The Dr. was great. He was friendly but professional. He came off caring and organized. After reading through out notes, a little questioning period, and then specifically asking what we wanted from the consult, he came up with 3 things we would do if we follow through with them.
Keep in mind, what we really wanted from this consult is to see if it is true that we are simply "unexplained" and it's like "rolling the dice". We may or may not be successful just depending on stats.
This Dr. actually said "you've had 11 embryos transferred back with no implantation. We should be questioning more than the stats". Our first and second RE have both said "it is what it is". Good to know at least some of these Dr's care about finding an answer.
So his suggestions are:
1. Genetic analysis (I've already asked for this in June at 1st RE follow up. The results should be in for our Nov. appt)
2.Sperm chromatin assay. His reason's for this is consistent with second RE stating that it's mainly the egg quality that matter from day 1-3 but the sperm and egg for 4 onward. So maybe there is a sperm problem that hasn't been diagnosed.
3. Beta 3 integrin, intrauterine biopsy. Apparently if this protein isn't present, implantation rates can decrease.
Basically, these suggestions are what is suggested to people who have had multiple miscarriages.
So, I feel good we have some suggestions. We're very unsure what we will do with these suggestions. I find it odd that the suggestions for someone who has never had any form of implantation can be put in the same basket as people who have several miscarriages. But at least it's a theory.
Done, and Yet, Not Done
6 years ago
It sounds like you had a decent appointment - I'm glad.
ReplyDeleteWith regard to the tests...not all clinics do the same genetic analysis. CCRM's is pretty thorough, so I'd recommend finding out what tests they do vs. what tests your 1st RE did.
Sperm chromatin assy. Is this the same thing as the SCSA DNA fragmentation test?
Beta 3 integrin - CCRM is the only place I've heard of doing this. IMHO, I'd rather do it and know whether I have the protein or not than go through another transfer and possibly waste the money if the test turns up negative. I've had 6 miscarriages, and we just did the test. Dr. Sch expected that I would test positive (and I did) because I've had one pregnancy make it to 10w5d, but I insisted on it just for the peace of mind.
With regard to someone not having implantation going through the same tests as women with RPL, I don't think it's that surprising. A lot of RPL cases involve very, very early m/c's (5w or 6w). Chromosomal issues (either genetic or just abnormal sperm/egg) can cause an embryo not to implant, or it can still start the beginning of the implantation process but then end very quickly. Same thing with immune issues and even implantation issues - the embryos isn't really fully implanted until ~9 weeks, I think.
I hope you get good news about the genetic tests next month.