|
|
|
|
|
|
Dear Dr. Jacobs,
I did a 5 day frozen transfer of 2 blast and 2 morulas. I was testing negative on home tests up through Friday morning (8dp5dt). On Sunday morning (10dp5dt), I decided to test again and tests were coming up positive.
I had my first beta today (11dp5dt) and the HCG level was 61. Is this average for where I'm at or is it so low that I should be lowering my expectations of a successful outcome? I tried to get information out of the nurse at my clinic and all she would say is "we consider over 5 to be pregnant" (not helpful!).
Please let me know what you think.
Thanks,
Staci
|
|
|
|
|
|
|
|
I'm not Dr.Jacobs but 61 sounds great to me. I have heard people starting from as low as 6 achieved healthy pregnancy. So try to relax and enjoy. Congratulations!
The below link has some more info on HCG levels
http://www.conceivingco
ncepts.com/learning/articles/hcg.html
|
|
|
|
|
|
|
You have a positive pregnancy test. GREAT! There is a very wide range of normal values for hCG in a normal pregnancy. The only means of trying to determine if the pregnancy is good is to repeat the study in 48 hours to see if the value at least doubles.
Good luck.
|
|
|
|
|
|
|
Thank you for the information. Unfortunately, I just went for my 2nd beta today and the result only went up to 63 so the nurse said it was either a lab error (highly unlikely) or a loss.
I'm highly distressed. Of 5 transfers and a total of 13 embryos transferred, this is the first time I have achieved a positive result only to have this happen.
We have been doing IVF for male factor infertility. I am 36. Husband is 42. I have been tested for all immune issues, clotting issues, etc. and all came up clear. FSH was 3.6. I respond well to the medications and only need minimal doses. Eggs always appear healthy and we do have top quality graded embryos; a good number of which seem to make it to blasts.
My husband did have an SCSA result of 29.8% which is borderline high. However, our current Dr. puts no stock in this as he says ICSI overcomes fragmentation issues.
My lining is generally on the thin side; around 8 mm. On this frozen cycle it was 7 mm at the time of transfer.
Do you think the loss was more likely caused by some sort of chromosomal abnormality or insufficient uterine lining? We honestly don't know whether we should be looking into a gestational surrogate, donor sperm or donor eggs at this point....or if we should just keep trying in the hopes we've simply been falling on the wrong side of the odds. I don't want to give up but am completely overwhelmed and not sure what the next logical step would be at this point.
Any advice would be highly appreciated.
Staci
|
|
|
|
|
|
|
I forgot to mention that both my husband and I also had a chromosomal analysis panel done and we both had normal results.
|
|
|
|
|
|
|
Your uterine lining at 8 mm is fine. We find that sperm morphology problems can frequently be resolved with ICSI, but after fertilization, by day 3, we occasionally have poor embryo developement. If we have a problem to correct, like a varicocele, we frequently get better embryo developement. That is a long way to say that ICSI can only take you so far.
Good luck.
|
|
|
|
|
|
|
I am 34 and my husband is 36. We have male factor infertility - there are problems with morphology (although it is not too bad we are told). On our first round of ISCI we did a 3 day transfer with 3 good grade embryos but 2 only had 4 cells and 1 had 5 cells. It resulted in a positive pregnancy and we have a healthy little boy. On our second round we got the same outcome with the embryos and transfered 4 - 1 at 5 cell and 3 at 4 cell but got a -ve.
All our embryos have been slow growing. On the first cycle nothing made it to 5 days. On the second cycle they froze 6 at 3 days but all 4 cells. They said they didn't think they would make it to 5 days. Aside from the number of cells everything else looks perfect.
Can you explain more how morphology can effect poor embryo development? Is there any way around it. Were we just very lucky the first time around?
Thanks for your help.
Jane
|
|
|
|
|
|
|
Certainly morphology is related to the ability of sperm to fertilize eggs. It appears that morphology may also be related to gene expression of the sperm. Genes from the sperm start participating in growth and developement of the embryo at day 3. If there is a gene problem (DNA fragmentation), there will be an effect on embryo developement. In our observation, it seems that repair of a varicocele, if present, helps with this problem.
Good luck.
|
|
|
|
|
|
|
Thank you for your reply.
1st - what is repair of a varicocele?
2nd - it seems our problem starts before day 3 . . . as it starts early in the process is it more likey to be an egg problem?
Jane
|
|
|
|
|
|
|
A varicocele is a varicose vein n the scrotum. It causes elevated temperature in the scrotum, and impairs sperm formation. A sub specialist urologist, and a few general urologists can help.
I our lab, we look at fertilized eggs the day after insemination, and again on day 3. It is the day 3 evaluation when we first start to see problems.
Good luck.
|
