QuestionHello Doctor,
I have two children, both took a year plus to conceive, we conceived both on our own, at the 11th hour, when we were about to start an IVF cycle. Instead of getting my period I got a positive pregnancy test. We were diagnosed with male factor. My husband has less than 6 million sperm, with poor motility and morphology. My husband is 35, and I am 29.
We began trying for our third and final child one year and 9 months ago. Our Re recommended iui, which we tried, then we moved on to IVF. Our first cycle we got 10 eggs, 9 were mature. 5 fertilized, and we ultimately ended up with three 5 day basts, all AA quality. We transferred two and froze one. I used vaginal progesterone support. Five days after the transfer I began spotting, I had a positive blood test at 7 days past transfer, and ultimately lost the pregnancy, as my beta only rose by 2 points after that.
With the FET I began bleeding again, 5 days past transfer, but with a negative beta.
With IVF #2 20 eggs were retrieved, 18 of them from one ovary. 10 were mature, four fertilized. We did a 3 day transfer of two embryos, both grade three, one 8 cell, one 9 cell. There was also a 7 cell and a 4 cell that were discarded, beavuse they were not good enough to freeze, and the doctor doing the transfer believed that I am too Young to transfer three. This cycle had less gonal-f, and PIO instead of suppositories.
I feel like my clinic missed something. Every time during my second cycle I asked if there was further testing, or anything else we could look in to, I was brushed off, and was told that my first cycle was an anomaly, and I was over thinking things.
My question is, what would cause the ivf cycles to go from so-so to downright crappy? Should I be demanding more testing?
Thank you for any input you might have.
(I am from Long Beach, by the way)
AnswerHello Jennnifer from the U.S. (Long Beach),
Well the first cycle worked, despite ending as a chemical pregnancy. Keep in mind that IVF does not actually GET you pregnant but can only give you the opportunity to become pregnant but doing most of reproductive the steps for you. By having gotten pregnant, you know that you can get pregnant. Now it is just a matter of getting the right or perfect embryo.
In terms of the following cycles, there is no way for me to know what happened, especially without reviewing medical records. I also can't suggest any tests without knowing what tests have been done. In this most recent cycle, the embryo quality was not very good. There are lots of reasons for that, including the affect that abnormal sperm may have. The fertilization rate was not good (40%). I presume you did ICSI. Laboratory technique and quality can significant effect on embryos, so that could have been a reason as well.
Considering that you have been pregnant twice before and had good stimulation, I would expected a very high chance of pregnancy so don't give up yet.
Good Luck,
Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
