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Have Infertility Problem. Gone Through IVF, Not Successful. What Should I Do?

Posted on Thu, 21 Mar 2013

Question: We are struggling with unexplained infertility issue. Have gone through an IVF cycle as well but been unsuccessful. Please help.

Answered by Dr. Biswajit Dash (8 hours later)

Hello XXXXXXX,
Well I can understand your concerns.But I need to know few other things/evaluations to give better suggestions.
1) The time since you are trying for a baby.
2) What is your cycle length, period of flow, whether associated with pain
3)Is there any suggestive past history like TB,endometriosis.
3)relevant investigation reports-hormone profile,(DAY 3, FSH, LH, ESTRADIOL),diagnostic hysterolaparoscopy,
4) What is the report of the semen analysis of your husband
5)What is the number of cycles of ovulation induction done with documented follicle rupture? What is the number of cycles of IUI done before IVF etc.
6) What are the IVF parameters like stimulation drugs,follicles retrieved ,embryo quality,day of transfer,and embryo preservation done if any.
To stamp it as UNEXPLAINED infertility,most of the investigations need to be normal.
In those cases please go for repeat IUI cycles on 3 to 4 occasions before going for further IVF.
I think I have put some light at your query. These are the detail which I need to know for further opinion. Please be in touch
Thanking you,
REGARDS
BISWAJIT DASH

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Biswajit Dash (14 hours later)

Dear Dr. Dash,
Many thanks for your prompt response.
Me and my wife have been trying for baby for about 4 years now.
The length my wife's cycle is normal 05 days and flow is normal
There is no history of TB and Endometrosis
Relevant harmone profile as listed are all with normal range (we have reports from at least 4 labs of reputed hospitals: Sir Gangaram, XXXXXXX Sitaram Bhartiya,Lal path labs.
Semen analysis (03-04 reports) are all healthy.
There were no cycles of IUI done before IVF.
The stimulation drug used was Mensopur, 07 embryos retieved. 05 formed good blastocysts and 02 were implanted in first cycle after five days. In second implantation was carried on 15th day of cycle after 04 months but the three frozen embryos after thawing were B grade.

We look forward to hear from you. XXXXXXX

Answered by Dr. Biswajit Dash (23 hours later)

Thanks XXXXXXX

I can assume from your answers that she most probably has an unexplained infertility. One of the important investigations you have not mentioned is whether she has undergone Diagnostic hysterolaparoscopy (DHL). I think it is a very pertinent investigations in the sense that it will provide you with a array of robust information regarding

1)the uterine cavity,
2)the tubal patency
3)the pelvis, the tuboovarian relationship etc(every detail is not visible by ultrasound)
So, if DHL has not been done please proceed for it under a good infertility specialist.
If it is normal, then proceed for ovulation induction and IUI.
I think my answers have met your expectations. Please let me know if you have any further queries.
Thanking You,
Yours failthfully,
Biswajit Dash

Above answer was peer-reviewed by : Dr. Shanthi.E