Polyp and donor IVF failure
1 Replies
mykonos - October 14

Dear Doctor,

I am 38 years old and I've been dealing with infertility for the past 10 years.

Initially, following several unsuccessful IUI cycles, I had a laparoscopy done. It revealed moderate endometriosis mainly around my ovaries. Up until the laparoscopy, all the tests (ie. hormone tests , immunological tests etc.) appeared to be within the normal ranges.

Immediately after the surgery, I had a couple of more unsuccessful IUIs and I decided to have a break from fertility treatments.

A couple of years later, at the age of 32, and right before my first IVF cycle, I was diagnosed with high FSH - 28 on Day 3. Even though I was exlained that I was going against the odds, I decided to go for 5 IVF cycles with my own eggs. My most successful IVF cycle yielded a chemical pregnancy.

On numerous occasions, we tested my husband's sperm which appeared to flactuate from normal to low count. We also had a sperm DNA fragmentation test done which was also normal ( A minus). On all our IVF cycles we did ICSI.

My last 2 IVF cycles were donor cycles. The former did not succeed because the eggs of the donor were not very good. On day 3, we transfered a 7 cell and a 6 cell emryo. My last donor cycle,which was recently completed did not result in a pregnany either. My donor was a proven donor and out of the 13 eggs we received, 12 fertilized. We decided to go until the blastocyst stage (for diagnostic purposes as well) and on day 5 we had 2 blastocysts ,which we tranfered, and out of the rest of the embryos, 2 more developed into the blastocyst stage on day 6 which we froze.

On my last cycle, I accidently and from the reaction of one of the U/S technicians, I discoved that I have a polyp. My doctor saw it of course when he did an U/S on me in the beginning of the cycle and he decided not to disclose it to me. When I confronted him , he said that small polyps don't prevent pregnancy.

Could you please respond with you opinion on the following questions?

a) do polyps interfere with the implantation proccess and in which way.

b) do you think that the polyp should be removed before the FET

c) how long after the removal should I try my FET

d) do you think that the laparoscopy is somehow related to my subsequent high FSH

e) do you suspect any other cause for my latest IVF failure

f) are there any more tets we should do

I appreciate that you took the time to read my post and I am looking forward to your response.

Best Regards,

Tina

 

B. Jacobs, M. D. - October 14

I routinely look for and remove polyps. I have no good scientific data to indicate that there is a definite link between polyps and failed implantation, but there are concerns that it may be the case. Since I have my patients on birth control pills before starting preparation of endometrium for FET, Removal of polyps while on the pill is an ideal time.

I have no way of knowing why your IVF cycles failed. As far as testing, I routinely test for an adhesion molecule, an integrin, in all my IVF patients. For more in formation, please see our web site, <www.texasfertility.com>.

Good luck.

 

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