Hi, I’ve been having IVF/ICSI treatment and am over 40. I tend to produce lots of eggs - 20 one go, 15 another. However, I have poor fertilization rates and the eggs don’t seem to like ICSI, many disintegrating when the needle is inserted. I’ve just been told that I’m on the short protocol because of my age and am on the highest dose of menopur. My clinic hasn’t altered this since my first attempt (I’ve had 4 goes so far at IVF and/or ICSI). Is it ever the case that the treatment can be TOO aggressive, thus damaging the eggs? I’m recollect reading this somewhere. I had a pregnancy (ectopic) a couple of years ago.

Many thanks!

janeincapetown - 05 March 2010 07:08 AM

Hi, I’ve been having IVF/ICSI treatment and am over 40. I tend to produce lots of eggs - 20 one go, 15 another. However, I have poor fertilization rates and the eggs don’t seem to like ICSI, many disintegrating when the needle is inserted. I’ve just been told that I’m on the short protocol because of my age and am on the highest dose of menopur. My clinic hasn’t altered this since my first attempt (I’ve had 4 goes so far at IVF and/or ICSI). Is it ever the case that the treatment can be TOO aggressive, thus damaging the eggs? I’m recollect reading this somewhere. I had a pregnancy (ectopic) a couple of years ago.

Many thanks!

Dear janeincapetown:
This is controversial.  In general most of the evidence favors obtaining as many eggs as possible.
Poor tolerance to ICSI is a strong sign of significant ovarian dysfunction and it is unlikely that a change in protocol will make a significant difference. However, if you are not ready for egg donation, it is not unreasonable to consider a change in drug protocol.
Very best of luck,

Serena H. Chen, MD
IRMS at Saint Barnabas, Livingston, NJ
IRMS at Hoboken, NJ
IRMS at Clark, NJ
http://www.sbivf.com