PCOS and short protocol IVF

Dear Professor Winston, I understand that I can’t expect specific advice, but any insight would be much appreciated. I have recently finished my first NHS IVF/ICSI cycle, but unfortunately it failed. We were were referred due to male factor issues, but at my baseline scan it was discovered I have polycystic ovaries. Because of this and my age (28) they expected me to over respond so we did a short protocol, using Cetrotide (0.25mg), Gonal F (112.5 iu) and Ovitrelle. I did not respond to the drugs, and only 1 egg was retrieved, I believe it was 26mm. It did not fertilise. We have seen been told that the egg was poor quality. We have been advised that we can self fund and try again in November, on a long protocol with a Gonal F dose of 187.5iu. Any advice or insight would be much appreciated, and I will of course make a donation to the charity. Many thanks K

Dear K,

Much as I would love to help, there really is not nearly enough information to give a steer in your email. The assessment of your progress in treatment so far must depend on your baseline hormone tests, possibly repeated over time, and also your hormone response – in particularly, the measurements of your blood estradiol levels whilst you were being stimulated and the measurements of your ovaries and the follicles by ultrasound in the run-up to egg collection. Without these basic data it is, I am afraid, really unwise for me to give you advice about your next step. The other crucial thing that is mentioned in your email is treatment by ICSI. You do not say why this was necessary which makes it even harder to give you useful suggestions.

My feeling is that you need to see help from the consultant running your clinic and get him or her to give you a detailed account of what is thought went wrong and what is advised as your next action. This is your right and they have a duty, I think, to ensure the person responsible for the overall direction of the clinic gives you adequate time to go through all the details with you. Having obtained that information it certainly seems that the short protocol is not a suitable IVF regime in your case.

Best wishes
Robert Winston