? about Implantation Failure....

Is it true that for some women, doing IVF stimulation creates an inhospitable uterine environment causing implantation failure (for example, excellent drug response to all medications, egg quality good, 100% fertilization rate with ICSI, PGD normal, great lining) but still no implantation)?

In these cases, I have heard that it may be better for these women to freeze their embryos and then do a FET in next cycle.

Have you encountered this and if so, is there a way to know that the uterine environment would lead to implantation failure?

I have seen this on several occasions.  There are really no good tests to determine whether or not this is the problem.  You have to just try it unfortunately.

Dr. Potter,

Thanks for taking time out of your busy schedule to answer questions for this forum.  I appreciate it and I know the others on this forum appreciate it as well.

I have a follow-up question on this topic.  You say you have seen this in several occasions - have you found that it is related to high estradiol levels?  For instance, women that have a good response may be in the 2000 - 3000 range for estradiol levels.  Would this cause the inhospitable environment? 

Could it also be related to an immune issue - is it possible for women who have conceived before to develop immune issues and if so, what would cause this?

Thanks.

 

It has been associated with very high estradiol levels in the cases that I have seen.  There also may be some association with the premature exposure of the endomtrium to progesterone, causing the lining and the embryo to be out of sync.  Immune issues can develop in the time between pregnancies.  They are rare in cases such as yours though.  I would try the planned FET before going down the immunology path.