Posted by Larry Grunfeld, MD on July 06, 19100 at 08:43:47:
In Reply to: Dr. Should my next step be IVF? posted by michellew on July 05, 19100 at 11:20:10:
Most RE's are aggressive with IVF. A study published today demonstrates the efficiency of IVF in reducing multiple pregnancies.
Older techniques such as surgery and ovulation induction/IUI still have a role, but should not be used for long periods of time (particularly as you get closer to age 40). Laparoscopy is of no benefit prior to IVF unless it is performed to remove a hydrosalpinx.
Testing of the uterus for implantation failure consists of some kind of imaging to test the shape along with ultrasound to test the thickness and pattern. If these are normal it is rare for implantation failure to be due to a uterine deformity.
If you have access to a good IVF laboratory IVF will likely help you to conceive.
Discuss the pro and cons with your RE.
Larry Grunfeld, MD
: I'm 33. HSG showed left tube blocked. DH is 35 and has
: good sperm count. I had 4 failed IUI's ( 2 on clomid, 2
: on injectibles) with good responses. I'm thinking that
: my next step is IVF. What if my problem is not
: fertilization but implantation? The RE can place
: perfect embryos in my uterus but they don't implant.
: Is there any test that will rule out the possibility
: of an implantation problem. What will hysteroscopy/
: laparoscopy do for me? Should I go thru these
: procedures first? I'm ready for IVF but I'm afraid that
: it won't work as well.
: Please advice. Thank you so much.