Recurrent implantation failure
0 Replies
allison k - February 18

Hello Doctors

I'm in dire need of some advice and rapidly running out of time.

I'm nearly 41 (FSH between 5.8-6.3) and have been trying IVF for the last 18 months. We are 'unexplained' although I have a little endometreosis and a small fibrod (2cm). After my last failure in October I had immune testing done which was normal and a thrombophylia panel which showed I have PAI1, MTHFR and Factor XIII problems, for which I'm taking Metformin and high dose folic acid.

I have had three IVF failures, each time producing approximately 15 eggs with 80% fertilisation rates, with Grade 1 embryos or blastocysts transfered. I have always bled early (day 10). I have had one FET from which I got pg with a very low beta (4 on CD14 past EC) but which rapidly increased. I had an empty sac by week 7 and m/c soon after. On my 3rd IVF I had 17 eggs, 14 fertilised from which 10 made it to Day 5 blastocysts, however all but the 3 I had transferred (2 x Grade 1, 1 x Grade ") suddenly deteriated before freezing.

I have just had my 4th IVF and had 3 x Grade 1 (no fragmentation) 8,9 and 10 cell 3 day embryos transferred. I was given baby aspirin from stimulation and also 3 Pregnyl injections after EC on Days 3, 7 and 10. On test day (CD14 past EC) my Progesterone levels indicated my body was ready for pregnancy but no beta level. I am waiting to retest to see if my beta's have risen and am still not bleeding but I suspect the treatment will fail again or if it is very late implantation will go on to miscarry. This isn't being pessamistic but realistic!

I apologise for the long history and I hope it is all relevant! I wondered if you could give me some advice on how I go forward from here. I have 6 frozen embryos.

Given my age is it possible that all my embryos were/are abnormal? The fact my blasts couldn't be frozen etc.

Could it be my endo/fibrod which are stopping implantation?

Is it worth trying with the frozen embryos? The embrologist suggested PGD with them. Or should we try donor eggs, would this work any better if it is implantation issues and not age related.

I have heard about an HOS (hypo-osmosic swelling) test for MF, which if low can impede implantation, could this be the problem? My husband has normal SA but has never had this test, or DNA sperm testing.

I'm really at a loss to know where to turn. It seems we can produce very good embryos and lots of them but they just won't stick.

Any advice you can give me would be invaluable.

Kind regards

PS I have just read Dr Smith's post about his absence and pray that everything is ok with his family.



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