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What Causes Absence Of Fetal Cardiac Activity During 7th Week Of Pregnancy?
Question: Hello Doctor,
We had recently done IVF (ICSI) with donor egg, my wife age is 35. We got success in first IVF attempt but after 7 weeks we had to abort as there was no heart beat. Initially her Beta HCG was 3100, after 7 weeks it was approx 6k then on 8th week it was 4000, hence doctor asked us to do D&C. My semen morphology was 1% normal out of 40 Million semen (which comes 40 Lakhs - and should be fine if we have done ICSI). My wife used to take injections twice a week (Lonopin 60mg and proluton)
Question : What must be the reason for failure and does these semen enough to keep fetus growing ? Are hormonal injections could be the cause ? Does chromosomes (Men/women) play role in growing fetus ?
My Wife's report is also normal like BP, Sugar, TSH, ANC report is normal.
We had recently done IVF (ICSI) with donor egg, my wife age is 35. We got success in first IVF attempt but after 7 weeks we had to abort as there was no heart beat. Initially her Beta HCG was 3100, after 7 weeks it was approx 6k then on 8th week it was 4000, hence doctor asked us to do D&C. My semen morphology was 1% normal out of 40 Million semen (which comes 40 Lakhs - and should be fine if we have done ICSI). My wife used to take injections twice a week (Lonopin 60mg and proluton)
Question : What must be the reason for failure and does these semen enough to keep fetus growing ? Are hormonal injections could be the cause ? Does chromosomes (Men/women) play role in growing fetus ?
My Wife's report is also normal like BP, Sugar, TSH, ANC report is normal.
Brief Answer:
Reasons can be many.
Detailed Answer:
Hi, I think there can be many reasons for the absence of cardiac activity. First of all it can be due to chromosomal abnormality or due to genetic reasons. For that fetus can be sent for karyotyping. Other reason can be a poor egg quality of your wife. But this can be assessed by embryo quality. Third reason can be inadequate hormonal support to the fetus. So, the injections like proluton are given after embryo transfer. May be you can try some other things next time like aspirin, corticosteroids, other types of progesterone and daily injections of heparin 40 mg. Talk to your doctor regarding this. The hormonal injections are given to support the pregnancy. They will not harm the pregnancy. Hope I have answered your question. If you have any other query, I will be happy to help.
Regards
Dr XXXXXXX
Reasons can be many.
Detailed Answer:
Hi, I think there can be many reasons for the absence of cardiac activity. First of all it can be due to chromosomal abnormality or due to genetic reasons. For that fetus can be sent for karyotyping. Other reason can be a poor egg quality of your wife. But this can be assessed by embryo quality. Third reason can be inadequate hormonal support to the fetus. So, the injections like proluton are given after embryo transfer. May be you can try some other things next time like aspirin, corticosteroids, other types of progesterone and daily injections of heparin 40 mg. Talk to your doctor regarding this. The hormonal injections are given to support the pregnancy. They will not harm the pregnancy. Hope I have answered your question. If you have any other query, I will be happy to help.
Regards
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
We have taken donor egg still we have to do chromosome test for my wife also? We have done blastocyst and laser hatching process. Her beta HCG was 3100 initially so still can say the embryo quality was poor? Is there any connection with Beta HCG and Embryo quality? Could you please suggest the name of the tests that we have to do in future to avoid this D&c situation? What precautions has to be taken in future as IVF pregnancy is very costly and very Precious for us, Our feeling got attached, please help.
Brief Answer:
Chromosomal analysis not required for your wife.
Detailed Answer:
Hi, as you have used donor eggs this time, chromosomal analysis of your wife is not required. Second thing, bhcg value can be correlated to embryo quality, but the intrinsic defects like genetic abnormality can't be predicted by bhcg value. For that you have to undergo peri-implantation genetic diagnosis. Also, sometimes uterine factors can be there. But these are more involved if there is no implantation. For that, tests like Natural killer cell biopsy can be done. There are some cells in uterus which hamper the implantation. So, if the number of these cells are higher, which can be detected on endometrial biopsy, some treatment can be given like intrauterine grafile ( granulocyte stimulating factor) instillation 3 days before embryo transfer. Also a test called ERA is available which is a genetic testing and it tells when is the best time for uterus receptivity after the progesterone injection is started, day 3 or day 5. You can discuss this with yourself doctor. Steroids and aspirin has shown to reduce the chances of missed miscarriages as some immune factors are also involved. Hope I have answered your question. If you have any other query, I will be happy to help.
Regards
Dr XXXXXXX
Chromosomal analysis not required for your wife.
Detailed Answer:
Hi, as you have used donor eggs this time, chromosomal analysis of your wife is not required. Second thing, bhcg value can be correlated to embryo quality, but the intrinsic defects like genetic abnormality can't be predicted by bhcg value. For that you have to undergo peri-implantation genetic diagnosis. Also, sometimes uterine factors can be there. But these are more involved if there is no implantation. For that, tests like Natural killer cell biopsy can be done. There are some cells in uterus which hamper the implantation. So, if the number of these cells are higher, which can be detected on endometrial biopsy, some treatment can be given like intrauterine grafile ( granulocyte stimulating factor) instillation 3 days before embryo transfer. Also a test called ERA is available which is a genetic testing and it tells when is the best time for uterus receptivity after the progesterone injection is started, day 3 or day 5. You can discuss this with yourself doctor. Steroids and aspirin has shown to reduce the chances of missed miscarriages as some immune factors are also involved. Hope I have answered your question. If you have any other query, I will be happy to help.
Regards
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Kampana
Hello Doctor, Thank you for the information.
What to do for Fetal growth, are these test mentioned by you (PGD, NK and ERA)are sufficient or there are some other test for me?
We had done blastocyst and Hatching where my wife's intrauterine lining was observed correctly and then embryo was implanted, still we have to do ERA test?
Does only karyotyping test needed for me?
What to do for Fetal growth, are these test mentioned by you (PGD, NK and ERA)are sufficient or there are some other test for me?
We had done blastocyst and Hatching where my wife's intrauterine lining was observed correctly and then embryo was implanted, still we have to do ERA test?
Does only karyotyping test needed for me?
Brief Answer:
Only karyotyping is fine.
Detailed Answer:
Hi, I think karyotyping can be done for you. There are no other tests required. For fetus growth, it can be supported by injectable progesterone, oral duphaston, vaginal susten, oral steroids, injection heparin and oral aspirin. ERA can't be done at this stage as transfer has already been done. Hope all these medications help you.
Regards
Dr XXXXXXX XXXXXXX
Only karyotyping is fine.
Detailed Answer:
Hi, I think karyotyping can be done for you. There are no other tests required. For fetus growth, it can be supported by injectable progesterone, oral duphaston, vaginal susten, oral steroids, injection heparin and oral aspirin. ERA can't be done at this stage as transfer has already been done. Hope all these medications help you.
Regards
Dr XXXXXXX XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
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