4 failed Iui's, one failed IVF, and failed FET


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Reply 4 failed Iui's, one failed IVF, and failed FET Posted on: Nov 13, 2011 at 7:17am
I don't know where to start. I had a successful pregnancy with birth of a daughter in 2009. She was conceived after 3 years of trying, 7 of those months with an RE. I was diagnosed with PCOS (I am lean and healthy though), compound heterozygous mthfr, and had 2 previous miscarriages. Once we discovered my right tube was slow to clear with hsg, and that my right ovary was dominant in producing follicles while using femara, we focused on stimulating the left ovary. The first month we used femara and menopur I produced 2 follicles on the left and conceived my daughter. As a side note she was born via emergency c-section.

11 months after her birth we returned to the RE and conceived the first try on the same protocol. I also developed ohss due to many immature follicles. Sadly I miscarried, chromosomal problem at 7.5 weeks. I had a d and c so that we could know the cause.

To shorten the story, we did this same protocol 4 additional times producing 4-10 follicles total each time, but no more than 3 at a time on the left. I experienced mild ohss a couple times. During this time a pain I have always felt near my right ovary when ovulating seemed to have gotten more intense, and would start days prior to ovulating.

We decided to do IVF with the thought that my left tube was no longer patent either. I did the antagonist protocol with lupron trigger. 97 eggs were retreived after 7 days of stimulation and two days of coasting. This outcome was quite unexpected I was not on high doses of stims. We ended up with 15 five day blasts that we were told looked excellent. Not surprisingly, the fresh transfer failed even with estrogen and progesterone supplementation.

3 months later we did a FET. Just a few days after my first estrogen injection to prepare for it, I began to have the pain I always thought was caused by follicles on my right ovary, but my ovary was very silent. The pain got intense as it does when I'm about to ovulate, then became dull. I'm assuming endometriosis. We ended up transferring 2 great and one fair blast, no success once again.

I guess after that little bit of history, my question for you is, do you think this is a problem? Should the focus be more on immunology or structural investigation? Would having a lap be beneficial? I am at such a loss, and we are starting to lose all hope.

By the way I had normal water US last April and we retested all the basic immune issues, ANA and APA, thyroid, and all was perfectly normal. Everything LOOKS perfect, but is obviously not.

Thank you for any sort of guidance.

Dr. Braverman

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Re: 4 failed Iui's, one failed IVF, and failed FET Posted on: Nov 15, 2011 at 2:31am
Please dont loose hope. The answer to your question is you investigate all avenues as many times there are more than one problem and you need to identify and treat each one. I have so many cases such as yours and it is unusual we dont find the problem and have a successful resolution.
Please call my office and schedule a telephone consultation with me . I would be happy to guide you in this workup and management. If you read my site on PCOS you will see that it involves so many areas that all need to be treated from protocol to immune management. I look forward to speaking with you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.