Want to Meet You So Bad! After Repeated Implantation Failure(I)

Do you have the experience of repeated implantation failure in IVF program? Or even though after pregnancy, still undergo miscarriage or fetal demise? In these situation, the most important thing to do is try to find out what factor is the "murder" of your child.
Author: Dr. Hsing-Hua Lai, MD

What's the most sorrow thing on the journey to get a baby?

Taiwanese celebrity 汪用和 use fourteen years trying to get a baby. The other celebrity 黃光芹 said "The hardship on the journey for getting a baby is like dying for several times ." They both decide to adopt a child in the end. And there are still a lot of people keep going on this journey. Such as super model 林志玲, celebrity 張秀卿 and the one who read this article without giving up. How can we do for next step to get to the happy ending?

Want to meet you so bad! It's OK that if you have a meeting with others but they cancel it at the very end. You can just rearrange it. However, what will you feel if they disappeared without saying why?

Friends that break their promise do not worth profound friendship. And what if this happen on your journey of getting a baby? Is it trustworthy to use the same treatment after repeated implantation failure without knowing the reason of failure?

Changing to another scenario. Getting pregnant every time after implantation but every fetus couldn't keep growing then get abortion is already miserable enough. When hearing a physician say "let's try harder next time" what will you feel? How can you bare this twice or even three times in a row?

“If you run on the wrong road, you will never reach the end.”

When you fail after two implantation or getting abortion twice in a row. It means "the murder" is still there. The most important thing to do at this point is to stop the pace and try to find out "the murder".

Everything happened for a reason. I always believe that you must have done something right to lead to success. In other hand, there might be something wrong lead to failure. If we find out the factor precisely and exclude it in next treatment, there's no reason that we will fail next time.  

Clients are our teacher. That's also why I like to use real stories to share with others. Following I'll take three clients that left our center with smile of success for example.

39 years old Mrs. A

When A came to our center for the first time, she already underwent two times of implantation failure. First time was IVF with preimplantation genetic screening(PGS). After failure, doctor suspect that window of implantation is not right. Therefore, she underwent Endometrial Receptivity Analysis(ERA). It turns out that she needs to take progesterone for one more day to get right implantation window.

For the second implantation, with the right time and prevention Heparin injection. She got pregnant successfully. However, the fetal heat beat stopped when it was 8 weeks. She remembered clearly that after first and second implantation, she got bleeding for both time. The blood test of autoimmune and Thrombosis were normal. Therefore, doctor declined the dosage of Heparin from two days a time to three days a time. Meanwhile add progesterone injections. Sadly, the baby is still gone.

“The most painful fact is not miscarriage, but not knowing "who killed my child?”

We restarted the oocyte retrieval again, but there were no chromosomally normal embryos. Can mosaicism(embryos have both normal and abnormal cells) embryo be an option of implantation? How can we success with two-third of embryo chromosome abnormal rate at her age? With my own experience, if there is bleeding situation after implantation and before pregnancy test, it might because of Thrombus problem. We rechecked related blood tests and as expected they were weakly-positive. Therefore, we adjusted Heparin dosage to one time a day. Today, she is pregnant for14 weeks and 3 days. After hearing the heartbeat, it's time to say goodbye. Finally, She can be transferred to Obstetrician.

45 years old Mrs. B

Before Mrs. B came to our center, she already underwent three times of both oocyte retrieval and transfer. Fresh embryo transfer for the first two times and frozen embryo transfer for the third time. It's a pity that the embryos were all only cultured to day 3 early embryos. Which makes it hard to analyze the possible reason for failure. She was 44 years-old when she came to our center. Oocyte donation program should be a better choice for her. However, she rejected and choose to use her own eggs. She collected four embryos that was not proper to do biopsy and then transferred for the fourth time. She also did ERA before her transfer. However, she failed again.

Then she changed her mind to do donor program, to try for her fifth time. After transferred one chromosomally normal embryo, with ERA test, she still failed. Were there still other "murders" out there?

We checked all her autoimmune and Thrombosis blood tests again. And found out her Nephelometry IgG result was higher than reference. The only difference between sixth transfer and fifth transfer is that we gave her Intravenous immunoglobulin(IVIG) injection three days before transfer. And started heparin injection one time a day from her transfer date. Now, she is pregnant for eleven weeks and one day. We are so happy for her.

45 years old Mrs. C

Before Mrs. C came to our center, she already failed for three times. She wouldn't want to try traditional IVF. Before our suggestion, she decided to do 3+ IVF( with PGS and ERA). She got pregnant after first transfer. Although she had some bleeding during her eighth week but baby heartbeat was normal at that time. With normal Thrombosis blood tests, progesterone injections and pills. When she came back after two weeks, the fetus is still growing. However, the fetus stopped growing next week unexpectedly. It was a real bolt from the blue that made her heart broke. Isn't it comparably safe after 10 weeks? Moreover, it is 3+ IVF this time!

My detective instinct told me it might be Thrombosis problem due to the bleeding situation after transfer. Therefore, I added two blood tests to be monitored this time. All tests were normal on the pregnancy test date. And there were no bleeding situation before fetal heartbeat check. We checked Thrombosis blood test for one more time and accidently found that one of the test became to abnormal. We immediately increased the dosage of heparin form two days a time to everyday. Now she is pregnant for eleven weeks and four days. Congratulations to her for finally finding the hiding murder and say goodbye to those misery days after failure.

Clients are our teachers

Mrs. A gave us two lessons.

  • >First lesson- please don't ask "should I do ERA test?" anymore.
  • Second lesson- If there are bleeding situation during pregnancy, please beware that Thrombosis might be killing your child. Don't just think of taking progesterone injections.

Mrs. B also gave us two lessons.

  • First lesson- Over 43 years-old should choose oocyte donation program directly. Don't waste money.
  • Second lesson-Infertility doctors should accept humbly that there are some people who have immune system problems that will lead to the system attacking embryos causing reimplantation failure.

Mrs. C gave us two lessons that's more valuable.

  • First lesson- follow only one Thrombosis test is not enough. It is more accurate to test two at the same time.
  • Second lesson- Today's result is not able to represent tomorrow's. The data of two Thrombosis tests were normal, and the fetal heartbeat also appeared as expected after 3 weeks. But why the Thrombosis test became abnormal? Our body situation is dynamic. If you are healthy today do not represent you won't get sick tomorrow.
“Think about why these three teacher pay for sky-high price to learn these before success in their tough journey.”

If you ask me where is the cheapest place to do IVF? I won't answer! Because there's always a cheaper place.

But if you change the question to "How to bring a healthy baby back home with the least hardship and most Cost-effective?'' I'll answer you without any doubt-- 3+ IVF! Because you can get 80% of successful rate with only one embryo transfer. We design your own personal precisely IVF treatment and every step is based on evidence. After failed unfortunately, we can also check from the very end to see is there any possible factors that become the "murder". Different from traditional IVF, using your own body to do "experiments".

Want to meet you so bad! Stork Fertility Center likes to choose a challenging path! This year is our 20th anniversary. We open a special appointment "Reimplantation Failure appointment". Please don't come if you like to chat or heard that Dr. Lai is not patient to clients. But for those who already traveled around the world and are longing to become parents as soon as possible, please come to join this journey. It's better that you believe in "precise treatment", knowing that everything happens for a reason and believing that you will only success when you are on the right track!

*This article only reflects the treatment status at the time of writing, and the actual situation should be discussed with the doctor.