Advanced IVF treatment – A Ray of Hope for a couple with multiple failures
36-year-old Mrs X, wife of 38 yr old Mr Y visited Dr Reena Gupta at the Nova Fertility Clinic in Rajouri Garden, Delhi. The couple was married for 11 years and have been trying to conceive for the past 10 years. They had three failed IVF cycles before coming to NOVA.
Past IVF Experience
In their last IVF cycle, the couple were advised an ERA (Endometrial Receptivity Array) test and PGT-A (Preimplantation genetic testing). The Endometrial Receptivity Array or Analysis is a genetic test in which a small sample of a woman’s uterine lining (called the endometrium) is taken to evaluate if it is receptive or developed enough to allow successful implantation of an embryo. The ERA test gives information about the window of implantation, which is the ideal time to transfer the embryo in IVF to the uterus.
A PGT-A or Preimplantation Genetic Testing for Aneuploidy is a test performed on the embryos created via IVF to determine the genetic health of the embryo and thereby, increase the chances of successful implantation.
In the case of Mrs X and Mr Y, the ERA was done twice and was inconclusive. Out of three blastocysts that formed, two were genetically normal and were transferred. However, that cycle only resulted in a biochemical pregnancy (a case in which a miscarriage occurs as early as 2-3 weeks after conception).
The NOVA Experience
Dr Reena evaluated the patient’s history and decided to redo all the medical investigations at NOVA, before proceeding ahead. The initial examination of Mrs X’s endometrium showed that it was very thin (around 6 mm) and irregular.
So, Dr Reena planned a hysteroscopy. During the hysteroscopy, some adhesions were observed and were cut with scissors. Post-hysteroscopy, Mrs X’s endometrium had a good thickness of 8 mm, while on estrogen therapy.
After this first step, an ERA cycle was done and Mrs X’s endometrium was found to be pre receptive. A pre receptive endometrium is one in which the window of implantation is found to be ahead of the estimated 19th to 23rd day of the menstrual cycle. A personalised embryo transfer was suggested after 6 days of progesterone.
Dr Reena performed an ICSI on Mrs X and 5 good blastocysts were formed. PGT-A was done on these blastocysts and out of the 5, only 1 embryo was euploid and suitable for transfer. This single euploid embryo was then transferred as per the ERA test, resulting in a positive pregnancy. The couple is now blessed with a healthy baby girl.