Dec2008
More Pieces of the Pregnancy Puzzle
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At this year's meeting of the American Society for
Reproductive Medicine, we presented results of our
study, Differential Relationship Between the Total
Number of Oocytes Retrieved and the Implantation
Rate in IVF and ICSI Patients.
This study is an example of the many facets of
reproductive medicine and of the tiny details that can
impact your success with fertility treatment.
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What We Did
Working with the Department of OB/Gyn at the
University of Sydney in Australia, Houston Infertility
Clinic staff analyzed 351 IVF cycles. In each case
included in the study, patients had used their own
eggs and non-frozen embryos. For each cycle, we
looked at the number of eggs retrieved, number of
embryos transferred, and results of clinical pregnancy
tests.
We divided the cycles into two groups: those that used
ICSI and those that used "conventional" IVF for
insemination. Then we sub-grouped them based on
the number of eggs that were retrieved from each
cycle.
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What We Found
We learned that, at least in our hands, patients using
ICSI who produced 11-20 eggs in a cycle had the
highest implantation rate. Patients
using "conventional" IVF w/o ICSI had higher
implantation rates when they produced more eggs
(21-40 eggs).
An important point: quality of eggs -- not quantity -- is
the more important factor in achieving pregnancy. If a
patient doesn't produce many eggs, the use of ICSI
seems to make a noticeable difference in outcome.
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Where We Stand
Some women's ovaries will produce far fewer eggs
than everyone hoped for in an IVF cycle. Different
clinics have different policies on how to handle this
situation. Some fertility experts will choose to cancel
an IVF cycle when that occurs. There are times when
such decisions seem to be guided by worries about
published success rates.
Houston Infertility Clinic's policy is clear. If a patient
wants to move forward and retrieve the one follicle that
her ovary brought forth, we will respect her wishes and
do our best to render highest quality care toward the
best possible outcome.
Every patient deserves the chance to make her own
educated decisions about getting pregnant, with and
without fertility treatment.
I welcome your questions and concerns about IVF and
other techniques to help you get pregnant, along with
my candid opinion on what routes are optimal in your
particular situation.
Sincerely,
Sonja B. Kristiansen, MD
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