Our expert says:
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.
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