
Hi, My Wife Has 5 Failed Cycles IUI And One

1) We did Era test and mywife was found to be P+7 day receptive for blasctocyst meaning it seems both report and doctor are ok to do day 3 emboryo transfer on P+5 day because our doctor believes day 3 emroyo have better chances of survival in mother's womb than in in lab to be a blastocyst in day 5.We trust our doctor on this. However love to hear your suggestion ?
2) Her emdometrical thickness never goes beyond 7 mm in any ART cycle on day of trigger . In the failed IVF cycle it was 6.9 MM in day of trigger but with exellent vascularity, triliminar pattern and blood flow .Thanks to PRP we didi. But this time to rule out endometrical tubeculosis doctor has precribed my wife akt3 (every day for 3 months) Now we are in 3rd month and plan is in the 4th-6th month they will reduce the dose to 2 days a week and do endometric scratching in 4th month and do emboryo transfer in 5th month if all works out well and continue akt3 to 6th month. I need your opinion on above line of treatment. There was no bioopsy done for endometric TB . No visisble symptoms of endometrium in high quality USG. My question is AKT3 ok to comsume evern for 2 days a week during emroyo transfer ? Does it interfares with emroyo transfer plan of my wife in 5th -6th month of dosage and does it creates any complications in achieving pregnancy ? Another Quetsion for one of her past ART cycle embroyo trasnfer was cancelled because her Pulsating index of Uterine Arteryis was more than 5 and it should be less than 2.5. What is that ? How can we control it with medication or excercise or food suplement into a desired level for ART cycle or its beyond human control ?Note she was on blood thinner ecosprin 75-150 in that cycle along with PRP like any other cycle.

1) We did Era test and mywife was found to be P+7 day receptive for blasctocyst meaning it seems both report and doctor are ok to do day 3 emboryo transfer on P+5 day because our doctor believes day 3 emroyo have better chances of survival in mother's womb than in in lab to be a blastocyst in day 5.We trust our doctor on this. However love to hear your suggestion ?
2) Her emdometrical thickness never goes beyond 7 mm in any ART cycle on day of trigger . In the failed IVF cycle it was 6.9 MM in day of trigger but with exellent vascularity, triliminar pattern and blood flow .Thanks to PRP we didi. But this time to rule out endometrical tubeculosis doctor has precribed my wife akt3 (every day for 3 months) Now we are in 3rd month and plan is in the 4th-6th month they will reduce the dose to 2 days a week and do endometric scratching in 4th month and do emboryo transfer in 5th month if all works out well and continue akt3 to 6th month. I need your opinion on above line of treatment. There was no bioopsy done for endometric TB . No visisble symptoms of endometrium in high quality USG. My question is AKT3 ok to comsume evern for 2 days a week during emroyo transfer ? Does it interfares with emroyo transfer plan of my wife in 5th -6th month of dosage and does it creates any complications in achieving pregnancy ? Another Quetsion for one of her past ART cycle embroyo trasnfer was cancelled because her Pulsating index of Uterine Arteryis was more than 5 and it should be less than 2.5. What is that ? How can we control it with medication or excercise or food suplement into a desired level for ART cycle or its beyond human control ?Note she was on blood thinner ecosprin 75-150 in that cycle along with PRP like any other cycle.
Blastocyst transfer with PGS required
Detailed Answer:
Hi,
I understand your concerns.
Following is my reply:
1) Blastocyst transfer is a best in any situation. I think you need to request for blastocyst transfer ONLY. If your doctor is not agreeing to this, please go to different fertility centre which does blastocyst transfer.
2) Triple line pattern with good vascularity of 6 mm endometrium is good enough to conceive.
3) I dont see any role or need of AKT in your situation as this is unlikely to be tuberculosis. Anyway as you have started it, you cant stop it. Please see a physician and complete the course.
4) There is no role of endometrial scratching or PRP administration. They are waste of time and money. There is not enough scientific data to substantiate this.
5) Pulsating index is not always correct indicator of blood flow and its not necessary to be observed to cancel FET cycle.
6) I think you need to go ahead with Blastocyst transfer with or without PGS ( Preimplantation genetic screening) of embryos to assess the genetic quality of embryos.
7) Let me know which city and doctor you are under treatment so that I can suggest you a more suitable fertility specialist / IVF centre.
Regards

Blastocyst transfer with PGS required
Detailed Answer:
Hi,
I understand your concerns.
Following is my reply:
1) Blastocyst transfer is a best in any situation. I think you need to request for blastocyst transfer ONLY. If your doctor is not agreeing to this, please go to different fertility centre which does blastocyst transfer.
2) Triple line pattern with good vascularity of 6 mm endometrium is good enough to conceive.
3) I dont see any role or need of AKT in your situation as this is unlikely to be tuberculosis. Anyway as you have started it, you cant stop it. Please see a physician and complete the course.
4) There is no role of endometrial scratching or PRP administration. They are waste of time and money. There is not enough scientific data to substantiate this.
5) Pulsating index is not always correct indicator of blood flow and its not necessary to be observed to cancel FET cycle.
6) I think you need to go ahead with Blastocyst transfer with or without PGS ( Preimplantation genetic screening) of embryos to assess the genetic quality of embryos.
7) Let me know which city and doctor you are under treatment so that I can suggest you a more suitable fertility specialist / IVF centre.
Regards


Thanks for your answer , regadring your repsonse
1)"Blastocyst transfer with PGS required". May i ask what is the approximate cost of PGS test in XXXXXXX I heard its not done in XXXXXXX and some has to come from XXXXXXX . Take sample and do test in XXXXXXX As my embroyos are freezed in XXXXXXX XXXXXXX Hall clinic Hospital.
2)" Regarding AKT3" . I want to ask after completing first 3 months of daily dose from 4th-6th month it is planned to take only 2 tabs a week as part of maintainance phase. Our Doctor has planned to do emboyo transfer on 5th month while in AKT3 . My question is it still safe to do transfer while in AKT3 (two days a week) in 5th month while moving to 6 th month with in same dose ? I was worried if AKT3 will have advserse impact on the embroyo inside uterus ? or i need to wait for completion of 6 months. we are loosing time and want to know is it safe or we needto wait ?
3) "Regarding Let me know which city and doctor you are under treatment...."
I am consulting at (Ruby hall clinic hospital XXXXXXX )

Thanks for your answer , regadring your repsonse
1)"Blastocyst transfer with PGS required". May i ask what is the approximate cost of PGS test in XXXXXXX I heard its not done in XXXXXXX and some has to come from XXXXXXX . Take sample and do test in XXXXXXX As my embroyos are freezed in XXXXXXX XXXXXXX Hall clinic Hospital.
2)" Regarding AKT3" . I want to ask after completing first 3 months of daily dose from 4th-6th month it is planned to take only 2 tabs a week as part of maintainance phase. Our Doctor has planned to do emboyo transfer on 5th month while in AKT3 . My question is it still safe to do transfer while in AKT3 (two days a week) in 5th month while moving to 6 th month with in same dose ? I was worried if AKT3 will have advserse impact on the embroyo inside uterus ? or i need to wait for completion of 6 months. we are loosing time and want to know is it safe or we needto wait ?
3) "Regarding Let me know which city and doctor you are under treatment...."
I am consulting at (Ruby hall clinic hospital XXXXXXX )
Finish AKT
Detailed Answer:
Hi,
1)PGS costs around 17000 per embryo.
2)Check with XXXXXXX IVF in XXXXXXX They have best infrastructure.
3) Embryo transfer is not advisable while on AKT. Finish AKT and go for transfer. Not to hurry with treatment as you are on AKT.

Finish AKT
Detailed Answer:
Hi,
1)PGS costs around 17000 per embryo.
2)Check with XXXXXXX IVF in XXXXXXX They have best infrastructure.
3) Embryo transfer is not advisable while on AKT. Finish AKT and go for transfer. Not to hurry with treatment as you are on AKT.


I wil take your advise and finish AKT3 as already prescirbed to me by my doctor
Just to know
1)Whats is the normal prescribed dose and duration of AKT3 consumptionif some one is suspected of mild endrometrial TB if not confirmed.

I wil take your advise and finish AKT3 as already prescirbed to me by my doctor
Just to know
1)Whats is the normal prescribed dose and duration of AKT3 consumptionif some one is suspected of mild endrometrial TB if not confirmed.
Standard treatment recommended
Detailed Answer:
Hi,
There is no mild or moderate TB. There are standard doses of AKT treatment as per government guidelines.
Dose and duration cannot be discussed on the online forum without examining the patient, hope you'll understand.
Regards

Standard treatment recommended
Detailed Answer:
Hi,
There is no mild or moderate TB. There are standard doses of AKT treatment as per government guidelines.
Dose and duration cannot be discussed on the online forum without examining the patient, hope you'll understand.
Regards


1) Before my wife failed iVF cyle we had 6 ART cycles cancelled because her endometric thickness was not optimun for tranfer.
Out of these 6 cycle she had spoting on 15-16th day 4 times which reduced her thickness below 6mm while in progynova 16 mg a day(started with 12mg a day
from D1-D8 and latter dose increased after 9-10th day by doc after ultrasound).Latter doctor concluded my wife does not responds to external estrogen cycle
and she was given lower dose of estrogen with GonalF and antagonist to stimulate her internal estrogen by doctor. Question what is the common causes of
spotting in 15th-16th day while in external estrogen though she was regular in her estrogen dose and did not skip anything at all.
2)Unfortunatlely 1st time in her current normal cycle she has spotting on 15th day while not in estrogen. She was om AKT3 from last 3 months and dctcor said
such spotting sometimes happens while on AKT3. Is it true? What are your advise on that.
Pateint Age: 33
Height 5.4 Kg
weight 73 kg initially now reduced to 67 in 3 -4 months
Her last ERA test result attached
Her last US report attached. No adenomyosis. No fibroid. No whiteliquid indicating bacteria or tubercular infection with naked eyes everything was normal
as per the doctor. She had PCOD in past and is taking metamorphin every day from last 1 year

1) Before my wife failed iVF cyle we had 6 ART cycles cancelled because her endometric thickness was not optimun for tranfer.
Out of these 6 cycle she had spoting on 15-16th day 4 times which reduced her thickness below 6mm while in progynova 16 mg a day(started with 12mg a day
from D1-D8 and latter dose increased after 9-10th day by doc after ultrasound).Latter doctor concluded my wife does not responds to external estrogen cycle
and she was given lower dose of estrogen with GonalF and antagonist to stimulate her internal estrogen by doctor. Question what is the common causes of
spotting in 15th-16th day while in external estrogen though she was regular in her estrogen dose and did not skip anything at all.
2)Unfortunatlely 1st time in her current normal cycle she has spotting on 15th day while not in estrogen. She was om AKT3 from last 3 months and dctcor said
such spotting sometimes happens while on AKT3. Is it true? What are your advise on that.
Pateint Age: 33
Height 5.4 Kg
weight 73 kg initially now reduced to 67 in 3 -4 months
Her last ERA test result attached
Her last US report attached. No adenomyosis. No fibroid. No whiteliquid indicating bacteria or tubercular infection with naked eyes everything was normal
as per the doctor. She had PCOD in past and is taking metamorphin every day from last 1 year
Hormonal variations
Detailed Answer:
Hi,
1) Though estrogen external and internal is on , there is variations in absorption and leading to sudden drop in estrogen levels. This causes spotting.
2) Yes. Spotting might happen while on AKT. She needs to undergo blastocyst embryo transfer.

Hormonal variations
Detailed Answer:
Hi,
1) Though estrogen external and internal is on , there is variations in absorption and leading to sudden drop in estrogen levels. This causes spotting.
2) Yes. Spotting might happen while on AKT. She needs to undergo blastocyst embryo transfer.

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