# implantation failure tests



## Stilltryingandhoping

Hi Everyone!

This is my first post, and im really hoping someone out there might have some advice for me.

Our IVF journey has been a long one so far. We had a fresh cycle in Jan 2015 , 4 blastocysts produced by ICSI. First single transfer was a BFN. Second single transfer BFN, third single transfer with Clexane BFN. We then had immune testing including Chicago tests which showed elevated levels for some of the tests and some clotting issues so i had interlipid steroids aspirin and clexane - again BFN!!

We had another fresh cycle recently (Im now 34 yrs old) we produced 6 blastocysts by ICSI. We had 2 transferred this time with the same immune treatment, again we got a BFN!

Our consultant is now referring me for an endoscopy at my insistence, although she says the scans did look normal, and when they have scanned during stimulation, my lining always thickened and had the 3 line definition. We go to CARE fertility and they are very good, although they don't offer an endometrium receptivity array or anything like a hidden C test. She is happy for us to go somewhere else and have these tests done, and she will apply the findings when we next want to do an embryo transfer.

We have also agreed to test the 4 frozen embryos for genetic screening. She has mentioned doing this before, and although i agree with the reasoning behind it, i really cant help but look at the logic. Not all of these amazing grade 1 and 1-2 blastocysts would be genetically bad, so there must be another reason the IVF has not worked.

I am now very confused as to who we should go to for further testing. I did think of going to Dr Gorgy at the Fertility and Gynaecology academy but they don't offer the Endometrium receptivity array. And i have been told that Lister Clinic is good and they offer this ERA test, but im really confused. 

Has anyone else had repeated implantation failure, similar to us?Did you get to the bottom of it? Or has anyone had experience with either of these clinics/Consultants at these clinics. I would appreciate any help or advice as im really confused.

Thanks


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## njr_26

Stilltrying, you can have the ERA test as a standalone test with Gennet City Fertility or there may be somewhere closer tonyou that does it.

Is your TSH under 2? Having it over 2 can cause implantation failure and m/c.

You could also try Prof Quenby in Coventry as a first step in immune testing as she does the uterine NK biopsy which is very reasonable in price at £360 for the biopsy, consultation and follow up.

The Grrek hidden C test you can get done cheaper directly with them here is a link: http://www.fertilityfriends.co.uk/forum/index.php?topic=242395.msg3904717#msg3904717

I have experience of being with Dr Gorgy, he is very expensive and if you have a few thousand to spend, he is the best. He will leave no stone un-turned in testing so at least you find out what is wrong. His treatment has worked twice for me.


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## Stilltryingandhoping

Hi Njr_26 

Thanks for your reply. My thyroid tests came back normal, that was all tested as part of my intensive immune testing. They check all thyroid functions, some genetics etc. In on immune treatment as a result of it, so having a NK Biopsy would surely not matter? If it came back with NK cells, I would be in the same treatment I had with my last 2 transfers- interlipid, steroids and clexane for clotting issues. 

The hidden C test is something I'm considering, although it's pretty controversial. The ERA is also something I've looked into, and found it difficult to find clinics that offer it. I know Lister Clinic offer it. Done know about any clinics up north that do. What would have been ideal is if DR Gorgy dos thai test along with all the other investigations he does. It would make it easier for me to know next steps. But no one clinic does all the test we want doing 😱 

I'm really confused about what to do next, and actually wondering it it's worth us spending our savings on something we might not get to the bottom of. 5 unsuccessful attempts has left us very deflated and I don't really know if I have hope anymore. I'm in the process of looking at surrogacy as an option instead, I'm just very very confused! 

Did you ever feel like giving up? I'm glad it worked for you eventually


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## njr_26

No, we never felt like giving up. We just didn't have the things other people had in order to afford treatment. We didn't buy many clothes, no ipad, iphones etc, no sky tv, no meals out, minimal spent on Christmas and birthdays, no life insurance, interest only mortgage, our car is 14 years and we only have 1, no fancy holidays, had lodgers living with us, took out loans and credit cards. We are not rich, we were just determined, read all the research and made our minds up to go with the best as we considered it cheaper to find out what was wrong rather than paying for more IVF cycles which never would have worked. Prague was so much cheaper for donor eggs as well than here.

The reasoning behind having the biopsy is you may have high NK cells in the blood but low inflammation in the womb, in which case steroids can be counter-productive.  I found out looking at all my treatment cycles  that when I took steroids from day 5 of my cycle I didn't have success, but taking them from day 10 (accidentally as my AF turned up early) resulted in my son. This cycle I repeated taking from day 10 starting with a low dose and building up to 40mg by ET. This worked.

Sometimes you have to find some of the treatment yourself. I went for a consult at Gennet thinking I might have the era done but they advised as I had implantation, it was unlikely something to do with the implantation window.


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## MariaR

Hi there, 

I am in a similar situation and was just wondering what you ended up doing and if you had any results? Also are you unexplained infertility? Our story is we are unexplained infertility 3 years now and did our first ICSI cycle last year which resulted in 5 good quality blastocysts. Apart from a chemical pregnancy on the fresh transfer we had nothing but BFN on the 3 subsequent FETs... to our doctors great surprise... I just turned 32 so was 31 at the time...  I took clexane for all transfers and steroids/ intrallipids on the last FET just in case... I also had a laparoscopy/ hysteroscopy/ d&c a few weeks ago and nothing "significant" was found although I did have a small polyp, cyst and small spot of endometriosis removed... However the surgeon felt like none were significant enough to explain 3 years of infertility so now we are planning on doing a second cycle with an embryoscope and MACS at a clinic in Athens...
The one thing we did find out is that my husband has abnormal sperm DNA fragmentation at 33% but we are receiving entirely conflicting opinions as to whether this makes a difference and most doctors are telling us since we got good blasts that it shouldn't... we are really confused about this...
I also heard about the endometrial biopsy with professor Quenby and a similar one with a doctor in Paris and it sounds really promising and I would really like to do it... but I just had the D&C so would have to wait a few cycles so we are thinking of having one more go at IVF before looking into the biopsy if we have to...
I also did the hidden c tests with Penny  at Serum and some other 7-in-1 life code tests and all came back clear... Penny however was the one person who was very concerned about my husband's fragmentation and thinks that is our main issue... other doctors I have seen do not agree... 
I also considered the ERA test, but was put off it by my doctor at the time... 
Not sure if any of this helps you but would love to hear about what you ended up doing!


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## Stilltryingandhoping

Hi MariaR

Thanks for sharing your experience. 

I haven't had anything new yet, I'm still waiting for my hysteroscopy date. Ours was initially explained as male infertility issues as my husband had low sperm count, low motility and morphology. We have had ICSI on all out attempts, for this reason. Our consultant has always said that if we test our embryos, if they are not viable(I still not convinced that is the reason we have by had success) it is most likely down to egg quality. I have also found that others in our situation use IMSI to help pick viable sperm, for better embryos. This has not been suggested to us, so I will speak to my consultant about this.

My first step is to have the hysteroscopy. And then to have our embryos tested. I am also visiting a clinic abroad for surrogacy, as a back up. I've decided to keep an open mind to all options, collect all thi formation I can about each option, then make an educated decision. 

I have 4 blastocysts in storage, so I can take a breather and explore all options properly. I think the worst thing would be to out too much pressure on making a decision, and regretting the choices later.

I hope everything works out for you. Have you figured out what you are going to do next?


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## Mihrimah

I don't know if anyone is still following this thread but I wanted to ask if anyone has any ideas about reasons for repeated implantation failure/ chemical pregnancy.

For both of my donor egg cycles, I have had positive tests to start with, initially rising hcg levels which then fell. After the first cycle I was diagnosed with elevated cardiolipin antibodies so took claxene, steroids and aspirin second time around. Also for several cycles now, my lining is really thick at baseline (between 5-6 mm on day 4 of my period) which meant we had to delay treatment several times.

I am now referred for a hysteroscopy to see if there are any polyps etc but I would be so grateful for any ideas/ advice about where to go from here...


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