I need some advice
12 Replies
ivfer - February 16

Hi. I am 28 years old and have a 10 year old son from a previous relationship. My husband and I have been trying to conceive since September 2004. In September 2005 we started seeing an infertility specialist. After every test imaginable our infertility problem is undetermined. We had 7 IUIs with either clomid or injectables turn up negative. In January 2007, we started an IVF cycle. The first fresh cycle failed. We used our frozen eggs and got pregnant. At 12 weeks we had a miscarriage caused by Trisomy 22. My husband and I had the genetic blood test done and it came back normal. We did another fresh cycle and had a chemical pregnancy. My doctor then ordered more blood test for me (to check for lupus/anticardiolipin antibody/antiphosphatidyl serine/factor V leiden/homocysteine/antithrombin III/Protein S&C activity/prothrombin mutation/prolactin, HgbAC/ and DX 629.9). We then used our frozen eggs and it failed. So, again, we go through another fresh cycle with assisted hatching. We had another chemical pregnancy. (I did take a baby aspirin with every cycle.) We have decided to take a break. We currently have 5 eggs frozen. My question is, do you think there is anything that we can do, or add to a cycle at this point to achieve a full term healthy pregnancy? Also, when I had a miscarriage at 12 weeks that egg was in the blast stage. The rest have been 3 day transfers. The 5 eggs that I have frozen now where frozen on day 3. Can those be thawed and grown to day 5 now? I thank you so much for any advice/answers you may have.


B. Jacobs, M. D. - February 17

I do not know the capabilities of the lab you are using. We usually transfer blastocysta and freeze only blastocysts.
Good luck.


nareen - April 25

Hi i,m 35 yr,ttc almost 4yr.have done all the blood test which come back ok done 2 laproscopy 1 in 2004 to remove endo. and cut one of my tube, Efter 6 ivf respons well to medicin retrives 16 more eggs with between 2/4 fretilize and between 1/2 put back inside me all failed. Laproscopy nr.2 november 07 they found out the tube they cut with the first surgery was,t done good so they have to remove reste of tube with some fibroids and clean up inside me they said it was a bit a mess. Tried ivf nr.7 january 08 retrives 18 eggs, because me hb has low sperm mobility we decide to blend with doner 1 from my hb fertilize and 2 from the doner so i have a 5 day blastocyst transfore which i have all 3 eggs put back inside me which also failed. What i can,t understand is,t normal that i always get my period 1 day before my blood work are 2 day efter. Could it be , because i,m studing and tyring ttc at the samet time why i never get pregnany not one time out of the 7, because my docters can,t see the reason why i,m not pg, ,because i always get top quality eggs put back inside me. Please give me some advise anythink wiil be apprecated. Thanks and keep up the good work.


B. Jacobs, M. D. - April 25

Without examining both you and your medical records, I cannot provide any meaningful advice. Please speak to your RE, or, if you want a second opiinion, see another RE in another practice.
Good luck.


victoira - May 4

I had an laparoscopy done on April 3, 2008. Well I ovulated on my own only for two days it that normal? Well when I was ovulating I had bad bad cramps for 3 day is that a good sign or it can go any way?


B. Jacobs, M. D. - May 5

In humans, ovulation is a rupture of a single fillicle containing an egg. Symptoms are generally not helpful in determining whati is happening.
Good luck.


nareen - May 12

Dear Dr Jacobs
I would like to know if there is a reason why i gets swellen breast and sore nipples before there menstration. I would like to know also if it have anything to do with imfertility are some form of hormone imblance that makes it hard for me to get pregnant. And is there a reason why i get upset stomh and feels like vomiting about a week are more before my menstration when i finally get my period it pain so much and have a dark colour it happen with my last two menstration cycle.
If you can give me any answer i will be very greatful . Thanks


B. Jacobs, M. D. - May 12

Your breast tenderness is probably caused by the elevated estrogen levles normal in the last 2/3 to 3/4 of the cycle. Your severe menstrual pain with nauseamay be caused by endometriosis. Please see a Reproductive Endocrinologist if you are having difficulty achieving a pregnancy.
Good luck.


angieo76 - May 17

Good morning!

I will be 32 July 30th. My husband and I have been trying to conceive for over 5 years. I have a son who will be 11 July 12th from a previous relationship. I was diagnosed with PCOS a few months back. My husband a few years ago took several OTC sperm testing that they now offer. Every single test came back negative. I was told that this does not mean anything. That it could mean that he has a low sperm count and not necessarily shooting blanks. I was also told that when a males sperm turns into a liquid stage within seconds this means that the man is shooting blanks. When my husband took those tests his sperm when from a jell like substance to the liquid substance within seconds. My husband did a research on the side affects of having Small Pox, because he just found out a few years back from his mother he had this as a child. The findings were that having Small Pox has a high side affect of becoming sterile.

Please give me your opinion and knowledge of what I have mentioned. We were thinking of IVF, however, if my husband is sterile than this would not be an option and we would then think about adopting.

I appreciate your time and medical expertise information that you provide.



nareen - May 25

Hi dr.Jacobs.
I will like to know if it is normal to have an high estrogen level.



B. Jacobs, M. D. - May 25


Do not rely on store boought tests for sperm. They will not provide adequate information. The 2 of you, as a couple, deserve a thorough evaluation by a Reproductive Endocrinologist.
Good luck.


Estrogen levels ride and fall during the mensrual cycle. Just prior ro ovulation, it is common for estradiol to be as high as 350 pg/ml in serum.


Kamivy - June 26

Good Morning Dr Jacobs,

My husband recently had his second SA done, which came back worse than the first - 8.6 mill/ml, 41% live, 28% slow, 5% rapid, rest non progressive or dead, 2% morphology. My question is the report that was faxed to us simply says as comment - "Triple defect with raised TZI" This sounds like a different language to us - Could you please tell me what this comment means and what the implications are? Thankyou.

Regards, Kam.


B. Jacobs, M. D. - June 26

I am not sure I know what is meant by "ZTI". You want greater than 20 million sperm per ml and greater than 40% motile forms. Different laboratories report different minimum normal morphology. The laboratory I use wants at least 6% normal forms. That correlates well with the ability of sperm to fertilize eggs.
Good luck.



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