The diagnoses behind fertility issues (2/4): Diminished ovarian reserve

Earlier this year we began looking into the diagnoses behind fertility issues, starting with ovulatory dysfunction. In this post, we’ll be digging into the most common diagnosis, “diminished ovarian reserve”, affecting 31% of cases in the CDC’s report, which is based on ~260k IVF cycles performed in the US. Diminished ovarian reserve does not only affect IVF treatment but any kind of fertility (preservation) treatment, making it particularly relevant for the Ovally community.

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How does my doctor figure out if my egg freezing or IVF cycle will be successful?

Doctors perform a series of tests and ask a number of questions as you prepare for and undergo the stimulation phase of egg/embryo freezing or IVF. These tests and questions help determine whether you’re a good candidate for the procedure, whether you’re able to proceed or have any risks, and what your outcomes may be. To make the process a bit more transparent, we’ve included some of these questions below (note that they’re neither comprehensive nor prescriptive). Keep in mind that every doctor will have their own protocols, and we recommend asking them about their process:

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Embryo freezing & IVF: What happens after the retrieval? A personal account (3/3).

This is part 3 of Ovally founder Kathy’s personal daily account of her embryo freezing journey to Spain. Read the previous two posts on the stimulation period and egg retrieval. This set of posts takes you from the egg fertilization through embryo development, genetic testing, and freezing. It doesn’t include the last IVF step of embryo transfer.

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Which fertility add-on treatments are effective and worth the investment?

The Human Fertilization & Embryology Authority (HFEA) in the UK has released a report testing various popular “add-on” fertility treatments from embryo glue to pre-implantation screening and endometrial scratching. These add-ons are fertility treatments that are typically offered at an additional cost. Six of the techniques the HFEA examined are still relatively new or have conflicting evidence. Another six techniques have been around for a while without evidence of their effectiveness. We’re hoping this evaluation of add-on treatments will be helpful for our Ovally customers, as well as anyone else undergoing fertility treatments.

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What happens to surplus embryos from IVF or embryo freezing?

We’ve at times talked about eggs and embryos in a somewhat utilitarian way on this blog. However, thinking about the fate of human embryos and eggs is a complex and deeply personal matter. The complexity of how people feel and think about frozen eggs or embryos is reflected in different countries’ legislations about what you are and aren’t allowed to do with any surplus eggs or embryos. As assisted reproductive technologies that can create this kind of surplus haven’t been around for very long, some laws are still in flux or being updated.

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What happens if I use my frozen eggs or embryos?

What happens if you use your eggs or embryos that you’ve frozen through Ovally or elsewhere later on? In the case of frozen eggs, the eggs would be thawed and then fertilized with your partner’s or a donor’s sperm. The resulting embryo(s) would develop in the lab until they’d be ready to be implanted in the uterus (typically on day 5 of development). Then one embryo (in rare cases more than one) would be implanted through a catheter inserted all the way into the uterus, which sounds really uncomfortable, but is usually painless. Ideally the embryo would implant there, and a few days later a blood test would confirm a pregnancy. In the case of frozen embryos, only the embryo implantation or “embryo transfer” would have to take place, as the eggs would already have been fertilized and developed.

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To freeze eggs or embryos?

If you already know who the biological father of your child(ren) will be or are planning on using a sperm donor for your frozen eggs, it’s worth considering freezing embryos instead of eggs. However, there are also compelling reasons to only freeze eggs instead of embryos. We’ve made both treatments more affordable through Ovally and have listed compelling reasons for either option below so you can make a more informed decision together with your doctor:

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Are more eggs always better for egg freezing or IVF?

Many women and couples we speak with at Ovally worry about the number of eggs they’ll be able to retrieve for egg freezing or IVF to increase their chances of having a baby. They’re often concerned that there might not be enough eggs, but also wonder whether more eggs are always better or whether more eggs could at some point pose more risks and diminishing returns. We dug into the research that addresses these questions and concerns – as usual, your doctor will be able to advise you on your particular case, but we hope that the below provides helpful scientific context.

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