Hi
I have copied this from the main board in the hope I can get a response
I am due to go to follow up for IVF ectopic (2 in total-1st from natural conception). From reading posts I have come across a few things that I would like more advice on:
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my clinic transfer at 2/3 days but read that trf better at 5 days as this mimics when embryo would naturally enter the womb - feel like not given best chance if this is correct ?
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someone said about a procedure called laprascopic ovarian drilling where laser some holes in ovaries and do an HSG. They conceived naturally 2 month later - what is this for and when is it used ?
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are there any other tests that I could request as really want to do everything to a have one healthy baby - I’m not greedy! I’ve had two ectopics with one tube left and told that only reason for infertility could be my age as AMH shows that ovaries are struggling in terms of no eggs left. I’m now 37 nearly 38 and been trying since 34. I’m concerned that there is something wrong with uterus that embryos do not want to go in and stay in tube or when placed in don’t want to stay and go in tube. I’ve been told lining is thick enough and progesterone level high enough.
Thanks for your help it is really appreciated at this difficult time
Hi Charley
The 3 day/5 day thing is very difficult. Broadly speaking 5 day transfers are more successful because they are stronger embryos. The reason you know they are stronger is because they have survived 5 days & the others have died off. So you would only attempt to culture them to 5 days if there were quite a lot of them & they were good quality. If you have say 5 embryos & they look fairly good at 3 days - you could put back 2 at that point. But you wouldn’t know if it was the best 2. So you could wait until 5 days, by which time it might be clearer which were the best (i;e that 3 might have died off). But the risk is that they might all have died & you wouldn’t have any to transfer. So the decision is by no means clear cut as there is a possibility that one put back at 3 days might go on to make a baby. But if left to culture to 5 days, might die off (as culturing is not as good as being in the womb).
So the bottom line is to choose a clinic w/ an excellent lab where you trust the advice of the embryologists. CARE offer something called Maps which takes thousands of photos of the embryos as they divide & apparently this gives you a good view of which are better than others.
I had my ep via ivf & so I really wanted to avoid it next time (and had a mc instead!) I do believe there may be something about the outside of the egg and/or the inside of the uterus which limits/stops implantation. BUT - it’s impossible to find out & it’s an extremely complex area where few people are doing research.
I would say consider donor eggs if you can.
Alternatively here are some things you could try (some in addition to donor eggs):
Assisted hatching (old eggs have tough shells & this helps the embryo to hatch)
Embryo glue (it might reduce the likelihood of an ep - but really it’s function is to assist hatching & implantation)
Immunity testing - this is expensive & not all clinics offer it. But esp. if you have had more than one mc you may have immune issues
Finally, you can test the embryo to see if it is chromosomal normal. BUT - you can’t do a fresh cycle (as the results take about 30 days to come back so the embryos must be frozen)
My absolute best advice in all of this is to choose a clinic & a doctor who you really trust and then they can suggest what is the best approach & you will believe it. And also choose a clinic with excellent results. Currently ARGC has the best results - but they heavily select patients. But if you get through selection, then you have a very good chance.
Thanks for this really appreciate the advice and I’m likely to come back to you but just found out need to go for meth injection today as even tho op hormone level not reducing.
When you say you wants to avoid as ep through IVF does this mean that you didn’t have any more IVF ? Was there a reasons for miscarriage?
Sadly after everything I’ve been through trusting the medics is difficult
Sorry for your loss and when I have the opp to absorb this info fully I will come back to you if you don’t mind
So sorry for all you have been through too
No - I meant to say that I really wanted to avoid another ep!! The next cycle was a chemical pregnancy & the most recent was a miscarriage. No - they never found a reason for the mc & it’s apparently (as far as they can tell) unrelated to the ep. But unfortunately we are now out of donor eggs and so currently on the waiting list.
No problem to ask any questions at all that you want to. My way of dealing with my ep was to do loads of research into it. But unfortunately, just like the normal entire implantation process - very little is actually known about it as it is such a complex area & difficult to study.
Also very happy to answer any questions about ivf - hope to be cycling again in August.