Friday, 11 October 2013

Why no eggs collected during IVF eggs retrieval process?

The number of eggs retrieved at egg collection can be predicted by the monitoring ultrasound scans, but very occasionally no eggs are collected from the fluid filled sacs in the ovaries (follicles), despite a satisfactory ultrasound appearance. Omission, delay or incomplete injection of the treatment that should be administered 36 hours before egg collection is sometimes responsible. Rarely, despite the injection, no eggs are collected. This is a poor prognostic sign that indicates a problem with poor egg quality and may prompt a discussion about using an egg donor to achieve pregnancy. When having IVF, most patients will grow a few follicles and the doctor will successfully retrieve eggs from most of these follicles.  However, sometimes no eggs are retrieved at the egg collection.   There are essentially five possible reasons as to why this may happen.

1.    The follicle may have ruptured (ovulated) prior to the egg collection. This may happen if the trigger injection is mistimed (i.e. given earlier than instructed); or if the egg collection is delayed beyond 37 hours of trigger injection administration. If the trigger timing is not correct or the egg collection procedure takes place 37 hours or more after the trigger injection is administered, there is a high chance that the follicles present on the ovaries can rupture.  This can result in the eggs being lost in the follicular fluid that is released from the ovary at the time of ovulation.

2.    The doctor may experience technical problems during the egg collection procedure. This may happen when the patient is very obese; or if there are adhesions (scar tissue) in the pelvic region.  Both obesity and scar tissue make it more difficult for the vaginal ultrasound probe to access your ovaries.  This can be a major problem if difficulties arise and the egg collection is not done under general anesthesia.  In these situations, it may be technically impossible for the doctor to access the ovaries to drain the follicles in search of eggs.

3.    Generally speaking the number of eggs expected from follicles seen on ultrasound scan is approximately 80-90%. It is important to remember that there will never be more than one egg per follicle. Unfortunately, when there are lower numbers of follicles, there is a higher chance that the egg is not collected in the follicle fluid.

4.    Another reason for the failure to retrieve eggs from mature follicles is due to empty follicle syndrome.

5.    Finally, another possible reason for no eggs being collected during the egg collection procedure is a patient may have low ovarian response.  This is more commonly seen in older women having IVF.  Apart from performing an Anti Mullerian Hormone test (AMH), there is no other way of predicting this in advance.

One in every three women is infertile but the causes of infertility vary. One of the most common causes is poor egg quality decreasing the chances of your eggs developing into a baby. You can still get pregnant but poor egg quality can make things more difficult. Thanks to modern technology, more and more options are becoming available to women who want to conceive.
Your eggs must respond to hormones in order for ovulation to start. Before your eggs can produce an embryo, they must be fertilized and cell divisions must begin. Internal issues such as production and chromosomal problems can prevent you from producing healthy embryos.

The older you get the lower quality eggs your body will produce. When you are in your 20s, or early 30s, you will have more good quality eggs than poor quality eggs. As you grow older these changes and the bad eggs outweigh the good eggs. Although you still have eggs left in your late 30s and early 40s, the chances of conception are more difficult, and the risk of miscarriage is higher. Other causes of poor egg qualities are:
·         Smoking
·         Cancer
·         Genetic Conditions
·         Health
·         Ovarian Surgery
·         Caffeine
·         Alcohol
·         Weight
Tests can be done to determine the quality and quantity of your eggs. Follicle-Stimulating Hormone (FSH) tests are completed to detect your levels of FSH. If they are low, specialists can prescribe fertility drugs (like Clomid) to increase your eggs’ quality. The ovarian reserve test reveals your remaining egg supply. Although males produce more sperm, females cannot produce more eggs. You are born with a specific number of eggs that does not increase over the years.

Do not be under the misconception that if you have a lot of eggs you will become pregnant. That is not always the case. Remember that the quality of your eggs is just as important as the quantity.

Age plays an important factor in the quality and quantity of your eggs but it is not always the deciding factor. For instance, a woman who is 25 can have poor quality eggs and a woman who is 45 can have good quality eggs. This is rare, but it is not impossible.

Do not let your menstrual cycle determine the quality of your eggs. Even though your menstrual cycle comes each month on time that does not necessarily mean you have high-quality eggs. It is also a myth that your eggs are only lost during ovulation. In fact, more of your eggs will be lost due to degeneration than ovulation.

Even though you have poor quality eggs, you are still able to get pregnant. There are also options available to you and your partner in the event that you do not get pregnant. One option is In Vitro Fertilization (IVF). During this procedure, your eggs are fertilized outside of your body before they are planted into your uterus. Alternatively, if your eggs are of poor quality, you can choose a donor who has a better quality of eggs, which can increase your chances of pregnancy.

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