repeat ivf failure

sunnygr

0 Posts
Reply repeat ivf failure Posted on: Dec 5, 2011 at 10:08pm
Dr, Braverman,

Hello, I would really like your help and opinion on the following. I just turned 43 and have just finished my third failed IVF. I don't have many follicles (between 2-5). The doctor I have been going to believes in little medication and working with what I have at the beginning of my cycle. I do Arvekap (I don't know the equivalent in the US) and 150 Gonal F, with 150 Puregon for my last cycle. I stimulate well with all follicles growing fairly evenly and all reaching 18mm on the day I trigger. My endomentrium is good always nine, with it at 8.1 the last time. I take progesterone supplements Crinone (one a day) and 600 Utrogestan after transfer and estrogen pills cyclacur, two a day. All my eggs fertilize and reach the third day (only one didn't). I do three day transfers. My questions are the following:

- I had a bad experience on the birth control pill in college and had ended up with a clot in my lung. Knowing that and having read various things about implantation failure and immune system problems I discussed this with my gyno and IVF doctor (even though this was in my file no one really paid attention). My fathers side of the family has a history of heart and stroke problems and my doctor sent me for the following tests: Protein S, Proten C, Factor V Leiden, G20210A, Anti-DNA. ANA, ENA, IgA, IgG, IgM, B2 GPI IGG, B2 GPI IGM, ATIII, PTT-LA, APC Resistance, and all have come back negative. I have tested 123 for RA and my doctor sent me to do a repeat of that and a MTHFR (even though I have low homocysteine). I also have very low C Reactive Protein in regards to the RA. I have not received the results of those two last tests back. Could there be something else immune related at play? Even though the results came back negative due to my history I was on 40 Clexane and 5mg presolon from day 3 of this last cycle. But still no success. Was 5mg presolon too little?
- Which leads me to my second question and something I read on your site. The quality of my eggs went from very excellent, to excellent and very very good to, very good embryos on my last try. Is the protocol and medicine I'm using starting to diministh the quality of my eggs? And can that be reversed? (All of this was in a period of less than a year).
-Can my husbands poor morphology be contributing to my implantation failure? I' have had a hysteroscopy and that came out fine.

I will be changing IVF doctors but am at a loss to what could be going on. My doctor said that it can happen on the 4th or 6th try but I want to rule out anything else. I'm at a loss. Any input is greatly appreciated. I live in Europe but am from the US.
Thank you very much,
K

Dr. Braverman

2016 Posts
Re: repeat ivf failure Posted on: Dec 6, 2011 at 4:27am
I am very sorry for your losses. Your age does not appear to be the only factor here, but your immune workup is essentially non existant. Its hard to recommend treatment with out this. we can arrange for testing any where in the world for you and help guide you and your local doctor in your treatment. Please call my office and schedule a telephone or skype consultation with me, I would be happy to help you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

sunnygr

0 Posts
Reply Re: repeat ivf failure Posted on: Dec 6, 2011 at 8:29pm
Dr. Braverman,

Thank you for your answer. As a first step do I call or fill out the information form? One another question. I did receive my results today for the MTHFR gene and I am heterozygous for C677T. Not surprising with my family history on my fathers side. I have read many answers you have posted to others and in some cases you recommend Clexane and in others not. With this gene mutation and my history of blood clots do you think Clexane and presolon from the beginning of my last cycle were unnecessary?

Thank you,
Kat

Dr. Braverman

2016 Posts
Re: repeat ivf failure Posted on: Dec 7, 2011 at 5:13am
yes please fill out and send in the questionairre, then call my office and we can schedule a skype or telephone consultation. Its hard to say whether you needed the lovenox based on your data, but after our consult and when I get the full history ill give you all my thoughts. but with your history I dont think lovenox was excessive and may have been necessary.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.