GHOST

[nej]

Hi Ghost,

I am 34 years old and my husband is 36. After trying for a little over a year I was able to get pregnant on my own but miscarried at 7 weeks. Since it took over a year the first time I went to see an RE. All the tests came back that everything was fine but both of us. I then did 3 rounds of chlomid and four rounds of IUI before moving on to IVF. My first round of IVF was a chemical pregnancy. My husband and I both had the bloodwork for chromosome testing since it was my second m/c. All the tests came back fine as well. I then did another round of IVF this time transferring 3 instead of 2 and was not able to get pregnant. During both rounds of IVF I had 12 and then 11 eggs retrieved. On day 3 the same result both times 2 good quality, one medium, and 2 poor, nothing ever made it to freeze. At this point they have told me that I have unexplained infertility. Are there any more questions that I should be asking. I am confused as to where to go from here and am thinking that maybe we should just try naturally again. I have been working with my RE for 2 1/2 years and don't feel like I really have any more answers than when I began. Any input would be appreciated.

Niki

[Ghost]

Hi Ghost,

I am 34 years old and my husband is 36. After trying for a little over a year I was able to get pregnant on my own but miscarried at 7 weeks. Since it took over a year the first time I went to see an RE. All the tests came back that everything was fine but both of us. I then did 3 rounds of chlomid and four rounds of IUI before moving on to IVF. My first round of IVF was a chemical pregnancy. My husband and I both had the bloodwork for chromosome testing since it was my second m/c. All the tests came back fine as well. I then did another round of IVF this time transferring 3 instead of 2 and was not able to get pregnant. During both rounds of IVF I had 12 and then 11 eggs retrieved. On day 3 the same result both times 2 good quality, one medium, and 2 poor, nothing ever made it to freeze. At this point they have told me that I have unexplained infertility. Are there any more questions that I should be asking. I am confused as to where to go from here and am thinking that maybe we should just try naturally again. I have been working with my RE for 2 1/2 years and don't feel like I really have any more answers than when I began. Any input would be appreciated.

Niki

1. Which clinic are you at? You can PM me if you don't want to post it in public.

2. Many clinics that transfer day 3 embryos like to freeze blastocysts. If your clinic is like that, then "nothing made it to freeze" might suggest your embryos do not make it to the blastocyst stage, and you may have an embryo quality problem. Keep in mind, embryonic DNA does not kick in until day 3. If embryos arrest after day 3, then that suggests an issue with embryonic DNA. Does your clinic ever culture to blast before fresh transfer? You might consider that option. It won't give you better embryos (it's argued that some with very many embryos can use blast transfer to help select the best among them, but that is not your case) but at least you might see if they are arresting.

3. IUI and clomid/coitus cycles have low success rates, around 10%. It's easy to have several and still fail. IVF cycles still fail around 60% of the time, so it's also easy to fail two IVF cycles.

4. How good is your clinic with frozen embryos? There was a report years ago of a woman who failed 10 fresh cycles, then succeeded with her first frozen embryo cycle. The idea was that some women have a less receptive uterus after stimulation, and there is some published evidence of this, so that the frozen embryo can actually have a better chance in those women. Might be true, I don't know. We've had some patients like that at my clinic. No pregnancy after a few fresh cycles, but then they do a frozen cycle and have twins.