Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Had Miscarriages. TB PCR Test Positive. Advised IVF. Any Other Way To Become Pregnant?
Question: Hello doctor
Greetings!
We are residing in delhi. Heard lot about you.
Since last 5 years trying to conceive. Had 1st natural pregnancy in 2009 that resulted in early miscarriage[nothing visible in ultrasound, low hcg rise, D&C conducted], after that visited an infertility specialist "Dr achana bajaj" she did laproscopy & findings and solutions were : left tube slightly blocked from lower end that was opened, there were adhesion that were blocking the opining of right tube , adhesion removed & there was free spill in right tube. She also did tbpcr test that was positive so took akt3 for about 11 months. Then she opted for IUI cycles : 3 IUI [endometrium thickness: 7.2] out of two resulted in pregnancy [ march 2011, October 2011] early miscarriage in both pregnancies (nothing visible in ultrasound, no visible sac, low hcg rise]
Now after taking an years break, I visited another infertility specialist, who prescribes an AMH test [ results were 2.09 ng/ml , age 34] . He said that the only solution is to proceed to IVF with donor egg after looking at past history & as amh levels are low. My question here is should we try IVF with my own eggs, what would be the % chance, is there any other solution to achieve a successful pregnancy. Please advice, we are lot under pressure.
Thank you
Greetings!
We are residing in delhi. Heard lot about you.
Since last 5 years trying to conceive. Had 1st natural pregnancy in 2009 that resulted in early miscarriage[nothing visible in ultrasound, low hcg rise, D&C conducted], after that visited an infertility specialist "Dr achana bajaj" she did laproscopy & findings and solutions were : left tube slightly blocked from lower end that was opened, there were adhesion that were blocking the opining of right tube , adhesion removed & there was free spill in right tube. She also did tbpcr test that was positive so took akt3 for about 11 months. Then she opted for IUI cycles : 3 IUI [endometrium thickness: 7.2] out of two resulted in pregnancy [ march 2011, October 2011] early miscarriage in both pregnancies (nothing visible in ultrasound, no visible sac, low hcg rise]
Now after taking an years break, I visited another infertility specialist, who prescribes an AMH test [ results were 2.09 ng/ml , age 34] . He said that the only solution is to proceed to IVF with donor egg after looking at past history & as amh levels are low. My question here is should we try IVF with my own eggs, what would be the % chance, is there any other solution to achieve a successful pregnancy. Please advice, we are lot under pressure.
Thank you
Hi,
Thanks for your query.
I have read your query & I understand your concerns.
Following is my reply:
1) Tuberculosis of reproductive tract is one of the worst diseases to afect women of reproducive age. As per your laparoscopy report, it has affected your fallopian tubes by blocking them, affected your abdomen by causing adhesions and also affected your endometrium by resulting in abortions.
2) Though the blocked tubes were opened , generally they close again in cases of tuberculosis. But they do remain open in some women. Anyway it wont matter if you are going with IVF treatment.
3) All 3 abortions you have undergone never showed a visible gestational sac and were only positive by blood test ( they are called Biochemical pregnancy).
4) You AMH appears to be good. Since you are already 34 years, it is better to hurry up with IVF. Donor eggs will surely have better results as donor's age is will be younger than yours. But if money is not a constraint for you, you can undergo IVF once with your own eggs as your AMH is good. If you dont conceive then think about donor egg. In your case its very difficut to predict percentage of success as we dont know tuberculosis has affected endometrium or not.
5) I would also like to know how much was your endometrial thicknesss as TB affects endometrium also. Because in your case the biochemical pregnancy were probably due to defective endometrium. If your endometrium is not good, your eggs or donor eggs will not give you good results and the only option left will be to use a surrogate with good endometrium to carry your pregnancy. Surrogate will definitely increase chances of your pregnancy.
I hope I answered your query. I will be available for any followup queries you have.
Regards,
Dr.Mahesh Koregol
IVF & Infertility Specialist.
Thanks for your query.
I have read your query & I understand your concerns.
Following is my reply:
1) Tuberculosis of reproductive tract is one of the worst diseases to afect women of reproducive age. As per your laparoscopy report, it has affected your fallopian tubes by blocking them, affected your abdomen by causing adhesions and also affected your endometrium by resulting in abortions.
2) Though the blocked tubes were opened , generally they close again in cases of tuberculosis. But they do remain open in some women. Anyway it wont matter if you are going with IVF treatment.
3) All 3 abortions you have undergone never showed a visible gestational sac and were only positive by blood test ( they are called Biochemical pregnancy).
4) You AMH appears to be good. Since you are already 34 years, it is better to hurry up with IVF. Donor eggs will surely have better results as donor's age is will be younger than yours. But if money is not a constraint for you, you can undergo IVF once with your own eggs as your AMH is good. If you dont conceive then think about donor egg. In your case its very difficut to predict percentage of success as we dont know tuberculosis has affected endometrium or not.
5) I would also like to know how much was your endometrial thicknesss as TB affects endometrium also. Because in your case the biochemical pregnancy were probably due to defective endometrium. If your endometrium is not good, your eggs or donor eggs will not give you good results and the only option left will be to use a surrogate with good endometrium to carry your pregnancy. Surrogate will definitely increase chances of your pregnancy.
I hope I answered your query. I will be available for any followup queries you have.
Regards,
Dr.Mahesh Koregol
IVF & Infertility Specialist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor for your response!
My queries are as follows:
1. As per laproscopy reports, left tube was blocked[very little] from the lower end, there was slow spill after opening it. Right tube was not blocked & patent. there was a free spill after adhesion from the opening of the tube were removed. At the time of laproscopy , sample of endometrium was taken & tested for tb again & at that time it came out negative [can it be due to the akt3 which i was taking?]
2. After performing laproscopy , conceived twice but only through IUI [not naturally, I am confused why?] and both biochemical [ Is it possible that embryo was struck in tube only , though doctors were not able to trace it ? ] . Also doctor in 3rd pregnancy, hcg levels were very high at initial stage [day 30] & from day 32, started bleeding[for 4 days like periods]. Doctor understood that miscarriage happened & didnt tracked the hcg levels again & after one month due to pain in lower left hcg levels were checked again & comes out to be around 800]
3. Endometrium thickness goes to 7.5 maximum.
4. As per my current doctor, AMH levels of 2.09 ng/ml are poor & that relates to past abortions thats why I should move directly to donor egg without doing IVf with my eggs even ones, however I read through various sources that at my age of 34 these levels are fair enough. Please guide.
Warm Regards
My queries are as follows:
1. As per laproscopy reports, left tube was blocked[very little] from the lower end, there was slow spill after opening it. Right tube was not blocked & patent. there was a free spill after adhesion from the opening of the tube were removed. At the time of laproscopy , sample of endometrium was taken & tested for tb again & at that time it came out negative [can it be due to the akt3 which i was taking?]
2. After performing laproscopy , conceived twice but only through IUI [not naturally, I am confused why?] and both biochemical [ Is it possible that embryo was struck in tube only , though doctors were not able to trace it ? ] . Also doctor in 3rd pregnancy, hcg levels were very high at initial stage [day 30] & from day 32, started bleeding[for 4 days like periods]. Doctor understood that miscarriage happened & didnt tracked the hcg levels again & after one month due to pain in lower left hcg levels were checked again & comes out to be around 800]
3. Endometrium thickness goes to 7.5 maximum.
4. As per my current doctor, AMH levels of 2.09 ng/ml are poor & that relates to past abortions thats why I should move directly to donor egg without doing IVf with my eggs even ones, however I read through various sources that at my age of 34 these levels are fair enough. Please guide.
Warm Regards
Hi,
Following is my reply:
1) Though free spill was seen after the surgery, generally they get stuck together later and that is the reason for infertility.
2) Since you took AKT3, the tuberculosis infection could have got healed and hence report came as negative.
3) Though report is negative for active infection, the old injury would still be there. Hence not only tubes but also endometrium will be affected.
4) The desirable size of endometrium is around 8 mm with triple line appearance. You are getting upto 7.5 mm means there is possibly endometrial injury.
5) Since you have conceived as biochemical pregnancy and even AMH is more than 2, I presume your ovaries are good and you dont need a donor egg. Perhaps you might need a surrogate as your endometrium is not supporting pregnancy.
I hope I made you clear of your doubts.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
Following is my reply:
1) Though free spill was seen after the surgery, generally they get stuck together later and that is the reason for infertility.
2) Since you took AKT3, the tuberculosis infection could have got healed and hence report came as negative.
3) Though report is negative for active infection, the old injury would still be there. Hence not only tubes but also endometrium will be affected.
4) The desirable size of endometrium is around 8 mm with triple line appearance. You are getting upto 7.5 mm means there is possibly endometrial injury.
5) Since you have conceived as biochemical pregnancy and even AMH is more than 2, I presume your ovaries are good and you dont need a donor egg. Perhaps you might need a surrogate as your endometrium is not supporting pregnancy.
I hope I made you clear of your doubts.
Regards,
Dr. Mahesh Koregol
IVF & Infertility Specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
