Recurrent Miscarriages

Hi,

I have been married for 7 years and 29 yrs old now. In 2003, I had doubtful ectopic and rt ovary was removed. My husband's sperm count was good at that time. In 2006, we went to fertility specialist and he suggested my husband's sperm count is low, I should go for IVF with ICSI - got positive HCG but same day started bleeding and miscarried (I did household chores, could be because of that). I did FET in September 2008, unsuccessful.

Recently, I did my second fresh IVF cycle, (I was totally on bed) positive HCG, 72 then to 345 and then to 640 (approx numbers). The day it was 640, same day I started heavy bleeding within couple of hours and then went to emergency room and HCG was 502, they said I am miscarrying. They removed clots manually, No DNC on 11th october 2009. I havn't got my periods yet and have a review appointment with my infertility doctor. Pls advise what could the reason for recurrent miscarriages. I am really feeling low...feeling like everything has finished for me.

Can anybody suggest, how long Frozen embryos are good for.

[Elaine Brown, MD]

Hi!
I'm sorry to hear about your losses!  Miscarriages can be very devastating!
First of all, frozen embryos are "good" as long as they remain frozen, I'm not aware of any time limit.
As for the miscarriages--I suspect that you have already had a fairly complete evaluation if you are working with an RE and going through IVF.  IVF protocols usually include medications that help to prevent the most common causes of miscarriage.
You may want to discuss low dose aspirin and/or heparin therapy with your RE--these agents help to prevent clots that can cause miscarriage.  Most protocols include one or both medications.  Medrol or other steroids are often included in the protocols to reduce the risk of an immune reaction to the embryos.  Also, most women have had their uterine cavity evaluated with a HSG or saline ultrasound prior to starting IVF.
What remains is the embryos--the most common reason for miscarriage is genetic abnormalities of the embryos.  A couple of options to try to reduce this risk include:
transferring blastocysts (day 5 embryos) Embryos that survive to this stage are more likely to be normal.  AND PGD--preimplantation genetic diagnosis--the embryos are biopsied and their chromosomes are analyzed.  Only genetically normal embryos are transferred.
In your case, Your RE will probably suggest all of the above ( with the possible exception of the PGD).  You may very likely be successful if you just KEEP TRYING.
Also, many IVF centers have counselors to help the patients through the rough spots--so check out that option too!  
I hope this is helpful!  Good luck!
Dr B

[sangsham]

Thanks doctor for advising few things which I can consult with my infertility doctor.