PCOS IVF/ICSI Stimulation Problems

[Belle723]

Does anyone have any experience with stimulation problems with IVF/ICSI?

I have PCOS & MFI issues too. Never made it to egg collection as I either don't stimulate enough mature follicles (& have loads of little ones left) or stimulate way too many and risk OHSS so they cut my stimulation dose down and then they don't grow.

Anything else I can do? Diet? Supplements? I already take inofolic. It's really starting to get me down now.

How bad was it when your clinic decided to drop the dose to avoid overstimming? The worst ohss happens when you get a BFP so it can be avoided by doing a freeze all + putting you on meds.

As much as I'm a firm believer in diet and supplements, I don't think that can replace the right stims. Are you already following a diet for PCOS ladies?

I have polycystic ovaries but not diagnosed as PCOS - no other symptoms apart from slightly irregular periods. We had IVF and the clinic were very cautious with stim dosages, so much so that the cycle was nearly aborted because there was insufficient follicle growth. I was utterly distraught, and they agreed to increase it as a last attempt and at the next scan I had about 20 mature follicles and was ready for egg collection and I didn't get OHSS.

I think that clinics can be very cautious about overstimulation for quite sensible reasons (OHSS can be life threatening) but as JoJo says, they can put you on meds if they're monitoring properly and freeze the embryos. If you're paying privately, I would try to find a specialist in OHSS for your next round.

Should also add that an alternative is (I think it's called) natural IVF where they don't use stims. We looked into it when we thought ours was going to be called off. From memory, it was a clinic in Oxford but may be more widely available now.

I had 40 follicles at day 6 so they dropped my stimulation dose to the minimum (which I had the first time) and scanned me every two days and no change.

I follow slimming world which has helped me lose weight but probably not PCOS friendly - but it helped me lose weight so that's good for PCOS?

By no change I mean they just didn't grow with the reduced stimulation dose

It's a while ago now (8 years) so I can't remember how many immature follicles I had when they upped my dose but I don't think it was as many as 40 (maybe 20-odd?). Can't really comment on diet, save that I think low carb or a v low cal pre-diabetic diet is recommended for PCOS. I think there are other posters on the infertility forum who have struggled with this.

If you can't get to egg collection with stims then natural IVF might be worth a go - we had 2 children from one IVF cycle (one was an FET) so I suspect that natural IVF would have worked for us if we'd had to try it. The problem with infertility is that you often don't know what's wrong until/unless you fix it. For us it was sperm v egg (some MFI issues, but not enough for it to seem impossible) but both children were ICSI babies.

I’m not sure how many follicles I had as they stopped counting. I had to trigger early - I think the largest was only 17-18mm. I had 36 eggs collected (although many immature) and got meds immediately + all embryos were frozen. It seemed a little sketchy at the time but at least we got a lot of blasts so I won’t be doing another full cycle.

Perhaps it’s worth trying to go with a clinic that will go for it a little more so that get somewhere. As long as they use a different trigger/smaller dose + put you on meds straight after collection + freeze all, you’re really unlikely to get more than mild OHSS, which a lot of women get anyway and it’s that big a deal.

With regards to diet, losing weight if you’re overweight helps but there are some other recommendations for PCoS to + it’s worth reading It Starts with an Egg.