Dr Kiriakidis, Reproductive Gynaecologist from Embryolab Fertility Clinic answers your questions
Anti sperm antibodies
Q: My husband was diagnosed with 100% anti-sperm antibodies. One failed fresh ivf transfer earlier this year and 1 frozen egg left, Fet has been delayed due to covid 19. Is there any way of conceiving naturally? Will changing diet help lower number? Also is it possible the anti-sperm antibodies have transferred to me?
A: Anti sperm antibodies can seriously hinder natural conception but you can never exclude that possibility. They will not pass on to you but in your next treatment ask for ICSI and avoid conventional IVF.
Q: I’ve had unexplained infertility for over 4 years, never been pregnant, no one can find anything wrong, is there any hope at all for natural pregnancy?
A: If you are trying for more than 2 years without having a pregnancy you might consider a series of tests and even an IVF treatment
Q: Me and my partner have been trying naturally for 5 years but nothing we are told he has 80% sperm antibodies and I have polcystic ovaries but ovulate on my own I have been told to be on metformin which I am now. We had icsi in 2018 but we never made transfer to we are about to try second cycle but worried for same outcome. We are told a dna fragmentation test won’t help either.
A: Remember that anti sperm antibodies do not influence fertilization when doing ICSI. On the other hand, PCOS may have an impact on egg quality. Try to regulate insulin levels with metformin. And do not quit!
Q: I had a successful pregnancy using FET and immune suppression of various sorts! I’ve had multiple unexplainable miscarriages before and after my live birth. I now want to give my frozen embryos a go but hesitant about immune treatments because of Covid. What would you recommend to a patient like me?! I’m 42.
A: The most recent COCHRANE review has concluded that there is a benefit from the use of low dose steroids in women with autoimmune history. The data on the impact of steroids on the treatment of covid virus is still emerging but are reassuring of its safety.
Implantation window test
Q: Would you say that patients just starting out should have the test to check for the best implantation window? I’m keen to explore all tests on my first round, that might enhance my chances.
A: The results about this test so far has shown that it benefits a specific group of women. This includes women with recurrent implantation failure. You should weigh up the cost of the test according to the benefit and ask the opinion of your physician.
Q: Can I ask how long I should you leave it after a failed transfer? I’m desperate to start again, although so scared.
A: I will recommend an intermission of 1-2 months before starting again. In the meantime prepare your self with a healthy diet and vitamins.
Improving my chances of the next transfer working
Q: My husband and I have just had our second failed Cycle. Our first was IVF 4 years ago and this was an FET from an ICSI cycle back in Feb. I was convinced it had worked (lots of symptoms) but on day 14 the tests we did were negative and I had a bleed 3 days later. We are devastated; we have 3 frozen embryos left but they are not as highly graded as the one we’ve just lost. What can I possibly do to improve my chances of the next transfer working besides the usual stuff?
A: Dear friend, one failed cycle should not stop you from trying again. Cumulative success rates are very high as long as you don’t quit. Remember that embryo grading is not 100% accurate. Give your embryos the opportunity to prove themselves!
Q: I’ve been trying for 6 years, 34 now, three failed rounds of ivf, apparently my eggs are good enough, however I’ve had constant pain on my left for months now, to be honest I’ve had it for years, but recently constantly throughout my cycle, any ideas what might be wrong?
A: The pain that you mention is very odd. Have you considered a diagnostic laparoscopy in case endometriosis might be the cause of your failed attempts?
Embryo glue and endometrium scratch
Q: What are your thoughts on embryo glue and endometrium scratch? Not sure if to try them or not.
A: We can do them both at the clinic. We usually do the scratching in specific groups of women with recurrent implantation failure and we rarely use embryo glue as it has not shown any significant benefit
Q: I would like to get your opinion on embryo grading? Should we put so much emphasis on a BC grading? We just had a failed cycle with an AA embryo.
A: Remember that embryo grading is a scientific arbitrary decision. It is not a natural law and healthy pregnancies have happened with low grading embryos. Give your embryo an opportunity and try to stay positive and relaxed to help this embryo.
Q: I had a chemical pregnancy using a donor eggs and I just don’t understand why? Why would this have happened?
A: A successful pregnancy is not entirely dependent on embryo quality. There are other factors to take into consideration and keep in mind that science and technology have certain limitations
If you have further questions for Dr Kiriakidis, please do drop him a line by clicking here
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