gotta try ivf before you go down the rabbit hole of implantation.

Tsh should be under 2.0 - some labs will call up to 5.5 normal, but you want it lower for ttc. Also check vitamin D levels - that impacts ovarian function. You want that in the high normal range.

Anonymous wrote:

Anonymous wrote:In my mind it means there is something wrong. Is it egg quality, implantation problem, or some other hormone issue causing the lining or some other parameter to be less than ideal? My advice is to explore the implantation issue if you think it is one. They can do a biopsy and look at receptivity and also immune testing to see if there are any red flags there.

Op has no reason to suspect it's implantation. For all she knows the sperm can't fertilize the egg. She's doing herself a disservice by going for extensive testing. She should move on to IVF first and try that.

+1. Unless you have some objection to IVF, I think that's your next logical step. I would decide how many IUIs you want to do total then move on. IUI success rates are just very low, you can't really tell anything at this point.

I've done implantation testing (ERA) after repeated embryo transfer failure. It can be a long process (it took me about five months total), and it's not just a matter of ordering a test. I don't even know if there is a version of it for the IUI protocol as opposed to the IVF protocol. And 75% of the people who do the testing come out as "receptive," meaning no indication of implantation problems.

Anonymous wrote:OP here. To answer your questions, my firstborn is a boy and I have read about the connection with having a boy and immune system sensitization. I will pursue further immune testing but the REs I've seen feel strongly against it. I also have no personal or family history of immune/autoimmune issues and thyroid is within normal limits. In addition, my FSH is pretty good (8) and RE said with that FSH it's likely my eggs are okay. Could be a hardened shell problem. My AFC count is a little on the low side (ranges from 8-10 consistently, I've had it checked 4-5 times).

Have you consulted Abbasi at CFA?

OP here. To answer your questions, my firstborn is a boy and I have read about the connection with having a boy and immune system sensitization. I will pursue further immune testing but the REs I've seen feel strongly against it. I also have no personal or family history of immune/autoimmune issues and thyroid is within normal limits. In addition, my FSH is pretty good (8) and RE said with that FSH it's likely my eggs are okay. Could be a hardened shell problem. My AFC count is a little on the low side (ranges from 8-10 consistently, I've had it checked 4-5 times).

Anonymous wrote:

Anonymous wrote:In my mind it means there is something wrong. Is it egg quality, implantation problem, or some other hormone issue causing the lining or some other parameter to be less than ideal? My advice is to explore the implantation issue if you think it is one. They can do a biopsy and look at receptivity and also immune testing to see if there are any red flags there.

Op has no reason to suspect it's implantation. For all she knows the sperm can't fertilize the egg. She's doing herself a disservice by going for extensive testing. She should move on to IVF first and try that.

I disagree. If there is an implantation or other immune or clotting issue, IVF is unlikely to work either. Plus, it's a lot cheaper to do the testing first. Many blood tests will be covered by most insurance as a diagnostic tool.

OP, who's your RE?

OP, is your first child a boy or a girl? There's hard to explain scientific theory behind what having a first born boy can do to your immune system and how it can in some cases prevent future pregnancies. It's one of the items on Dr. Braverman's checklist when women are trying to determine if they have immune issues.

Anonymous wrote:OP here. But I've never had a miscarriage or chemical pregnancy in 16 months. Doesn't that seem unusual (with TTC every month plus 2 IUIs with injectible Follistim)? I was monitored with the IUIs every other day.

IUIs don't have that high of a chance of working even with no problems whatsoever.

Anonymous wrote:In my mind it means there is something wrong. Is it egg quality, implantation problem, or some other hormone issue causing the lining or some other parameter to be less than ideal? My advice is to explore the implantation issue if you think it is one. They can do a biopsy and look at receptivity and also immune testing to see if there are any red flags there.

Op has no reason to suspect it's implantation. For all she knows the sperm can't fertilize the egg. She's doing herself a disservice by going for extensive testing. She should move on to IVF first and try that.

Anonymous wrote:OP here. But I've never had a miscarriage or chemical pregnancy in 16 months. Doesn't that seem unusual (with TTC every month plus 2 IUIs with injectible Follistim)? I was monitored with the IUIs every other day.

Means something is wrong but not necessarily implantation.

Try IVF.

In my mind it means there is something wrong. Is it egg quality, implantation problem, or some other hormone issue causing the lining or some other parameter to be less than ideal? My advice is to explore the implantation issue if you think it is one. They can do a biopsy and look at receptivity and also immune testing to see if there are any red flags there.

OP here. But I've never had a miscarriage or chemical pregnancy in 16 months. Doesn't that seem unusual (with TTC every month plus 2 IUIs with injectible Follistim)? I was monitored with the IUIs every other day.

You only did IUI so probably wasn't implantation. Go for IVF with icsi

I'd say more age related than mechanical failure. I'd move on to IVF if you are able--IUIs are pretty low intervention.

It's been 16 months TTC, two IUIs, and zero pregnancies. I'm 39. Should I start wondering about implantation issues (repeat implantation failure) or just age related infertility? We have a 2.5 year old who I got pregnant with easily (second month TTC at age 36) and so far it's been 16 months for baby #2 and no pregnancy yet.