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Why did the doctor get such few eggs ? What every IVF patient needs to know



Each mature follicle normally contains 1 eggs, which means if you had 10 follicles on the ultrasound scan, you would expect the doctor to retrieve 10 eggs .However, if the number of eggs the doctors collects is much less than the number of follicles, this is the analysis you need to do to try to figure out what happened

Before the egg collection, you need to find out how many mature follicles there are on your ultrasound scan , and what your blood estradiol ( E2) level is. Tragically, we find that many doctors don't bother to share this information - and patients don't even ask . This ignorance can be a huge problem , and that's why you need to be actively involved in your treatment . Ask these questions during each scan, rather than after you find out that the doctor wasn't able to retrieve as many eggs as expected, because by that time, the damage has already been done

Sometimes the doctor isn't able to collect any eggs at all .

This can happen when the follicles rupture before he gets around to doing the egg collection. This can happen when clinics schedule a large number of egg collections in one day, as a result of which they start running late.

Another reason for not getting any eggs is called Empty Follicle Syndrome . This is an iatrogenic problem, and occurs if the HCG injection is not given properly . You can read more about this distressing situation , which is preventable, athttps://www.drmalpani.com/knowledge-center/articles/about-the-empty-follicle-syndrome

Its far commoner that the doctor does get eggs, but these are much fewer than the number of follicles. A common problem is very busy corporate clinics is there are in a rush to do as many IVF procedures as possible, in order to maximize their income. This means they spend only 5 minutes doing a pickup and some take perverse pride in how fast they are , and how quickly they finish the procedure . What this means is that they are not systematic , and even though there are eggs in your follicles , they don't take the time and trouble to collect them all. This is especially true of you have adhesions around your ovaries . The doctor then claims the ovary was inaccessible , but this actually means that the doctor was technically incompetent, and didn't spend devote enough energy and patience in collecting all your eggs . This is completely unfair on you , because his rushed carelessness means your chances of getting pregnant have dropped significantly.

Another problem we sometimes find is that doctors aren't honest with their patients. This means that even though they collect a large number of eggs, they lie to the patient, and donate the extra eggs to another patient.

They can get away with this unethical and illegal practice because patients are clueless . This lie allows them to maximize their income , because they can collect fees from both the patients.

The tragedy is that clinics routinely get away with this , which is why you need to be actively involved in what's happening to you during your treatment.

And finally the problem sometimes may not be with the doctor, but with the embryologist . If he is not well trained , he may not be able to identify the eggs ( for example, because his microscope is of poor quality) . This is why it's so important that you select a clinic which has both an experienced IVF specialist as well as expert embryologist , who work well together, and will spend as much time, energy and expertise required to maximize the number of eggs they collect for you.

The more the eggs you get, the more the embryos you will have , and this will maximize your chances of getting pregnant !

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.