3rd Failed IVF

Jessica

1 Posts
Reply Posted on: Feb 4, 2015 at 10:24am
Hi Dr. Braverman,My husband and I just experienced our 3rd failed IVF. I'm able to produce several eggs, but only around 20% are mature. Most of them fertilize, but all arrest after day 3 (they stop developing at 8 cells, some at 4 cells). We've both been testing and everything is normal, we've had karyotype testing and results were normal, my blood levels are normal all throughout my stims. We've been TTC for 3 years now, 1 year naturally and the rest with an RE. I've had several failed clomid, Fermara, Follistim + Ovidrel cycles, 3 failed IUIs and now 3 failed IVFs.IVF #1 protocol: 225 units of Follistim and 75 units of Menopur days 1-6, then began using Ganirelix 250 days 7-9. I triggered on day 10 and ER was on day 12. Results: 36 eggs retrieved, 6 which were mature… 6 more were cultivated and matured giving us a total of 12. 6 fertilized and made it to day 3. After day 3 all arrested. This was when RE ordered the Karyotype testing and put me on Metformin.IVF # 2 protocol: 300iu Follistim (days 1-10) and used .10 units of microdose Ovidrel this time ( Micro dose was used days 1 - 4 and day 7 & 9). I started Ganirelix cycle days 7 - 10. I triggered with 250mcg Ovidrel on cycle day 11 and ER on day 13. Results were: 35 eggs retrieved, 14 mature, 11 fertilized, day 3 we had 7 of which all were fair. On day 5, 3 had dropped down to poor, and 2 were fair. On day 6, 2 hit blast but were poor quality. We sent 1 off to biopsy (the other blast was too poor and didn't make it to biopsy) and it came back abnormal- 'chaotic' fragmentation. My husband and I switched REs and clinics for our third IVF.IVF #3 protocol: Menopur 150 units days 1-5, then increased to 225 units days 5-12. I stimmed for 12 days. RE took me off Metformin as well. I also took a daily steroid injection (Omnitrope .25 units), he said this may or may not help, but wouldn't hurt. I triggered on day 13 and went in for ER on day 15. Results: 17 eggs retrieved, 4 mature, 2 fertilized. The next day, 4 more matured and fertilized in the lab. None made it past day 3 (they stop developing at 8 cells, some at 4 cells).Could there be an underlying autoimmune issue on my end? DH has excellent sperm, but could it be fragmented? All IVFs are ICSI'd, but we've never had a problem fertilizing. Dr. Braverman, your thoughts and knowledge is so appreciated. We're willing to try anything. Our RE suggested a mini IVF (using Follstim 75 units + MicroDose Ovidrel, and using a dual trigger shot Novarel) for our 4th attempt, which would be in March/April depending on the timing of when I start my period again. Do you think back to back IVFs are safe (as in, continuing our 4th, 5th, etc)? Our 1st was in October, 2nd December and our 3rd this past January. Although I've been seeing an RE since 2013 and have been on some sort of med/stim for awhile. Should we have more tests run? I'm 30 years old with a BMI of 20 and DH just turned 35.Thank you so much Dr. Braverman for your time.
ME (30) DH (35) TTC since 2012
Several failed Clomid
Fermara
Follistim + Ovidrel Cycles
3 Failed IUIs + 3 Failed IVFs

Dr. Braverman

2026 Posts
RE: 3rd Failed IVF Posted on: Feb 4, 2015 at 3:09pm
Yes there could be immune issue here and if so most likley related to endometriosis or PCOS both of which have this type of clinical presentation. I would be happy to assist you in this work up , feel free to fill out a consult request from the website and we can schedule a free 10 min chat .
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.