Tests to consider when ivf has worked before?

[whatcangowrong]

I'm hoping for some advice on what could have changed between having one baby via ivf 15 months ago and now. My doctor doesn't seem keen to start testing me for a load of other stuff on the basis that we know I can get pregnant and carry to term, so she thinks it's just bad luck / aneuploidy that my last few FETs haven't worked.

So does anyone know:

• can your implantation window change over time? So might I need to do an era or is it the case that this stays the same?

• can you acquire natural killer cells?

• can any of the stuff in the thrombophilia screening change or is that all genetic. Eg we found last time I had the mthfr mutation but no other findings, so is that still the case??

• any other things that can change? Ashermans etc etc?

Thank you so much

Hi @whatcangowrong
Our first IVF transfer worked first time, so we naively thought we stood a good chance going for a sibling. Four miscarriages later we decided to throw the book at a final round. Our consultant suggested investigation into Killer Cells as she said this is something that can change when your body has been through a pregnancy. My tests showed high levels so I went on a protocol of steroids and intralipids. If you are using your partners sperm have you thought about further testing for him? We did DNA fragmentation testing which again found high levels and also that he had an infection. We threw the book at tests and drugs, and we very lucky to have success with a fresh transfer. I can’t say that I know what worked, as we tried so many different things that round. And it could still have just been luck, as I’m 41 so high levels of bad eggs expected. But I think it’s definitely worth some extra testing if you can. Wishing you luck and strength , it’s such a difficult thing to go through.

Thank you @ByTheSeaCatsandAll that's so
helpful.

Now doing pgt a and have also taken a course of antibiotics and probiotics to rule out any nasty bacterial issue.

think I should push a bit on the immunes. I can't believe all 4 of my decent quality embryos have been no good :-( but they were untested and I am now almost 39 I suppose!

If we are testing for euploidy, do you still think dna fragmentation is worth doing? I thought the pgt a would catch all genetic issues. We have generally had good fertilisation and blastocyst rate so I have tended to assume the ingredients are ok, possible naively as you say...

Sorry that you had to go through all that as well :-(

I guess the thing with DNA fragmentation is it can cause eupolidy, so might be worth looking into if you haven’t already created your embryos for testing? But if you already have them then I think better of waiting to see what the results are.

We also had no problems creating high grade blastocysts, and it’s really hard when they don’t work. We didn’t get to testing the embryos though, and I think it’s great that you are doing that as it should give some answers. All the very best to you x