Hello Ladies,
I finally had my appointment with Dr. Palter yesterday. The drive there and back was horrid, and we were stuck on the way to the GW bridge into NJ for over 2 hours! What should have been a 1.5 hour drive, turned into 4 hrs 20 mins just getting home from the appointment.
After reviewing all my lab reports, here's what he had to say:
1) He believes the rate of "Unexplained" is pretty low. Sometimes they're hard to diagnose, but there is almost always a contributing factor. He believes that the factors that could be responsibile in our case are:
a) Structural issue at opening of the cervix - the bump that causes a difficult and painful transfer, if it is extreme, it could be corrected through surgery to simplify transfer.
b) Poor egg quality - the high doses of medication I was on, suggest that even though I had a good number of eggs, it took the maximum dose of meds to achieve that. It could indicate poor egg quality.
c) Lower than normal sperm count - DH's sperm count is also lower than normal range. That could indicate abnormalities in sperm.
d) Chromosomal abnormalities in the embryos themselves - The embies were not tested for genetic abnormalities. That could have been a contributing factor.
e) Fluid in the fallopian tubes - When he did a routine ultrasound, he noticed fluid around the ovaries. He wants to do a an HSG to check if that fluid is inside the tubes or around them. If its inside the tubes, he believes that itself is a 75% implantation failure without any of the other issues adding to the complication.
He recommended that we go through extensive bloodwork for genetic conditions (he already drew blood for that) and the HSG (to determine where the fluid is) and SHG to test the ease of transfer. He also felt that a different protocol would be helpful in preparing the lining for transfer.
If all other tests are normal, he wants us to do PGS before embryo transfer so that only the normal ones are put back in. If I have all bad eggs, we would have to consider donor eggs.
He is of the opinion that Autoimmune conditions have been conclusively proven to NOT affect implantation, that they are only known to have a small impact on miscarriages. Furthermore, on the HCG infusion, he believes that it has worked for some people, but its results are highly inconclusive. I know HCG infusion worked for Sunshine, but he doesn't have much faith in that assisting implantation.
Sorry to have written a long essay, but I thought I ought to share what we learnt, especially cos' I raved and ranted for all these weeks, Lol. And it will help to have your inputs on it as well.
We are going ahead with the diagnostic tests, and we will determine how to go ahead... Whether we do a fresh cycle or use the remaining three frosties, will be determined from the results of all the preliminary testing. From the looks of it, we will probably be going for a cycle (fresh or FET) in April!