POI (Premature Ovarian insufficiency) Problem

[AnuTanuj]

Hello Everyone,

I am new to this Forum. I am 31 and have a problem called "Ovarialinsuffizienz" and I cannot concieve (have been trying for last 14 months to get pregnant). Meine Deutsch ist schlecht, deshalb Ich schreibe in English :(
I was told by my doctor that IVF is the only option. I am not sure how this procedure would go and I am very scared. I have very less follicles (2 on each ovary) per cycle. I am taking CycloProgynova for 3 months before IVF would start. Does anyone of you also have similar experience. I would be really happy to know more.

Best regards,

Anu

[Katzie]

Hi Anu,

I don't have the same problem as you do, quite the opposite (PCO). But I have read and heard lots of POI.

It's quite common to start with Cyclo Progynova to balance your cycle and to keep your FSH-level low. Have you had your hormones tested already? I guess your FSH is quite high, the AMH-level is pretty low? These are signs of beginning menopause, which goes hand in hand with POI. However, you are still very young so chances are you might be successful to retrieve at least two follicles. 2 on each ovary is quite a good result for POI-candidates!

IVF is stressful. I cannot deny this. I have been trying for 2 years with help of the Kinderwunschklinik, but I was successful finally. Still, you don't need to be scared of the procedure. When the 3 months are over you start to stimulate your ovaries until the follicles are large enough to be retrieved. But I guess your doctor has explained this already?

All of us here are little experts on IVF or ICSI. If you have more questions, just ask!

Hugs

[AnuTanuj]

Hello

Thank you very much for your response. Yes, I have had my hormones tested and my FSH levels were extremely high and my AMH was really low. Well, my doctor has not explained completely to me, I guess she would eventually after three months before the IVF treatment. As of now, I am doing the reading myself.

One of my question is: Is there something in lifestyle/Food that I can change or improve to regulate my ovary function? anything I can do to increase my follicle count per cycle? I know that POI is irreversible, but I want to increase the follicle count in my ovaries to improve my chances in the IVF treatment. I do regular Yoga, I dont smoke or drink. I dont know what else I could do.

I had another question: Does this kinderwunsch zentrum also do Blastocyst cell culture? I have read and heard that when fertilized cells that are cultured longer ( upto 5 days - cells are in Blastocyst stage) before embryo transfer, then the chances of implantation is much higher than normal embryo transfer.

Would be very happy to get any helpful suggestions.
regards,

Anu

[Katzie]

I thought so.. But I think you can trust Cyclo Progynova, it does help to keep the FSH level low.

Who is your doctor, by the way?

The problem with POI is that there is actually nothing to increase the follicle count. I'm pretty sure you will use the "antagonist protocol", which means that you start stimulating at cycle day 1 (the agonist protocol starts one cycle before, but downregulating you too early would affect your ovaries too much and then there might be no follicle left).
There are some studies that show there could be something done to improve your chances, but none of them has been proven so far.

I can recommend the following:
DHEA (3x25mg)
Coenzyme Q10 (600mg)
Zinc
Selenium
Resveratrol
Melatonin

Only the DHEA is said to help POI patients, the rest is "only" to improve the follicles you already have. I'd give it a try, but only if your DHEA-level is low. I'm pretty sure it is.

The Kinderwunschzentrum does do the Blasocyst cell culture, but if you only have a few follicles I would not recommend it. It's expensive and chances are there is nothing left for transfer. And no, the chances of implantation are not higher! My doctor told me that they have found this out recently and they don't prefer it anymore. I have had 4 IVF cycles, three of them with blastocysts, all of them looked great and were expanding already. But none of this cycles was successful. In this last cycle the transfer was 4 days after retrieval, but two of my eggs had to be fertilized one day later as they weren't ripe after retrieval. So I finally got back a morula and an 8-cell-embryo and I am pregnant. So this is something you should really discuss with your doctor.

[AnuTanuj]

Oh...Thank you soo much for explaining me all this.. I had no idea. Your right, I really need to discuss these with the doctor. I think they know the best, and it probably depends from case to case. My doctor is Julia Limberg. She has been very nice and patient with me.

Thanks once again for all the Info. I am a little hopeful now.
Regards,

Anu

[Katzie]

You can also decide if you want to have the blastocyst cell culture right after retrieval! You get a whole lot of papers to sign and usually you have to hand them in before, but if you're unsure whether it makes sense to cultivate the embryos longer, then you can tell them and wait for the retrieval result. If you have more than, let's say 5 eggs, it might make sense to cultivate them longer. Also the biologists might know the answer as they can assess the quality of the eggs.

I think you're in good hands with Dr. Limberg. She has helped some difficult cases here and she is willing to go unusual paths with her patients. Some doctors don't like it when their patients have uncommon ideas or have read too much on the internet, but since you are not one of the "we only have to inject a sperm into an egg"-case (me neither, and I hated it! I always thought it's easier if "only" the sperms were too slow, although most girls will contradict me here..) I'm sure you need a doctor with new ideas.

I wish you all the best and I think you can be hopeful, indeed!