QuestionDr Ramirez - i have had 4 full IVF cycles, 4 Frozen cycles and 1 ICSI with polscope, out of these 1 resulted in a positive preg test but was a blighted ovum. This was in Dec 09, since then implantation is not happening. We have had all imnuology testing completed, and my clinic has advised that my eggs are of grade A and grade B, since using polscope however it was identified that not all my eggs had normal spindles. So for my last full cycle i had 4 out of 8 eggs with normal spindles.
I have also been taking prednisone for the fresh cycle - which did not work, and for the last frozen cycle took no drugs at all except baby asprin.
Pls help.
AnswerHello Prav from Australia,
I will first refer you to my blog where I have an entry regarding implantation failure. It is one of the most popular entries in my blog.
Secondly, there are many factors regarding implantation that cannot be influenced. Assuming that the embryo transfers were all done well, then the interaction between embryo and endometrium is really up to nature, or in the hand of God. There is no technology that will make this happen.
However, in my patients, once they have failed one cycle of IVF, I automatically add low dose aspirin, heparin 2000U twice per day, Medrol 16 mg, increased progesterone (injection and vaginal suppositories) and Estrogen patches. These have been shown to be beneficial in recurrent miscarriage patients and in some IVf studies. At the very least it does not hurt. In my experience it has helped some patients. Beyond that, there is not much we can do.
Now, making the assumption that the embryo transfers are being done well is a VERY BIG assumption. Studies have shown that pregnancy rates will differ between doctors in the same group because of the quality of embryo transfers. So, you might want to consider moving to a different IVF clinic since it has been 8 unsuccessful cycles.
Good Luck,
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
