# 3 failed ICSI cycles - what/where next?



## Keepfaith (Sep 3, 2014)

Hi ladies,

This forum has been a god send to me in dark times and I really need some help from you now.

We have just finished our third (and last NHS funded) ICSI cycle at St Barts. I have PCOS and my DH has severe motility and count issues. We've had two fresh cycles and one FET. All were BFN. We had one 4bb on the first fresh cycle, 2 blasts in the FET (which didn't survive the thaw well) and one 5b+b+ on our last fresh cycle. 

Before our last fresh cycle, I had some blood tests done for immune issues on the NHS (though I don't know exactly what tests were done). One of the tests was Lupus Anticoagulant which came back as a weak positive. As a result I've been taking prednisolone (20mg), baby aspirin and clexane since ET. I also had a hysteroscopy which included a uterine biopsy (NHS though so not for NK cells) and apparently this was normal.

I don't know where to turn now. We have no more NHS funded cycles but I really feel that I might have immune issues (given positive lupus anticoagulant, the fact that my dad was paralysed from the waist down by an autoimmune condition 3 years ago and because I've had a sore throat during implantation time on both fresh cycles).

I'm reluctant to spend lots of money on anther cycle until I get to the bottom of the issue but I don't really know what to test/check.

What do you think about a lap? I know it's not normal to have one unless Endo is suspected and I don't think I have symptoms but I do get lots of watery discharge & I wonder whether I might have a hydro? I've had a HSG which was normal and my ultrasounds and hysteroscopy haven't shown any problems. Do you think a lap will just be a waste of time and money?

I'm thinking about having  the immune tests done but I'm not sure whether to have the bloods or the uterine NK cell test or both. I've read that it's possible to get very different results from both and some women get better results applying treatment based on the uterine tests. I also know that a lot of clinics don't necessarily ascribe to the whole immune issue theory and I am nervous about the possibility of being recommended Ivig and/or lipids.

Basically I don't know where to turn and what investigations to do next. Any suggestions you lovely ladies may have would be so gratefully received after what has been another heartbreaking week


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## Petalchild (Apr 26, 2015)

Hi Keepfaith.
I am just in the middle of my third cycle right now but I couldn't not reply to you. Your case is very similar to ours in that I have PCOS and my DH has severe motility issues. 
My first cycle was a success but we ended with a MMC at 7 weeks.  I was devastated and felt like there was somehting that I could  have done but made myself believe that I was just panicking.  My clinic thought I was just unlucky and recommended that I didnt need any immune tests or change in treatment. It had worked before so we did round two on the exact same protocol which was a BFN. This time I pushed for Immune issues to be tested and they found that I do have high NKC and T cell counts which essentially tell my body that the fast growing tissue (embryo) is a cancer and so I attack it.  It sounds mad but I was actually relieved to find that there was  a reason why the I had the MMC and why the embie didn't take on round two.  This time round we are on Steroids and other things to counteract it and fingers crossed we will get over the line this time.  

Sorry for the long background but I suppose what I am trying to say is push for what your gut is telling you.  I didn't until after we had two failed rounds and I wish I had trusted myself more. I'm from Ireland so we don't get any cycles free and have had to pay 6000 a pop for each one of our rounds.  It is worth getting all the answers before you pay out for another round. If this doesnt work with our current clinic I will definitely be taking my info to another pair of eyes for their advice. 

 Its a long road but keep strong that you will get there by trusting your gut


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