I hope this will copy...


1. PGD preimplantation genetic diagnosis (what you will be doing by the sounds of it... )

2. Thickening of the zona pellucida or egg shell ( I had this.. ) this is where they do AH - assisted hatching

3. Coculture -- where often the patient's endometrial cells from uterus are used to create a natural environment... this is not often used in most clinics.

4. Evaluatsion to rule out fibroids, polyps, or scar tissue by a HSG or a saline infusion ultrasound. (sonohysterography) or even visualization with a hysteroscopy. Biopsy can occasionally demonstrate chronic endometritis (inflammation of the uterus). ---- here they give antibiotics

5. Very thin endometrial lining, improve blood supply to uterus including taking baby aspirin, vaginal estrogen, as well as vaginal viagra suppostories. (yeah!! on that one)

6. Uterine environment can be (-) affected by the presence of hydrosalpinges (dilated Fallopian tubes) this results in lower preg rates, lower embryo implantation, and higher risk of m/c INTERESTING ! Data shows removal of affected tubes improves significant chances. Diagnosed by HSG, Lap, or even transvaginal ultrasound if they are large enough.

7. A specialized endometrial biopsy occasionally provides information on intrinsic endomentrial defects that can be detected utilizing experimental tests such as the "endometrial function test" or a test for ?- integrins. (yes typed it exactly)

8. Immune system in some cases of preg failure , esp. for patients with recurrent preg loss. Some say those who don't get preg are actually experiencing a very early loss due to immune issues. Treatments include baby aspirin, heparin (blood thinner), corticosteroids and intravenous immunoglobulin infusions (IVIG) this is getting more controversial

9. Even more controvercial is the evaluation for inherited thrombophilias (Factor V Leiden, Protein S, Protein C, Antithrombin III, MTHFR and prothrombin G20210A mutation. These patients have a higher risk of thrombosis (blood clotting) and preg complications. Impact on IVF has never been demonstrated.

Maybe too much information ... but interesting never-the-less.


Heather
_________________
we can and will make it happen!!!
"family" may not be what we had always intended. Adoption is a baby/child who desperately needs a mother, and a women to be a mother.

5 failed IUIs
IVF # 1 BFN
starting FET Mar. 2007