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Wednesday, September 11, 2013

What can I do differently after a failed IVF cycle to increase my chances of success ?

This post is for you Anu (thanks for the kind suggestion!) and for all my blog readers! I will be very happy if you could ask me more questions. Remember, every of your questions and doubts will help others who are in a similar situation too !

"Manju, what did you do differently this cycle ? You have undergone 7 embryo transfers without success, so what helped you to succeed this time ?" This is the question I am asked most frequently now-a-days.  I wonder how people came to the conclusion that doing something different helps in achieving success ! Here are my answers.

1. Can you tell us something about your medical history ?

My reason for doing IVF is tubal factor infertility. At the age of 29 I was diagnosed with a hydrosalpinx in the left tube and I had to remove it. My right tube is present but non-functional due to adhesions. I started my IVF journey at the age of 29. I learned that women with tubal factor infertility have very good chance of IVF success and now I am 35 years old and pregnant with embryos that were created from eggs extracted from my ovaries when I was 33 years old ! I expected my IVF journey to be short but I it took almost 6 years to get pregnant and carry it past the first trimester !

2. Is there any problem with you other than non-functional fallopian tube ?

I was diagnosed with PCOD and I am insulin resistant (this tendency run’s in my dad’s family!). I have been on metformin 1500mg from the age of 25. While on metformin , I had regular periods. Many different tests were done on me during my IVF attempts and after my miscarriage. The following “abnormalities” were found :

  • Compound heterozygous MTFHR mutation – I started taking 5 mg folic acid because of this diagnosis.
  • I was tested for HLA compatibility with my DH. They found 2 or more HLA loci compatible with my husband. This test was done immediately after my m/c. I didn’t have much knowledge then. I thought let them do whatever is needed so that I will have my baby. My RE in Germany asked me to undergo paternal lymphocyte immunotherapy to help my embryos implant and prevent further m/c. I didn’t even understand the principle behind the therapy then. I asked my RE but he had no clue either ! The therapy was performed like this : they isolated lymphocytes from my husband’s blood, injected them under my skin and monitored my blood after 1 month to see whether I had developed antibodies against his HLA ! They said “you have to get pregnant within a year, otherwise the antibody titer falls and you have to repeat this therapy again”. This therapy was done in 2009. I never conceived in my further attempts. I really started to panic whether this therapy did any irreversible harm to me and then I started to explore what this therapy really means. Then Dr. Malpani asked me whether I could write about it. During that time I learned a lot about HLA matching and about the “mindless” therapy I underwent for no good reason. My current pregnancy shows that HLA matching between husband and wife has nothing to do with successful embryo implantation or early pregnancy loss ! Please read :
  •  I have PAI 4g/4g mutation. The literature says PAI 4g/4g mutation predisposes me to insulin resistance. Another information I now know about this is, this mutation carriers may have increased risk for HELLP syndrome.

3. What kind of therapies were suggested by your REs ?

As mentioned already , I underwent paternal lymphocyte immunotherapy in Germany 4 years ago without it helping at all! My RE in Germany firmly believed that giving me heparin will help. I asked Dr. Malpani about it once and he said it was unproven and not necessary. I was so comfortable with Dr. Malpani’s conservative approach. He never wanted to experiment on me with any therapy which had no evidence to back it. His confidence made me very confident too. He believes firmly that embryo quality matters the most and that is what is my current pregnancy shows. I never again thought about using heparin – after all , I don’t have any problems with blood clotting. I did not even use baby aspirin this successful cycle.

4. How many IVF cycles have you done and where ?

I have done 6 IVFs and 3 FETs (9 embryo transfers altogether). The last FET was a success and I am currently 11 weeks pregnant with twins. I have done 5 IVFs and one FET in Germany without success (although I conceived in my 2nd IVF , that pregnancy was short lived !). I did my 6th IVF with Dr. Malpani of Malpani infertility clinic. You can see all my IVF cycle details (dosage of medicines, how many eggs retrieved, how many embryos were obtained and how many were transferred to the uterus ) in this post : You can also read about a more detailed description of how I ended up with more eggs in my 6th IVF in this post :

In my 6th IVF cycle with Dr. Malpani, I got more eggs than all my other 5 IVF cycles combined. Dr. Malpani allowed me to tweak the protocol in the beginning a bit , but I do not think that could be the sole reason for a high egg yield. I took 75 mg DHEA for 8 months (as per Dr. Malpani’s recommendation) before my 6th IVF and I also stopped metformin which I was taking for years. I also didn’t use Gonal F (a recombinant form of FSH which is a highly purified form) during my 6th IVF. I used a much cheaper version of FSH called Menopur ( a crude form of FSH preparation which is isolated from the urine of menopausal women). Might be a combination of everything or just the increased dosage of FSH which Dr. Malpani started me on from day 1 of cycle worked its magic and I got 24 eggs in that cycle. I am sure Dr. Anjali’s egg retrieval skills played a major role too.

5. What kind of transfer was your successful cycle – was it a fresh embryo transfer or frozen embryo transfer ?

I got 24 eggs in my 6th IVF. 3 good embryos were transferred during that cycle (fresh transfer) and 7 embryos which were of good quality were frozen. Out of 7, 2 were blastocysts and 5 were 8-celled day 3 embryos.

My fresh transfer was not successful. I had a great endometrial lining during that cycle. It was around 10mm, trilaminar. The next was a FET where we transferred 2 frozen blastocyst stage embryos. Again no pregnancy was established- the embryos failed to implant. We thought my poor endometrial lining (only 6.5 mm) was to be blamed for this failure (I used G-CSF for this cycle as uterine infusion to help my endometrium grow but it was of no use, my endometrium didn't respond well to G-CSF as expected).

I got a BFP with my recent FET during which my endometrial linig was only 6.7 mm. We transferred 3 8-celled embryos which were graded excellent. The remaining two 8-cell embryos ( out of the 5 frozen ) were grown to blastocyst and were refrozen again. Out of the three transferred two implanted and I have completed 11 weeks as of 28.8.2013 - and so far so good !
Remember, FETs are much more successful than fresh transfers now-a-days ! So find a clinic which uses vitrification for embryo freezing ! Please read this post for more info :

6. So what did you do differently this time ?

To be very honest, I didn’t do anything differently.

Many things went wrong this cycle. I had a poor endometrial lining again. It was only 6.7mm at the time of transfer ! I took 4 progynova (estrogen, 2 mg each) from day 1 of my menstrual cycle until day 21. Usually I ovulate at around day 21 so I thought why not give my lining a bit more time to grow. Since my endometrium was thin I just continued taking 4 progynovas until day 21. But the lining didn’t increase its thickness beyond 6.7 mm. I didn’t use lupron this cycle to suppress my pituitary. We actually thought lupron use might have caused poor endometrial growth but later we found that lupron was not the culprit (omitting lupron didn’t make any difference in my endometrial response to progynova). Since I didn’t use lupron this successful FET, at around day 7 of taking progynova I had an early LH surge (which indicates ovulation !), my LH at that point was 22 IU/l. But my progesterone was within pre-ovulatory range at that point and I didn’t have any follicles in my ovaries ripe enough for ovulation. Hence there was no chance for ovulation. So we continued with the cycle. Just 5 days before transfer I ended up with severe pain in my stomach (perhaps amoebiasis due to eating in restaurants in Mumbai !), so I ended up taking metrogyl 400 mg twice a day and I stopped it just the day before embryo transfer !

So with a lining of 6.7 mm, a premature LH surge and taking massive doses of metrogyl (actually this wouldn’t have had any ill effects anyway !) we carried on with embryo transfer. Dr. Malpani was not so happy that I decided to transfer my precious embryos to my poor lining but he was happy to let me decide. I always told him “Dr, I have the best lining in the whole world”.

7. What went right this cycle ?

Lot of things :)
  • I believed in what I did. My poor endometrium (as per so many scientific publications !) did not deter my spirit. I didn’t waste my time thinking that something is wrong with my endometrial lining and I didn’t do anything to improve it. I didn’t take massive amounts of estrogen nor did I take baby aspirin or any other blood thinners. No Viagra too :) After thinking a lot, I came to the following conclusion - My endometrium grew very well during all my fresh IVF cycles (10-12mm). This clearly showed that I had no underlying problem (fibroids, adhesion, infection etc) with my uterus. I confirmed it with a hysteroscopy which took just 5 minutes. The doctor who did hysteroscopy concluded that I had a small uterus but there was nothing to worry about – after all there will be lots of biological variations in the size and shape of uterus ! Since my endometrium grew well in fresh cycles (where enormous estrogen is present in the body) any end-organ damage is ruled out. During FET my estrogen levels (on progynova) rose to about 200pg/ml and this is in the normal range for an ovulatory cycle (200-300 pg/ml). With that amount of estrogen in my body, my endometrium could only grow upto 6.7 mm. I thought well and good, that might be my body’s natural response. I see so many women in infertility forums worrying about their lining thickness and trying so many different therapies to increase the thickness. From my experience I would say, If you do not have any underlying problem in your uterus , then do not worry about the lining thickness. The receptivity of the lining is what matters the most, and a thin lining can be receptive. What matters most is your embryo quality. If endometrial lining is that important for embryo implantation how come ectopic and extra-uterine pregnancies occur ?
  • I had wonderful people around me who made me so comfortable during embryo transfer. Dr. Sai’s gift to me did magic to my confidence level ! I suggest every IVF clinic give their patients some cute gifts before ET to boost their morale (how much does a gift cost when compared to the huge amount they charge :)
  •  I was so relaxed and was ready to face whatever comes my way. I always have plan B, C, D etc
  •  I believed in the competency of embryologist and my Dr - I trusted them !
  • My embryos looked so beautiful-thanks to the embryo creating skills of Dr. Sai !
  • My loved one’s prayed for me. My mom sent me to the ET room like a warrior, she applied some holy ash on my forehead ( and my DHs’ as well for extra god luck) . I did feel like going to a war front :) The love I felt in her gesture and HER prayers, the sacrifices she made (removed her hair, gave up eating sweets and pickles – the things which she likes most !) did play a major role in achieving this BFP.
8. Manju, did you take any supplement ?

I personally don’t believe in taking supplements to improve endometrial lining or its receptivity. So I didn’t take anything at all. All I took was 5 mg folic acid, 500 mg metformin (I am insulin resistant !), 4 progynovas and uterogestan ( progesterone) as instructed by my Dr and that is it. Please read :

9. How about bed rest ? Did you restrict your activities ?

I was on my feet 5 minutes after ET . I went back to hotel room, had my dinner and slept. From the next day onwards I took it easy, meaning, I didn’t engage in any strenuous activity. I went out for shopping, walked to a nearby restaurant to have my lunch, roamed with my mom and husband in the evenings. No bed rest at all ! Please do not torture yourself by lying down in bed for 3 or 4 days-it doesn’t help. It can harm your physical and mental well-being. Please read :

10. Can I fly immediately after ET ?

Yes, you can. But I stayed in Mumbai for 5 days after ET. The sole reason was to spend time with my mom. I get a chance to see her only when I come to India . She lives with my old granddad , and takes care of him, so it is not possible for her to visit me in Germany. I was not able to take holidays because I needed holidays for my treatment. I was so happy to be with her and my DH those 5 days. They both treated me like a queen :) (few joys of being infertile !)

11. What was your thyroid level pre-pregnancy ?

I was diagnosed with sub-clinical hypothyroidism (TSH 5.5) few years back. So I am on thyroxine. I do not have TPO antibodies. I tried hard in the beginning to keep my TSH around 1, as it was said that a TSH of close to 1 is ideal for achieving a pregnancy. I took 75 mcg of eltroxin and my TSH was around 1.3 or so but I felt like crap. I felt too hot, got frequent cramps in my leg and lost weight. After sometime I gave up worrying about the numbers on the papers and tried to concentrate on my body. I took 50 mcg and my TSH was around 3.5. I felt good. I had no symptoms of hypo or hyperthyroidism. So I maintained my dosage of 50 mcg. Last week during my visit to gynecologist (at around 10 weeks of pregnancy) they checked my TSH again and it was 0.88 to my surprise. As hCG hormone increases TSH levels tend to fall. Such increase in thyroid function is normal during pregnancy I learned. If you have thyroid autoantibodies it is wise to regulate your levels before getting pregnant but please listen to your body rather than obsess about the values on the lab report. Maintain a dosage which is comfortable for you and do not try to bring your TSH too low if you are not comfortable with this . A large scale study didn’t show any association between sub-clinical hypothyroidism, chance of conception or miscarriage. Women with TPO antibodies are prone to increase in their TSH (due to declining thyroid function) during pregnancy. So please check your TSH during pregnancy and adjust your dosage accordingly. Remember, severe hypothyroidism has to be treated as it can lead to abortions and premature deliveries.

12. Is there any advice you can offer me to increase our chance of IVF success ?

Yes, for sure !
  • Select a competent clinic. Go to the best IVF clinic available nearby. It does make a lot of difference.
  • Learn a lot about the IVF procedure. Opt for information therapy before IVF therapy.
  • Ask your clinic to show you your embryos. Educate yourself about how your embryos should look according to their age. Do not say I trust my doctor so I do not have to look at my embryos. There is a old saying “ Believe in God but lock your car”. Be wise and protect yourself from fraudulent activities which exist in the field of IVF. If someone cheats us once, they are fools . If they cheat us twice, we are. Please read :
  • Demand a copy of your medical records.
  • Do not think IVF is a single attempt process. The younger you are and the more the eggs you produce , the more likely you are to succeed. So have patience and be persistent in your attempts. Be flexible and open to different treatment options (like donor eggs, donor sperms etc)
  • Trust the doctor you selected, appreciate them for the work they do for you, be friendly with the hospital staff. If you treat them only as workers you will fail to get their warmth and compassion when you need it the most !
  • Please do not undergo any unproven therapies like IVIG, LYMPHOCYTE IMMUNOTHERAPY, USE OF STEROIDS, BLOOD THINNERS (if you are not diagnosed with clotting problems) which are not scientific established when undergoing IVF. IVF is a game of probability. If you are young and lucky enough you will find success soon. Otherwise it might take a few more attempts. I recently received a mail from an infertility specialist who conceived in her 17th attempt. An IVF failure doesn’t mean something is wrong with your body and you need to “correct” something. Human reproduction is a remarkably inefficient process. A normal, fertile couple needs on an average 12 months to conceive. If they don’t conceive in their bedroom in 4 months, they do not go to the doctor and ask him to “correct” something in their body- you don’t have to either!
Please read :

13. Can you provide me with an IVF checklist – what kind of tests are a must before an IVF cycle ?
  • Check your anti-muellerian harmone (AMH) and antral follicle count (AFC) to test your ovarian reserve.
  • Check your Thyroid stimulating hormone (TSH). If it is not within the normal range please see an endocrinologist to further asses the reason for thyroid dysfunction.
  • If you are diagnosed with PCOD and have high BMI, check your fasting insulin. If the fasting insulin is high, life-style changes along with metformin use will give you a better chance for IVF success. Metformin use during the first 12 weeks of pregnancy was shown to reduce miscarriage rate in PCOD women.
  • Check your blood sugar to make sure you don’t have diabetes. This test becomes very important if diabetes runs in your family.
  •  Hysteroscopy to check your uterus if any abnormality was detected using ultrasound images.

14. What did your infertility experience teach you ?

I will never consider my infertility experience as ill-fate. Infertility taught me many good things, introduced many wonderful people in my life, and made me knowledgeable. I have an infertility blog (thanks to Dr. Malpani !) now which helps many people and all the writing I did and the knowledge I gained because of that made me very confident. The confidence thus obtained and emotional protection it gave me is also one of the reasons for my success.

The lessons I learned :

  • Never believe in unproven therapies that exist in the field of IVF and waste your time, energy and money.
  • IVF is a game of probability, you may need few attempts before finding success. If you do not find success soon, It doesn’t mean your body is defective.
  • There are only three main components important for IVF success : good embryo, efficient embryo transfer and a uterus without any defects. Your embryo quality is decided by two factors : your age and your clinic’s competency in producing good embryos and to some extent the quality of sperm (perhaps a 10%). Embryo transfer (please read : depends on two factors again : the ease with which your uterus can be accessed and your doctor’s skill. Your uterine cavity must be free from adhesions, scar tissues and certain type of fibroids which might interfere with embryo implantation.
  • The competency of your IVF clinic matters a lot ! Always asses your clinic’s competency by how your embryo looks. Please, please do see your embryos before transfer and demand pictures of your embryos.
  • Patience and persistence during times of infertility provides rich dividends. 
  • Helping others is the best way of helping yourself.
  • Find good emotional support.
  • Have healthy hopes and weed out unhealthy expectations.
  • Infertility struggle doesn’t end when you get a positive BFP. The real struggle starts then and doesn’t end until you have your baby. Even if you get a positive BFP be cautiously optimistic. I was totally heart-broken with my m/c after my 2nd IVF attempt – I wish someone could have warned be about the possibility of m/c. 1 in 4 pregnancies end too early and the risk of m/c increases as your age increases.
  • Enjoy the journey !

15. I do not have enough money to do IVF, IVF is too costly for me – what should I do ?

This is a tough question and a question which breaks my heart all the time. I will try to suggest some possibilities :
  • If you are ready to donate half of your eggs to women who are in need of egg donation , then you are entitled for free IVF in some clinic. Please do find out if this is feasible. But for egg donation you must be within 30 years of age.
  • Some clinics offer a money-back guarantee programme. You have to pay for 3-4 cycles and if your IVF is not successful, they then repay 100% of your treatment costs . This gives you some financial security . You can check out an example of such a program at Not everyone qualifies for this programme, and age matters , so enquire about this option in your clinic.
  •  Bargain – there is nothing wrong in bargaining with your IVF doctor. Doctors are humans too and if you could give a valid reason and show proof that your income is low , many doctors might help you. I know in Dr. Malpani’s clinic they do free cycles for people who couldn’t afford IVF. But again if you are healthy and young the chances are more that your doctor is willing to help you.
  • The most important solution is to fight for the rights of infertile couples. We need to pressure the government to pass rules which ensure that IVF treatment is covered by medical insurance. It will take a lot of effort and lots of people to achieve this.


  1. Very well written Manju. Covers many different very useful things like heparin usage, TSH antibodies. Answers many of the questions. Thank you so much!

  2. I am happy to find this post very useful for me, as it contains lot of information. I always prefer to read the quality content and this thing I found in you post.
    IVF clinic India
    Surrogacy india

  3. What can be better than this,to end up the struggle with two lovely babies:)
    God is always kind and merciful on us.
    All this is your Determination and Great Persistence.
    Many Heartfelt Good wishes and congratulations once again.
    Do enjoy this Beautiful Chapter of your Life.Wishing more fortune for the Angel Mother and loveliest Babies...
    Ashu !

    1. Thanks Ashu :) Please do keep praying. But I feel so uncomfortable to accept your appreciation. I feel you are idolizing me. I am a very normal person Ashu. Anyone will get the determination and persistence when situation arises. But thanks a lot for all the love !

  4. Hi manju

    Thank you sooooooo much for all this valuable information. I am so happy for you pray deepest down my heart that you carry on with healthy pregnancy. Manju feel so close to you than friends I m surrounded otherwise with.
    Presently little anxious as I am today 7dp3dt andkeep analysing pain here and ache there.did u get some symptoms that made you think u might b pregnant this time.?????
    And yes congrats to your husband and mother too.....


    1. Dearmost Anu,

      You feel close to me because I know how you feel and I have undergone everything what you are going through.

      I agree 2ww is very difficult. It feels great to obsess about symptoms. Anu, I must say that after undergoing 9 transfers I found that my successful cycles and unsuccessful cycles were the same in terms of symptoms. Unless and until bHCG starts to rise really high it is impossible to feel pregnancy symptoms. Please be cool and patient, only few more days are left. The final answer will be a "yes" or "no". I am praying for you and I will be the most happiest person if you tell that you have got a BFP. Lots of good luck ! Please read the "2ww prayer" in my blog and stay calm.

      Lots and lots of love,

  5. Excellent post Manju! So detailed and so wonderfully written for everyone to understand. I'm sure it will help many out there.


  6. Great post Manju. Thank you for taking the trouble to write it all down. Such a treasure of you for this. Can't wait for your book though :)

  7. Manju....does the timing of your metformin dosage really matter? I used to take 500x3....but recently another dr made it 850x2 .....since it affects insulin and he way it breaks down glucose it's logical to think that timed intervals may help,no? Also....if I have a small dinner of just 200 cal or so then should the dosage be different? Another post on this would be really great...after all it's a wonder drug and needs a few more mentions in your blog :)

    1. Dear Zeus,

      No, the time of taking metformin doen't matter. Every drug has a particular half-life and hence it remains active in your system until it is cleared from your body. But taking metformin thrice (1500mg/day) a day by splitting the dosage into 500 mg/dosage will be kind for your stomach. The beauty of metformin is, it doesn't have any effect on the insulin secretion. It just helps the body in the better utilization of secreted insulin. So even if you eat less calories you can safely take metformin. Ofcourse it is a wonder drug for many and when combined with diet and exercise can do magic. Do you know it has potent anti-aging effects? :) I will definitely do a post on it Zeus. Thanks !

  8. Hi manju
    Are u thinking of writing a book?????.....I have missed few posts of yours and really dont know. If no than Pl make up your mind as you will have to do this. And if you vl allow i would also like to contribute a chapter in it. People not very active on internet and future generations shall be very thankful to you. Above all when your kids grow up how lucky they will feel to be the ones who ultimately made the couple complete and happy. Knowing your struggleful journey Vl definitely make them respect you more.......was just thinking about you and this came to my mind. Pl don't. Mind if I am being too interfering and sounding like a dictator.


  9. Anu, that book work is already in progress. It is a book with Dr. Malpani and I am always thankful that I met him and he is my Dr! He is the one who encouraged me to write and said to me that your aim must be a book. In the beginning I thought he is expecting too much from me and I have no such talents. I didn't take it seriously. But now it is going to be a reality. The work is progressing but it is getting delayed because of my laziness. Dr is patiently waiting for it and your comment reminded be how blessed I am and how I am neglecting that work now.

    Regarding your willingness to contribute a chapter in it, I am happy about it. But it can't be solely my decission. If you intend to write something, write and send it to me. I will definitely post it in my blog and will be happy to include in the book if Dr says yes !

  10. Hi manju

    Really happy to know you are already into writing book. You are really privileged to b co-author of such a renowned doctor and even he is lucky as you are very empathetic and understands emotional and social aspect of infertility so well. ....waiting for it!!!!!!


    1. Anu, where are you ? Do mail me.

    2. Hi manju,

      Thanks you thought of me. Went through a lot these last 4-5 days. Desperately need your guidance. Will mail you soon.


  11. Dear Manju,
    Heartiest congratulations to you on your successful pregnancy and dual happiness growing in your tummy :)
    I came across your blog while searching for infertility friends or forum, to find people who could relate to me or share the same journey....I am so glad I found you.....I read your blog whenever I find some free time in my the way you put down the emotions and feeling in words which are so difficult to explain.
    I have been trying to conceive since 7yrs now and have been educating myself every time I fail… still got so much to learn from you, you are an inspiration.
    God bless!!

    1. Dear Rakhi,

      Thank you for all the kind words ! I wish you all success in your future endeavor. I am sure you will realize your dream.

      If you need someone to talk to, please do mail me :

  12. Hi Manju ,
    hope u r doing gud. Read ur post and happy to hear ur NT scan went on gud. Happy to hear both the babies are doing gud. My prayers will be there for u dear. Send me ur number to my email if possible. Keep updating too. Its going busy with my son.

  13. Manju,

    I cannot tell you how helpful your posts are and how hopeful it makes me. I ran across your blog today and cannot stop reading. I wish I would have found it sooner. I have done 2 fresh cycles and am in the process of my 4th FET (starting the 6th total transfer). We did genetic screening on my embryos from my last fresh, however, that cycle again resulted unsuccessful. It's hard for me to get excited and hopeful that this FET will work, but you have definitely restored some faith in me and in the process. I especially took comfort in your post about the unlikelihood of the uterus being the culprit of an unsuccessful cycle as I have been down on myself thinking I was defective.

    It's refreshing to read a blog written by someone that knows a thing or two about science and has been through so much. I look forward to catching up and reading more about your journey.

    Congratulations and best of luck to you. You deserve it!


    1. Dear LT,

      Thanks a lot for all the kind words and I wish you lots of good luck for your endeavor. All will be well.

      I am happy that my blog helps you.


  14. Hi manju!!
    Does embryo transfer dependes on seasonal changes too? My clinic is not very keen to perform fet in months of april-may as temperature can rise above 45 deg cel here in northern india.

    1. Dear Neha,

      They do so because during summer there are lots of chances for contamination in IVF lab. The outcome of ET will not be affected by seasonal changes, normal woman conceive irrespective of seasons :)


  15. So would you suggest not going for the fet as thawing may affect the embryos?

    1. In order to do a FET you have to thaw the embryos. I don't understand your question, can you be a bit clear ?

      You asked that your clinic doesn't do FET in summer. The reason can be increased risk of culture medium. That is what I said.

  16. They dont do it in the month of may particularly. I was thinking to go for the fet in april if doc is ready. I dont want to take any risk either as in april too the temperature wont be too different from may.
    So in your opinion whether I should go for it in april or should wait till summer is over.?

    1. You must talk to your clinic. If they assure you that they will not have a any problems of contamination then you can go for it.

  17. Okay.. thanks a lot, Manju!

  18. Hi manju!!
    I wanted to know whether bilateral fimbrial blockage leads to hydrosalpinx? If not, then how does the fluid from tubes drains out?
    I suffer from bilateral fimbrial blockage and am undergoing my third ivf attempt. I always fear about hydrosalpinx, though dr said nothing about it after hsg and laparoscopy. I am trying to find an answer for previous failed attempts.

    1. Infection in the tubes leads to hydrosalpinx, so not every blocked tube will be filled with fluid. It is the irritation caused to the delicate lining of tubes due to infection increases the fluid secretion. Is the reason for bilateral fimbrial blockage known ? Do you have endometriosis ? Why don't you ask your doctor who performed laparoscopy about it, just for your peace of mind ? Hydrosalpinx is visible even in an ultrasound. Can you please send me the details of your IVF cycle, your age, AMH level and the reason for IVF. I would be happy if I could be of some help. My mail id is manjupadmasekar@yahoo. com

  19. I have a very similar story as you except the outcome! :)
    Did you get checked for endometriosis?


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