I did a fresh and frozen donor cycle with a friend. At the time, we got 9 eggs, 7 embies went to 3 day and 4 to blast. This was considered not bad, but not ideal, as clearly, neither the fresh nor the frozen worked and the whole cycle then failed. We have no frozens to work with. That was a year and a half, maybe 2 years ago.
I am starting over now and looking at donors. I am sort of freaking out as SO many of the proven donors have similar stats! The most I am seeing is 12 eggs retrieved, 6-8 embies, 2-5 blasts total.
I am planning to start with a new doc, and while he is not happy with the idea of stimming a donor to reach 40 eggs, he has told me, due to my history, that he will be seeking a donor for us with the past proven ability to give us more blasts to work with just in case things do not work with the fresh. I agree with him.
The doc I am moving on from (but I do respect), seems to feel that small egg production is fine, as long as there has been a pregnancy.
However, I am already an outlier in terms of failures, so I want as much room to cover my bases as possible -- I don't need 20 frozen embryos, but I want more than 1 or 2!
Are you seeing this trend of lower stims for donors? I do understand that you can hyperstim a donor to the point of producing poorer quality eggs...but doesn't this seem like it is trending too conservatively?
What are you ladies seeing out there with the donors you are looking at?
So far are you saying you did 1 DE cycle, where the fresh was bfn then frozen was bfn?
While that SUCKS (I know personally!) it isn't really an outlier based on average stats, is it? I thoroughly understand you wanting to get 40 eggs and keep all of them, just don't know if you can find a donor who is ideal in other areas and is also a mega producer.
Yes, I did DE with fresh and frozen failed. Total 4 embies. It may not be totally unique, but I have a longer history than that and was the only de failure at my clinic over a 6 month period. Everyone who looks at the embies and my charts is stumped. Now, we just did a myomectomy and are adding lovenox, nevertheless, I have been at this for 7 years and would like more than 2-4 blasts to work with.
I don't want 40 eggs, I just thought there was something in between -- you know, 18-20, with maybe a total 5-6 blasts. Most of my friends who have cycled in the past two years with DE have about 5-6 to work with.
But all the donors over the last year I am looking at seem to barely get 2-3 blasts total, 5 is outstanding. I am looking at A LOT of donors and am starting to wonder if the docs are getting very conservative about stimming.
I'm not sure, but I have a guess that clinics are moving towards less stimulation medication for donors. I don't know that our clinic did that for sure, but our donor was only 22 and had only 13 eggs for our cycle and a similar number for the previous cycle with another family. Our fresh SET failed, but I have twins from the frozen cycle (after the bfn on the fresh I didn't want to take any chances). What I am coming to realize is that an embryo, even one created from a very young egg, is a pretty fragile thing and the majority of them don't make it. When you are paying so much and have gone through so much soul searching and struggle to get here, you want the cycle to succeed and of course we hope the chances are much greater than with our own eggs. Statistically that is true, but so many women here have been trying for a long time and you just have to wonder what is really going on, even with a young donor, to not have pregnancies happen more easily. I really wish you luck moving forward. I would definitely ONLY use a young, proven donor. How old was your friend?
Yes, I hear you. It is interesting to hear about young gals only producing 12 eggs. I do think they are being more careful, and I like that...I do not want 40 eggs or a sick donor! But wouldn't 18-20 be nice? With 8-10 blasts to work with?
My previous donor was a friend, she was 28, and she had been a big producer before our cycle.
I am now considering only proven donors under 25 (maybe 26) -- preferably aged 22-24.
it's not so much a trend...different REs do things differently. Some donors, no matter how high you stim, only produce a certain limit of eggs. It depends on how big the ovaries are, etc. A donor who typically produces 12 to 15 eggs will probably always get something close to that number regardless of amount of stims. To a large extent it's out of the hands of an RE as to how many eggs a donor produces.
Having said that, some REs do believe lower stims produce better quality, others simply do not want to risk hyper stimming a donor they are not familiar with (as is often the case) by aggressively giving high doses of stims. There may be some out there who have other reasons to stim lower but I cannot imagine they don't want their stats to be good so that seems illogical.
If you want a higher number of eggs (and I can certainly understand that -- it does give you a sense of confidence) best thing to do is find a donor who consistently produces 20 or 30 plus eggs per cycle (always check their egg to blast ratio if that's available), and cycle them somewhere where they have cycled before so the RE is sure of what he or she can give them to produce an optimal cycle. Typically using a clinic donor would acheive this.
I am looking at donors from all over the country and their cycles, with differing clinics, and they are ranging in egg production from 12-20, depending upon the clinic, but most are producing 12-13 eggs and 2-5 blasts for transfer or freeze.
I have yet to find a donor who meets my criteria who produces 20-30 eggs (and yes, I am definitely looking at eggs retrieved, embies at 3 day, blasts, total transferred and frozen, then pregnancy results).
I don't understand "using a clinic donor" -- could you help me understand what you mean? Do you mean in house donor pool? My RE does not have a donor pool, and I am looking at about 15 different agencies all over the country, primarily So Ca.
My current RE (I am switching, but both are highly regarded and have great stats) specifically told me he does not like getting too high a count, and I trust his judgement...however, if you really are too conservative, you could end up with nothing. I know that these things are beyond our control, but if an RE is aiming to be happy with 2 good blasts to transfer total, well...you said it...sense of confidence...pretty shaky.
Just wondering if anyone is experiencing this. Maybe you are right if by donor pool you mean "in house donor pool", as I have a lot of friends who used another clinic in town with an in house donor pool and they all produced an ungodly number of eggs...which does not seem ideal either.
Now that I am thinking about it -- this in house donor pool clinic has a program which does not allow you to keep more than 12 embies, and then they take the rest (I think for research or something...I don't really understand it and I do not want to put any negative energy out there about this clinic, but we have all heard of trend with clinics), so maybe they have a different motivation.
I noticed my clinic's DE consent forms have changed
March 24 2011, 3:18 PM
For people who are doing a dedicated cycle, they are offered "up to 25" eggs and that any "remainder" might be banked or given to another couple. If they are banked, the clinic can use them for another patient who wants to cycle more affordably (which is an option I tried last year; I used banked eggs from a "rock star" donor who got everyone pregnant, at least until I used her eggs).
Of course this extra opportunity for another patient cycle would mean more income for the practice too.
As a primary recipient who is funding the donor's compensation and her meds, I can understand feeling like all the eggs belong to you, but as someone who has maxed out her savings (having fully funded a dedicated donor cycle back in 2009) and now needs more affordable options to try again, I appreciate the opportunity to try with a frozen egg bank.
I don't know if whay I described is a consistent practice in the industry, or if many RE's are using lower stim protocals for improved donor health (less side effects) and potentially improved egg quality, or if it is a little bit of both.
On both counts -- none of these things are mutually exclusive. I think they do not want to overstim donors, but that is hard to separate from their egg banking programs, etc.
As I told my current doctor, it's great everyone has had so much success at your clinic, and I guess I should relax, but not only are we going to be out of money, we will be out of time at some point. I want the option to do as many FETs as I need to if it comes to that.
I like my current RE, but yes, I feel like he is not protective enough of us. We found another highly regarded clinic and doc and he has been much more concerned with analyzing our possible donors.
As soon as I am done with this mock cycle, we are moving it over to the new clinic. Since the myomectomy, I wanted to stay under my current docs care.
I feel bad...but not badly enough to stay with the current RE and chance his casual attitude toward donors.
Hi M, I know what you mean by wanting more embies so if it doesn't work then you have more options.
I know that in S.Africa they always stimmed lowish to try to get quality eggs. I think the number of eggs depends on the donor's ethnic/genetic ethnic background. I know that asian donors get tons of eggs but caucasian donors much less.
Talk to your RE. He is giving you good advice. Always go with proven of course but if you could also go with someone who produced more eggs than the average then that would also be good.
I wish you luck my friend. I have you on my list of people I pray for on a regular basis when in church, best, TH.
I noticed myself that it seems very rare now a days to see a donor produce 20+ eggs, that all fertilize properly. I've had 2 cycles, 1 was 13 eggs, resulting in 4 embryos on day 3, and 2nd was (split cycle) 5 eggs, 5 on day 5, 2 transferred, 1 frozen on day 6.
I think North America is starting to get a little bit more conservative on the stimulation. And I don't necessarily think it is a bad thing. I think it is wise to take into consideration the donor's future fertility and health. And there is a lot of research out there that says less = more, so I kind of agree with it. However coming from someone who needs DE, I do wish I had like 6-7 embryos frozen waiting for me to try again.
It's definitely a double edged sword.
I hope you end up with a good producer and some great quality embies!
My (twice proven) donor was 24. She was stimmed very, very conservatively, and I was upset that the RE was being waaaaaay too conservative. Conservative protocols seemed to be the only way my RE would go with the donor.
The donor ultimately gave us 13 eggs, 10 mature, 7 fertized normally. I was FREAKING out at the low numbers.
We transferred two 8-cell embryos on day 3... Convinced I was headed for failure (as usual) I was asking how soon we could come back to try again.
We froze four embryos (two 10-cells, one 9-cell, one 7-cell). One 5-cell embryo was discarded.
Two weeks later, I ended up with twins on the fresh.
So my lesson: it's really, really, really about QUALITY not QUANTITY. Proven donors are where it's at. I know every proven donor starts out unproven, but I would never roll the dice with an unproven. Get the donor's records, and adjust accordingly, but stick to the protocal that worked previously with that donor.
The whole shabang is such a crap shoot. You just never know.
I will add that, looking back from a perspective of success, I am nervous about having four frozen embryos. Knowing my current children, I have a deeper love of those frozen embryos... yet I know I cannot have four more children. So my lesson: less is more. I can't imagine having a boatload of frozens and the burden of making the decision about their future.
It's so hard. I'm sorry you are feeling nervous... this journey is fraught with decisions, fears.
Clinics in the Czech Republic don't hyperstim donors, and figures like yours are close to what most of us who cycled there see. I got, I think, 8 eggs, 6 fert., 2 made it to gr 1 blast, none to freeze. Second cycle it was 10 eggs retrieved, 9 mature, 7 fertilized, had 3 gr. 1 embies on ET day; tx'd 2; embryologist let remaining culture and had 2 gr. 1's the next day; froze 2.
I'm not sure how much the preference for not hyperstimming rests in the belief that not doing so produces better quality eggs and how much it is about concerns over potential harm to the donor. As you probably know, in most of Europe compensated DE is illegal, and I've heard opponents of DE in the media give hyperstimulation syndrome as the main rationale for not allowing it (they invariably fail to mention that not all clinics hyperstimulate their donors to sound as though this is an unavoidable phenomenon).
But overseas we are paying about a quarter of the cost of a typical U.S. DE cycle. If I were paying U.S. cycle prices for retrieval numbers like those, I'd be unhappy, too. Personally, I think this is another aspect of the way that the de facto price fixing that makes IVF cycles so expensive in the U.S. affects treatment.
I think overall the clinics do not want to hyperstim the donors. They give them a "normal" amount of medication, but the goal is not to have 20 eggs. Some of this is for quality reasons, others is for the intent of a donor cycle. It is not meant to be a way to have multiple children. It is basically 1 attempt. I do agree that I would want a reasonable chance at that, therefore ending up with less than 12 eggs retrieved/fertilized seems unacceptable to me. I did a split donor cycle and was fortunate to get pregnant on my first attempt with twins (12 eggs retrieved, 6 were mine, 5 fertilized, 3 transferred day 5). My thoughts were: FETs are less successful than fresh; split donors are proven; the costs were considerably cheaper ($6200 vs $12,000), alot of perfectly good embys do not meet freeze criteria. I am now in the midst of my second split DE cycle. My donor is unproven. I asked my clinic to allow this since my friend and I wanted to cycle together. If they retrieve less than 10 eggs, I will get cancelled. That said they said they would try to stim her a little longer so we could get enough eggs for a split.
Your post makes a lot of sense. It's true that each cycle aims to render one healthy live birth. Funny how we forget that and hope to get an entire brood out of one cycle. There's just so much money at stake... hard to accept "just one". Good luck with your upcoming cycle.
I have four frozen, and I wonder about their potential. Any ideas?
Just a note regarding my situation, I am not hoping for a brood or for twins, I am dreaming of a single healthy pregnancy. My last donor cycle produced 4 grade A embies, and we are currently childless, so I simply want enough to work with in case it take 3-4 fresh and frozen tries to get one child.
Also, on my last failed de attempt, I chose to cancel the first cycle we did with our donor as I was concerned she would hyperstim. She was willing to proceed, but I felt her estrogen was too high and there were too many follicles...the next shot we had, she underproduced. I am just saying that to point out that I am not seeking a hyperstimmed or 30-40 batch donor cycle.
This message has been edited by minniet on Mar 24, 2011 3:52 PM
I cycled with a great clinic. Proven donor.
we had high numbers. 34 retrieved two transfered. One healthy baby boy.
we have 14 frozen in various states but in general I think they are good. We were a bit over whelmed near the end of it.
Hard to say. I feel my clinic is deeply caring for the donors so I can't imagine the protocol being dangerous. I don't know.
For the cycle in which my donor risked hyperstimming, the doc and the gal both offered me the choice to either proceed or cancel. She not only had massive resting follies, but very high E2. In retrospect, I am SO thankful I cancelled...she is a dear friend with a child. During the cycle we did proceed, she had hemorhaging afterward that nearly killed her. If she had had 30 eggs retrieved, I am not sure she would have survived the bleeding.