Poor egg quality - suggestions for second opinion

[Anonymous]

Hello all. I am looking for recommendations for an expert on egg quality who can give us a second opinion about whether to pursue donor eggs or donor sperm. I am on my second IVF cycle with poor fertilization. First cycle only one embryo fertilized. We transferred on day 3, but no success. Second cycle with ICSI and two have fertilized, but I am not too hopeful given we were told to expect much higher fertilization rates. I am 33 and all our other tests come back normal. Also, I have had one previous pregnancy (concieved naturally last year) that ended in a miscarriage around 8 weeks after we saw a heartbeat. I suspect this is an egg quality issue, but when I asked in the past, my RE has said it could be either sperm or egg problems causing the poor fertilization, even after trying ICSI. We are currently at SGF. I am looking for someone who is known for handling these types of cases who can advise on how to best proceed. We are happy to get an opinion from anyone in the country. If you have suggestions, they would be very much appreciated! We are very open to using a donor, but I hate to go down the donor egg road only to find out that it was a sperm issue and we wasted all that money, time, and emotional capital. Thanks!

[Anonymous]

We have a known male factor issue and I've just turned 43. We talked to SGF, Dominion, Cornell and an RE out in CA about the IVF cycles. Seems like whoever you talk to is likely to have their "go to" treatment that has worked for others, but there's still no guarantee it'll work for you. I think the docs at each clinic are very good, but it's definitely a frustrating process when you don't fit into the perfect patient box or if you have complex issues. However, I also was happy I got the additional input. Usually, you can do a 1 hour consult that runs about $600-700, even if you don't intend to go to that RE.

If you suspect male factor issues, SGF's urologist, Dr. Shin, is great. We've also consulted with a urologist at Cornell who seemed more willing to try some other things. A urologist should be able to give you some clear info on whether there is a male factor at play. Even if the #s are good on the SA, they can do fragmentation tests that can give some info about quality.

I will say that I saw an improvement in the number of eggs I got after taking supplements (Vit D, ubiquinol, fish oil). I also decided to do a mini stim cycle using low doses of stims to see if that would improve quality. I got essentially the same # of eggs that cycle as I did on max stims, but our fertilization rate was much higher (77% instead of 50% or less as was the case in all 5 prior cycles). I also did start taking DHEA a few months ago, which some think will improve egg quality and/or #s for people with DOR. There are also people who think DHEA is a bad idea, so I'm not necessarily recommending it. AND, I made my hubby take supplements, too.

Some people will also swear by REs that check immune issues, but I don't know much about that. There are lots of threads on here, though.

I hope you get some answers!