QuestionI am 33 years old and have been TTC for 2 years. I have secondary infertility (my son was conceived without difficulty 5 years ago). I have Graves Disease (diagnosed 2001) which has been under control for past 18 months of TTC. I have been taking 2 50mg tabs of PTU to control. I have just completed my first IVF cycle. I responded well with 16 good eggs. HOWEVER, only 2 fertilised!! My FSH day 3 test was all good so I have no other indication that my eggs are bad. I did get pregnant with this cycle but the embryo failed to develop and I had a D&E at 9 weeks (bradycardia).
My RE has 2 possible suggestions for my poor fertilisation. (1) Chromosome issue - being tested now (2) prolonged use of thyroid meds but there is no medical evidence of this or previous research. I am now weaning off them.
Do you have any other ideas? Any investigations you would pursue?
AnswerHello Amy,
Poor fertilization is due to either poor egg quality or poor sperm quality. Despite the fact that your husband got you pregnant before (I am assuming he was responsible), that is not proof that there is not sperm problems.
Certainly chromosomes could be a culprit and should be checked in you and your husband. Antisperm antibodies should also be checked. My recommendation would be to have ICSI with your next cycle. That should overcome the fertilization problem.
The miscarriage, at 9 weeks, was probably due to an abnormality in the fetus. There is an up to 40% chance of miscarriage with each pregnancy, IVF included. However, do not despair. The majority will have a successful pregnancy evantually.
Sincerely,
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A
