spinoff from egg quality - add PCOS (long and rambly)

The egg quality thread got me thinking. I have PCOS and haven't produced a lot of follicles/eggs on my IVFs. It seems that so many PCOers have crazy high egg #s. Do you think it is the PCOS or my weight? I know PCOS and the obesity go hand in hand for a lot of us.
Dr. B always mentions my weight as a huge factor in my infertility, but why? Why does my fat affect my ovaries? Why doesn't he just say it's the PCOS causing the insulin and other hormonal issues which affect my ovaries?

Is my weight preventing my ovaries from stimming well? What about when I transferred 2 good quality embryos? Did my weight prevent implantation?

Dr. B just says it's the weight and NEVER gives me an explanation. That's why this will be my last cycle with them.

My question to you all is, what is your experience with this? I'm looking for anecdotal answers, not medical answers. Do you know what I mean?

Re: spinoff from egg quality - add PCOS (long and rambly)

I think I know what you mean...I found this info online:

What’s the link?
One common finding in obese women with fertility problems is a tendency towards abdominal obesity, or an “apple-shaped” body. Exactly how excess body fat affects fertility is not completely understood, but obesity is known to influence reproductive function in several ways:



Obese women are more likely to menstruate irregularly or not at all. This is due to the presence of excess subcutaneous fat that produces large amounts of the estrogen hormone.
Obese women are more likely to have problems with successful ovulation and a poorer response to fertility drugs.
Obese women are at increased risk for miscarriage, both spontaneously and after infertility treatment.
Obese women are also at higher risk of pregnancy-related complications such as gestational diabetes, hypertension and preeclampsia or toxemia, which poses a threat to both the mother and developing fetus.
In addition, many obese infertile women suffer from a hormonal disorder called polycystic ovary syndrome (PCOS).

PCOS is a major cause of infertility and is thought to affect 5% to 10% of women of reproductive age. Many researchers believe that the underlying problem in PCOS is that although insulin levels are normal, there is insulin resistance, a primary cause of type 2 diabetes. This is worsened by excess weight. It impacts fertility because the insulin resistance causes elevated circulating insulin levels that result in hormonal imbalances in the ovaries. These hormonal imbalances can then interrupt the normal cycle of ovulation and make it difficult to conceive.

Maintaining normal reproductive function requires a complex balance of sex hormones. Being overweight can upset this balance — with or without PCOS — and contribute to infertility in several ways:



Excess abdominal fat can increase production of androgens, which are male sex hormones that are normally present in small amounts in normal women. Their levels need to stay consistent for normal ovulation to occur. If androgen levels soar, ovulation may be disrupted and conception cannot occur
Excess body fat can trigger imbalances of the hypothalamus and pituitary hormones in the brain that are needed for normal ovulation.
Even without a full diagnosis of PCOS, an obese woman can still have insulin resistance that leads to increased levels of circulating insulin. With more insulin in circulation, the balance of sex hormones in the ovaries can be disrupted, interfering with the delicate reproductive hormonal balance needed to trigger ovulation and contributing to infertility.

Re: spinoff from egg quality - add PCOS (long and rambly)

I'm not sure if there is a correlation there. I also have PCOS.

I did two IVF cycles:

#1 - 6 eggs retrieved, 5 fertlized with ICSI, 3 made it to transfer day (day 3 transfer), none to freeze

#2 - 18 retrieved, 14 fertilized with ICSI, 10 made it transfer day, we put 3 back and 6 made it to freeze.

I'm also overweight.

Re: spinoff from egg quality - add PCOS (long and rambly)

I am overweight also. Dr. B never mentioned anything weight related to me and that was my biggest fear and I dreaded getting on the scale as I always do. I always ovulate and get my AF on time. I recently stimmed (or attempted to) as some of you know and had no response to the meds, I convinced myself the medicine was not getting into my system due to the fat on my belly and the needles being too small.

Re: spinoff from egg quality - add PCOS (long and rambly)

I am 43 and slightly overweight (size 12) with PCOS. I wasn't overweight at all when I began fertility treatment.
I have stimmed three times and every time I produce a ridiculous amount of eggs.
About half fertilized w/out ICSI the first two times. Haven't done retrieval on this one yet....

I think the RE's know that weight can affect response to stims, but there's no way of knowing how much. And I'm not sure that they can tell what the egg quality is without PGD.

Re: spinoff from egg quality - add PCOS (long and rambly)

Exactly. From what I understood, I thought egg quality referred to the chromosomal aspect of them and that maternal age affected that the most.
I guess if we truly knew what affected egg quality, then we'd have a lot more answers about our infertility.

Re: spinoff from egg quality - add PCOS (long and rambly)

I too have PCOS and am overweight. I have never done IVF but have done Gonal-F. I needed large doses to produce multiple follicles (3) and always got 1 when I was on Clomid.
I have heard that the potential to get an abundance of follies/eggs with PCOS is high but personally feel that it involves other factors such as age, length of time PCOS was untreated and length of time with infertility treatment.
You are right to say it is the PCOS that causes the issue though b/c being overweight is a SYMPTOM of PCOS not the be all and end all of the "disease". Which is why I love my RE b/c that's what he treats it as...a symptom, not a cause.
Good Luck to you!
Shawnna

Re: spinoff from egg quality - add PCOS (long and rambly)

I have PCOS also and am 'young' by fertility guidelines. I only had 7 mature follicles for my IVF cycle, of which 6 fertilized.
During my IUI cycles the first one I had maybe 2 or 3 mature- the second one he said I had over 25 that were mature- so he cancelled my cycle. The only difference between cycles (as far as meds) was adding lupron beforehand. And I wasn't as stressed during my 2nd IUI cycle. Didn't help much though considering my cycle got cancelled.

Re: spinoff from egg quality - add PCOS (long and rambly)

I am no slim Jim, but my RE said that weight COULD have a factor, but he knew that he would get me pregnant. And he did, TWICE! He worked on quality eggs not quantity!

Each cycle I had fewer then 8 eggs, 5 fertilized with ICSI.

Got pregnant twice, miscarried once, twins born in 07. I really think that the accupunture helped me!