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

thank you
Nisreen

As for the issue of embryo quality, I would suggest full embryo karyotyping …after all you have been through. CGH embryo evaluation with subsequent Staggered IVF (see below) is in my opinion not only advisable but essential at this stage.

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)

4. “Thyroid autoimmune disease and IVF”

9. “Staggered IVF”

10.“Embryo Banking”

I suggest you call 800-780-7437 or 702-699-7437 and set up 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.

Geoff Sher

Situation: 38 yrs old w/ PCOS and pituitary adenoma, and 35 yrs old w/ severe male factor — as in “only frozen sperm, very low count, very low motility after thaw”. We live in a single (huge) medical center city, one of the top 5 medical universities in the US. We went straight to IVF/ICSI, two rounds, resulting one in nine 3-day embryos, and the second in eleven 3-day embryos, quality ranging from 8A cell (perfect) to 5B cell (good enough). I’m not counting the few embryos that didn’t make it to 3-day. Before you ask, the center traditionally does only 3-day embryo transfers. The exception was our recent fifth transfer, when the lab agreed to thaw four of the embryos, attempt to grow them to 5day transfer and transfer the survivors. For this lastest transfer, the successful growth to 5-day rate was what the lab had forecast: 50%, i.e., two blastocysts.

For each transfer, we’ve had two “good” embryos each time (that means at least one, if not two, 8-cell embryos transfered each time; no PGD, per the center advice), lining “great” each time (good thickness, trilaminar pattern), sonohysterogram check comes always clean; transfer technique not under suspicion (the center has a good record, and the transfers were done by 3 different skilled REs).

In terms of differences in the protocol for each cycle: standard protocol for the first two cycles. For the third transfer (FET #2) the RE added synthroid (diagnosed sub-clinical hypothyroidism), and assisted hatching; we added acupuncture. The fourth transfer was IVF#2, no further change in protocol. For the fifth transfer (FET#3) the center recommended no further change, we requested 5-day embryos, and an immunology panel. The panel recommended by our RE was: ANA SCREEN IFA W/REFL TITER (negative), CARDIOLIPIN ANTIBODY BATTERY (one out of three tests — Cardiolipin Antibody IGM — high at 28), LUPUS ANTICOAGULANT PANEL II (two our of four tests borderline high — AntiCardiolipin IgM at 18.3 and APTT (Blood Bank) at 42.1); the high results may be a fluke due to the flu ten days earlier; resulting change in protocol: begin baby aspirin two weeks before transfer, redo panel in 12 weeks.

In terms of results, negative. IVF#1 resulted in a brief chemical, hcg back to negative w/in three weeks of transfer. We have five 3-day embryos left in the freezer, we assume maybe one or at most two would make it to blastocyst stage. Is it even worth considering a 6th transfer, given the circumstances? Is there anything else we could do different? It’s incredibly disheartening hearing the embryo transfer team praise the quality of the transfer only to get a negative every single time.

Geoff Sher

You might consider calling 800-780-7437 or 702-699-7437 to set up a video conference consultation with me (which is free if you reside in the U.S.A or in Canada) so we might discuss your case in detail.

Geoff Sher

Ms. Hussain

Ms. Hussain

After reading your post I am ready to be tested for immunological factors impeding implantation and use viagra before trying an IVF treatment, but I have a question. I was put on.025 vivelle.dot permanently since May to see if I wouldn’t get pregnant naturally (I have a day 3 AMH of .87 ng/ml FSH of 6.8 ui/l, LH of 5.0 ui/l, and estradiol of 42 pg/ml.) but poor cervical mucus. The patch does wonders for that, but should I stop using it or do I continue while I await testing before IVF?
(Since I still haven’t gotten pregnant after trying since MAY, Im ready to move to IVF as I am over 35). Please advise

Thanks,
Ms. Hussain