Number of Eggs Retrieved Helps Predict IVF Success: Study - US News and World Report

 

Original Article Link: Number of Eggs Retrieved Helps Predict IVF Success: Study - US News and World Report

WEDNESDAY, May 11 (HealthDay News) -- Retrieving about 15 eggs from a woman's ovaries in a single in vitro fertilization (IVF) cycle offers the best chance of achieving a live birth while avoiding complications from fertility medications, according to a new study.

Researchers analyzed more than 400,000 IVF cycles in the United Kingdom between 1991 and 2008 and found a strong association between live birth rates and the number of eggs retrieved in one cycle.

The live birth rate rose with an increasing number of eggs up to about 15, leveled off between 15 and 20 eggs, and declined steadily beyond 20 eggs.

The study appears online in the journal Human Reproduction. "Our data show that around 15 eggs may be the best number to aim for in an IVF cycle in order to maximize the chances of a live birth while minimizing the risk of ovarian hyperstimulation syndrome (OHSS), which is associated with a high number of eggs, usually over 20," Dr. Arri Coomarasamy, a clinical reader and consultant in reproductive medicine and surgery at the University of Birmingham, said in a journal news release.

"Mild stimulation protocols aim to retrieve less than six to eight eggs; a standard stimulation should aim for 10-15 eggs, and we believe this is what is associated with the best IVF outcomes," said Coomarasamy. "When the egg number exceeds 20, the risk of OHSS becomes high."

Ovarian hyperstimulation syndrome can occur when women are given hormone drugs to stimulate the production of eggs for collection for IVF cycles. Abdominal pain, swelling, nausea and vomiting often appear in mild or moderate OHSS. In rare, severe cases, OHSS can be a life-threatening medical emergency.

How many eggs do you have anyway? By guest blogger Sharon LaMothe

I attended a fascinating session lead by Dr. David Adamson, MD at this years SMART ART XI. His topic was Careers, Babies and Biological Clocks. I wanted to share one particular tid-bit that I don't think is in your typical woman's magazine or doctors office reading material.

Just how many eggs do we women have anyway? Have you ever wondered? I never have. I just figured that I had what I needed and left it at that. I never gave my husbands sperm a thought either...it seemed to be there when it was needed (and sometimes even when it was not! BTW male fertility drops to 70% in their 50's) But I never had a sit down with girl friends and chatted over how many eggs we had left or where they all came from. We might have talked about their expiration date but we used the word 'menopause' to describe those topics!
        
Dr. Adamson showed a slide that said this: In Utero (aprox at 5 months) an unborn baby girl has about 4 Million Eggs. At birth that same baby girl will have about 700,000 eggs and at puberty a young girl would have approximately 350,000! And just so you know...at menopause the number is about 1000 eggs and they are not doing well! Most of these eggs are lost to artesia, not ovulation which means that they are lost to the cells dying.

As you can see, we are born with all the eggs we will ever have. Amazing to know but now the question is just what will we do with those eggs?


Sharon LaMothe Infertility Answers, Inc. http://infertilityanswers.org/ LaMothe Services, LLC http://lamotheservices.com/ *Please note: Sharon LaMothe is not a MD, is not an attorney nor does she hold a mental health degree. All advice given is solely the experienced opinion of Ms. LaMothe. If you have any medical, legal or psychological questions or concerns, please contact your own Doctor, Attorney or Mental Health Professional.

'You Asked, We Answered': Questions About Egg Donation

This is a wonderful Q&A session from ABC World News with Diane Sawyer originally posted on their website January 15, 2008. I felt it was worth repeating as the questions are very common and the most asked of women considering becoming an Egg Donor.

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Last week "World News With Charles Gibson" aired a report on egg donation and invited viewers to ask questions. Our expert contributor, Dr. Rick Paulson, has answered some of your questions below. Paulson is chief of the Division of Reproductive Endocrinology and Infertility at the University of Southern California and co-author of "Rewinding Your Biological Clock: Motherhood Late in Life: Options, Issues, and Emotions."

Question: How do I find out where I can donate my eggs in my area? Is there a Web site where safe or approved sites or facilities that perform the extraction are listed by ZIP code?
Tara in Emmaus, Pa. 
 
Paulson: I would recommend two Web sites: The first is the American Society for Reproductive Medicine (ASRM,), where you can find specialists, a listing of the programs in your area, etc. The other Web site you may want to check out is the Society for Reproductive Endocrinology and Infertility (SOCREI). I would suggest that you choose a physician who is board-certified in reproductive endocrinology and infertility, and these are listed on that Web site.  

Question: Where do we go for information on donating our eggs? Whom do we contact? Who pays for the medication that we take before we donate our eggs? Who is actually paying us for our eggs? Where is the list of agencies in our own city/state that want to buy our eggs? How much can we get paid for our eggs?
Seleta in Charlotte, N.C.
 
Paulson: It's very nice that you want to donate; an infertile couple will be very grateful! We don't consider it "buying" or "selling" eggs, but rather that you donate, and are reimbursed for your time and trouble! There is no cost to you, and a typical payment ranges from $2,500 to $,5000. The recipient couple pays for the medications and the medical treatment. You should start with the Web sites of the professional organizations that deal with infertility and egg donation, like those mentioned above (or click here for ASRM Web site, or here for SOCREI,) to find a doctor and practice near you. That practice can then either match you to a recipient couple directly, or it can direct you to an agency it likes to work with.

Question: What are the cancer or other health risks, short and long term, associated with the many drugs used to stimulate the ovaries?
Linda in Dix Hills, N.Y.
 
Paulson: Every medical procedure is associated with some degree of risk. Some risks are known, and others may not be known. As of now, egg donation is about 20 years old. We know that some 1 percent of donors experience ovarian hyperstimulation syndrome (where the ovaries get very swollen and the donor becomes bloated and uncomfortable) to the point where it interferes with her life to an appreciable degree for about two weeks. The egg retrieval is associated with a very rare but possible risk of bleeding and infection (much less than 1 percent).

There were several studies that seemed to link ovarian stimulation to ovarian cancer, but they have been disproved, at least for now. So at the present time, there is no proven reason for limiting the number of donations. However, because we know we don't know everything, most programs recommend limiting the number of donations to five or six. But this is an arbitrary rule, and is not based on a risk of cancer. And yes, having babies decreases the risk of ovarian cancer by quite a bit (30 percent for the first pregnancy, more with additional pregnancies).

Question: Does undergoing fertility treatments and all the medication one takes over years of trying to conceive increase the risk of ovarain cancer? Are any of the drugs more likely to cause ovarain cancer? How and where would one get more info, and what should one ask a doctor for? Thanks for giving your time to a looming question long after treatment.
Maria in Ill.
 
Paulson: See links to Web site above for additional information on these issues.

Question: I was an egg donor at the age of 20, and now that I am 27 and trying to have a baby, I can't. I have had four miscarriages. Have there been any kind of studies on women who donated their eggs and having subsequent problems of getting pregnant themselves?
Barbara in Melbourne, Fla.
 
Paulson: What bad luck! It would be very interesting to know if the recipient of your eggs actually had a baby when you donated. As far as we know, there is no effect of egg donation on subsequent fertility, or on the risk of a subsequent miscarriage. Remember that there are many reasons for miscarriages, and they may include factors such as your male partner. Also, your uterus was not a factor in being an egg donor but may be a factor in miscarriages. I would suggest that you see a reproductive endocrinology specialist to evaluate your situation. With a complete work-up, chances should be on your side that you will eventually be successful.