We had 3 failed pregnancies in the last 5 years. IVF with PGT or without. No other health issues. Sperm morphology is abnormal

[Stay_positive_mom]

We had 3 failed pregnancies in the last 5 years. All are below first trimester. The first and third one are 10 weeks. The second one is around 5 weeks .The last pregnancy we got fetus analysed and found out trisonamy in chromosome 22. However our kariotyping is normal .We are in the process of doing IVF but not sure whether a normal IVF will benefit or PGT. PGT is not covered in NHS and I cannot pay Seperately and private option is very expensive. We are not sure what to do here…

[DreamingOfTwo79]

Hello Stay_positive_mom, I am very sorry for all your losses, I hope you have lots of support. I suffered four first trimester miscarriages in the past two years, like you I only had my last baby's tissue analysed and they diagnosed trisomy 16. I was seen by the recurrent miscarriage clinic and they tested for blood clotting orders (none present) and their advice was to keep trying, it was allegedly a numbers game. For me, personally, trying again naturally was not an option as I was conscious with both our advanced maternal (42 at the time) and paternal (57) age our chances of hitting on a euploid embryo in a natural cycle were very slim, not impossible but I knew I was emotionally, physically and mentally not prepared to risk another loss without knowing I had done everything to reduce the risk of that happening. For me this meant to go for IVF with PGT-A (old name PGS). We are funding this privately as we wouldn't have qualified for NHS treatment due to ours being secondary infertility, our age and my AMH level being below the NHS acceptance threshold. PGT-A has advanced significantly over the past few years but it is still not an exact science and of course it is not a guarantee that it will lead to a successful live birth even if the embryo(s) are considered to be euploid and may have promising grades given by the embryologist. We are doing two back-to-back cycles of embryo banking (or batching) where all viable embryos are frozen on Day 3 of the first cycle and then thawed during the second cycle to allow all embryos from both cycles to be cultured to Day 5 where they will then biopsy all viable Day 5 embryos and freeze them. The biopsied cells will be sent away for testing and hopefully three weeks later you would know whether any of your embryos are considered euploid or low level (and ideally segmental) mosaic. These could be chosen for transfer at a later stage. In your case it would be worth getting both you and your partner checked for various conditions and markers, it is good to know that your karyotyping came back normal, however this doesn't tell you the state of your ovarian reserve or your partner's sperm health. We had the following tests done: Sperm Analysis and Sperm DNA Fragmentation, Ovarian Reserve Test (internal scan with Antral Follicle Count plus AMH, FSH and Estradiol levels) and Thrombophilia & Thyroid Screening (blood clotting disorders and thyroid related antibodies). My ovarian reserve is considered diminished meaning that I have fewer eggs left and due to my age the expectation is that these would also be of a lower quality. My partner's sperm came back with a high fragmentation rate which means he only has very little good quality sperm. In our case, PGT-A really is our best chance at reducing the time to successful pregnancy and hopefully live birth. I have regular cycles and used to ovulate almost every month (stopped tracking after my last loss in March), so while we managed to conceive naturally, unfortunaely all the investigations indicated poor egg and sperm quality so that's why we went with PGT-A testing. I am due to start my second and final cycle of embryo banking, all going well we would know in about three weeks from now if we even have any embryos for testing and, if yes, we would know by the end of November if we have any euploid embryos for transfer. I know it is a difficult decision what option to try next, especially when this means a significant financial investment. Have you already had any other investigations done other than the karyotyping? Wishing you the best of success and lots of strength for your next steps!

[DianeArnold Partner Nurse Fertility Network UK]

Hi Stay_positive_mom. So sorry to hear about all your losses and I do hope you have had plenty of support. My feelings are to perhaps go for PGT if you can afford it, for at least you would know that your embryo to be transferred was a good one. Also, speal to the clinic about low dose soluble aspirin or heparin if not already used, to ensure good blood supply to the womb and lining, and also to hopefully prevent blood clots from forming. Good luck! Diane

[soccerkt6]

Hi lovely

I'm so sorry to hear about your losses. Has your partner had a sperm DNA fragmentation test done? Abnormal morphology can indicate that there are other underlying sperm issues, and a DNA fragmentation test would tell you if this is an issue. High sperm DNA fragmentation can also be a factor in recurrent pregnancy loss. It it turns out that your partner does have a lot of fragmentation, your clinic would prob want to use a sperm selection method like PICSI, IMSI or ZyMot during your IVF cycle. Best of luck xxx