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Improved Success in Women Over 38, and Repeat IVF Failure Using Co-culture

July 10, 2007 - Tuesday
5:38 PM to (EST)
Guest Speakers: David Kreiner, M.D.
East Coast Fertility

Categories
Acupuncture • Endometriosis • IUI • IVF • Pregnancy • Pregnancy Loss


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Corey_Whelan Hi everyone and welcome to tonight's chat. Our scheduled speaker is Dr. David Kreiner of East Coast Fertility. He will be discussing egg quality and maternal age and their link.
Corey_Whelan I'm Corey Whelan, The AFA's Director of Development and your chat moderator tonight. Dr. Kreiner should be here shortly.
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Corey_Whelan Sorry he seems to be delayed folks. Hang in there please
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Corey_Whelan Welcome Dr. Kreiner! Folks, please feel free to ask your questions of Dr. Kreiner
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ghelweh are you aware of any 45 year old women having a baby using her own eggs? That's my situation and we have IVF planned for next month
cjm Is there any way to test your egg "quality"? I've already had my FSH tested and it's pretty good, but I've had 2 miscarriages in a row.
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JADE0199 Hi I've also had 3 early m/c's and a chemical pg. I will be 37 in August
Dr._Kreiner I have had 45 yr olds have babies through IVF but they are a great challenge with much greater odds against them. Best of luck
irene Hello Dr can you please explain CO CULTURE
Dr._Kreiner Egg quality can be assessed indirectly by microscopic inspection and PGD. But as they say the proof is in the eating of the pudding. You really dont know unless you see outcomes with IVF. You cannot assess directly.
JADE0199 After everything I have read and learned, mainly from my own experience, FSH does not indicate the quality of a woman's eggs, possibly only reserve. Is this true?
Dr._Kreiner Jade. That is incredibly bad luck so it is worth investigating a medical reason for this
alp Hello Dr. Kreiner, I am 45 yrs old and got pregnant three mos. ago spontaneously but had a miscarriage six weeks after conception. Two questions: is the miscarriage likely due to poor egg quality AND what is the probability of having other healthy eggs for future pregnancies?
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mara hi
mcox Dr. Kreiner, I'm 43 and recently completed my 4th IUI. In the most recent cycle, there were 2 follicles of 20, and I was told that I had the progesterone of a 20-year old. I'm meeting with the doc next week to discuss other methods as I have 2 vials of sperm remaining. I gave birth to a very healthy baby at 41 in 2005. Any suggestions?
Dr._Kreiner FSH is a marker for the number of eggs not quality. In 1985 Dr. Georgeanna Jones told me to look at early follicular phase FSH to get an idea of ovarian reserve. This is the value of FSH
Corey_Whelan Let's let Dr. Kreiner catch up, please. Hold your questions till Jade and alp have their answered.
kidake I'm having IVF this month and also elected to have the PGD. Are you saying they'll be able to give me details about my egg quality?
JADE0199 Had a full fertility workup with RE in Oct 06. Just did my first IVF w/PGD in May. Cancelled PGD on day 2 b/c only had 4 embryo's by Day2 that were only 2 cell. Total # of eggs retr'vd 9, 7 fert- 3 had 3 pronuclei and 4 appear normal. We transferred 2 embies, 1-7 Grade 2 and 1-5 cell grade 1. Ended in a Negative.
Dr._Kreiner At 43 I would be aggressive with IVF. Time is running. We are doing well with coculture and embryo glue in this group
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Dr._Kreiner im doing ok i think corey
AmandaUNCC can you please explain what co culture is
Corey_Whelan I think so too!
ghelweh is there anything additional beside typical IVF procedures you would recommend for a 45 year old to do?
Dr._Kreiner no. kidake. PGD will reveal 60% of chromosomal abnormalities. It may be useful if you have a lot of embyros with regard to saying something about your eggs in general. Otherwise, not very much
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jackjoe Dr Kreiner have you seen women with FSH 14 to 16 have success with IVF. I am 36 years old.
mara doctor i did i am 34 my FSH is 9 6 antral follicle i did one IVF but 10 follicle appeared then only 3mature and 8 eggs retrived only 2 ebrios on day 5 was transfered. it was not success. what can i do to make it more success this time does it mean i have poor egg and my time for getting pg is diminishing? i wanted to do assisted hatching does it improve the chances?
mara thank you
Dr._Kreiner jade, some people get pregnant from those transfers. you have potential. cant say any more about that.
dc Is age the sole factor in egg quality? Is it possible to be in your early 30s and have poor egg quality?
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JADE0199 With all of that said, we are moving onto Donor Egg now.
Dr._Kreiner amand coculture is growing a different cell line in conjunction with your embryos. We use the granulosa cells obtained at retrieval
AmandaUNCC dc. I'm 28 and have poor egg quality
Dr._Kreiner thanks corey
mara i took 400 puregone for 12 days was it a ling protocol and bad one? can i change it
JADE0199 Just wondering if you agreed that I may have poor egg quality?
irene Can you please explain CO CULTURE
rogpic Can poor egg quality be enhanced with the right med protocol? Is metformin helpful? I am 34, have had recurrent miscarriages and 1 success with PGD, but am now being told that my chances are slim due to poor egg quality.
Dr._Kreiner ghelweh sometimes IUI works as well as IVF in 45 yo. sometimes its just time to try DE
AmandaUNCC so what are the benefits to co culture?
cjm I'll be 38 in Nov. I've already a recurrent preg loss panel done, as well as genetic testing for my husband and I and everything has come back normal. I've already done 6 Clomid cycles, 3 of them with IUI (1 resulted in pregnancy w/ early miscarriage). I'm now debating between doing injectibles w/ IUI or just going straight to IVF. I'm very concerned about the risk of multiples w/ injects/IUI so I'm also considering doing a "low dose" injects/IUI cycle. Any suggestions?
Dr._Kreiner yes jack joe it is important to remember FSH reflects number not quality
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alp Hi, I think my first question may have been missed - I'm watching the string of questions and I didn't see a response - Thx
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Dr._Kreiner mara, there are factors that your doctor knows about you that may be helpful. we use coculture successfully in pts with prior failure
JSGB What is embryo glue?
mara what is coculture?
sflower What does anti -mullerian Hormone test cmpared to FSH? Is it useful in your opinion?
mara and what is pts?
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Dr._Kreiner dc age is very important to egg quality. Fact is you can be young with nml FSH and still have poor egg quality. sometimes dont know unless do IVF
Dr._Kreiner mara i am unable to comment without seeing your stim sheet and examining you
Dr._Kreiner jade, im sorry but you may.
dc Does this mean that IVF should be pursued aggressively in order to evaluate egg quality?
mara Waht question will you need to be answered for that but generally is assisted hatching helpful?
JADE0199 Yes, thank you for answering. That is what we were thinking, my husband and I.
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irene Hi can Metphormin help with egg quality and how long should it be taken to see results? I have also heard that accupunture can help egg quality?
Dr._Kreiner irene coculture again is the growth of a cell line along with the embryos. we use granulosa cells obtained at retrieval
irene THANKS
jackjoe Dr. Kreiner Thank you, Also I am wondering if I should do IVF now I only did two rounds of IUI. I had stage 4 endo?
Dr._Kreiner i think stim can help improve quality. metformin should be helpful with patients with glucose intolerance
rogpic Is there anything that can be done during a cycle to improve a thin lining?
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mara should i ask my doctor if they do COCULTURE?
Dr._Kreiner in our experience coculture improved implantation and pregnancy rates by improving growth and development of the embryos
JADE0199 Do you think that 9 eggs retrieved is good, average? other?
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jackjoe what is stim sorry?
gertyrae What are the advantages of coculture?
Dr._Kreiner embryo glue is a culture medium which appears to improve an embryos ability to adhere and implant
mara my docotr says that the result with assited hatching or without it are the same no need to do it but what do u think?
Dr._Kreiner dc it depends on your case. I would speak with a doctor familiar with your case
JADE0199 Who decides when to use co culture or embryo glue? The RE?
gandhl One clinic told us endometrial cells were better to use for co-culture... what are your thoughts?
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Dr._Kreiner we use assisted hatching with previous failures, women over 38 and thickened zonae
Dr._Kreiner metformin should be helpful if you have glucose intolerance. Acupuncture might be helpful
thornj I had 3 failed IVF's with ICS in my mid 30's, I am now 43 and seeing the RE tomorrow. Will you explain aggressive IVF?
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Dr._Kreiner i would do Ivf jack joe with stage 4 endo
dc what was the reason for the failed IVFs thornj?
JADE0199 I've just started acupuncture. do you think it will help improve success with my DE transfer in October?
thornj I was told unexplained IF. All egg quality was good each time. Husband has poor sperm
Zimmy What is a DE transfer?
Dr._Kreiner rogpic it is very difficult to improve lining. i am sure i do same things your doc does sometimes with success. maybe they didnt try gonadotropins which works sometimes or natural cycles\
Dr._Kreiner stimulation sorry
JADE0199 Zimmy - Donor Egg transfer.
Zimmy Thx
Dr._Kreiner 11 eggs is average
Dee_Dee What are the pros & cons of using a 3 day old versus a 5 day old blast (fertilized embryo)?
mara docotr i have a small endometrioma for 2 .7 sm the docotr says it is too small and i did one IVF with it. now before proceeding to the second one i want to take contraceptives to stop the groth before i go for second IVF is it possible and when should i stop before second IVF?
JADE0199 Thank you. Re said 9 was average. I wassn
dc 11 eggs retreived or 11 fertilized
Dr._Kreiner coculture improves growth and development of embryos resulting in improved implantaiton and pregnancy rates
JADE0199 wasn't impressed with 9. only 4 fert. That's why we have chosen to move on.
Dr._Kreiner we discuss it with all our patients with previous failure or over 38
JADE0199 Dr. why is it that some women in they're mid 30
Dr._Kreiner high dose, no suppression, embryo coculture, glue assisted hatching = aggressive IVF
dc mara i had an endometrioma cyst removed by laparascopic surgery. Just finished my first failed IUI. Was the reason for the failed IVF the endometrioma?
JADE0199 30's - 40's can get pregnant without any problems, and some women just keep having problems or m/c's? I guess my question is, how do some women still have good enough quality eggs and others do not?
Dr._Kreiner acupuncture may be beneficial
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jackjoe Dr. Kreiner do women with endometrosis ever get pregnant naturally?
shaymer01 Dr., I am 39, had 3 chem pg's in last year: one natural, one IUI/clomid, latest IVF. Have been told probably egg quality issues. I am wondering if immune testing is in order. Doc suggests donor eggs.
Dr._Kreiner day 3 vs. day 5- day 5 you can select best embryos with more confidence
mara no DC the ednometrioma was not
alp I am 45 and have had one child via UIU at age 43. I was told at age 44 that based on my FSH my only resort was an egg donor. I got pregnant two months ago (spontaneously) but had a miscarriage shortly thereafter. Is it a good idea to keep trying on our own and was this a freak occurence?
Dee_Dee thanks
gertyrae As a 41 year old who hyperstimmed in January (retrieved 49 eggs, 22 of which fertilized) I am about to start my 5th FET. Am I wasting my time or is it possible that all embies were of poor quality due to my age?
Dr._Kreiner contraceptives do not help endometriomata
thornj What do you think about natural IVF for a 43 year old and failed IVF's in the past?
Dr._Kreiner endometriosis can be reason for failed IUI
mara but i just want to stop groth of it can it help? and i get functional cycts i am just scared i will get one befor procedure
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gandhl After 3 failed IVF, attributed to poor egg quality, we started talking to other clinics for more info...one said they would want to do the retrieval earlier, that the eggs could be getting damaged by the follistim/menopur towards the end... is there any research to back this up?
Dr._Kreiner jaded- its a fact of nature that some women have better quality eggs than others
dc if the endometriosis is removed could it still cause problems with IUI failure?
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AmandaUNCC WOW.. Gertyrae, you beat me.. I got 42 in Jan and over stimmed.. only one to FET later in April.. Was a negative.
Dr._Kreiner jack joe yes women with endometriosis sometimes conceive naturally
JADE0199 thank you dr
Zimmy I'm 36, just went through first IVF cycle, retrieved 17 eggs, 14 fertilized, 9 progressed to day 3 embryos. Transferred 3 (to a gestational surrogate) and the other 6 failed to make it to day 5 (when they were going to be frozen. Any thoughts as to why they all failed? Transfer was unsuccessful, by the way.
JADE0199 zimmy - i am sorry.
Dr._Kreiner with egg quality issues DE probably best answer i dont see immune issues as being related
Zimmy Thank you
mara endometriosis grows back i removed it in january of last yea and in september the same year i got endometrioma
jackjoe Thank you, not my luck so far. I wish
dc what are the chances of a successful IVF with endometriosis (which was removed).
Dr._Kreiner at 45- you got much better chance with DE but i cnat say that it cant work with your own
mara mine want success but no idea why DC
gertyrae Amanda - Only one made it to transfer? How many fertilized?
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Dr._Kreiner at 41 hyperstim sign that ovaries responding so it may just be a matter of finding that one normal genetic egg
AmandaUNCC Gerty.. 10 fertilized but by day 5 only two were worth saving and then one didn't survive the thaw
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shaymer01 But if there are immune issues, wouldn't DE be unsuccessful also? When do you test for immune issues versus assuming it is age/egg quality?
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gertyrae Dr. Kreiner - so is it worth my while to do another fresh cycle...I'm nervous about hyperstimming again.
Dr._Kreiner we have not had a good experience with natural ivf
mara Dr Kreiner do you think 8 eggs from 3 follicles is bad result. i responded late to medications and i used 5ml of suprefact for suppression was i suppressed too much? the doc will diminish it for next time for 2ml do you think it is good?
gertyrae Amanda - I am so sorry, are you going to try again?
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rogpic I, too, had mild hyperstim (I'm 34), but how do you find the one normal genetic egg?
AmandaUNCC I just tried a second cyle. Took half the meds as to not over stim... Got 22 eggs.. NONE fertilized..
Dr._Kreiner zimmy thats rough but ivf still not good enough to expect success. check to make sure you are at high quality program and if so trust your doc
gertyrae Amanda - I'm so sorry...are they doing ICSI?
jackjoe Dr. Kreiner what is your feeling on Acupuncture for high FSH?
JADE0199 zimmy - why are you using a surrogate?
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Dr._Kreiner endometriosis surgery is 50% successful of course average age is less than 35
mara hwo can we find high quality programm? my doc gave me 60 % but it failed
AmandaUNCC YES!!!
cjm Are "low dose" gonadotropin cycles with IUI a waste of time? I'm very concerned about high order multiples. Our next step is injects/IUI or IVF. I'm wondering if I should go right to IVF. I'll be 38 in Nov.
AmandaUNCC Going to try again in September with yet another approach
Dr._Kreiner gertyrae if you are courageous enough i would try it
Zimmy I've had 2 miscarriages - one at 15 weeks (naturally conceived twins) and one at 17 weeks (IUI). We believe it is an incompetent cervix, so prognosis is not good.
gertyrae Amanda - different RE or different approach?
Dr._Kreiner i wouldnt use any suppression. but 8 eggs not bad
Dee_Dee What is an incompent cervix?
s1976 what is considered repeat IVF Failure? Two tries?
Zimmy Incompetent cervix - cervix cannot hold the pressure in the uterus, so dilates too early.
mara could you recommedn any clinc in Canada which has good programm? please
AmandaUNCC Gerty, different regime of meds.. same RE. I would definitely do another FET.. IT's better than stims and risking OHSS
Dr._Kreiner acupuncture for high FSH can rarely make a difference
mara than you
Dee_Dee Zimmy - thanks
Dr._Kreiner low dose gonadotropin cycles have reasonable success with iui
jackjoe does it hurt to try acupunture also for relaxation?
JADE0199 What are or where can I find accurate national statistics of a full donor egg IVF cycle? They seem to range from 50% to as high as 92%?
Zimmy Dr K - what is considered a high quality program? What should I be looking for?
Dr._Kreiner i would do acupuncture routinely if not for the cost
cjm Thank you Dr.
ghelweh when would you do acupuncture - prior to IVF, during?
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Dr._Kreiner i would look at cdc results of programs to get an idea of quality of program otherwise it is hard for lay people to know
mara why i responded well to IUI with only 125 dose of puregone and with 400 it took sooooooooo long to respond because of supression and if i dont do supression won't i get a cyst?
Dr._Kreiner go to SART.org for data
Zimmy Great, thx
shaymer01 Dr., when do you think testing for immune issues is warranted versus assuming there is an egg quality issue?
Dr._Kreiner if you could only choose 1 time to do acupuncture it would be before and after tx
JADE0199 zimmy - would a stitch be an option?
AmandaUNCC Good questions shaymer... waiting for answer
Dr._Kreiner i recommend immmune testing for repeat miscarriages when everything else has failed
gandhl Dr. K: We were considering changing clinics after 3 failed IVF... one clinic we spoke to said they would want to retrieve earlier than the first clinic as they were afraid the eggs were being damaged by the drugs towards the end... is there any research that supports this?
jackjoe I am not sure about anything anymore I have two friends that did acupunture and there FSH came down I know FSH fluctutes month to month. I willing to do anything I feel desperate
JADE0199 I've been told by my acu dr. to start 3 mo. before procedure for max. benefits.
s1976 Dr how wouuld u define repeat failure?
Dr._Kreiner i have data supporting that gandhi based on elevated LH and progesterone levels
Zimmy Jade, yes, it is an option, but the prognosis is still only to get to 27 weeks, plus 100% bed rest from 12 weeks on, so not an attractive option.
AmandaUNCC Gandhl.. my doc thinks he retrieved too early.. I had so many immature eggs. That is always a risk too., This time, I'm going longer on the stims meds
Dr._Kreiner yes jade i agree, its a matter of cost
JADE0199 yes zimmy. I understand that and it makes sense. thnk you for sharing.
JADE0199 that would be difficult
gandhl Our FSH is between 9 and 11, does this mean anything?
Dr._Kreiner repeat failure depends on context
Dr._Kreiner i was referring to one failure
kidake I didn't have any problems concieving and delivering at 38. I am now 40 and have resorted to IVF with 2 failed IUI's. What are my chances for success with IVF?
AmandaUNCC Zimmy, I wish you luck
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Zimmy thanks...
JADE0199 Good luck zimmy!
Dr._Kreiner yes that you have two personalities gandi and your ovarian activity is not too bad
gandhl 2 personalities?
Dr._Kreiner kadake- i see many pts like that succeed i cannot give you specifics without exam or more info
Dr._Kreiner good luck zimmy
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Dr._Kreiner did i miss anyone
Zimmy thank you, everyone!
jackjoe Dr. Kreiner I want to confirm acupunture can't hurt anything?
mara u missed my question
JADE0199 I've given up on FSH. Mine was 6.1 on Day 3. still no success,only losses and 1 failed IVF.
Dr._Kreiner no it cannot but my wife thinks its painful
Dee_Dee Doc - you are doing great!
gandhl Dr K: also, one clinic said to use endometrial cells for the co-culture instead of the granulosa cells... your thoughts?
Dr._Kreiner mara please restate
ghelweh how often would you recommend actupunture - once a week, once a day?
JADE0199 Dr. does a patient continue w/ acupuncture once pregnant? if yes, for how long?
mara ok
shaymer01 Sorry to keep on this issue, but after 3 chem pg's in less than a year, would you suggest donor eggs PRIOR to testing for immune issues or should I be tested first?
Dr._Kreiner cornell does this very successfully
Dr._Kreiner quite good
MariaRiordan Dr. Kreiner: I'm 42 and we have never been able to conceive. All our test are normal. Our specialist suggest IVF, since he thinks it is an implantation issue. My question is, how does IVF increase our chances of implantion?
Dr._Kreiner accupuncture frequency is a matter of cost
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Dr._Kreiner maybe PGD first for 3 chem pregs
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Dr._Kreiner its more a matter of probabilities
gandhl But other clniics don't seem to be able to repeat cornell's success?
JADE0199 aside from cost. is it safe?
mara i did very well with only 125 puregone for IUI but i took 400 for IVF and it took long to respond. was it becuase of supression and if i dont do supression will i respond the same goo and isn't it dangerous to get a cycst and cancel the IVF if i dont do supression
Dr._Kreiner with ivf you get many eggs fertilized and with low rate of normal eggs at 42 IVF will increase your odds of fert nml egg
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Dr._Kreiner i dont know anyone else doing endometrial coculture, we are repeating their success with granulosa cells
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Dr._Kreiner accupuncture should be safe
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JADE0199 thank you.
gandhl Our clinic says they tried the endometrial without success, so they went back to the gran...
jackjoe thank you
s1976 what is a good number of eggs to be harvested and fertilised through IVF
Dr._Kreiner ok mara i see. i have had pts respond better with less meds because of ocp or lupron suppression
gandhl They're also talking about splitting our follistim and menopur into half doses, twice a day, have you heard of this?
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JADE0199 what tests consist of immune testing?
dc good question jade
Dr._Kreiner if they are doing well with granulosa as we are then thats good. endometrial culture is more difficult to get working well
gandhl Thanks
AmandaUNCC gandhl.. I split my gonal-f dose (same as follistim).. and i only did it once a day
tsmoore I am 44 years old just had a baby through natural conception after two failed IVF. iS THERE ANY SUCH THING AS A REBOUND PREGNANCY FROM THE IVF, EVEN THOUGH IT WAS A FAILURE?
mara i didnt understand the answer docotr
Dr._Kreiner 11 is ave number of eggs. numbers become irrelevant compared to quality though
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JADE0199 tsmoore - i think thats considered a miracle
jackjoe tsmoore. that is awesome
Dr._Kreiner twice a day dosing may benefit by exposing your ovarie throughout the day
AmandaUNCC unbelievable tsmoore!!!!
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dc could it be possible that there were remnants of the meds in yoru system that kicked you into iverdrive
Dr._Kreiner preg rates increase naturally immediately after ivf
JADE0199 tsmoore - congrats!!
dc wow..great
gandhl So, last one, you would advise granulosa over endometrial?
sam what is the egg quality of a 38 old healthy women who can conieve naturally...what are the chances of a birth defct?
jackjoe so nice to hear success stories.
mara i wish we all had success
AmandaUNCC WE WILL!!!!
gandhl Accupuncture aside, do you have any home relaxation tips, and how important is that?
tsmoore Is Pregannacy 4 monthsd after the last IVF considered a rebound pregnancy?
jackjoe so do I. I feel like my life is on hold which we are all in the same boat
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Dr._Kreiner i think coculture helps. endometrial is better than granulosa only in lab that can do it well like cornell otherwise i would go with granulosa
mara it is considered a gift from GOD
dc is my prognosis good? 30 year old, recent removal of endometrioma cyst, i failed IUI, on BCP to resolve cysts from the IUI meds, and then starting 2nd IUI shortly. If all fails then IVF. There is a slight male factor (below average motility).
mara DOctor can u recommedn any good clinic with good program in Canada?
Dr._Kreiner dc- you have excellent prognosis
JADE0199 with that said...preg rates increase imm after IVF. After my failed IVF cycle, menses was late, over a week, possibly didn't ovulate. Is it possible that IVF meds I did not ovulate at all?
gertyrae What are your thoughts on a t-shaped uterus...would that inhibit implantation?
Corey_Whelan Mara, you can call The AFA helplline for a referral to a Canadian program
Dee_Dee Sam - you would probably want to do first trimester screening for some main genetic effects. May also want to do CVS (placentia biopsy) or amino centisis later in the pregancy.
gandhl Is it OK to be taking Protonix (acid reflux) and Allegra (for allergies) during cycle?
AmandaUNCC I've always been put on BCP after failed IVF.. no chance in conceiving naturally
Dr._Kreiner perhaps jaded
mara what is the number
mara how can i find it
Dr._Kreiner t shaped uteri especially do to des exposure is a potential negative factor for implantation
sflower How many ivf's do you suggest before moving on to DE at 41?
Corey_Whelan 888-017-3777
dc what is your opinion regarding clots during menses. Is this a sign of a possible problem for implantation?
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mara thanks
gertyrae And if the T-shaped uterus is not related to DES?
Corey_Whelan sorry, 888-917-3777. typo
Dr._Kreiner sflower it is not just number but quality of embryos
mara thanks
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sam what is the chance of a birth defect in a 38-39 year old
mara how can we know that the qualityt is good or bad docotr?
Dr._Kreiner t shape not related to DES probably is a negative especially if associated with a hypoplastic uterus, small
Corey_Whelan Folks, we're nearing the end of the chat. May I please ask that as you leave you let us know what state you are from?
s1976 i have already had 2 ivfs and 2 gift treatments in the UK resulting in 1 miscarriage and I ectopic I am 31 would IVF in the united states be a better option for me?
tsmoore Dr. Kreiner is there a relation to IVF and Rebound Pregnancy and if so for how long after IVF?
jackjoe Thank you Dr. Kreiner and I wish you all the best of luck
dc new york
Dr._Kreiner NY
MariaRiordan Oregon
ghelweh ca
gertyrae New York
Dee_Dee I'm from California - Southern California
gandhl NY
alp Nevada
Sharon_ nj
Zimmy Good luck, all. From Maryland.
s1976 nj
shaymer01 NY
jackjoe NY
mv32097 32 year old with 3 iui 2 miscarriages scheduled for surgery to remove severa fibroids, then will try again with iui because cannot afford Ivf, insurance does not pay, should i wait and save up for Ivf so my chances are greater, also some male factor with motility
tsmoore TEXAS
Dr._Kreiner good luck and god bless
shaymer01 Thank you Dr.
sflower florida
mara thank you docotr
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gandhl Is it safe to take Protronix and Allegar during cycle?
ghelweh can we get a copy?
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Corey_Whelan Dr. Kreiner, thank you SO MUCH for being here tonight. What a great chat!
JADE0199 good luck and thank you dr for answering all of my questions
JADE0199 FLORIDA
dc thank you
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Dr._Kreiner jaded maybe in winter i make house calls
Corey_Whelan ghelweh, do you mean a copy of the chat? The transcript will be up at The AFA site in about a week. All of the past chat transcripts are on line for your fyi
rogpic NH
JADE0199 ;O)
mlkelash MN
Corey_Whelan I wish all of you so much luck in your journey.
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ghelweh thx everyone
Dr._Kreiner ditto
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AmandaUNCC Thanks Dr. and cory.. From North Carolina!
Dr._Kreiner again best of luck to everyone
mv32097 Dr Kreiner can you answer my question
dc thanks
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Corey_Whelan And I'm from Brooklyn, NY. A state of its own!
Corey_Whelan mv, can you repeat your question?
Dr._Kreiner fuhgettabowtit
alp Thank you for your time, Dr. Kreiner.
JADE0199 Corey, I grew up in Brooklyn!!
Corey_Whelan cool.
JADE0199 Dr made a funny!!
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gertyrae Thank you, Dr.
AmandaUNCC Gerty good lucK!!!
Dr._Kreiner bye
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gandhl Thanks for everything Doc... Does Protonix affect things?
gertyrae Amanda, you too!!!
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Corey_Whelan sweet dreams all. See you next week. Tuesday - third party options
tsmoore iS THERE ANY TRUTH TO A REBOUND PREGNANCY AFTER A FAILED ivf AND IF SO WITHIN HOW LONG IS THE REBOUND EFFECT?
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JADE0199 Thanks corey and GOOD LUCK EVERYONE! Babydust to all!!
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gertyrae I hope everyone's dream comes true!
JADE0199 Ditto gert!!
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mv32097 32 year old 3 iui 2 miscarriages schedule for surgery to remove fibroid then will try iui again cannot afford IVf insurance does not pay. Should I just wait and save up for Ivf so my chances are greater also male factor with motility
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mv32097 Can anyone answer my question
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Inigo hi lt3333
moesbaby Don't know if this helps a girl I know who was 31 had trouble because of a fibroid had surgery and got pregnant right after....Good luck!
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