3 failed ivf cycles what next


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Reply 3 failed ivf cycles what next Posted on: Dec 16, 2010 at 9:17pm
HI Doctor,
I really hope you can help. My husband (he is now 35, i'm 33) was diagnosed with obstructive azoospermia in 2008 and he had a tese performed resulting in 2 straws of sperm which were frozen.All my hormonal tests came back normal , also auto immune fine also. Both sperm straws were used in our first ivf icsi cycle. 17 eggs, 12 mature resulted in 3 8 cell and 1 5 cell day 3 embyros. 2 grade A 8 cells 3 day embryos were transfered and resulted in our beautiful baby girl in feb 2009. We started our journey again in Nov 09, only the 8 cell frozen embryo survived thaw as a 5 cell and was transfered but resulted in a bfn. Also my lining was an issue as it was only 6.5. It was 7 for our first cycle. We then did a fresh cycle in mar '10,fresh tese, resulting in 20 eggs,12 mature, only 2 good quality embyros survived to day3, these were frozen as I developed mild ohss. My lining was only 6 for this cycle. My re decided to do fet using a natural cycle and for 3 months my cycles were scanned but none ever came to 7 even with supplementary estrogen (patch and tablet)My periods have always been light and my cycle~ 29 days, opks showed lh surge day 20. I started on maca after research on internet and my next cycle lining was 7 , unfortunately 2 frozen embies did not survive thaw. Next ivf cycle aug ’10, fresh tese, 12 eggs, 8 mature, 2 embyros on day 3 , one 9cell grade A, one 6 cell transferred resulted in bfn. My re was surprised this one did not work. Re said egg quality was issue. Next ivf cycle dec’10, fresh tese, re changed from luveris to gonal f with idea of lower stimulus resulting in less numbers but better quality eggs. After 8 days stims, retrieval resulted 8 eggs, 6 mature, 1 3 day embyro 8 cell grade A transferred resulted in bfn.My lining was 7 on last 2 cycles as I take maca, but this may not be the reason for better lining. I havw also been on clexane and prednisone for the alst 2 cycles. I’m now afraid re will discourage us as they don’t want to keep performing tese and say my egg quality is poor. Money is not an issue as we really want another baby. Is there any hope for us. Is the fact it work once enough to give hope. Our fertisation rates are poor, is there anything I could do about my egg quality, my fsh is in normal range, re suspects mild pcos but early day 2 scan showed ~ 6 eggs. How many tese can my husband do? I look forward to you advice

Dr. Braverman

2026 Posts
Re: 3 failed ivf cycles what next Posted on: Dec 16, 2010 at 11:44pm
I would look into several issues here, you respond and fertilize as a PCO patient would. Even when the hormonal profile for PCO is negative my patients still perform better when treated with Metformin, both in egg quality and with lower miscarraige rate. Second the immune profile (not autoimmune profile) needs to be looked at as their is significant crossover between PCO/immune/thrombophilia issues and all would need to be addressed.
Lastly you may want to consider our neupogen trial for lining issues which has shown excellent response rates.
Feel free to call my office to schedule a consult and I can reveiw all my thoughts with you, I see no reason why you shouldnt be able to have another baby.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.