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Egg Donor IVF: A Different Perspective

a blog by Dr. Michael DiMattina, Dominion Fertility, April 29, 2015

What should you do when your infertility treatment should work but does not?

Here is a story of a patient of mine who had three healthy children and then suffered secondary infertility. She went to another local infertility clinic and failed five IVF procedures using her eggs and two egg donor IVF treatments. That made no sense to me.

The patient presented to me in May, 2014. She was 49 years old with three children, the last delivered in 2006. All were naturally conceived. In 2011, she had a biochemical pregnancy using clomid and intrauterine insemination. She was then treated with five stimulated IVF procedures and two egg donor IVF procedures, all unsuccessful.

Interestingly to me, in all of her egg donor IVF treatments, all of her embryos were “slow growing”, so the doctors transferred her embryos on day 6. Clearly, she had no good medical reason for her slow growing embryos when using young ova, so I carefully reviewed her two previous ova donor IVF records. In my opinion, this young ova donor should have produced very high grade embryos but she did not. Indeed, there were no extra embryos cryopreserved and this was a concern. Reviewing her donor’s IVF stimulations, I believed that her hCG trigger shot was administered too early. This may result in immature ova, poor fertilization, poor embryo growth and no embryo implantation.

Obviously, this patient had undergone a lot of infertility treatments with no pregnancy and she was understandably distressed. In my opinion, she should have been pregnant as there was no other reason for her infertility other than her age and an ovarian factor, which is easily remedied when using donor ova IVF. So, she decided to give us a try with one more donor egg IVF.

At Dominion Fertility, all of our donors are in their 20’s and we do not perform egg sharing because judging the quality of an egg using simple microscopic visualization is very limited and inexact. Thus, we believe that the recipient patient should receive all of the eggs retrieved. Her donor produced 18 eggs producing 15 blastocysts of which 9 were tested as genetically normal using PGS (embryo biopsy). A single embryo was transferred and she immediately was successful, expecting her delivery in October.

You might say, "Just what was she thinking about having more children at 49 years old?" However, she was a very healthy, fit person who loved being a mom. My oldest successful patient was 56 years old when she delivered. In general, I use 50 years old as my fine line in the sand, individualizing each case above that age.

The simple lesson here is to consider another perspective when things aren’t working out for you. It never hurts to get a second opinion. Good luck to all. Michael DiMattina, M.D.


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