Help! Need some advice please.

[ACK41]

Hi all,
I was hoping I may be able to get some advice. I’ve been ttc for a few years. About to turn 41. Have had 4 failed ICSI cycles and one frozen transfer with a PGS embryo which also failed to implant. No clear reason - infertility unexplained. I am under the Evewell with Mr Davis who is lovely. I’ve had an ERA and other tests including a test for NK cells but still failed. Mr Davis is now suggesting a laparoscopy but whoever else I ask says it’s not needed and unnecessary. I had a consultation with Dr George at Zita West who said to run the Chicago tests which are more accurate and to look more at the immune side of things. I’m just so confused. Has anyone had any experience with Zita West or a laparoscopy? I’d be grateful for any help.

Hi @ACK41 I'm sorry the IVF hasn't worked so far. I've just done an ERA cycle myself ahead of my first transfer.

It occurred to me that if you've transferred one PGS embryo, then it has about a 60% chance of implanting and leading to a successful outcome, so 40% of the time on average it won't work. Could you try again with another PGS tested embryo? It's sometimes said that ideally you need three PGS tested embryos per baby that you want, although I totally get that euploid embryos aren't always easy to come by.

Other people on here have had more luck with mild IVF, but I don't have any personal experience of that.

Unexplained infertility is no diagnosis at all and is basically given to couples when they have failed to find out what is wrong.

I would be asking why a laparoscopy is now being suggested at this very late stage. Why this and why now?. Is endometriosis suspected?. Why was ICSI mooted; presumably this was because of male factor issues. It is worth looking at a second opinion also because some private treatment as well is of poor quality as well as expensive.

Thank you @msgloria and @AttilaTheMeerkat

The lap wasn’t mentioned previously as in theory in ivf it shouldn’t really make a difference unless there are known issues. I had a chemical pregnancy with my first cycle so the assumption has always been that the embryos were at fault especially as I’ve only had one embryo come back normal of those that were tested. But since the PGS one failed it’s making him think more about the environment. The ERA and other tests didn’t point to anything too specific and I had an intralipid infusion too so I think the lap is just another way of looking to the environment more. Apparently there are recent studies that show in doing it and treating any unknown issues there has been increased successes with implantation.

I’ve had a NK test done before the transfer too hence the intralipid but Zita West have said the London labs don’t test as accurately as Chicago and would want them done again. I just find that hard to believe. So then they want to do endometrial immune profiling which is another biopsy. I just think they wouldn’t Mr Davis have done these if appropriate and why would he suggest a lap now if he didn’t think it would make some difference. I think he’s just weary of continue to do cycle after cycle if he hasn’t checked everything out first.

And agree - I’m just in that unlucky 40%.