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.
From your experience having seen many many many pregnancies result from IVF, what is the most likely week/s of pregnancy women seem to miscarry following a successful transfer?
Within the first 6-8 weeks .
Geoff Sher
Hi Dr. Sher,
Mine is FET. I had my 14 weeks US today. In the report it is mentioned as “FH-158 bpm FH+. Collection seen posterior and inferior to the sac measuring 1.2cc”. I dont have bleeding as such. Doctor suggested me to admit in hospital for observation. Since I have a son of 1 year old, my husband cannot manage alone home and hospital. So, doctor told me that there are chances of miscarriage. My NT/NTD scans were all fine, and no issues were told.
Please suggest what to do…. I am so worried. What medications can I take to reduce collection ?
Hi Swetha,
If this is a subchorionic bleed, you do need rest…at home would, in my opinion probably do just as well.
Geoff Sher
Dr Geoffrey. I am 42 and I had a FET transfer 3 embryos on 8 October. 5 days later, I had a terrible cramp, which after that went on to mild cramps on and off everyday. The same heavy pain again on the following Monday night. No bleeding or spotting , but the pain was so bad that i have lower back pain. Spoke to my doctor, but he couldn’t explain the pain. I will be testing my HCG tomorrow and I am losing confidence as I do not have other symptoms of sore boobs, or nauseous, except cramps on and off.
I failed my first IVF fresh cycle a year ago and there was no bleeding too.
Can you advice what cause the pains? I want to try again if I fail this time round, but I am afraid of all these cannot be explained pains.
Thank you!
Sorry Julianna,
I really do not understand your question. lease restate it fully.
Geoff Sher
Hi Dr. Sher!
I had a Skype consultation with you today and I am excited about being under your care. I wanted to know whether you thought micro IVF would be an option for me? I’ve had 6 early miscarriages before 6 weeks. You said I might have an immunologic issue.
Thank you
Yes I do!
Geoff Sher
Dr. Geoffrey I am 30 years old and just had a chemical pregnancy with my first fresh ivf cycle. I had 9 embryos to freeze and scared that it will happen again with a frozen transfer. My doctor didn’t test me for natural killer cells or pgs testing because of my age. I have endometriosis on my right ovary only. Should I be concerned that a had a chemical pregnancy? Does it seem to you my eggs are bad?
More than half of women who have endometriosis harbor antiphospholipid antibodies (APA) that can compromise development of the embryo’s root system (trophoblast). In addition and far more serious, is the fact that in about one third of cases endometriosis, regardless of its severity is associated with NKa and cytotoxic uterine lymphocytes (CTL) which can seriously jeopardize implantation. This immunologic implantation dysfunction (IID) is diagnosed by testing the woman’s blood for APA, for NKa (using the K-562 target cell test or by endometrial biopsy for cytokine activity) and, for CTL (by a blood immunophenotype). Activated NK cells attack the invading trophoblast cells (developing “root system” of the embryo/early conceptus) as soon as it tries to gain attachment to the uterine wall. In most cases, this results in rejection of the embryo even before the pregnancy is diagnosed and sometimes, in a chemical pregnancy or an early miscarriage. . As such, many women with endometriosis, rather than being infertile, in the strict sense of the word, often actually experience repeated undetected “mini-miscarriages”.
Women who harbor APA’s often experience improved IVF birth rates when heparinoids (Clexane/Lovenox) are administered from the onset of ovarian stimulation with gonadotropins until the 10th week of pregnancy. NKa is treated with a combination of Intralipid (IL) and steroid therapy: Intralipid (IL) is a solution of small lipid droplets suspended in water. When administered intravenously, IL provides essential fatty acids, linoleic acid (LA), an omega-6 fatty acid, alpha-linolenic acid (ALA), an omega-3 fatty acid.IL is made up of 20% soybean oil/fatty acids (comprising linoleic acid, oleic acid, palmitic acid, linolenic acid and stearic acid) , 1.2% egg yolk phospholipids (1.2%), glycerin (2.25%) and water (76.5%).IL exerts a modulating effect on certain immune cellular mechanisms largely by down-regulating NKa.
The therapeutic effect of IL/steroid therapy is likely due to an ability to suppress pro-inflammatory cellular (Type-1) cytokines such as interferon gamma and TNF-alpha. IL/steroids down-regulates NKa within 2-3 weeks of treatment the vast majority of women experiencing immunologic implantation dysfunction. In this regard IL is just as effective as Intravenous Gamma globulin (IVIg) but at a fraction of the cost and with a far lower incidence of side-effects. Its effect lasts for 4-9 weeks when administered in early pregnancy.
The toxic pelvic environment caused by endometriosis, profoundly reduces natural fertilization potential. As a result normally ovulating infertile women with endometriosis and patent Fallopian tubes are much less likely to conceive naturally, or by using fertility agents alone (with or without intrauterine (IUI) insemination. The only effective way to bypass this adverse pelvic environment is through IVF. I am not suggesting here that all women who have endometriosis require IVF! Rather, I am saying that in cases where the condition is further compromised by an IID associated with NKa and/or for older women(over 35y) who have diminished ovarian reserve (DOR) where time is of the essence, it is my opinion that IVF is the treatment of choice.
Geoff Sher