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Dr Captain
Dr Captain, Doctor
Category: OB GYN
Satisfied Customers: 770
Experience:  A family doctor, with medical and residency training in Boston, MA, patients of all ages and wide range of illnesses.
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I am trying to help my sister with her fertility struggle.

Customer Question

I am trying to help my sister with her fertility struggle. She is 34 years old. She has done 3 rounds of IUI with no luck of pregnancy. She has also done 3 rounds of IVF. During the last 2 rounds of IVF they discovered her egg quality is poor. The third round they did not even do the transfer because none of the eggs were worth transferring. Her husband has also been tested and he has low sperm count (age 33). My question is...with no luck with IUI and IVF not being successful, does she have any options?? Her fertility doctor suggested an egg donor, but my sister does not want to do that. Is there something else she can try, another procedure, medication to help her egg quality, anything?? All possibilities and insight into this situation would be greatly appreciated. Thanks so much!!
Submitted: 10 months ago.
Category: OB GYN
Expert:  Dr Captain replied 10 months ago.

Hello!

Welcome to the JustAnswer.com question/answer interface.

I am a Family Medicine doctor, board certified with active licenses and certification in Internal Medicine, Pediatrics, Obstetrics and Gynecology, as well as Integrative Medicine & Naturopathy, with advanced training in Neurology, Cardiovascular Medicine, Gastroenterology, Endocrinology, and Psychiatry. I am also well-trained in Functional Medicine. For your review, here is my direct link with my current ratings from patients like you: http://www.justanswer.com/medical/expert-familydoctor/

I have read your post and observations about your sister's fertility struggle. I'm so sorry to hear of the difficulty! That sounds so frustrating. Would you prefer a summary answer to your question, or would you prefer more back-and-forth, where there will be a series of more questions and more details clarified? There is no difference in charges for your preference.

Either way, I’ll do my best to take the appropriate time to help you.

Expert:  Dr Captain replied 10 months ago.

The summary answer is that there are certainly options left. many. As you've mentioned, egg donation is a possibility, and there are ways (expensive) whereby some of your sister's DNA could still be involved. There are always clinics who are willing to keep trying with IVF. 3 rounds may seem like a lot to you, but I've been involved with patients who have many many more trials than that. 3 is a lengthy start, but I would strongly recommend more trials. Perhaps at a different clinic, who has alternative tools and staff.

Customer: replied 10 months ago.
I guess I would prefer a more back and forth in case I have further questions!
Expert:  Dr Captain replied 10 months ago.

Good luck can spring, sometimes, from good talent and good staff education and skillset.

Customer: replied 10 months ago.
What alternate tools would there be other then keep trying over and over again..a different procedure??
Expert:  Dr Captain replied 10 months ago.

Well, different clinics use different size pipette's to insert sperm to egg, and that may play a role in her success/failure, alternatively, sometimes clnics are maintained at different temperatures, or with staff who are trained in less or more rigorous technique. To your question, we are starting to learn how to harvest DNA from eggs and from sperm, and it may soon be available for us to implant this information into a new (donated) egg, so that genetic material is preserved. This is already done with mitochondrial DNA, for example

Expert:  Dr Captain replied 10 months ago.

There may be value in a new harvest of your sister's eggs. It's possible that something when awry in the first harvest, and a start-from-scratch approach can also find success with new rounds of IVF.

Expert:  Dr Captain replied 10 months ago.

it's not clear to me whether her uterus is viable.. I assume since they tried IUI, the embryos were viable. Perhaps a surrogate uterus would be helpful too?

Expert:  Dr Captain replied 10 months ago.

As an aside, it is important to note your own role in your sister's health. Clearly you care so much about her, and that can have healing impact too!

Here are some ways you can continue to be helpful for your sister.

- I believe there are medical, physical, and emotional ways you can help.

- we've discussed the medical, but the others:

- From an emotional perspective, believe it or not, patience and understanding, loving kindness and compassion, are all vital aspects for any human healing. People who feel sympathy and love, or notice their environment is smiling and happy and uplifting are much more likely to share these feelings of positivity and energy than their opposites. There are many anecdotes around the hospital and in the public at large, where laughter, kindness, and love have brought health where it could not have come without.

- Physically, it sounds like you believe your sister has the appropriate support systems (physical, intellectual, emotional) available to him, and my impression is that you believe your sister has the cognitive capacity to seek these resources out if she so chose. While some may believe in more aggressive treatment strategies than I do, I believe greatly in a positive human spirit, and I believe in the power of positive motivation and reinforcement, and less so in the power of forceful or negative encouragement. These are matters that are easier said than done, I am aware, but nevertheless, I think the carrot serves better than the stick (or the annoying nag or threat, etc etc). Perhaps you could find activities that you can share with her? Fun board games, or exercise activities? Could you reconnect some of her friends or acquaintances to join in the motivational effort with her? Perhaps trips to a park or enjoyable activity from time to time? A change of scenery can often bring a change of heart.

Expert:  Dr Captain replied 10 months ago.

Lastly, I would encourage you to keep you head/chin up. It sounds like you and your sister have been through a roller coaster of difficult times. Fertility can be a long and arduous process. Time often heals. We live in a very fast-moving society, with high expectations for everything to be done instantaneously. As I'm sure you're aware, our bodies take their time, and grow and improve very slowly. Another benefit of time is that when it doesn't heal as we expect it to, it helps us adjust peacefully to different circumstances.

Expert:  Dr Captain replied 10 months ago.

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