Why are high stims bad for low ovarian reserve?
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Anonymous
| I have heard this many times. What is the scientific reason? |
Anonymous
| I don't think there is anything scientific; I think some believe that high stims can compromise an already lower quality. |
Anonymous
| I think the other theory is that high stims will cause you to produce eggs that Mother Nature, knowing that it was a poor quality egg, would not have selected during a normal cycle, thus yielding a higher number of eggs, but a lower percentage of good ones. |
Anonymous
|
I don't know if there is necessarily firm scientific research to prove the correlation, but DW participated in a clinical trial back in 2012 in which the clinic tested traditional vs. mini IVF. Results have yet to be published, but informally speaking, I can tell you that nearly all of the women we encountered who did mini IVF had success. Here is the link to the NIH site for more trial specifics:
https://clinicaltrials.gov/ct2/show/NCT00799929 Again, our experience in terms of who succeeded is purely anecdotal - there was a forum as well as a Facebook page where we kept up with these ladies. Several who succeeded in their first mini and had leftover embryos went back for #2. |
Anonymous
| high stims can "fry" your eggs |
Anonymous
No scientific evidence to support this. |
Anonymous
|
This is still being studied but I believe the current theory is that anti-Mullerian hormone (AMH), LH, testosterone, and E2 are significantly higher in follicles from a natural cycle than in stimulated IVF follicles whereas FSH is significantly lower. This suggests an alteration of the follicular metabolism in stimulated cycles.
Here's a paper that compared hormone levels in the follicular fluid from NC-IVF and conventional IVF http://www.ncbi.nlm.nih.gov/pubmed/24608520 However, here is a paper that compared the number of live births from women under 35 who had normal ovarian reserves and it found no difference between mild stimulation and conventional stimulation. http://www.ncbi.nlm.nih.gov/pubmed/26524799 |
Anonymous
So to me, the takeaway based on current research is why use high doses if natural IVF or lower doses yield similar results? |
Anonymous
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shady grove feels that evidence indicates reducing the number of eggs reduces the number of successful pregnancies: https://www.shadygrovefertility.com/treatments-success/advanced-treatments/in-vitro-fertilization-ivf/stimulated-ivf-vs-natural-cycle-ivf
I'm not advocating for or against this (i'm not a doctor/researcher!) but just want to give people the info. i do think there are many factors that might affect whether or not low stims/no stims might work like whether the infertility is as a result of AMA/DOR or ENDO or some other factor (most of the studies i've seen on this list deal with women <35-38.) i personally struggled with whether or not to do traditional or natural cycle, and in the end my dr. at SG advised a very low dose protocol (due to my numbers ohss was a concern) so i was okay with trying traditional. not sure what i would have decided if she had wanted to do a heavy stim cycle. its very promising to hear these studies are going on hopefully they will have some more definitive answers soon. |
Anonymous
From the second paper: "For aged ? 35 there were no differences in pregnancy rates per transfer but a trend for higher pregnancy rates per retrieval with conventional stimulation. For all other age groups both pregnancy rates per transfer and retrieval were significantly higher with conventional stimulation. This was reflected with a higher average number of babies born per retrieval with conventional." In other words, women over the age of 35 who had good ovarian reserves had higher success rates with conventional IVF. Also, the authors noted that more than one pregnancy can be achieved with conventional IVF through freezing embryos. |
Anonymous
| For aged ? 35 should be <35 |