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Had failed IVF treatments. Advised anti TB treatment even endometrial test negative. Should I go for further tests?

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Infertility Specialist
Practicing since : 2000
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Question to Infertility Specialist/IVF Specialist Hello Doctor I am a female of 34.5 years, I have underfone 3 failed ivf attempts, the last being an ectopic pregnancy.I have undergone all the tests for TB , which came out negative. TB -PCR , laproscop and some blood work . Now my doctor is advising me to take anti TB treatment even though my tests are negative as she said that in some cases TB cannot be detected , where the infection is mild. and in my case pregnancy has not resulted even after good quality embroyos, etc. My question is should i take the medication even after negative TB tests , will it improve the chances of ivf. My doctor is not saying that i have tb, but shes saying that taking the treatment will improve the chances of successful ivf. In the laproscopy report there was left tube dribbling and right patent. Endometrial test was done for TB but was negative. However this test was done in 2010. Should I repeat the test before starting on medication or consult some other doctor. What would your advice be or should I go for some further tests. If yes, please advice me the tests?
Posted Tue, 3 Dec 2013 in Infertility Problem
Answered by Dr. Mahesh Koregol 3 hours later
Brief Answer: more details Detailed Answer: Hi, i would like to know the details of previous IVF cycles. How many embryos you got and eggs too. Please provide as much details as possible so that i can give detailed analysis. Regards, Dr. Mahesh Koregol. IVF & infertility specialist.
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Follow-up: Had failed IVF treatments. Advised anti TB treatment even endometrial test negative. Should I go for further tests? 4 hours later
ivf#1 done on 10/4/2012 Nine eggs were retrieved, eight embryos were obtained.enodometrium lining was 9 mm as per color flow imaging of pelvis.3 were put into the uterus on day 3. Standard medicines like folvite colsprin, porgy XXXXXXX gestone and ivf c 5000ium was prescribed, along with aliver and duphastone. Pregnancy test after 3 weeks was negative. Ivf 2 done on 25/6/2012 .frozen cycle. 3 embryos which were frozen from cycle 1was used.negative pregnancy test Ivf 3 done on 3/10/13 Five eggs were obtained. Four reached embryo stage.three implanted. The doc did mention that they were excellent quality embryos .endometrium lining was 9. Same line of treatment but instead of gestone injections shifted to sustenance 400thrice a day vaginally.this cycle resulted in very early one ectopic pregnancy for which medical mgmt done using medicine metrophnine.not sure I think got the spelling right of the drug used. Now the doc is suggesting as I wrote earlier anti tb treatment though tests were negative earlier as I have failed to conceived in 3cycles inspite of good quality eggs , sperms, embroyos, etc as per her so to rule out any latent mild tb infection she is suggesting that.PLease also note I have tried 5-6cycles of iui before moving to ivf. Please suggest what my next course of action should be.i can scan and send u the photos of embryos, in your personal email id or any other specific report if that helps u make a better decision. Thanx. Please let me know any other info which u would like me to mail u. Thanks once again for taking time and replying to my query.
Answered by Dr. Mahesh Koregol 12 hours later
Brief Answer: dont take anti TB drugs Detailed Answer: Hi, 1) Your first cycle endometrium is 9 mm which is thick enough. It is good enough for implantation. Hence no need to take anti-TB medicines. Since you are approaching 35, no need to waste anymore time on this. 2) Good news with third IVF is that you conceived. It may be ectopic treated with methotrexate inj. But conception shows you can conceive again. 3) There are 2 options infront of you. Undergo another IVF cycle with your eggs. Otherwise try IVF cycle with donor eggs which is last option as your eggs are aging and got only 5 eggs third time. 4) Please undergo hysteroscopy if not done already to see intrauterine space. Let me know if you have anymore doubts. Regards, Dr. Mahesh Koregol IVF & Infertility Specialist.
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Follow-up: Had failed IVF treatments. Advised anti TB treatment even endometrial test negative. Should I go for further tests? 3 hours later
Hystero laproscopy was done showed fundal fibrosis in cavity.and periorteal fibtosis in right and left ostia.endometrial cuttings were sent for was normal.and 3d scan of uterine cavity done.i am also not in favour of taking anti tb treatment if not reqd.should I undergo any more tests to rule out tb and cause for implantation failure.i have not undergone a test which shows ovarian reserve.shld I take doc feels that up to 40 one shld not be too worried abt producing eggs when I told her that she said 4months will not make a diff to egg quality.when should I go with donor eggs after how many more cycles.shld I start with ivf immediately or wait for a few months since drug was used to end the ectopic.when will it be safe to start another ivf cycle if I don't take the tb treatment.thanx for your time.
Answered by Dr. Mahesh Koregol 3 hours later
Brief Answer: Fibrosis? Detailed Answer: Hi, 1) I wish to know if Your hysterosopy showed fibrosis or fibroids? 2) Fibrosis means the sticking of uterine wall with a tissue. Any treatment was given for that? Send me a picture of hysteroscopy if you have. 3) I dont think you need to worry about TB. Just forget it. 4) You may keep producing eggs after 40 also , but quality and quantity is reduced hence decrease chances of pregnancy. 5) You can go ahead with IVF after another month as you finished methtrexate recently. Regards, Dr. Mahesh Koregol IVF & Infertlity Specialist
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Follow-up: Had failed IVF treatments. Advised anti TB treatment even endometrial test negative. Should I go for further tests? 3 hours later
Fundal Fibrosis. Right and left ostia - periosteal fibrosis, tubes right and left congested - drop like spill. HPE report - section showing endometrial glands in proliferative phase, the glands are regular rounded in shape, lined by tall columnar epithelium. No atypia seen, stroma is moderately dense showing focal oedema. Evidence of TB or any other specific pathology is not seen. Treatment was given as follows cap doxy for 15 days, tab cipzend for 10 days, betadine 10 days, tab ciplox 500 mg for 10 days, FAS kit for husband and wife 1 day. Is this treatment ok or some other treatment should have been given. If yes , let me know what further tests/treatment I should take. I do not have a copy of the historography.the ivf clinic didn't give me,I have a report which says what I have written. When I had asked the doc after the procedure the meaning of fibrosis, she had told me that it means the tissue was red, like inflammation, raw. , not clean and had said with the medicines given it would be taken care of. No follow up was done, and iui was started after the endometrium report was normal.Do I need to see another doc for fibrosis or the treatment given was on expected lines. Thanx.
Answered by Dr. Mahesh Koregol 3 minutes later
Brief Answer: Right treatment Detailed Answer: Hi, This treatment you received is fine. No need to worry much about fibrosis now as your endometrium was good. Go ahead with IVF after a month. Regards
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