# Recurrent implantation failure clinic



## Cdavis254

Hi, 
I'm new to this site and hoping for some advice.

My husband and I have just gone through our 5th Ivf try which was a BFN and now we don't know where to go next.

We have 'unexplained' infertility and our Ivf history is
1st fresh, 1 good quality embryo transferred, biochemical pregnancy however, bleeding started 10 days post transfer so it did'nt really take and I was amazed that we had a positive HCG at all
1st FET,  1 good quality embryo, BFN
2nd FET, 2 good embryos, BFN
2nd fresh cycle, 2 good quality embryos, BFN
3rd FET, 2 good quality embryos, BFN. Endometrial scratch prior to the FET cycle
(Is this 5 or 2 cycles? I don't know what's considered a cycle!?)

Our consultant said we could consider uterine NK cells but would need to have this done privately. The info we got from our clinic about this is three years old and was for the Spire hospital in Liverpool.

Any recommendations for a clinic which offers a full recurrent implantation failure work up?

We can't start our third and final Nhs funded fresh cycle without trying something different

Any advice or experience would be gratefully recieved

Thanks xxx


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## ivyf

Hi I'm so sorry, if you look at my signature you'll see we went through similar. It's impossible to know what's wrong without expensive tests but many women find clinics willing to try some treatments without testing eg clexane, steroids etc. read agates info called 'learning from your failed cycle' as a start. Some clinics will tell you it's a numbers game and just bad luck but I wish I'd gone for testing sooner. Good luck x


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## Cdavis254

Hi IVYF,

Thanks for your reply and the link to the agates info. It was really helpful and will definitely help to know what questions to ask at our next consultation appointment.
I sorry to read your history but so so pleased that you have a BFP at last

Thanks again x


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## Lorsha

Hello, I had 2 failed implantations my consultant suggested a hysteroscopy  and endometrial biopsy which showed hyperplasia meaning my womb lining wasn't right for implantation I had 3 months of progesterone pessaries to correct it and my next ivf a week after the 3 months worked ... implanted ! baby due in 7 weeks. Good luck


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## Hbkmorris

Hello, 


Sorry to read of your failed cycles.. It's heartbreaking and I know how it feels so Hun so big    to you. 


I went to CRM with Professor Quenby. She is very well known in her field and actually teaches other clinics in her field. 


So I had the NK Cell biopsy which revealed I had high killer cells and although it wasn't sky high it would of been enough to stop perfect embies/blasts from implanting. After the biopsy she tests the tissue and then calls you with the results and a review working forward. For me it was a case of incorporating steroids, iintralipids and clexane. 


I also had to have my left tube removed due to the incompetence of my first clinic clipping the Hyda tube in the wrong place so this too could of had an impact of implanation as the fluid was still leaking out a little. 


Low and behold once all this was dealt with I had a bfp which sadly ended in a mc and now I'd wasted 6 years (cycles previous to tubes being removed) along with my old age I moved to donor egg and again just got my 2nd bfp...


Hope this gives you some hope. Defiantly check our professor Quenby and her partner in crime Professor Brosen.. They are lovely and its a well worth test...thankfully all my other immunes blood tests came back normal. 


X


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## emma26

Hi,
As you can see from my signature, DH and I are in a very similar situation to you. We have been treated at London Women's Clinic in Swansea to date, but this week we had a consultation with Care Fertility in Nottingham. Took us nearly 4 hours to get there, but have had a huge number of tests, including Chicago tests and DNA fragmentation test for DH.
I was really impressed with them and although I don't have a positive outcome to tell you yet, I have come away feeling incredibly motivated and confident in what the future may hold for us!!!
I have quite a lot of information on immune issues, implantation failure, sperm dna issues etc, so please feel free to PM me at any time.
Best of luck to you hun and take care
Emma xx


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## itsonlybridge

Hi *Emma26* We are in the process of moving fertility clinics after ours closed following a 1st failed cycle in Nov 2014. and we have chosen CARE Nottingham. We have our 1st appointment on 5th May.

We had a nightmare with our previous clinic in Burton who decided to test me for NK cell in February 2015 costing £600 but did not take a large enough sample of tissue, so the lab were unable to analyse it. We also had to fight before they agreed to refund the fee. On top of this our consultant was made redundant due to the clinic closing (which in hindsight is probably not a bad thing!) so we did some research and have heard some great things about CARE and decided to invest our next cycle with them.

We have our first appointment on 5th May and have a lot to discuss with them. I expect the first thing they will want to do is re-do the NK test. Is this the same as the 'Chicago test' you mentioned? If so I wondered what their process is for this, did you have a blood test or a womb biopsy?

Great to hear that CARE have given you re-newed confidence, I am hoping for the same with them after a terrible experience with the 'profit before care' previous clinic!

I am also going to now stop worrying about the 1 hours drive to Nottingham after hearing you are travelling 4 hours!

Wishing you all the luck in the world for your treatment and hope to catch up with you along the way 

Bridget xx


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## emma26

Hey Bridget,
I am so sorry that i am only now replying!! I have literally just seen your message.
I was going to answer your question re the NK cells, but can see that you have already had your apt, so in no doubt know already... How did it go hun
I am gettting our results today, i am feeling really nervous!!
Will keep you posted on how we get on and please let me know how things went for you on tuesday
xxx


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## itsonlybridge

Hey Emma, Don't worry it's difficult to keep up to date with these boards sometimes isn't it  

Well we had our first appointment at CARE Notts on Tuesday and which left us with very mixed emotions.

Firstly our old clinic in Burton had not sent all of my previous test results across to CARE which was very annoying as they have been so useless and now can't even get this bit right. I have chased them but they feel they have sent all results for all tests done.. I know for a fact some are missing because I have letters from the consultant proving that I have had these tests done, so I have had to send copies of these off on an email and I have made it clear that we are not impressed!  

So CARE Notts have so far established that our issues seem to be with 'implantation' because of the 3 miscarriages and failed first ICF cycle with 2 blasto embies. They believe this is caused by 1 of 2 issues, either the environment that the embryo/s are in ie. my womb/uterus  or the quality of the eggs/embryo. So the next step is Killer Cell testing and like you, they will take a blood test which is sent to Chicago.  The old clinic attempted to do this by biopsy but didn't take a big enough sample to be analysed).

In addition to this, CARE want to do Chromosome screening during the IVF whereby they will take a tiny biopsy from the egg or embryo to to test for genetic disorder/abnormal chromosomes. 

So that all sounds good, however the cost for all of this runs up to the 9K mark which is double what we were expecting!! We have spent the last couple of days in shock and have had a few heated discussions which came to a head last night with us both getting upset. I am due on which is not helping my emotions at all ! So having finally been able to have a rational discussion and sort through out finances, we have agreed that we will have to delay our next cycle until we have remortgaged in August, otherwise we just won't be able to copy financially which is not the atmosphere we want to head into this cycle with, particularly as this is going to be our last shot due to the cost.

So theres been quite a lot to get out heads around this week and I shall be very glad of the weekend tomorrow! We have some friends coming over for dinner tonight which I am looking forward to, they are always relaxing company.

I hope you get the results you need to move forward today, I will be thinking of you. 

Keep in touch and you never know we may end up meeting at the clinic one of the days   xx


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## emma26

Oh Bridget, your old clinic sound awful 
The tests etc that Care have suggested for you are the same as us!!
You will be encouraged to hear that my tests came back as being high risk for thrombosis, which means I need baby asprin and clexane and slightly elevated NK cells, which means I need 1 round of Intralipids.
They are confident that this is the cause of our 2 miscarriages and 3 implantation failures, but with the treatment mentioned above, should give us a much better chance!!   
Like you, we are having a break, finacially and mentally needed. Think we will run with our next and final cycle in Jan 2016...
Due to my issues being uncovered, we probably do not need to go for Array CGH (genetic testing of embryos) but we will go for the Care Timemaps instead, which is less than half the price...
Are you going to get the Chicago/NK Cell tests? I would definitely advise you to, in light of my results yesterday!!!
Good luck hun and definitely hope to see you in Nottingham in the near future!!
Em xxx
Ps - hope your dinner party went well x


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## Luckyluck

Hi Emma,
Can I know the Cost of Chicago/NK Cell tests ? Is this the only test care recommended you in level 2 ?


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## emma26

I had 3 tests in total - PAI 1&2, something beginning wit a C (sorry i can't remember now!!) and the level 2 Chicago tests. I think the PAI was around £300 for me and my husband and the Chicago tests were £1100.
Are you thinking of having them?
xx


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## Luckyluck

Hi Emma,
I'm actually very confused. Last 3 times our embryo quality was very average mainly due to my egg quality. But My previous clinic drs told me since I'm young I should b producing chromosomal normal egg despite the quality. As there was no hint of implantation on our last 3 cycles I'm unable to decide whether are not to go for the tests as they are really expensive. Sometimes I feel I'm over analyzing the stuff and making things more complex.


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## emma26

Sorry I took so long to get back to you!!! Back in work now, so flat out!!!
I understand why you are feeling so confused hun. It is a very confusing and stressful time. However, IVF is very much a game of trial and error. I have tried different drugs/protocols and some have paid off, others haven't. I would definitely advise you to undertake as many tests as possible, in order to rule things out, or, like in my case, to finally get an answer for all of the failure/loss.
Like you, I 'should' have great eggs. I'm 34, with a good ovarian reserve, however, 2 out of 3 fresh cycles, I have had terrible quality eggs with just 30% fertilisation rate. Care have put it down to the wrong protocol and a few other issues re drugs. So, as well as the intralipids and clexane for all future cycles, i will also be on a short protocol with norithisterone instead of suprecur/buserelin and gonal f instead of menopur.
I'm thrilled with the changes and have new found positivity that all is going to work out for us!!! 
xx


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