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 did two back-to-back IVF cycles two years ago, when I was 35 (diagnosis of DOR), and banked the embryos. Our first FET of a single grade 5AA embryo resulted in my amazing son, now 20 months old. The second FET this past July, a single 5AA embryo, ended in a missed miscarriage at 9 weeks, trisomy 15. We have two embryos left: a 4bb and a 2bc. My question is whether to transfer both next month or do one at a time. The situation is complicated by the fact that we are moving across the country in December, so if we transferred only the 4bb and it failed, I would have to make a separate trip back for the next cycle, and my RE is a little bit concerned that the 2bc may not survive the thaw. My RE recommends two single embryo transfers, but she also thinks it would be fine to transfer both if we prefer. What do you recommend? Thanks in advance!
I personally would transfer two.
Geoff Sher
Dr. Sher, you have such an amazing blog! Thank you for taking the time to answer people’s questions whom are obviously struggling getting advice from their own clinic. With that said, hoping you could answer a question of ours. I am 36 and my husband has male factor. We have frozen (not PGS tested) 5 embryos. 1 is frozen on Day 5, grade 4BB. Others were frozen on Day 6 with Embryo Grading: 6BA, 5BA, 5BB, 3AB. I know you are the expert. Should I be asking the clinic about “fragmentation”? Which ones and how many would you transfer first, or which ones do you think seem more successful? I know it can vary greatly but I’m curious YOUR recommendation!
If the blastocysts are expanded and the inner cell mass is cellular, then they have a good potential. I would start with the 5 day blastocysts.
Geoff Sher
Hi Ashley
Your story is very similar to mine. I wish you all the best in your journey. I still have 2 frozen embryos left fron my 1st IVF cycle. I didn’t give thought yet if I wanna do a second cycle.
Just wanted to ask, what made you decide to change clinics? Was it just the fact it did not work? I’ve been thinking of doing the same but do believe I’m currently at one of the best clinic in my region.
I hope you get a response!
Good luck!
Geoff Sher
Joan I changed clinics because the first clinics response to my Field transfers was ” sometimes it just doesn’t work and you have to keep on trying “. I was not happy with that response as I wanted them to further look into reasons for failure.
Dr. Sher do you have any knowledge as far as the luteal phase defect I am experiencing?
Thank you for your prompt response. I just wanted to confirm some information as I have booked an appointment with my fertility doctor.
From what I have read, I would need to:
1. Confirm the quality of the embryos being transferred. I think that is already done when they tell me they are 5 AA or is there other testing?
2. Confirmed the integrity of my uterine cavity as I have had surgeries and may have scar tissue
3. Make sure the problem is not with implantation. And request testing of NK cells? I am in Canada but if my clinic is unable to provide this testing I can contact Reprosource.
4. Perform Embryo banking as I am 35 and quality will contine to decline with age.
1. Confirm the quality of the embryos being transferred. I think that is already done when they tell me they are 5 AA or is there other testing?
A: Only if they did PGS testing…otherwise not!
2. Confirmed the integrity of my uterine cavity as I have had surgeries and may have scar tissue
A: Yes by hysteroscopy or hystrosonogram
3. Make sure the problem is not with implantation. And request testing of NK cells? I am in Canada but if my clinic is unable to provide this testing I can contact Reprosource.
A: yes
4. Perform Embryo banking as I am 35 and quality will contine to decline with age.
A: May not be necessary if you can still produce enough eggs.
Good luck!
Geoff sher
Dr. Sher
I am 34 years old my husband is 36. We have been trying to conceive for 4 years. 1 year on our own until we found out my husband had a vericocile vein causing a low count (he did have surgery to correct this) and the last three years with assistance.
We did three chlomid stimulated iuis and were unsuccessful all three times. We then moved forward with ivf. I responded very well and 17 eggs were retrieved of which 14 fertilized. of the 14 8 made it to blast and were all frozen after PGD?PGS testing. Of the 8 blasts 6 came back normal.
My first fet a year ago was a medicated cycle using injectable estrogen and progesterone, and two blasts were transfered. This resulted in an early chemical pregnancy. My next fet was a natural cycle supported with progestin suppositories twice a day, two blasts were transferred this time as well. This fet was negative for pregnancy.
I switched clinics and did another ivf round where 16 eggs were retrieved and all fertilized. I refused doing any genetic testing this time. Most embryos were high grade 3 and 4 +. My new DR. wanted to try something different so we did a fresh transfer of two 3 day embryos. Another failed transfer.
At this point my new DR. wanted to do some testing. First I had an ERA biopsy that came back receptive. Next we did a medicated (estradiol and crinone) biopsy on day 26. The results showed my lining was out of phase and looked like it should on day 21. The next month we did another biopsy and included 1 CC of progesterone in oil to see if it would mature my lining. The results of this biopsy showed edema and exhausted glands. I am currently awaiting the results of a third biopsy where HCG was incorporated with a natural cycle, supported with 1 CC progesterone in oil and crinone am and pm.
I am nervous nothing is going to change. any suggstions.
Thanks kindly
Ashley