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How Many Times Should You Try IVF Before Giving Up?
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- Recurrent Pregnancy Loss: The Role of Immune Therapy and IVF
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Because of the emotional, physical, and financial toll exacted by IVF, it is preferable that a couple undertake the process with the mindset that they will be in it for more than one attempt. If a couple can only afford one treatment cycle, IVF may not be the right course of action. Recall that on average, with conventional IVF, there is only about one chance in three that it will result in a live birth, and there is a tremendous letdown if it fails. It is thus unreasonable to undergo IVF with the attitude that “if it doesn’t work the first time, we’re giving up.” In vitro fertilization is a gamble even in the best of circumstances.
Statistically speaking, a woman under 40 years of age, using her own eggs, having selected a good IVF program is likely to have a better than 70% chance of having a baby within three completed attempts – provided that she has adequate ovarian reserve, (the ability to producing several follicles/eggs in response to gonadotropin stimulation), has a fertile male partner (or sperm donor sperm) with access to motile sperm, and has a normal and receptive uterus capable of developing an “adequate” uterine lining. Women of 39-43 years of age who meet the same criteria, will likely have about half that chance (35%- 40%).
When the most “competent” embryos are selected for transfer using a new genetic process (introduced into the clinical arena by SIRM in 2005), known as comparative genomic hybridization (CGH), the birth rate per single, completed IVF cycle is likely to exceed 60% (regardless of the age of the egg provider) and, more than 85% within three such attempts.
Unfortunately, there will inevitably always be some women/couples who in spite of best effort at conventional IVF will unfortunately remain childless. In my considered opinion, it rarely advisable to undergo more than three IVF attempts using the same approach each time. There is of course one important caveat: in women where the reason for repeated IVF failure is finally uncovered, it would indeed be justifiable (assuming there are sufficient emotional, physical and financial resources) to continue trying, using a defined and new approach that addresses the reason for prior failures. Simply stated, “the time to stop trying is when there is no remediable explanation for repeated failure to achieve a viable pregnancy”.
One very interesting case comes to mind. It happened a few years back when I consulted with a 42 year old Australian patient (she happened to also be a physician) who had undergone 22 prior failed attempts at IVF elsewhere. After determining that the reason for prior failures (at least in part) was due to a hitherto unrecognized immunologic implantation dysfunction (IID), I took her through yet another IVF attempt using selective immunotherapy. She conceived (using her own eggs) and went on to have a healthy baby boy. This case serves to point out that the time to stop doing IVF should not always be based on the number of prior failed attempts alone.
When conventional IVF (with or without egg donation and/or CGH embryo selection) fails to yield a successful outcome, other options such as ovum donation, IVF surrogacy, or adoption should be considered.
Although it is the right of any healthy women who has a uterus and is capable of producing even one follicle/egg to have the right to decide on doing IVF using her own eggs, given the very low success rate after 43 years of age (less than 10% per attempt and under 25% within 3 tries) it is my opinion that women over 43 years should be advised to rather do egg donor IVF. Here, regardless of the age of the embryo recipient, the IVF birth rate after a single attempt is about 60% – and better than 80% within three IVF attempts.
Couples who choose to undergo IVF should be encouraged to view the entire procedure with guarded optimism, but nevertheless must be emotionally prepared to deal with the ever‑present possibility of failure. It is important for IVF patients to be made to realize from the outset that an inability to become pregnant should never be considered a reflection on them as individuals.
75 Responses to “How Many Times Should You Try IVF Before Giving Up?”
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Ask Our DoctorsA Question
Dr. Sher,
Through my internet research I have found you to be a reprooductive endocrinologist who is knowlegable, trustworthy, and compassionate. I just signed up to receive a consultation on your website. I want to know what IVF protocol you feel is the most aggressive protocol for someone who is running out of time. My RE said that the micro-dose lupron flare portocol that he has me on is the best he has to offer. I wonder if he is conservative at times. Although, my RE is very intelligent he has many other responsibilities and cannot give me the individualized attention that I suspect you provide your patients. My RE is at a university setting. Here is my history in a nutshell. I am 39 and I have an elevated FSH level of 14. I have had 2 prior IVF attempts without success. (I had previously tried IUI's without success too – however, my husband's semen samples with the IUI's were inadequate to the level of 2.5 million after washing on one occasion.) With both IVF cycles the same stim meds were utilized. Lupron 10 units (40mcg/0.1ml) twice daily for 2 days followed by Gonal-F 300 units twice daily with Luveris 75 units in the evening (while continuing the lupron) for about 1 week untill enough follicles were of appropriate size by ultrasound monitering. (I was prescribed ovidrel as well.) I began progesterone 50mg IM on the evening after egg retrieval both times. I was given a short course of doxycycline with both attempts. I was prescribed a short course of steroids both attempts – methylpred 4mg tid for 3 days beginning post retrieval. I was told to take a baby asprin daily after egg retireval with both attempts. With the first attempt 3 high quality embryos were transferred on day 3 and ICSI was used. No pregnancy. With the second attempt the same basic protocl was utilized with the addition of viagra suppositories 25 mg every 6 hours for 10 days during stim and I had a spontaneous cycle where 2 endometrial biopsies were performed for promotion of a more hospitable endometrial lining. He used estrace to suppress me during the latter half of my spontaneous cycle with the second IVF just prior to stim. I had a weak positive pregnancy test 2 weeks post egg retrieval- hcg of 29. The level did initially climb almost doubling every 2 days briefly – I had a miscarriage 1 week after my initial weak positive pregnancy test. With the second attempt I had 4 high quality embryos transferred on day 3. I did not have any embryos to freeze with either attempt. 8 and 6 eggs were retrieved with my cycles respectively. (Some eggs were immature and some did not fertilize properly and some just were not high quality embryos that had to be discarded.) I wonder about your thoughts on intralipids for me as well as other stim protocols that might produce more mature eggs. Would you think that more immunologic factors should be investigated at this point?
Please advise.
Thanks. Kay
Dear Kay,
Sorry for the delay in responding.
I would respectfully point out that in my opinion microflare protocols are suboptimal for women with diminished ovarian reserve (DOR). Please read my article that deals with "IVF ovarian stimulation: An individualized aproach" ..elsewhere on this blog. What you need is an agressive agonist antagonist conversion protocol-A/ACP (to be found in an article I wrote for this blog, elsewhere).
Also IUI ( proudly a procedure that I introduced into the field in the early 80's) is relatively contraindicated in cases of DOR…see my article on IUI elsewhere in this blog.
You certainly need IVF with a very customized protocol of stimulation. …and you need it soon.
I look forward to our telephone consultation when we can explore your issues in detail.
Geoff Sher
Dr. Sher,
I'm looking for a professional opinion in my case. My husband and I have been TTC for 3+ years. We are both 27. We have been diagnosed as unexplained infertility.
Our first IVF cycle resulted in 12 eggs, 9 of which fertilized, and only 2 made it to 8-cell embryos that were transferred on day 3. The remaining embryos stalled and were unable to be frozen. The cycle resulted in BFN.
Our second IVF cycle resulted in 14 eggs, 12 of which fertilized, and only 2 made it to blastocyst and were transferred on day 5. Again, the remaining fertilized embryos stalled and were unable to be frozen. The cycle resulted in BFP but I just miscarried at 7 weeks, the baby stopped growing at 6 weeks.
My question is regarding the possibility of a genetic issue or incompatibility between my eggs and my husband's sperm that results in slow growing or poor quality embryos. Given the fact that out of 21 fertilized eggs only 4 have gone on to be viable embryos, could that lead one to believe something more series is going on genetically?
My RE said it is impossible to answer this question and I am looking for a second opinion.
Thank you for your time.
Brittney
First off…This is highly unlikely to be an inherent egg defect. You are simply too young for this explanation. Unless there is significantly abnormal sperm, the most likely explanation is the protocol of ovarian stimulation used.
Please see elsewhere on this site, an article I posted on November 22nd 2010 entitled "An Individualized Approach to Ovarian Stimulation…".
Feel free to call and discuss your case with me.
Geoff Sher
I am 32 and had 2 IVF and both have failed. First cycle I was on Lupron,menopur,folistim,estradiol and crinone 8%. RE told me out of 12 eggs 7 fertilize and 2 embryos (4CB and 3BB) of good quality where transferred on day 5. RE told me, out of the 5 that were left only 2 were frozen 5AA and 4AA. I had my last FET on 2/6/13 and my RE transferred both of my last embryos. Meds Lupron,estradiol and crinone 8%. And then on 2/15/13 RE told me that this cycle failed. I asked him why, he said that its a 40%. Please advise me if my RE missed anything or if I need a different protocol? My husband and I have beenTTC for 4 years now. Can you please help us?
At 32 with 4 blastocysts transferred, given that 1:2 should be chromosomally normal, the fact that no pregnancy resulted raises the question as tro whether there was an implantation problem. This needs to be thoroughly evaluated, taking into consideration anatomical uterine factors, thickness of the estrogenized uterine lining and immunoloogic factors.
Please go to the home page of this blog, (www.IVFauthority.com). When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
2. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
3. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
4.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
10.“Embryo Banking”
11. “Egg Donation”
12. “Gestational Surrogacy”
13. “IVF Success Rate Statistics: The Time Has Come to Revise the Present Reporting System”
Consider calling 800-780-7437 or 702-699-7437 to arrange a telephone or Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.. While an audiovisual (Skype) interaction is much more personable and preferable than a discussion by telephone, either will suffice.
Geoff Sher
Dr Sher,
We just did our first round of ivf and included PGS. We had 8 eggs, 6 fertilized and 3 made it to blast. All 3 tested abnormal. My question is should we do a 2nd round? Have you heard of women having normal embryos after having all abnormals?
Indeed…It happened with me and my own daughter at 40Y. First round…zero normal. 2nd round -only 2 months later, and with the identical stimulation protocol…6 normal.
Geoff Sher
800-780-7437
Make certain that the PGS done is CGH.
I just got the detailed report. We had one monosomy 15, monosomy 21 and monosomy 21. Does that tell you anything about our chances to have a successful round?
Thank you so much for your time.
It tells me that all the embryos were aneuploid (“incompetent”). This almost always stems from the egg rather than the sperm. Virtually no one is born with all their eggs aneuploid. Aneuploidy is always present in some eggs and the incidence increases with age. It also increases with certain conditions such as PCOS. Most importantly, the incidence is influenced by ovarian hormonal environment which in turn is very much affected by the protocol of ovarian stimulation used.
I think I might be able to help here.Please go to the home page of this blog, (www.IVFauthority.com). When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
5. Factors affecting egg and embryo quality”
6. “Staggered IVF”
7. ” Embryo selection: The critical factor in IVF”
You might consider calling 800-780-7437 or 702-699-7437 to arrange a telephone or Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.. While an audiovisual (Skype) interaction is much more personable and preferable than a discussion by telephone, either will suffice.
Geoff Sher
Revised : 15, 21 and 22. Sorry!
I’ve been searching the internet to help me figure out my next step and running into your website has given me more information and I look forward to your opinion regarding my situation.
Here is my situation, I just turned 40(not much time left) and have PCOS. I was diagnosed with PCOS for at least 10 years. I’ve been taking Metformin and currently on 1000mg twice a day. Taking metformin has finally regulated my period (35 days cycle) for the past 4-5 years.
What has been on my mind lately is should I try again and get a second opinion…I went through my first IVF cycle in November and retrieved 26 eggs. I transferred 2 embryos(4AB and 4BB) and that turned out a negative. I did a FET in January transferring 3 embryos(4bb and 2 4BC) and that was also negative. After consulting with my RE, RE stated my egg reserve maybe not good because of my age, but I was wondering if there anything wrong with my lining. According to the RE and staff it was fine, but gut feeling was telling me what if something is wrong with my lining. I didn’t ask any questions because doctor’s are the experts in this matter. RE also stated that I may have to use donor eggs but I want to avoid that as much as possible to figure out what is wrong with me. RE did not do any other testing and I am wondering if the RE should have tested my immune system or something to find if there were other contributing factors besides my age and PCOS.
Also, prior to IVF I had done a HSG test and showed both tubes were blocked. RE stated that he can go in and unblock them if I wanted to. That also made me think and confused me that I am looking for a second opinion but don’t know where to go or start because we have only one clinic in the city I live in.
I am not sure what to do and hope what I wrote made sense. I guess I am looking for suggestion or opinion of what can my next step be.
I appreciate your help.
Evie
Respectfully, if you make as many eggs as you do, you cannot have diminished ovarian reserve. It is true that PCOS women tend to have difficulty with egg quality but individualizing the protocol of ovarian stimulation can go a long way towards addressing that issue. You do not need an egg donor, in my opinion. What you need is an individualized approach to ovarian stimulation followed by Staggered IVF with CGH embryo selection (see below)
Please go to the home page of this blog, (www.IVFauthority.com). When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “PCOS”
4. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
5.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
6. “IVF success: Factors that influence outcome”
7. “Staggered IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.
Geoff Sher
Dr Sher,
I am 34 with good AMH normal scans etc. Husband has very low count and poor motility. We gave just failed our first cycle of ivf with icsi. I received bcp down regulation and then final F and liver is then Cetrotide. Retrieved 15 eggs, however only 7 were mature. Of the 7, 4 fertilized with icsi but only 2 survived to day 3. Anxious that they wouldn’t make it (had planned for 5dt) we implanted day 3. Unfortunately it didn’t work. I’m heartbroken but also worried about the eggs…why would only half be mature? and only half fertilized with icsi, is that low? Is there also an egg problem? Do you think we should try again? Thank you for your expert opinion.
At 34, it is highly unlikely to be an intractable egg issue. I need much more information to comment intelligently.
Feel free to call 800-780-7437 and set up a Skype consultation with me to discuss.
Geoff Sher
Sorry, predictive text errors. I was on luveris gonal F and Cetrotide.
Thanks.
Copy!
Geoff Sher
Hello, I just found out today that my first round of IVF /ICSI yielded no results. I am 43 and DH is 49. Sperm count and motility a major issue; ER says I have ovaries of 35 y/o. First round used Follistim and Menopur. Retrieved 15 eggs, 6 fertilized, 2 morula for day 5 transfer and none to freeze. Progesterone since transfer.Wondering how long I should wait for round 2 and if advice to amend protocol . Gratefully…
Ideally you should rest a full cycle before trying again.
Good luck!
Geoff Sher
800-780-7437
I am 44 years old, and just completed my third IVF tratment. I had 16 eggs, 9 matured, 6 fertilized. 4 grade AA, 2 grade AB. Four implanted, 2 did not make it to cryo. They say my numbers all look good. What do you suggest for me next?
Egg donation will give by far the best results. However, the next best is “Embryo Banking” with Staggered IVF…see below.Please go to the home page of this blog, (www.IVFauthority.com). When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. Embryo Selection: “The critical factor in IVF”
2. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
3.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
4. “IVF success: Factors that influence outcome”
5. “Staggered IVF”
6.“Embryo Banking”
7. “Egg Donation”
Consider calling 800-780-7437 or 702-699-7437 to arrange Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.
Geoff Sher
Dr Sher,
I am 39 years old and about to go through my 2 round of Ivf. I have a permanent ileostomy from crohn’s disease. I’ve had 2 hsg tests and my fallopian tubes are patent. We underwent 2 unsuccessful iui’s and our first Ivf they took 6 eggs. All 6 were injected via icsi but only 2 eggs survived, on day 2 1 was 4 cell and the other 2 cell and they were transferred on day 2 but unfortunately they didn’t survive.
I was 38 years old at the time of our first Ivf. My fsh levels are “slightly elevated” according to the hospital, my fsh was 12 last count I think my lh was 7. I am currently taking all my vitamins so my body is in best condition for the next cycle. I would appreciate your views on how I should approach my next cycle and my chance of concieving. Thank you. Melanie
It is about choosing the optimal (but aggressive) strategic protocol for ovarian stimulation while at the same time recognizing that some of your health issues could be autoimmune-related thus necessitate an evaluation for immunologic implantation dysfunction.
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there look for a “search bar” in the upper right hand column. Then type in the following subjects into the bar, click and this will take you to all the relevant articles I posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dr. Sher,
I am 32 and recently found out that my first frozen embryo transfer failed. This is also following a failed fresh transfer. My ivf cycle yielded 25 eggs, 20 fertilized, 13 became blastocysts and 10 were found to be normal following cgh. Considering the statistics you have on your site regarding success rates with cgh I am confused as to why it has not been successful for me. I would also like to add that I have had 3 natural pregnancies that all ended in miscarriage during the first trimester so I know that I can get pregnant. Do you have any insight as to what we should be doing differently?
I strongly suspect that you have a hitherto undiagnosed implantation dysfunction.Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1.”Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
2. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “IVF success: Factors that influence outcome”
9. “Staggered IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dr. Sher,
I am a 37 year old woman diagnosed tubal factor. We have done 3 rounds of IVF since 2010 ( 2 fresh with own eggs and in March one fresh DE cycle). 1st cycle was chemical pregnancy (d&c@ 10 weeks) after 2 very good blasts transferred. 2nd cycle total fail with 4 good 3 day embryos transferred. Most recent DE cycle transferred 2 excellent blasts and beta was a 3 (presumed chemical). After chemical pregnancies, I was given no explanation other than “it just happens”. I am overweight, but very active. I have had 2 normal pregnancies when I was 21 and 22 years. My initial bloodwork (thyroid and diabetes) did not seem to raise flags. I have to wonder if something else is wrong, though, since we failed with donor eggs (from a 20 year old healthy girl)!
We have 2 frozen from donor cycle, but until we are sure I have been properly diagnosed, I don’t want to transfer again.
My questions:
1. My uterus has not been a concern because I have 2 teenagers from 1st marriage. Current hubby has great SA. Do you feel further testing should be conducted on me in regards to implantation issues? If so, which tests?
2. We switched to donor eggs because of 2 failures and an fsh of 10. Do you feel moving to donor eggs was a good decision? Or, if implantation was cause of failures, would another cycle with own eggs be reasonable?
Thanks for your insight in advance!
Emily
This sounds very much like an implantation dysfunction that can be anatomical, lining related or immunologic. The fact that you have two teenage children might make an autoimmune implantation dysfunction unlikely but not an alloimmune dysfunction (see below). Most importantly, use of donor egg will not counter the latter either. We should discuss this.Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
In the meanwhile, please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
Geoff Sher
Dr. Sher,
You confirmed what my “gut” has been telling me. I am having a “scope” of my uterus (have already had HSG and saline ultrasound) on May 10. Following this test I will, certainly, contact your office for consult. As I am a teacher, travel becomes easy for me during summer vacation. I truly hope you can complete my diagnosis so treatment can be determined. I would be delighted if findings indicate use of my own eggs is possible.
Thanks for such prompt reply and good information. Looking forward to our consult.
Emily
You are welcome!
Geoff Sher
Hello,
I just had a failed ICSI cycle and have lots of doubts. my boyfriend has antisperm antibodies (for unknown reasons). we did 2 failed IUIs before. im 35 and he is 36. i have multifollicular ovaries. in the ICSI cycle, my eggs took a while to get big enough, and when they did my estradiol went really high even though from the number of follicles (about 13, with some small and some big) it didn’t look like. i was coasted for 4 days and got very stressed. EC yelded 6 eggs; 5 were mature, 3 fertilised normally. because there were only 3, the doctor decided on a day-3 transfer of 2 6-cell embryos. he said my lining was “textbook”, but the cycle failed. we have a frozen 6-cell embryo waiting now. we are wondering whether the antisperm antibodies can be linked to problems such as chromosomal issues that we might not be aware of. whether we should test for these, and which tests would be recommended if so. the doctor says my AMH is normal for my age. i am also afraid of future side effects of all these drugs. any advice would be really appreciated … thank you.
The sperm antibodies are not a problem when you use ICSI. This sounds like a possible ovarian stimulation issue. I suggest you call 800-780-7437 for a Skype consultation and let us discuss.
Geoff Sher
Hi Dr Sher,
First off, thanks for building such an informative and authoritative website on infertility-related issues. It has been a great source of comfort to me in my research.
I’m 35, and have just failed my second fresh IVF/icsi cycle after 2 failed FETs last year. All three were 3-day transfers with two good-to-excellent quality 7-10 cell embryos each (blastocyst transfers are not encouraged in my country for some reason). My first IVF/icsi cycle 4 years ago was a success, resulting in the birth of my lovely daughter.
Both fresh cycles had similar long protocols (on 150 gonal-f and 200 puregon respectively), both resulting in 20-21 eggs retrieved and around 12-15 eggs fertilised. I had 8 embryos to freeze the first time, and now i have 5 frozen embryos awaiting my next FET.
My qn is: since the number and quality of embryos are relatively high, do i have an implantation issue? My lining for all the cycles have always been good at 12mm thick. But then my first cycle was a success, so I’m really confused as to why the previous 3 cycles with good quality embryos have failed to implant. BTW, we are resorting to IVF due to serious MFI (on all factors and count). How should i proceed any differently for my next FET/ fresh cycle? Thanks in advance for your kind advice!
You have likely just diagnosed your own problem. Indeed, the most likely explanation for recurrent “unexplained” IVF failure in relatively young women who have had morphologically good quality embryos transferred to an apparently anatomically sound uterus, is immunologic implantation dysfunction. I think I might really be able to help here. Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
In the interim, please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “Unexplained IVF Failure”
Sincerely,
Geoff Sher
Thanks very much!
I would just like to add that i have no known fertility issues, and have been maintaining a healthy lifestyle/diet, and that I had complete placenta previa during my pregnancy and had a C-section. Would this somehow have impacted on the implantation failures in my last 3 cycles since? Also, my last failed fresh cycle was done at a different clinic from the first successful fresh cycle and 2 following failed FETS. Thanks again
Copy…see my response to your 1st post, below.
Geoff Sher
Hello dr sher!
I am 28 years old and have had lots of female issues since I was 19! As a result I have had several Dnc which led me to scar tissue within my uterus! My husbands and I yvhave been trying to conceive for 3 years. We were able to conceive last June on my left ovary but ended in a miscarriage at 12 weeks. That time we conceived using 200 mg clomid and a trigger shot. After seeking an RE we found out our miscarriage was most likely due to scar tissue we didn’t know was there. I had my scar tissue removed in jan and just received word that our first attempt at ivf failed. I was on 10 units of Lupron and 75 units of bravlle as well as menopur…they increased my menopur and follistim toward the end as I wasn’t getting very many follicles. My ovarian score was 12 prior to stimming which I was told was average for my age! From my ivf they only obtained 6 eggs with 4 beingimmature leaving just 2! Both of those fertilized with an 8 cell and 6 cell with a 3 day transfer. I continuously asked my re if my lining was ok and they assured me over and over it looked perfect! My husbabnd wants to try again as we were told it takes 2 times for average success. If we do it again we would like to use eggs from my sister however I am vey concerned that it may not work again due to my
Hi Corina,
I really think we should talk . perhaps I can help you shed light on your situation and find a solution. On the face of it it does sound like an implantation dysfunction. However it needs to be thoroughly evaluated before you try again.
Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “Asherman’s syndrome”
9. “Endometrial thickness and IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Hi Dr. Sher,
I am currently 33 years old and on the way to my fourth IVF cycle. Luckily after our stimulation we had 40 eggs retreived, 38 viable and 36 matured. So far I have been through a fresh cycle: negative; frozen cycle: a chemical pregnancy; third cycle: positive but with 2 embryos transferred at fair quality which resulted in a miscarriage. Now my husband and I are moving into our 4th round and wondering if something else might be wrong. Do you think we should insist on transferring only good or excellent embryos? The first and second time we only transferred one, third time 2 and this next time will be 2. Also, my mother is a five year breast cancer survivor and I am worried about a lot of estrogen exposure. At what point do we condsider a surrogate? I have always responded to the estrogen but hate the feeling of being on hormones. Thank you,
Jodi
The fact that at such a young age (33Y) when you would expect 1/2 embryos to be chromosomally normal and competent and you have with numerous embryos not achieved a viable pregnancy means that this is not likely to be an inherent egg/embryo issue. It is more than likely that you are dealing with implantation dysfunction that more than likely is due to immunologic implantation dysfunction.
Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
2. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
3. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
4.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
5. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Hi Dr Sher,
I am 33, husband 35, both have normal tests results – chromosome, immune, hormone, lap, hysteroscopy, hsg, sperm etc. We have done 6 cycles of IVF, 2 of these resulted in a chemical preg and m/c at 8 weeks both with OHSS, the others negative. Each cycle produces 12 – 22 eggs, 80% fertilization rate, but only 2-4 good enough embryos to transfer on day 3. Have tried various different protocols but not much change, doctor now suggesting egg donor. Would very much appreciate your opinion.
Kim
Respectfully, in spite of your representations above, I strongly suspect an implantation dysfunction which unless addressed, will result in your continuing to spin your wheels.
Might I suggest you go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
2. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
3. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
4.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
5. “IVF success: Factors that influence outcome”
Perhaps you should consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dear Geoff
I have had 5 full stimulated cycles of ivf icsi starting at age 32 now 35. I achieved pregnancy 1st go but ended due to a blighted ovum then achieved a successful pregnancy on 4th full cycle. I have PCOS and my husband’s count is 2million per mil. My son is 2 and we are trying for a 2nd child except the first cycle has failed with 10 eggs retrieved we only had 4 fertilize, 2 transplanted on day 3 none to freeze. With my son I self prescribed baby asprin and was put onto Clexane during 1st week and up to 13 weeks of pregnancy due to OHSS. I always now wonder whether it was the Asprin and Clexane that made this a successful pregnancy or that fact that I had a blighted ovum initially (which I had to have removed) rules that out? I’m interested in your thoughts on this.
Regards
Nicole
Sorry, I should say DR Sher
“Geoff” is fine!
Geoff Sher
I do not think it was either…Nicole. But it is the end result that counts!
Geoff Sher
Hello Dr Sher,
OI really enjoy reading these forums. I have a question to ask. I am 34 years old and did a FET; resulted in a chem pregnancy. I transferred 2 excellent embryos from ICSI and PGD, grown out to day 5. I was placed on the antagonist protocol and had 24 eggs at retrieval. In the end only 4 were chromosomally normal. Both my husband and i have Beta Thal minor traits. I was never tested for Vit D deficiency and I was reading that being deficient i this vitamin can have an impact on embryo implantation. Is this true? My levels were really low and I was Prescribed 50,000IU twice weekly. I never took these pills. Could this be a causative factor that affected the outcome of my FET? PMHX: one blighted ovum prior to IVF…was still vit d deficient also.
thank you
lisa
Honestly Lisa, I doubt that this is related to vitamin D deficiency. There are so many other much more plausible factors. Since 2 chromosomally normal embryos were transferred in the mix and you did not conceive, the most important is implantation dysfunction.
The same recommendations apply to you as I made to “Amruta’s” post today (see above). Please see these and call 800-780-7437 to set up a Skype consultation with me.
Geoff Sher
I honestly do not believe that vitamin D deficiency explains your predicament.
Geoff Sher
Hi Geoff,
I’m currently 32, since last 4 years trying for pregnancy.
Two misscarriges in 2 years (around 5 week) natural Pregnacy & (around 10 week) with Clomid 50 mcg.
In 2011 feb started taking clomid 50,100,150 for 7 months no succes then tried IUI with Clomid 150,for one month and later IUI with fertility medications- failed.
In mid 2012 performed IVF with fertility Medications retrived 4 eggs and 2 were fetilized transfered 2 embrios on 3 day – result failed.When discussed with doctor asked me reduce weight(My height is 5.6″ ,weight @ 257lbs).
As I have tyriod issue it is hard to reduce but tried to reduce to 10 to 12 lbs for next ivf cycle
Changed the doctor for IVF 2 ,In early 2013 permored Ivf 2 with medications retrieved 6 eggs and 4 were fertilized 2 made to Morala stage on Day 5, Transfered 2 morulas on Day 5 again failed.
When we disscused with doctor he check all the reports and told this may be because of the slow egg growth or the eggs might got arrested after the transfed and he suggested to loose weight.
So trying to loose weight(215lbs) so far reduced (From 257 to 226)
My questions is If i get the pregancy naturally why it is becoming so hard?
Main concern is Time & age, is it good to try other IVF around weight @ 215lbs instead of waiting to reduce more weight?
or do we have any other tests to be done or differnt way to improve the egg quality?How do we know it is improved or not?
It would be important to test for antithyroid antibodies and for natural killer cell activity (by the K-562 target cell test). The reason is that 50% of women whom have antithyroid antibodies also have activated NK cells and in such cases it can cause implantation dysfunction.
Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “Thyroid autoimmune disease and IVF”
2. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
3. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
4. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
5.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
6. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Geoff Sher
last 6 months back tested antithyroid antibodies and results look good.Still do we need to do
K-562 target cell test?
Lisa
Dear Dr. Sher,
I got pregnant for the first time when I was 31 after about 8 months of trying. We discovered at 20 weeks that our baby had a big deletion in chromosome 15 and ended up loosing the baby at 23 weeks. We were told this was really bad luck as both our chromosomes are completely normal. We have been trying since then and apart from one or two chemical pregnancies, I have been unable to get pregnant again.
I am now 33 years old (4 months away of turning 34) and just went through my first ivf cycle. We have done all tests including HSG and nothing seems to be wrong, though my husband had slightly low sperm count and low on good shape but the doctor said he had enough good sperm to produce a baby. So we thought ivf would be the solution.
I wonder if you could help me understand what went wrong and if the problem we have is with my eggs? They retrieved 22 eggs and fertilized half with ICSI and half naturally. 9 eggs fertilized. 3 blasts were biopsied on day 5 and all were abnormal. One had deletion of chromosome 15, one trisomy 19 and one trisomy 20. We had one that was biopsied on day 6 and frozen and we are waiting the results for this one. Can you help me understand what happened? Is it a problem with my eggs?
Thank you in advance
Ana
Hi Ana,
In a woman of 34, only about 1:3 embryos are chromosomally normal so what happened to you could be just plai bad luck. The fact that there were several types of aneuploidy and only one involved chromosome pair 15, would support that view.
The protocol for ovarian stimulation is also very important.
Please go to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
5.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
6. “IVF success: Factors that influence outcome”
7. “Staggered IVF”
8.“Embryo Selection: The Critical factor in IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Hi.
I am 30 and want to know if you could help. My husband(low sperm count 2.5 mil due to vericoc.) and I have had 2 ivf and 2 fet. Pregnant with all 4. Ivf #1: 13eggs 12 mature 11 fertilized 3 blasts frozen
2 8cell transferred- lossed twins 23 weeks ptl
Fet: 2 survived thaw (bb) one transfered, mc 5 weeks ( great beta)
Ivf#2: (doctor changed med to menepur, ivf1 was follistem)
6 eggs 6 mature 5 fertilized, transferred 2 8 cell, 2 blasts
Frozen: 2 transferred- eptopic ( both tubes removed)
Fet#2: both blasts transferred (ba,bb)= chemical
My question is, would this be a implantation issue, egg/sperm or a genetic issue? My hormone levels have been good and lining always 10 or above at transfer. My clinic hasn’t been very helpful with my concerns and questions. Thank you for your time.
Jessica…your age and history makes this highly suggestive of an underlying implantation dysfunction. I really think I can help you.Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail. In the meantime, please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “IVF success: Factors that influence outcome”
Regards.
Geoff Sher
Hi Dr sher,
We have just had our 10th failed IVF cycle. We started when I was 36 I am now 41. I have changed drs and am now with a doctor who is willing to experiment and try what he can. I have been on the Colorado protocol, been on liverish, aspirin, prednisone and all the goodies.on our 8th attempt we fell but miscarried twins at 9 weeks. At first they thought it was an implantation issue now e dr tHinks it was egg quality so we had the cgh genetic testing.only had one egg out of 11 transferred and yesterday we found out it didn’t work . I have been diagnosed with adenomyoisis and pcos however I normally get 12-21 eggs. This round was my lowest egg count. Just before my transfer I was also diagnosed with anaemia and being iron deficient . I am having more tests done in relation tmthat now to seenwhatnthe problem am be. I know I am not getting any younger and egg donation is a viable option but I feel like I can do it at least once with my own egg.i had a child when. Was 21 however she passes away when she was 2.no genetic problems. I just feel like I’m not getting answers, if I can pop out lots of eggs and my lining is ok(supposedly) then what else do I need to do…. Any suggestions, advice, wisdom,ideas would be greatly appreciated.
Kind regards
Vanessa
Vanessa,
I would very much like to discuss your case with you. There are 2 issues here. The first is to select an individualized and strategic protocol of stimulation that will best protect your eggs through meiosis and optimize their chromosomal competence (see below). The second is directed at what I believe to be the most likely reason for your numerous filed cycles and your miscarriage…namely an implantation dysfunction.
You need immunologic evaluation, CGH embryo selection, Staggered IVF with embryo banking and then selective embryo transfer to a receptive uterus. This needs to happen before you run out of time.
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Staggered IVF”
7.“Embryo Banking”
8. “Embryo Selection: The Critical factor in IVF”
9. “Use of the Birth Control Pills in IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Hi Dr Sher,
My background: Age 36, unexplained infertility. Seven years ago I had a natural pregnany that resulted in miscarriage at 7 weeks. Two years ago My husband and I went through IUI with a pregnancy ending at 7 weeks. Pathology results came back as trisonomy 16. After 3 more failed IUI’s (all using GonalF) we moved on to IVF using Menopur, Follistim, Cetrotide and bby aspirin. This first IVF (5 eggs retrieved, two resulted in 5-day blasts and 1 transferred resulted in a miscarriage at 7 weeks. Our second round of IVF (same medication protocol, 10 eggs retrieved, all fertilized 5 made it to 5 day blasts and 1 transferred) resulted in a chemical pregnancy.
We have had all of our genetic test results, karyotyping and clotting tests come back as normal.
We attempted our first FET (transfered two) which resulted in a negative result. Before continuing the madness of another round of IVF, perhaps with a new Dr and considering PGS, is there anthing else that could be causing this repeated loss and failure? Egg quality or Implantation Issues?
Kind Regards,
Tracy
Usually it is an egg quality issue that is primarily a function of age but can also be affected by the protocol used to stimulate.
Feel free to call 800-780-7437 if you wish to discuss.
Geoff Sher
I am a healthy 37-year-old, all tests normal, but…never been pregnant. Not even a chemical or miscarriage. We tried for a year, then moved on to ART.
After 3 failed IUIs, we did our first IVF (Bravelle, Menopur, Ganirelix) with ICSI.
They retrieved 15 eggs, 11 were fertilized, and by Day 3 there were still 8 developing. On Day 5, they had all stopped growing.
Our RE said this is a very bad sign, but that she could not tell if it was a sperm or an egg issue–but she seemed to think bad eggs.
She advised trying again with the hopes getting a better batch (slightly tweaked dose and with PICSI), but admitted that if they all arrested again that it meant we would not be able to have a biological child.
I am so sad and stunned. Is there something wrong with my eggs? Should we give up if the same thing happens again?
Again thoughts would be so appreciated.
HP
We really should discuss this . I think I might be able to help here.
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4 “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
5.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
6. “IVF success: Factors that influence outcome”
7. “Staggered IVF”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dr. Sher
TTC for 4 years no problems detected with my husband or myself, Did 1sr round of IVF retrieved 18 eggs, had 11 embryos, all 11 didn’t make it past 3 day transfer was cancelled. Is it normal to loose all embryos at the same time? Dr. ordered blood work for husband & myself for Y chromosome deletion & Karyotype if tests come back normal how common is it that this will happen again to the embryos?
IT could be the protocol of stimulation. See #s 1-3 b3low.
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
5. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dr. Sher,
I have a question. I have been diagnosed with mild PCOS ( I have regular cycles every 32-36 days) and my husband has severe mail factor (last count was 6 million, ‘sluggish”? motility and 1% normal morphology). Despite this have had 5 pregnancies, 4 early miscarriages and 1 live birth (severe hyperemesis was my only pregnancy complication). I have never used fertility treatments to conceive but IVF with ICSI has been recommended. I have the homozygous C mutation for MTHFR and elevated T helper cells (per RIP). The immune testing was actually done by my OBGYN and the RE that we saw said he does not give immune issues a lot of weight. So given my history should I seek out a clinic that does focus on these issues? I am very new to all of this and not sure what I should do at this point. Thanks so much!
Respectfully I strongly differ from the opinion that immune issues are not a likely cause here. In fact this sounds to me like an immune issue (possibly alloimmune.).
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.
5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)
6. “Recurrent Pregnancy Loss (RPL)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “IVF success: Factors that influence outcome”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
I am 33 and my husband is 49, I am guessing age is relevant.
Copy..that makes me feel even more adamant about what I said below.
Geoff Sher
I’ll be 43 next month. I have done (antagonist) two(2)IVF failed.(1)IVF:8 eggs, 4 embryos were transfered – 2 fresh embryos and then 2 frozen embryos on day 3rd. All good quality 8- 9 cells.
(2)IVF:I had ovario over stimulated produce 18 eggs, 11 embryos: 1st transfer with 3 frozen embryos(good quality)failed. The 2nd and last transfer: My Dr. decided to transfer only the strongest embryos on day 5th, only we got 3 embryos, but under law in this country only they can tranfer 2 embryos.(1 mature and other finally grew well(8 cells)failed.
I was suggested to go for egg donner but by law is ilegal only we can buy from Europe or USA ($15,000).My Dr. doesn’t find the problem. the eggs looks good quality and nice.but we don’t know the quality inside the eggs. What could be the reason on failed implantation.Before go to 3rd IVF she required me some genetics test (made in USA)to see any genetic problem that avoid the successuful implantation of the embryos.I/m waitting the results.Also she required again an endometrio biopsia to check if i have intern inflamation. Do I have still chance to get pregnant on the 3rd IVF at 43y If I have a genetic problem? it will be serious? it can be chances to overcome that treatment?
Or should I give up?.What other options i have? thank Dr. in advance for your advice.
Hi Doctor,
Is it a good investment for a 41 year old single like me to freeze eggs/oocyte cryopreservation. FSH=9; estradiol =65, AMH=2. AFC is 16. responds well to clomid. or maybe i can wait 2-3 more years when im 43-44 years old already hoping to find somebody and go straight IVF if i dont get pregnant naturally by that time
It is a good idea but you need to recognize that a 41 only about 1:10 eggs will be chromosomally normal Ideally you should do CGH-testing on the eggs up for freezing because if that is abnormal, those eggs would not be “competent” (see below).
Please go to the home page of this blog, http://www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Fertility preservation (FP)”
3. “Egg Freezing”
4. Egg Banking”
Please read these articles and then call 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Dear Dr Sher , I had my first round of Ivf in 2011my fsh levels were 11, I am 34 years . 5 eggs were collected anf three fertilised. I had 2 eggs transferred on day 3 (8 and 6 cell)・ .this resulted inti a pregnancy. I would like to try for a second baby through ivf and have had my fsh levels tested anf they are 24. Im concerned that we wont be successful due to the quality of eggs.
Thank you for any advise you can give.
Anna
You almost certainly have diminished ovarian reserve (FSH=14). I would suggest you do an AMH too.). Then it is all about the protocol used for ovarian stimulation to try and optimize egg quality.
Please go to the Home page of this blog, http://www.IVFauthority.com. When you get there, look for the “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there. Also, please read below on embryo banking and Staggered IVF.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Staggered IVF”
5.“Embryo Banking”
6. “Egg Donation”
13. “IVF Success Rate Statistics: The Time Has Come to Revise the Present Reporting System”
Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher
Geoff Sher
We will do so on Monday!
Geoff sher
Irene…the answer is a “qualified yes”, subject to a due diligence process of course.
Call 800-780-7437 or 702-699-7437 on Monday morning and set up a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail
Geoff Sher