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Other tests we should consider?


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#1 boalaxr

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Posted 17 November 2019 - 02:56 PM

Looking for suggestions on other tests we might have missed or should do. Our road has been rocky thus far, but we are hopeful. We've been trying for 3 years or so. We were able to get pregnant naturally 3 years ago, but that ended in a miscarriage after 7 weeks and had to get a dnc done. My periods are normal and my husbands sperm tests are fine as well. We haven't been able to pregnant naturally since. After the MC we went to a fertility clinic and they suggested clomid, which didn't work. Then we had 3 IUIs which didn't work. Then we decided to try IVF, the fresh transfer didn't work, but the 2nd FET resulted in pregnancy but that ended at 7 weeks. We got testing done on this and it came back that the chromosomes were off.  We just did a 3rd FET and that failed with two eggs.  We have gone through many tests which are all normal - hysterosalpingogram, karyotype, tsh, semen.

 

I'm reaching out to see if there's any other testing we might have missed before doing another FET.  We are thinking maybe the DNA fragmentation, but all our eggs from the retrieval fertilized, or an ERA but we have had two positive tests so not sure if that's worth it, or try the greece blood tests.  Any ideas?

 

Also, has anyone done NK testing in the Vancouver area?

 

Thanks



#2 annatarz79

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Posted 17 November 2019 - 03:14 PM

I had multiple chemicals and I remember being tested for autoimmune and blood type tests. Also I was asked to do a laparoscopic exam as an extra measure to make sure there is nothing there. I had treatment for Chlamydia even though I was tested negative (it was just oral antibiotics). In my last IVF I also took antibiotics for two weeks after positive results ( didn't ask why though). A friend was asked to do a celiac testing and she turned up having celiacs which is gluten intolerance. Sometimes it is causing early miscarriages. You can consolidate with your physician if you thing you are missing something in tests.good luck

#3 annatarz79

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Posted 17 November 2019 - 03:21 PM

Also sperm DNA fragmentation was something my last clinic focused on cause it was borderline acceptable but we did icsi

#4 Cotton

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Posted 17 November 2019 - 03:33 PM

What is your AMH and AFC? How many eggs retrieved, fertilized, day 5 blasts, what grades were the blasts? How old are you? I'm thinking egg quality issues. Or maybe immune or clotting issues.

 

2/2 miscarriages is alot but over the course of 3 years you should have been able to conceive naturally several times over



#5 boalaxr

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Posted 17 November 2019 - 04:19 PM

Thanks for the quick replies.

 

I'm 37 now.  I'll have to look up the AMH and AFC numbers.

 

On the IVF cycle they retrieved 7 eggs, 5 fertilized, 5-5day blasts.  We tried 1 fresh and 2 frozen (2eggs) transfers, we didn't get them PGS tested.  Clinic said the eggs looked good and the lining was textbook.

 

Do clinic's in Canada test for immune?  What's tests do you recommend?



#6 Cotton

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Posted 17 November 2019 - 05:32 PM

7 eggs is not alot but you had a solid fertilization rate and and amazing % of those turn to blasts. They say poor sperm quality causes a drop off from day 3 to day 5 so that seems to be ruled out.

 

You might just be unlucky. Sometimes a whole batch of embryos is bad and the next batch in the same person is nearly all good. Even a PGS normal embryo is 65%-80% chance of a take home baby. At age 37 somewhat more than half of eggs are bad, but in a batch of 5 you should have had a good one statistically.

 

I don't know alot about immune testing. That wasn't our issue. But I do know some RE's think it's borderline nonsense but some couples swear it made a difference for them. I think overseas clinics are more likely to take immune testing seriously.

 

If I were in your position I'd collect all my records and try to get a second opinion from another RE. You might want to poke around and find one who specializes in failed cycles/immune issues. Hopefully someone from this forum can give you a recommendation. If you have to do another cycle I'd strongly consider PGS just to rule that out as a problem.

 

Look into DHEA



#7 boalaxr

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Posted 17 November 2019 - 10:28 PM

Thanks for the info, Cotton.  We will be asking for all records and have considered getting a second opinion from a different RE.  Will look into DHEA as well.



#8 SynchroGirl

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Posted 20 November 2019 - 07:38 PM

Thanks for the quick replies.

 

I'm 37 now.  I'll have to look up the AMH and AFC numbers.

 

On the IVF cycle they retrieved 7 eggs, 5 fertilized, 5-5day blasts.  We tried 1 fresh and 2 frozen (2eggs) transfers, we didn't get them PGS tested.  Clinic said the eggs looked good and the lining was textbook.

 

Do clinic's in Canada test for immune?  What's tests do you recommend?

 

Hi boalaxr,

 

I'm sorry to hear the last few years have been tough... I know how difficult the unexplained diagnosis can be.

 

I can't say that I've had success yet but I feel I am on a much better track than I have been in the past.  Dr Virro at Markham Fertility does immune testing that I believe not many (or maybe even none?) of the other clinics in Canada do.  I did not do the full immune testing (~$5K), I only did the ones that could be treated (~$1K) which were the NK Assay, TH1/TH2 Cytokine Ratios and the Leukocyte Antibody Detection Panel.  The test revealed very low LAD and I've been doing treatment for it since.  If you're interested in immune related fertility issues I recommend reading "Is Your Body Baby Friendly?" by Alan Beer.

 

Dr Virro is also a big advocate of PGS testing which might be something you want to explore.  It took me many cycles to get any PGS normal embryos so sometimes it just takes a while to find those golden eggs.  DHEA also worked well for me however I have read a lot of stories of people where it didn't help so best to research it and speak to your doctor.  My Dr was indifferent but he let me try it.

 

Good luck to you!


  • elephantshoes likes this

Me: 40 DH: 52

Dx: Mild Endo, Immune Related Issues, Unexplained

TTC #1 since 2003... 3 years ending in heartbreaking divorce...

Lap #1 in 2005 (mild endo), Lap #2 in 2013 (confirmed no regrowth)

6 IUIs 2013-2014 @ RCC

IVF #1 (March 2018) - 4 eggs retrieved, 1 blast - 3BC (not tested), fresh transfer, BFN

Changed clinics - now @ MFC / Dr Virro - referred for immune testing, Dr wants to first get 2-3 PGS normal embryos before doing immune testing

May 2018-May 2019: 6 more IVF cycles.. 12 embryos, 3 PGS normal (5AB, 3AB, 4BC), 1 mosaic (4BB), 1 too small to test (3BC), 7 abnormal

Immune testing revealed low leukocyte antibodies (1%)

May-June 2019: LIT #1 (x2 treatments) with DH - minor improvement

July-Sept 2019: LIT #2 with donor (x3 treatments) - again minor improvement

Oct-Nov 2019: LIT #3 with new donor (x2 treatments) - not going to wait for the results, proceeding with transfer in December 2019

Dec 20, 2019 - first ever BFP!

 

 


#9 boalaxr

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Posted 20 November 2019 - 09:10 PM

Thanks SynchroGirl.  We just went for a consult the other day.  The clinic we are seeing in Vancouver said they do immune testing with Alan Beer's clinic.  But they will go down that road once we do another round, see how many eggs we get, and how many pass the PGS testing.  We asked about DHEA and they said it used to be normal, but don't recommend it anymore.  I guess the verdict is out on that one.  Thanks for the info about the clinic in Markham.


  • SynchroGirl likes this

#10 Misskika007

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Posted 21 November 2019 - 04:43 PM

Hi boalaxr- I have reoccurring pregnancy losses and my clinic recently ran a series of genetic tests on me to see if I carry any genetic mutations that link to reoccurring miscarriages. There is a whole panel of specific mutations, a lot of them are linked to folate absorption and blood clotting disorders. I found out I have three mutations that need to be addressed once I begin transfers, namely, PAI-1, Factor XIII and MTRR A66G. I now have to take Lovenox injections (blood thinners), prednisone (in case there is a random immune issue they haven't found) and can only have a prenatal with methylated folate since the other kind will not absorb. It may make sense to go this route for you, just to rule it out.

 

But, that being said, I've not yet had a child and just had a chemical. I also have DOR so it's a crapshoot to know if my previous failures were due to the genetic conditions or just abnormal embryos. If I have to do another egg retrieval following the cycle I'm in now, going to focus on improving egg quality. If you have DOR, this may also be something to factor into the equation along with PGS testing. 

 

Wishing you a lot of success.


Me: 35, Hub: 36

TTC 3.5 years

Beginning 3rd IVF cycle- hopefully 3rd time's a charm! heart.gif

 


#11 Dawn82

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Posted 24 November 2019 - 08:19 AM

Hey.

Just thought Id pop in. I had two ectopic which lead me to ivf. After two they say the chance of a pregnancy in the right place is less than 15 percent. So we did ivf. Did three full cycles. 8 embryo transfers. And finally a pregnancy.

I always was able to yield lots of blasts. Its was just finding that right one. In our case it ended up twins because we had repeated failure and you are able to transfer two at that point. I did not opt for much testing. It does sometimes take a few to find that golden embryo. Every transfer was the same it looks text book
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#12 lenle

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Posted 29 November 2019 - 09:11 AM

Hi boalaxr, I have a different situation but no more eggs left so my doctors tried to do everything they could think of before my last transfer (I am in 2 ww right now). I had these tests or specialists: full standard blood work, hormonal profile, hematology, immunology including NK cells, genetics. I was lucky since it is not standard here to have these tests done before multiple failures which I cannot understand because you just loose time.

#13 boalaxr

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Posted 02 December 2019 - 02:49 PM

Hi Dawn82 - yes our RE said so another cycle and get them PGS tested.  We want to run some blood work and cross off that we don't have another issue.  We are going ahead with the testing at Locus.

 

HI lenle - since our 2nd transfer worked, but resulted in a MC, nothing different was done for the 3rd transfer.  Unfortunately, we don't have any eggs left and would need to do another cycle.  Good luck!