FSH Question and Answer with Cody Bailey

Clients often ask, can I run my donor non-stimulated? The answer is YES! Our team will work with you every step of the way to determine what is best for you and your donor. Cody Bailey, one of Trans Ova’s professional services technicians, joins the blog this week to do a deep dive into the differences and questions you should ask yourself when deciding what is best for you.

What does it mean to use stimulation/FSH?

Cody: Stimulation is using a follicle stimulating hormone, or commonly referred to as FSH. The product we use is Folltropin, which is the one sole product that the FDA has approved in the United States for stimulating follicles and use for this process. We give a single or a series of FSH injections to donors to create follicular growth in anticipation of the OPU, and then utilize those oocytes in IVF. We can create a number of different schedules from a single shot to multiple injections, and different doses depending on the class, breed and age of cattle that we’re working with.

What is the difference between stim vs no stim?

Cody: No stim is simply that you are just not utilizing any FSH drugs before the OPU. When most of these non-stim, procedures are done, you simply bring your cow to the chute, and we do the OPU with no synchronization of cycles or follicular waves at all. It is important to note that we are talking about IVF and OPU, but FSH is necessary for stimulating donors for conventional flushing.

What results do you see from both methods, or what have you seen in your years of experience with the use of FSH and non FSH?

Cody: In mature cows we expect about 6-8 embryos per donor in IVF. In open heifers 10 to 16 months of age we expect about 3-6 embryos per donor, but there is variation in both situations. We have evaluated data comparing stim vs non stim using the data in our system from OPU’s and fertilizations we have performed. Sometimes the use of FSH provides either more embryos or better-quality embryos, and sometimes there is no difference. When it comes to results on stim vs non-stim, it depends on the specific cow you are working with. I wish it were black and white and we could just say if you have this breed or this age of donor, you use it every time no matter what. But it really does depend on the donor and a lot of times we have to run that donor to find out what works best for them.

Does Trans Ova require the use of FSH or can you do both stim and non stim?

Cody: We offer both because we find that both work and you can be successful with either a stim or non-stim program. We believe no two programs or no two donors are alike, so we shouldn’t try to fit all donors or programs into a single box and say you have to do one or the other. We have to figure out which one works better for your specific program, and that makes it better for the donor and for the client.

How do you determine a plan for running a donor for the first time stim or non stim?

Cody: We like to start at the very beginning of the process and talk with the CSR’s and our production team to determine a plan with the client. We ask questions like what are your goals? How many embryos do you need? How many times are you going to run your donor? What is your budget? What is more important, maximum number of embryos from this exact sire or cost per embryo? In the end we have an idea of the goals of the client and donor and that helps us decide if we start with stim or no stim. The more information we get on a donor and the goals of that donor, the closer we are going to get to an ideal schedule. 

What are the biggest misconceptions around this topic, or common questions that you get?

Cody: One question I get often is will FSH mess up my donor? There’s no data to support that FSH use will mess up a donor or cause her to become infertile or even have increased risk associated with the OPU. The only thing that you might get into is if you happen to give too much FSH, you can overstimulate a donor and there can be some overreaction in terms of inflammatory response that can create some adhesions, but of course we’re going to do everything we can to not overstimulate.

Another misconception is that more is better when it comes to FSH. Clients might say well I know that the CSR sent me a schedule and it calls for four cc’s, but I figured I’d give her eight just to get a little bit more. More is not better in this situation. More FSH does not create more follicles or more oocytes. It just makes follicles bigger which can create some mucus and be negative towards oocyte quality. We like to stick to the plan and stick to the schedule that was sent. 

What happens if you don’t follow your shot schedule by mistake and you don’t give enough or at the right time?

Cody: As soon as you recognize that you made an error, call your CSR and we can make plans. The good thing about OPU and IVF is that these things are pretty flexible. We can modify the schedule on the fly and salvage the situation. Even if you happen to not give enough and you gave half of the dose you were supposed to, a lot of donors will perform just as well. 

Has there been a shift in the ratio of stim vs non-stim procedures over the years? 

Cody: There has been a shift, and there are a number of reasons why. In the transition from mostly conventional flushing to IVF, we used a lot more FSH because we thought that was necessary. The data still supports medium follicles, but we’ve learned that those small follicles still make embryos at a pretty good rate. Our IVF systems have improved over the years, so it’s also possible that FSH was more important in the late nineties and early 2000’s than it is now.

Listen to the Powered by Trans Ova Podcast on your favorite streaming platform or click here for more information.