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Treatments Questions - Page 2 of 23

Immunologic recurrent pregnancy loss

Hello Doctor,
My husband and I have suffered three first trimester losses in a year. The first two ended at week 5, and the third one ended at week 7 after noting a heart beat of 119. Our karyotypes are normal, and the baby was 46xx normal by chromosome microarray analysis without maternal contamination. I have hashimoto's thyroiditis with positive TPO antibodies (500+). My TSH was being managed but at the time of the third pregnancy spiked to 7.1. Using progesterone vaginal suppository 200mg twice daily. Thrombophilia panel was negative. Rh+. No infectious diseases. No uterine issues voiced by our RE. My husband and I are 37 years old with no prior live births. My most recent day 3 FSH was 10.9, AMH was 1.2, Estradiol was 40, and AFC was 7 (trans abdominal day 8.) Semen analysis is normal. Ethnically, I am Caucasian, and my husband is Asian Indian. My RE at Mayo Clinic recommended IVF/PGS. He said he is not concerned about the immunological or endometrial receptivity aspect. I was wondering if you may be able to shed some light on it, and give us your opinion if we need an immunological work up, and if IVF is a sound choice to make given the diminished ovarian reserve?
Thank you.

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Endometrial lining

I'm in a FET cycle, and on day 10 of estrogen stimulation my endometrial lining was 7.6. I’m scheduled to start progesterone treatment in 2 days - how much can I expect my endometrial lining to grow until then (with same dose of estrogen, 200 mg Vivelle Dot)?
Thanks in advance for your help.

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Clomid

Can you advise if I am able to be prescribed Clomid following a consultation without my partner or would we both be required to attend?

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Embryo transfer whilst breastfeeding

I have some embryos stored with you. I am currently breastfeeding my 9 month old baby but am very keen to try and have an embryo replaced in the new year. Is it possible to go through treatment and continue breastfeeding?
Thank you

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Can number of eggs extracted be improved?

Im 38 and we underwent ICSI earlier this year which lead to 5 eggs, 4 mature, 1 embryo and a pregnancy that ended at 17wks, which was devastating. We are now considering another round of ICSI, but with FSH 9, AMH 18.7 and AFC 12 I think the total number of eggs retrieved seems low. I was given Suprcur 1mg, Meopur 75x3 amps and Pregnyl 10,000iu. Do you think the number of eggs retrieved in a future round of ICSI could be improved?

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Possible Hydrosalpinx

I have currently had one failed FET and my last scan showed fluid in my uterus. The nurse who scanned me said it didn't look like hydrosalpinx but the doc said it is and wants to take my tube out with laparoscopy. Would a hsg be recommended before undergoing this op?
Thanks, helen (30 yrs)

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IVF follicle monitoring

Hi,

Would like to know that during follicle monitoring during IVF, do number of follicles seen on day 6 of cycle increase as the cycle progresses . They grow in size but do they also grow in numbers

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Question regarding Sperm sort (Ericsson or gradient method)

I was to ask the embryologist: in order to have a successful IUI for gender selection, is it possible to have multiple sperm sample collected (say over the course of a week) and then have the sperm sort (gradient method) done on them a few times i.e. separate first time, then take the layer containing most of the desired sex and separate again one or two times, until you have a final sort sample that hopefully contains majority sperm cells of desired gender?

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