Dear dr Sher,

Thank you so much giving me the option to ask you a question! I’m very curious about what your differential diagnosis/following steps would be.

I’m 34 years old and we have been dealing with unexplained infertility for more than 3 years now. We started ICSI in May this year; we collected 7 euploid embryos, 2 low level mosaics and one high level mosaic in two cycles. They used the fertile chip because of DNA fragmentation. Almost all our embryos are rated BA. Our first transfer (AA embryo) unfortunately didn’t result in a clinical pregnancy ( I had a chemical pregnancy).
I’ve been pregnant in the past (after IUI) but had a miscarriage after 7 weeks. Trying naturally I also had a two or three positive early pregnancy tests, but always got my menstruation on time (very regular; 28 days). I’m using levothyroxine because of subclinical hypothyroidism, but never tested anti-TPO positive. I think this was caused by a Iodine/selenium and vitamine A deficiency because I followed a vegan diet for years (not anymore).

Now they recommend endomeTRIO, immune testing and hysteroscopy.
Concerning our first transfer; is ‘bad luck’ the most likely ‘diagnosis’? Is is too early to do more diagnostics? What you do think of endomeTRIO? How likely would autoimmunity as underlying cause be?

Thanks a lot!