2nd infertility and repeated implantation failure_1
Short summary
41-year-old female with 2nd infertility and repeated implantation failure was treated with 4 long protocols with no success. The expert suggests to perform diagnostic hysteroscopy, hysterosalpingogram, and thrombophylia workup, to switch from the long protocols to a short one, and try to do double transfer or blastocyst transfer and consider assisted hatching as well.
Medical Background
- Appendix removed in October 1987
- Laparoscopy April 2004 : results showed very mild Endometriosis
- Fertility treatment started in May 2004 : Clomid(50MG); Pregnal(5000 IU INJ); Menopur Vial.
Became Pregnant in June 2004, but miscarried at 11 ½ weeks. Had a D&C procedure following my miscarriage.
- Mole removed September 2005 : results showed cancer cells,
Further surgery was performed in October 2005, to get a clear margin, Lymph nodes removed. All Clear was given in November 2005
- Colonoscopy on May 2006 , required as a precaution, as her Father died of Colon cancer in 1979 at the age of 47.
- 4 cycles of IVF treatment in Galway
1 cycle of IVF treatment in Athens
All with a negative result
Medical opinion
It seems that this 41 years old lady suffer from 2nd infertility and repeated implantation failure.
She was treated with 4 long protocols with no success
The endometrium lining from the ultrasound charts seems OK.
I did not see the Athens chart. Only the 4 Galaway treatments.
At this stage I will suggest to perform:
- Diagnostic hysteroscopy to verify that there is nothing in uterine cavity that prevents implantation.
- Hysterosalpingogram to rule out hydrosalpings (especially since she is past D&C).
- Thrombophylia workup to rule out another interfering factor.
Thereafter I would have switched from the long protocols to a short one (Menopure+Cetrorelix) and try to do double transfer or blastocyst transfer and consider assisted hatching as well.
In any case I will supplement the luteal support with at least daily aspirin 75mg.
