Posted by: ivf | 2005/12/13


Hi with response to your questions

1. Number of embryos put back and grade

The first time they put 1 embryo back a 4cell and one that had not divided yet
The second time they put 3 back a 10, 8 and 6 cell.

2. The method they used....i know they used a catheter to transfer them back to utereus and was happy that no blood was on catheter.

3. What does atraumatic mean?

4. Regarding the progestrone supplement,I used gestone for 3 days before transfer back, and then after that 2 utrogestan 3 times a day, also continued with proganova until pregnancy test
They also said that my progestrone levels where acceptable

WIll this help you to be able to give you more insight as to why it may not have worked, and what steps i should ask them to take during next ivf ?

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Our expert says:
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Dear IVf

I do apologise again for the delay in response. This time of the year is always hectic!

Thank you for the info that you have presented. Unfortunately it is not just the no. of cells that the embryo has but it is also the QUALITY of these cells which are important in grading. There are many other criterior we use in evaluating embryo quality, and therefore I would presume the embryos were of good quality the second time round.

The fact there was no blood on the catheter would be encouraging and would suggest that the technique was probably atraumatic, meaning that there was no need to mainpulate more than necessary.

The progesterone supplementation appears to be adequate and the progesterone levels would be indicative of this.

Therefore, the only possible conclusion is that you suffer from :
1.) implantation failure as a result of possible immunolgical factors or
2.) that there is an underlying problem in your endometrium or lining of your womb ,such as low grade infection or receptor abnormalitites( that means that the cells of the lining do not respond as they should to the progesterone and circulating hormones in the blood stream.)

It is also an option that laser assisted hatching could be used .i.e small appetures are made in the wall of the embryo to facilitate the embryo hatching and attaching to the lining of the womb.
However, this will need to be done at the discretion of the embryologist as it is important to measure the thickness of the embryo wall.
In certain first world instituitions, embryo hatching is becoming more common place, and the pregnancy rates have improved tremendously as a result. The rationale behind this is sometimes, in some cases, even though the embryo wall is not grossly thickened, many embryos fail to 'escape' the shell and implant for reasons unknown to us at this stage.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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