did my third cycle, my FS got me to follow a very strict low-carb, low-GI, high protein diet... and we also were struck with low egg numbers, but apparently got better quality and my 14 month old son is the result.

Sorry I can't go for a longer reply, but I honestly believe that it's not just a matter of cutting carbs - make sure the carbs you do eat are low GI and make sure you're getting good quality protein as well. Made a huge difference for me.

BW

[Sophie Baby Makes 3]

Thanks BW!
My FS told me to use the Calorie King website. Actually I did make a suggestion in the clinics survey that Dietician support should come as part of the deal if this impact so significantly on the outcomes.

[butterfly_warrior]

It was my FS that made me do calorie king as well. He actually got my username and password and checked everything I'd done in the 4 weeks between appointments at one stage. He used slightly different dietary guidelines to what calorie king suggested for me, though.

I had a long list of "do not eat" foods, but after the first week or so it wasn't too bad. I'm not a person who does well with a diet that specifies what things to eat at which meal on what day, so being able to choose my own foods to fall within certain limits actually worked well for me, but I can see how some people would prefer the other kind of diet.

Have a bit more time to post a reply at this time of night...

With that third cycle, I still ended up on daily blood tests with the puregon injections. After spending a week in hospital with OHSS, I was pretty happy to do anything to avoid another case of it. I distinctly recall one Sunday - I'd had blood taken that morning, my levels were fine, but they dropped my puregon dose again and had me come back again on the Monday for more blood. I was tired, over it and generally craving some junk food - so I ate a hamburger and chips for lunch. My first and only slip up during the entire cycle. My results the following day were not so good and I very nearly got my E2 levels up high enough to need yet another freeze all cycle. That was the point where I was convinced! I still got OHSS again - but it was mild, and only set in with a positive pregnancy test.

One question - do you take metformin to help with the PCOS/insulin resistance? It's the insulin problem that mucks up the hormones and makes OHSS more likely (less insulin spikes means less likelihood of getting OHSS from sky-rocketing E2 levels) so it could quite possibly help a bit if you're not already taking it.

BW

[Sophie Baby Makes 3]

Thanks heaps for sharing!
Yes a big fat green and blacks chocolate bar the night before my final blood and ultrasound had my first cycle cancelled! There I was rewarding and comforting myself for my perfect cycle when I really just sabotaged it.

Can I hazzard a guess Dr David Knight might be your guy? If not at least it means others are doing this as well. The thing that had me confused was he told me off one day right in the beginning saying you eat to many carbs but really didn't explain why. I really don't understand the PCOS thing myself or if I have a subtype or if it runs or scale or what. Contrary to the usual type, I am very slim 168.5cm and 49kg, and not somebody who needs to lose weight - for the life of me i eat the same as my husband if not more and it won't budge. I understand it has something to do with insulin resistance and the impacting the hormones. And I do overstimulate easily and produce the immature eggs.

This is my final question as I am already trying to find a dietician to give me some ideas (I want a pick from list as well and to understand it a bit bettter).

I have been following the "eating plan" through my cycles, I don't religiously every day enter my into C/King - maybe a week at a time then a few day off and on again. I am trying not to get myself stressed if my % don't add up perfectly as it is hard to reverse it. Obviously I try to eat all the right things during cycle. The thing that confused me is you are told a % of protein, carbs, and fats you can have. Does every meal in the day need to be balanced this way? I have found myself cramming down cheese, silverside or say fruit in the night just to try and bring my % in to line. To me this seems like I am getting it wrong already even if I am going low GI .. and finally yes I know it is question number two..did you stick to the plan after transfer, how important is this?

BTW, I am not taking metformin. I'll ask about that at the next appt then.
Thanks again!

[butterfly_warrior]

Got it in one! But I seriously doubt I'd go back to him if we decide to try for number two (don't really like some of the things about the way the new clinic does things).

I'm a bit like you - not overweight and really don't have any of the usual physical signs of PCOS, but when I was sent to do a glucose tolerance test David just about fell out of his chair at my results. He usually only does the eating plan thing with people who are overweight but my insulin levels were so high that he made me do it as well. After transfer and through the early stages of pregnancy I still stuck to the plan as much as I could. It made sense to do so - PCOS can increase the chance of miscarriage and I'd already had three, so I still did what I could to keep the PCOS and my insulin levels under control.

I would balance what I ate over the whole day. Sometimes I would try to eat eggs for breakfast to lift my protein levels, but I'm very much a cereal girl so I would often have my usual cereal for breakfast and then have virtually no carbs for the rest of the day (apart from what you find in fruits and vegies - I would avoid bread, pasta, rice, potato, etc) and stick to things like meat and salads or stir fries with lots of vegies. I even managed to have pizza once without killing the entire day, and I wouldn't stress if one day was a bit high in carbs, as I'd often have others which were low so it would tend to balance out over a week. Except for during that last stim cycle - I was absolutely rigid with it and didn't allow any "carb borrowing" from one day to another. I did it from when I started lucrin right through until I was so ill with morning sickness that the constant need for a ginger nut biscuit to nibble on meant I really had no hope of keeping carbs under the limit.

But it does work. And I know David likes to tell you that and he'll often tell stories about different patients who got nowhere until they followed the plan... and sometimes it helps to actually be able to talk to one of those patients and find out that it is actually true.

One thing I do want to comment on - I was told that the only chance I had of getting pregnant was to use a frozen blastocyst and that I just had to get used to the hyperstimulation because that's what my body just liked to do. Well, I did a cycle without hyperstimulating - and thought all was lost when out of my 20 eggs only 12 were mature and of those only 3 fertilised. We didn't have enough embryos to grow to blastocyst so we transferred at day 3 (and I think this is one thing that his clinic no longer does)... so after being told my only hope was a frozen blast, I got pregnant and stayed pregnant with a fresh day 3.

BW