The question
Hi Dr Sher I’m 38 y/o and and going through fertility treatment using donor sperm. I have just had an unsuccessful fresh ICSI embryo transfer (6 eggs retrieved, 6 fertilised, grade A embryo transferred, 3 embryos frozen grades B B and C), negative pregnancy test 9dp5dt, I also had some pink discharge/spotting day 6/7 post transfer. and bleeding post egg retrieval. This was my second ICSI cycle, first cycle I got 7 eggs, 5 fertilised and 1 good embryo transferred, none to freeze, and negative pregnancy test. I have also had 3 unsuccessful IUI cycles prior to IVF.
I have 3 frozen embryos and wondered if you had any advice on further testing that could be done to improve my chances of success? My clinic is in the UK. A small polyp was seen on US scan before beginning this recent ICSI cycle and wasn’t mentioned again. My clinic offers PGT but my embryos have not been tested, would you recommend testing my frozen embryos? Is there a risk with re-freezing the embryos?
Many thanks for any advice!
E
Answer from Dr. Geoffrey Sher
I
Thank you for sharing your IVF treatment details. From what you’ve described, you are 38 years old and have recently undergone your second IVF cycle, during which three cleaved embryos of reasonable quality were transferred, but unfortunately, conception did not occur. In your first cycle, a single good-quality embryo was transferred, but no others were available for freezing. You currently have three frozen embryos, which, based on your description, are cleaved embryos rather than blastocysts. I understand your concern about the potential for unsuccessful implantation with these embryos.
Additionally, you mentioned the presence of an endometrial polyp identified on ultrasound during stimulation, which has not yet been removed. You also noted that the three frozen embryos have not undergone PGT (Preimplantation Genetic Testing).
Based on your situation, I recommend that the frozen cleaved embryos be cultured to the blastocyst stage and thereupon undergo PGT-A testing so only the good are selectively transferred. However, if these embryos are in fact at the blastocyst stage of development, I would advise against performing a biopsy for PGT, as the process of thawing, biopsying, re-freezing them only to have to thaw them again for the embryo transfer can cause trauma, which may reduce the chances of success. I would suggest transferring them as is and hoping for the best.
Regarding the endometrial polyp, I strongly suggest it be removed hysteroscopically before proceeding with another embryo transfer to ensure the best possible outcome.
If the transfer of these frozen embryos does not result in at least one viable pregnancy, I would recommend scheduling a detailed online consultation with me. I have successfully assisted many patients in the UK and would be happy to provide further guidance and support as needed.
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Herewith are online links to 2 E-books recently co-authored with my partner at SFS-NY (Drew Tortoriello MD)....... for your reading pleasure:
- From In Vitro Fertilization to Family: A Journey with Sher Fertility Solutions (SFS) ; https://sherfertilitysolutions.com/sher-fertility-solutions-ebook.pdf
- Recurrent Pregnancy Loss and Unexplained IVF Failure: The Immunologic Link ;https://drive.google.com/file/d/1iYKz-EkAjMqwMa1ZcufIloRdxnAfDH8L/view
If you are interested in having an online consultation with me, please contact my assistant, Patti Converse at 702-533-2691 or email her at concierge@sherivf.com\
General information only, not medical advice for your own situation. For that, book a consultation.