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Hi, My Wife Has 5 Failed Cycles IUI And One

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Posted on Sat, 30 Nov 2019
Question: Hi, My Wife has 5 failed cycles IUI and one failed cycle of IVF with 4 grade A emroyos(Day3 embroyo transfersed on P+5 day) but she still failed to conceive with proper medication like Progestorne and anti Thrombosis medications and Intafol D, home rest after transfer as precribed by our expert doctor. as a result of IVF failure we did following steps as prescribed by doctor
1) We did Era test and mywife was found to be P+7 day receptive for blasctocyst meaning it seems both report and doctor are ok to do day 3 emboryo transfer on P+5 day because our doctor believes day 3 emroyo have better chances of survival in mother's womb than in in lab to be a blastocyst in day 5.We trust our doctor on this. However love to hear your suggestion ?
2) Her emdometrical thickness never goes beyond 7 mm in any ART cycle on day of trigger . In the failed IVF cycle it was 6.9 MM in day of trigger but with exellent vascularity, triliminar pattern and blood flow .Thanks to PRP we didi. But this time to rule out endometrical tubeculosis doctor has precribed my wife akt3 (every day for 3 months) Now we are in 3rd month and plan is in the 4th-6th month they will reduce the dose to 2 days a week and do endometric scratching in 4th month and do emboryo transfer in 5th month if all works out well and continue akt3 to 6th month. I need your opinion on above line of treatment. There was no bioopsy done for endometric TB . No visisble symptoms of endometrium in high quality USG. My question is AKT3 ok to comsume evern for 2 days a week during emroyo transfer ? Does it interfares with emroyo transfer plan of my wife in 5th -6th month of dosage and does it creates any complications in achieving pregnancy ? Another Quetsion for one of her past ART cycle embroyo trasnfer was cancelled because her Pulsating index of Uterine Arteryis was more than 5 and it should be less than 2.5. What is that ? How can we control it with medication or excercise or food suplement into a desired level for ART cycle or its beyond human control ?Note she was on blood thinner ecosprin 75-150 in that cycle along with PRP like any other cycle.
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Follow up: Dr. Mahesh Koregol (0 minute later)
Hi, My Wife has 5 failed cycles IUI and one failed cycle of IVF with 4 grade A emroyos(Day3 embroyo transfersed on P+5 day) but she still failed to conceive with proper medication like Progestorne and anti Thrombosis medications and Intafol D, home rest after transfer as precribed by our expert doctor. as a result of IVF failure we did following steps as prescribed by doctor
1) We did Era test and mywife was found to be P+7 day receptive for blasctocyst meaning it seems both report and doctor are ok to do day 3 emboryo transfer on P+5 day because our doctor believes day 3 emroyo have better chances of survival in mother's womb than in in lab to be a blastocyst in day 5.We trust our doctor on this. However love to hear your suggestion ?
2) Her emdometrical thickness never goes beyond 7 mm in any ART cycle on day of trigger . In the failed IVF cycle it was 6.9 MM in day of trigger but with exellent vascularity, triliminar pattern and blood flow .Thanks to PRP we didi. But this time to rule out endometrical tubeculosis doctor has precribed my wife akt3 (every day for 3 months) Now we are in 3rd month and plan is in the 4th-6th month they will reduce the dose to 2 days a week and do endometric scratching in 4th month and do emboryo transfer in 5th month if all works out well and continue akt3 to 6th month. I need your opinion on above line of treatment. There was no bioopsy done for endometric TB . No visisble symptoms of endometrium in high quality USG. My question is AKT3 ok to comsume evern for 2 days a week during emroyo transfer ? Does it interfares with emroyo transfer plan of my wife in 5th -6th month of dosage and does it creates any complications in achieving pregnancy ? Another Quetsion for one of her past ART cycle embroyo trasnfer was cancelled because her Pulsating index of Uterine Arteryis was more than 5 and it should be less than 2.5. What is that ? How can we control it with medication or excercise or food suplement into a desired level for ART cycle or its beyond human control ?Note she was on blood thinner ecosprin 75-150 in that cycle along with PRP like any other cycle.
doctor
Answered by Dr. Mahesh Koregol (19 hours later)
Brief Answer:
Blastocyst transfer with PGS required

Detailed Answer:
Hi,

I understand your concerns.

Following is my reply:

1) Blastocyst transfer is a best in any situation. I think you need to request for blastocyst transfer ONLY. If your doctor is not agreeing to this, please go to different fertility centre which does blastocyst transfer.

2) Triple line pattern with good vascularity of 6 mm endometrium is good enough to conceive.

3) I dont see any role or need of AKT in your situation as this is unlikely to be tuberculosis. Anyway as you have started it, you cant stop it. Please see a physician and complete the course.

4) There is no role of endometrial scratching or PRP administration. They are waste of time and money. There is not enough scientific data to substantiate this.

5) Pulsating index is not always correct indicator of blood flow and its not necessary to be observed to cancel FET cycle.

6) I think you need to go ahead with Blastocyst transfer with or without PGS ( Preimplantation genetic screening) of embryos to assess the genetic quality of embryos.

7) Let me know which city and doctor you are under treatment so that I can suggest you a more suitable fertility specialist / IVF centre.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Mahesh Koregol (0 minute later)
Brief Answer:
Blastocyst transfer with PGS required

Detailed Answer:
Hi,

I understand your concerns.

Following is my reply:

1) Blastocyst transfer is a best in any situation. I think you need to request for blastocyst transfer ONLY. If your doctor is not agreeing to this, please go to different fertility centre which does blastocyst transfer.

2) Triple line pattern with good vascularity of 6 mm endometrium is good enough to conceive.

3) I dont see any role or need of AKT in your situation as this is unlikely to be tuberculosis. Anyway as you have started it, you cant stop it. Please see a physician and complete the course.

4) There is no role of endometrial scratching or PRP administration. They are waste of time and money. There is not enough scientific data to substantiate this.

5) Pulsating index is not always correct indicator of blood flow and its not necessary to be observed to cancel FET cycle.

6) I think you need to go ahead with Blastocyst transfer with or without PGS ( Preimplantation genetic screening) of embryos to assess the genetic quality of embryos.

7) Let me know which city and doctor you are under treatment so that I can suggest you a more suitable fertility specialist / IVF centre.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mahesh Koregol (12 hours later)
Hello Sir,

Thanks for your answer , regadring your repsonse

1)"Blastocyst transfer with PGS required". May i ask what is the approximate cost of PGS test in XXXXXXX I heard its not done in XXXXXXX and some has to come from XXXXXXX . Take sample and do test in XXXXXXX As my embroyos are freezed in XXXXXXX XXXXXXX Hall clinic Hospital.
2)" Regarding AKT3" . I want to ask after completing first 3 months of daily dose from 4th-6th month it is planned to take only 2 tabs a week as part of maintainance phase. Our Doctor has planned to do emboyo transfer on 5th month while in AKT3 . My question is it still safe to do transfer while in AKT3 (two days a week) in 5th month while moving to 6 th month with in same dose ? I was worried if AKT3 will have advserse impact on the embroyo inside uterus ? or i need to wait for completion of 6 months. we are loosing time and want to know is it safe or we needto wait ?


3) "Regarding Let me know which city and doctor you are under treatment...."

I am consulting at (Ruby hall clinic hospital XXXXXXX )

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Follow up: Dr. Mahesh Koregol (0 minute later)
Hello Sir,

Thanks for your answer , regadring your repsonse

1)"Blastocyst transfer with PGS required". May i ask what is the approximate cost of PGS test in XXXXXXX I heard its not done in XXXXXXX and some has to come from XXXXXXX . Take sample and do test in XXXXXXX As my embroyos are freezed in XXXXXXX XXXXXXX Hall clinic Hospital.
2)" Regarding AKT3" . I want to ask after completing first 3 months of daily dose from 4th-6th month it is planned to take only 2 tabs a week as part of maintainance phase. Our Doctor has planned to do emboyo transfer on 5th month while in AKT3 . My question is it still safe to do transfer while in AKT3 (two days a week) in 5th month while moving to 6 th month with in same dose ? I was worried if AKT3 will have advserse impact on the embroyo inside uterus ? or i need to wait for completion of 6 months. we are loosing time and want to know is it safe or we needto wait ?


3) "Regarding Let me know which city and doctor you are under treatment...."

I am consulting at (Ruby hall clinic hospital XXXXXXX )

doctor
Answered by Dr. Mahesh Koregol (4 hours later)
Brief Answer:
Finish AKT

Detailed Answer:
Hi,

1)PGS costs around 17000 per embryo.

2)Check with XXXXXXX IVF in XXXXXXX They have best infrastructure.

3) Embryo transfer is not advisable while on AKT. Finish AKT and go for transfer. Not to hurry with treatment as you are on AKT.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Mahesh Koregol (0 minute later)
Brief Answer:
Finish AKT

Detailed Answer:
Hi,

1)PGS costs around 17000 per embryo.

2)Check with XXXXXXX IVF in XXXXXXX They have best infrastructure.

3) Embryo transfer is not advisable while on AKT. Finish AKT and go for transfer. Not to hurry with treatment as you are on AKT.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mahesh Koregol (3 days later)

I wil take your advise and finish AKT3 as already prescirbed to me by my doctor

Just to know
1)Whats is the normal prescribed dose and duration of AKT3 consumptionif some one is suspected of mild endrometrial TB if not confirmed.

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Follow up: Dr. Mahesh Koregol (0 minute later)

I wil take your advise and finish AKT3 as already prescirbed to me by my doctor

Just to know
1)Whats is the normal prescribed dose and duration of AKT3 consumptionif some one is suspected of mild endrometrial TB if not confirmed.

doctor
Answered by Dr. Mahesh Koregol (22 hours later)
Brief Answer:
Standard treatment recommended

Detailed Answer:
Hi,

There is no mild or moderate TB. There are standard doses of AKT treatment as per government guidelines.

Dose and duration cannot be discussed on the online forum without examining the patient, hope you'll understand.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Mahesh Koregol (0 minute later)
Brief Answer:
Standard treatment recommended

Detailed Answer:
Hi,

There is no mild or moderate TB. There are standard doses of AKT treatment as per government guidelines.

Dose and duration cannot be discussed on the online forum without examining the patient, hope you'll understand.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Mahesh Koregol (3 days later)
Last questions in this thread.

1) Before my wife failed iVF cyle we had 6 ART cycles cancelled because her endometric thickness was not optimun for tranfer.
Out of these 6 cycle she had spoting on 15-16th day 4 times which reduced her thickness below 6mm while in progynova 16 mg a day(started with 12mg a day
from D1-D8 and latter dose increased after 9-10th day by doc after ultrasound).Latter doctor concluded my wife does not responds to external estrogen cycle
and she was given lower dose of estrogen with GonalF and antagonist to stimulate her internal estrogen by doctor. Question what is the common causes of
spotting in 15th-16th day while in external estrogen though she was regular in her estrogen dose and did not skip anything at all.

2)Unfortunatlely 1st time in her current normal cycle she has spotting on 15th day while not in estrogen. She was om AKT3 from last 3 months and dctcor said
such spotting sometimes happens while on AKT3. Is it true? What are your advise on that.

Pateint Age: 33
Height 5.4 Kg
weight 73 kg initially now reduced to 67 in 3 -4 months
Her last ERA test result attached
Her last US report attached. No adenomyosis. No fibroid. No whiteliquid indicating bacteria or tubercular infection with naked eyes everything was normal
as per the doctor. She had PCOD in past and is taking metamorphin every day from last 1 year
default
Follow up: Dr. Mahesh Koregol (0 minute later)
Last questions in this thread.

1) Before my wife failed iVF cyle we had 6 ART cycles cancelled because her endometric thickness was not optimun for tranfer.
Out of these 6 cycle she had spoting on 15-16th day 4 times which reduced her thickness below 6mm while in progynova 16 mg a day(started with 12mg a day
from D1-D8 and latter dose increased after 9-10th day by doc after ultrasound).Latter doctor concluded my wife does not responds to external estrogen cycle
and she was given lower dose of estrogen with GonalF and antagonist to stimulate her internal estrogen by doctor. Question what is the common causes of
spotting in 15th-16th day while in external estrogen though she was regular in her estrogen dose and did not skip anything at all.

2)Unfortunatlely 1st time in her current normal cycle she has spotting on 15th day while not in estrogen. She was om AKT3 from last 3 months and dctcor said
such spotting sometimes happens while on AKT3. Is it true? What are your advise on that.

Pateint Age: 33
Height 5.4 Kg
weight 73 kg initially now reduced to 67 in 3 -4 months
Her last ERA test result attached
Her last US report attached. No adenomyosis. No fibroid. No whiteliquid indicating bacteria or tubercular infection with naked eyes everything was normal
as per the doctor. She had PCOD in past and is taking metamorphin every day from last 1 year
doctor
Answered by Dr. Mahesh Koregol (13 hours later)
Brief Answer:
Hormonal variations

Detailed Answer:
Hi,

1) Though estrogen external and internal is on , there is variations in absorption and leading to sudden drop in estrogen levels. This causes spotting.

2) Yes. Spotting might happen while on AKT. She needs to undergo blastocyst embryo transfer.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Mahesh Koregol (0 minute later)
Brief Answer:
Hormonal variations

Detailed Answer:
Hi,

1) Though estrogen external and internal is on , there is variations in absorption and leading to sudden drop in estrogen levels. This causes spotting.

2) Yes. Spotting might happen while on AKT. She needs to undergo blastocyst embryo transfer.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3830 Questions

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Hi, My Wife Has 5 Failed Cycles IUI And One

Hi, My Wife has 5 failed cycles IUI and one failed cycle of IVF with 4 grade A emroyos(Day3 embroyo transfersed on P+5 day) but she still failed to conceive with proper medication like Progestorne and anti Thrombosis medications and Intafol D, home rest after transfer as precribed by our expert doctor. as a result of IVF failure we did following steps as prescribed by doctor 1) We did Era test and mywife was found to be P+7 day receptive for blasctocyst meaning it seems both report and doctor are ok to do day 3 emboryo transfer on P+5 day because our doctor believes day 3 emroyo have better chances of survival in mother's womb than in in lab to be a blastocyst in day 5.We trust our doctor on this. However love to hear your suggestion ? 2) Her emdometrical thickness never goes beyond 7 mm in any ART cycle on day of trigger . In the failed IVF cycle it was 6.9 MM in day of trigger but with exellent vascularity, triliminar pattern and blood flow .Thanks to PRP we didi. But this time to rule out endometrical tubeculosis doctor has precribed my wife akt3 (every day for 3 months) Now we are in 3rd month and plan is in the 4th-6th month they will reduce the dose to 2 days a week and do endometric scratching in 4th month and do emboryo transfer in 5th month if all works out well and continue akt3 to 6th month. I need your opinion on above line of treatment. There was no bioopsy done for endometric TB . No visisble symptoms of endometrium in high quality USG. My question is AKT3 ok to comsume evern for 2 days a week during emroyo transfer ? Does it interfares with emroyo transfer plan of my wife in 5th -6th month of dosage and does it creates any complications in achieving pregnancy ? Another Quetsion for one of her past ART cycle embroyo trasnfer was cancelled because her Pulsating index of Uterine Arteryis was more than 5 and it should be less than 2.5. What is that ? How can we control it with medication or excercise or food suplement into a desired level for ART cycle or its beyond human control ?Note she was on blood thinner ecosprin 75-150 in that cycle along with PRP like any other cycle.