QuestionI have had two failed IVF and five failed ICSI cycles at two different clinics. All cycles produced embryos of good quality and two ICSI cycles produced blastocysts (three transfered each time). The luteal phase was supported on the last five occassions with duphaston 10mg twice a day and cyclogest 400 suppositories twice a day and one aspirin 81 mg a day. We have had a normal full term baby naturally 13 years ago, then a molar (two D&Cs followed) then an ectopic (loss of tube) then 7 week miscarriage and then another ectopic (loss of the other tube) This is why we started IVF and then did ICSI due to poor IVF results and risk of molar. I am 38 years old and my FSH ranges from 10 to 13 with good hormonal response and good uterus, my husband has 'normal' sperm and is 39. Please can you give us any information/answers as to why we are failing???
Answer
Dr. R
Hello Kim from Oman,
If I understand you correctly, you have now undergone 7 IVF cycles, two without ICSI and five with ICSI.
I cannot tell you why you are failing based on the limited information that you have given me. I would have to review all your IVF records looking at every aspect, stimulation, retrieval, fertilization, embryo quality and transfer quality.
Assuming you had good embryos to transfer, then you have some type of implantation failure. However, you have been pregnant before so that does not make complete sense. Implantation failure usually occurs from an inadequate endometrial lining development, or poor embryo quality or poor transfer technique. In fact, you could have the very best embryos in the world but if the transfer is not done well, then it won't work.
Based on your age, I would think that the culprit is embryo quality. As you know, pregnancies decrease with increasing age, and that is due to worsening embryo quality. If that is the case, you would have to do one of two things, either continue trying with your own eggs (if you are getting good quality embryos) or change to donor eggs.
I hope this helps answer your question.
Sincerely,
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 and twitter with me at @montereybayivf.
