Ask Our Doctors – Archive
Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.
Hi Dr. Sher,
I don’t know what to do.
My husband and I started fertility treatment last year. Before our first iui I had a spontaneous pregnancy that ended up being a blighted ovum. Had a dnc oct15, 2019. First iui afterwas unsuccessful. Husband has low sperm count and morphology so we started IVF. With stimulation I had 22 eggs that ended in 7 high quality day5 embryos. We did our first Fet may 14. 13 days later hcg was 323. 2 days later hcg 786. 3 day later 2230. Us 4 days (5 weeks 5days) later showed no sac. Hcg that day was only 2028. They say this will not be viable pregnancy. I’ve had no cramps or bleeding.
My history just turned 35
At least 1 large 7cm fibroid ( not in the cavity, actually can be felt on my abdomen)
Left ovary endometrioma
No other endocrine or hormonal issue I know of
Normal bmi
They suggest myomectomy before trying again citing misshaped uterus.
My question is could these two losses be related. Is it a chromosomal or genetic issue between my husband and I? Could it be and immune problem. I’m scared of having the myomectomy then having another early miscarriage. Just looking at this from all angles.
I do have a an ultrasound and blood work tomorrow (6 weeks, 1 day)
Any thoughts?
It is highly unlikely to be related to a genetic issue affecting you and your husband. It is unlikely to be due to a fibroid that is NOT encroaching on your uterine cavity. It could have to do with an immunologic implantation dysfunction linked to endometriosis but is very likely due to a chromosomal embryo defect (aneuploidy).
The possibility of an immunologic implantation dysfunction(IID) needs to be evaluatyed and the protocol used for ovarian stimulation needs to be reviewed and possibly revised. Finally, the large fibroid is best removed before proceeding because it will grow substantially in any pregnancy and compromise the timing and mechanics of birth:
Geoff Sher
PH: 702-533-2691
Dr,
I’m 39 and this is my 6th pregnancy. I don’t know my lmp as I am breastfeeding but did track ovulation due to having very painful ovulation pain (hurt even to sit!)
My hcg at 18 dpo was 936 then 72 hours later 21 dpo 2552 is this a normal rise? Do you think possible twins? Thank you.
It is OK.
Good luck!
Geoff sher
Dear dr. Sher,
Just wanted to ask please when is a good time (early but accurate enough) to do a blood pregnancy test ? I transferred 2 blastocyst embryos 3 days ago (June/2), I have a trip abroad next week and really want to know before I do it but my doctor says I should test only on June/16, two full weeks after the transfer, but I was thinking to test 7dp5dt … right before I start my trip?
Also, this time I was not put on progesterone injections (only on pessaries 200mg -1 in the morning, 2 at night) although doctors haven’t checked my hormone levels since egg collection (which is also unusual to me)
Shouldn’t I have the injections too? I had a late miscarriage at 23weeks 3 years ago for cervical incompetence.
I would love to hear your thoughts & advice dr.
Thank you so much !
Diana
I personally prefer the PIO injections + pessaries. However, you can supplant the former with the latter. The earliest time for a blood test is n my opinion, 9 days post-blastocyst transfer or 11 dys post-day 3 transfer.
Good luck!
Geoff Sher
Dear Dr,
I am really worried and I would really appreciate your help.
I was transferred two fair quality 3-day embryo on 15th May. My betas were as follow:
8 days post transfer 26
11 dpt 52
13 dpt 120
17 dpt 1033
20 dpt 2145
I had u/s at 5+1 weeks on day 19 post transfer and they only saw gestational sac (5mm) and said it was normal.
I am afraid hcg is too low and that they didnt see yolk sac. Do I have options? Last beta doubled in 3 days, not in two. I also would like to know if frozen embryos produce less hcg as I have read as this could be my case. Thank you so much in advance
I think you are doing the US too early. Repeat in about 14 days time for an accurate diagnosis.
I am still rather optimistic for you.
Good luck!
Geoff Sher
Just to update:
Today we had US at 6 weeks and saw yolk sac, «baby» and heartbeat. My obygyn said everything looked right. Thank you so much for your help, I really appreciate it.
Hi Matt,
So I took a 2 pregnancy tests Wednesday morning, both said I was pregnant. I took another yesterday morning (different brand) that also came up positive. Had the blood test yesterday around lunch. Got my results today and my reading is 20. Which the doctor said is the ‘grey area’, and can’t confirm pregnancy, I took another test now and the positive line is coming up darker and darker every test. The doctor will retest Monday. I have been feeling pretty ill, I would only be 3 weeks and 4 days. Would these levels be normal for that early? My bloody pressure is a little high too.
I’m just a little stressed about the results as I thought for sure they would be positive
Thanks
You will need tests done 48h apart to determine if the level is doubling appropriately.
Good luck!
Geoff Sher