Why Can't I Get Pregnant with IVF

by Mariam
(Providence, RI)

I have been trying to conceive for almost 2 years with 5 failed IUIs and one failed IVF. My IVF process went very well:
Day 0: produced 27 eggs and 22 mature
Day 1: 15 fertilized eggs
Day 3: 8 good quality embryos with 8 cells, 1 embryo 9 cells, 3 embryos 6 cells
Day 5: 3 blastocysts (5AB, 5BA, 3BB) and 4 early blastocyst, 1 compacting, 1 morula
I transferred 2 blastocysts (5AB and 5BA) but did not get pregnant. I did get cramping for a couple of days after the transfer but within a week the cramping was gone.

Generally, I have a very regular menstrual cycle (28 days). My ovulation usually lies on day 14. I have tracked my cycle several times in the past and can identify the following:
- My BBT during my period is 36.2C
- Week after period 36.4C (remains relatively constant) and I notice white thick creamy mucus (I have to wear panty liners)
- I get the LH surge on day 12 and my mucus starts thinning and gets more transparent
- Temperature sometimes dips to 36.2C on day 13/14/15 (Ultrasounds were also done to confirm ovulation) my mucus is transparent
- Temperature rises next day to 36.6C and mucus is still transparent
- Week after ovulation gradual rise to 36.8C and mucus get thicker and white again (my breast grow bigger and many times hurt)
- Week before period I get a gradual drop of temperature and experience light cramping a few days before it is due. (My temper is the highest during this week and I get very moody.)
- Day before period temperature is 36.2C and I get brown spotting for a day or two before heavy flow.

Menstrual Period Begins:
- First 2 days of flow is relatively heavy with dark red color and some clotting (Sometimes I get 2 big clots 1.5 cm, but rest of clots are small). I have painful cramps that gradually go away as I get through the first two days. I also get a very cold feeling in my uterus.
- 3rd day I still have a flow but not as heavy with bright red color
- 4th day I sometimes do not get any bleeding on that day
- 5th day flow is very light and brown in color
- 6th light brown spotting
- 7th white discharge indicating the end of my period

I have done several tests that indicate that everything is normal. My progesterone level goes to levels of 10 or higher in unstimulated cycles and to levels of 46 or higher in stimulated cycles. I did a hysterosalpingogram to check my uterus and tubes. Tubes are open and uterus is good (they think it's a little bit big but they found no fibroids).
Ultrasound shows that I get 3 layers for my uterine lining with a width of 6mm-9mm (when I am stimulated I usually see a 9mm-13mm). No one in my family suffered infertility before. Also, if this might help, my husband has a good sperm count 126 million with a 60% motility. He has anti-sperm antibodies but it's very low.

So given the above information, please advise me on what to do before my 2nd IVF. What could be the possible problems preventing my pregnancy?

I have few acupuncturists covered by my insurance, so I can visit them for any acupuncture therapy required. I just need your advice before proceeding with acupuncture and my 2nd IVF.

Thank You,
Mariam

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The Power of Preconception Care
by: Amelia Hirota

Dear Mariam,
Thank you for writing in with your question and for including enough details to give me an idea of what is going on with you and your husband. At your age, with your patent fallopian tubes and your husband's apparently healthy sperm, I'm confused why you've done 5 IUIs and 1 IVF. I'm assuming that you tried on your own for a year before moving on to the IUIs, but honestly that is just too soon at your age.

It appears that you've had the requisite diagnostic tests to rule out blocked tubes, fibroids, polyps, low progesterone or low sperm counts. However, with such a good IVF cycle up to the transfer, it appears that the problem may lie with holding the pregnancy. I find that this is often the case with failed IVF, especially with a Day 5 transfer, where the success rate is significantly higher.

I recommend looking into the following regarding your husband: If your husband's sperm is 126 million/ ml that is a good count. However, if it is 126 million total, it's just below adequate. Also, 60% motility is just borderline. I'd like to see general motility 65% or higher. I would also check the forward progression and the morphology. You want the best sperm possible!

In terms of you, I'm concerned that the ovulation temp surge isn't very strong and that you have cramps, brown spotting and clots in your period. I would recommend getting your Day 3 (without drugs) FSH, LH, Prolactin and TSH levels checked. Most importantly, I'm concerned that your luteal phase temps don't appear to remain high for 12 days

I would encourage you to take 3-6 months off before the next IVF cycle. I would work with an acupuncturist that is experienced in treating infertility with acupuncture and herbs. With a good nutritional program, proper herbs and supplements, and acupuncture, I believe that your fertility and your husband's can rise to the level where conception takes place naturally and your body holds the pregnancy. If after 3-6 months of diligently following a healthy preconception program (with acupuncture and herbs,) you're not pregnant, at least you'll both be healthier for the next IVF cycle.

At the very least, I would recommend that you and your husband eliminate all smoking, alcohol, caffeine, decaf and artificial sweeteners from your diet. It takes 4-6 months for follicles to mature naturally and 72 days to make new sperm. This is why I recommend a 3-6 month hiatus from IVF. You want to nourish your genetic material to the best of your ability, so that you produce the healthiest baby you can. Please continue charting. You should see improvements in your luteal phase in just a couple of cycles of taking herbs and getting acupuncture. Best of luck to you!

Sending Baby Dust Your Way,
Amelia Hirota

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Hi Mariam
by: DAY

I am also from RI. I literally just came back from my obgyn & am devastated that I need to start infertility treatments. It was so hard to tell my husband who is ten yrs my senior that it is me who has the problem conceiving.

I haven't gotten my period in four months, which isn't a good sign obviously. I thought I was pregnant, but didn't feel anything. I am so sorry that you are going through this also. If you want to talk, email me at ladyday185(at)aim.com.

I am starting Tues with IVF for my first time. I am so sad. I want the option of having a child, but I always just wanted on. Now that is probably not going to happen; twins are more probable. I am praying for myself, you Miriam and all who are experiencing this awful news. I know our stories are so similar. You can always talk if you want.

All the best,
Day

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Stressing is Bad!
by: Anonymous

You might just be stressing about getting pregnant or it "not working like you hoped". Try to relax and don't worry too much. Stress can send signals to the body to tell it not to get pregnant. It can be a battle of the mind, so relax and try to think positive. Best of luck!

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