Egg retrieval

Dear Robert,

I had success on my second ivf attempt 3 years ago. I was 41 at the time and turned 42 just before the birth of our daughter. We are in favour of the mild approach and chose a clinic that promotes this. Over the last year, we have had a number of ivf attempts with the same clinic, trying for a second baby. I am hopeful but of course trying to remain realistic, as I am now 44. My amh is 2.7, antral follicles found at base scan normally around 8-10. On average they have been able to extract 1-3 eggs. On our last attempt however, they managed to get 7 eggs, of which 6 were mature. From these, 4 embryos were created and these have now been frozen for a later transfer. My question is: Is egg collection a relatively easy procedure or is there a lot of skill involved? The clinic says its straight forward and my varying result is due to each cycle being different. I can’t help but feel there is a skills issue too. 1-3 eggs versus 7 is such a big difference. I don’t think its down to anything else. I have used either Ovidrel or Buserelin as trigger injection. The protocol has always been the same with 150iu Gonal-F. The last scan before egg collection has most often shown 3-5 follicles with good potential. I would be very interested to hear your thoughts on this. Many thanks. With kind regards C

Dear C,

I certainly do not think there is anything wrong at the clinic you have chosen. The number of follicles produced and eggs retrieved at each IVF cycle varies enormously and this variation is exaggerated as you get older. I think you have done pretty well, given your age, if anything rather above average. Incidentally, in most women the collection of eggs is not a desperately skilful process so I think it very unlikely you were unlucky with a less well-trained member of staff. It strikes me they have done an excellent job. But realistically, how ever you measure your chances they are not more than about 5% in each cycle at the age of 44.

Best wishes
Robert Winston