Posted by: Karin | 2009-02-12


Dr we have been struggling with infertility for 15 years...We had 3 ICSI' s in the past.....unsuccessful. My husband has low sperm count and poor morfology(?). The gyne always said that he doesn' t really have a reason why it didn' t work....He also said that I have endometriosis. But for the past 2 yr it was better...I do still get sists on my overies once in a while...I' ve been diagnosed with Von Willebrand disease type 2 one month ago. Could this have contributed to the failures of the ICSI' s-|-well as infertility? My gyne never mentioned this and I don' t know if he ever tested for it during our treatment....

My gyne also tried to put me on oral cantraceptives to cure the excessive bleeding, one yr ago. But this caused more bleeding...While I was on the pill I bleed for 22 days and more, when my gyne took me of and said I musn' t use estrogen again...He put me on progesterone to stop the bleeding...Do you have any explenation why the bleeding got worse on the pill? I' m not using any birth controll at the moment....


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Our expert says:
Expert ImageFertility expert

Dear Karin

In our practice we come across Von Wilebrand disease very regularly and if not appropriately dealt with will continue to cause implantation failures. In most cases were the appropriate clotting factors have been replaced at the appropriate stage of the treatment we have had fairly good outcomes. I therefore would encourage you to pursue the ICSI option bearing in mind the latest development and to take the appropriate measures to correct the clotting disorder. It is quiet possible that the oral contraceptive, which usually encourages clot formation, may have further disrupted the delicate clotting factor profile and hence resulted in the aggravated bleeding. However it is also likely that the hormonal balance may have been altered by the contraceptive use resulting in irregular break down of the endometrium (lining of the womb) which manifest as a mid-cycle bleed or a break through bleed which is unfortunately exacerbated by the underlying clotting disorder.

Answered by: Dr M. I. Cassim

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