My marriage had completed 6 yr nt conceive bby - #9725

Hello Niti, This is a matter of concern . You need proper treatment and I am here to help you. Thank you for sharing your details, I understand this must be an emotionally and physically difficult journey. While I can’t give a definitive diagnosis without access to full clinical records, I can explain possible reasons for implantation failure in your case and suggest what might help next, in a format that mirrors a specialist’s note. Follow-Up Clinical Note – Recurrent Implantation Failure Evaluation Patient Name: [Niti Makkar] Age/Sex: 36/F Date: 12-04-2025 Chief Complaints: 2 failed IUI cycles at Rani Bagh clinic 2 failed IVF cycles at AIIMS No successful embryo implantation History of PCOD, low AMH, thyroid disorder, and endometriosis Probable Contributing Factors to Implantation Failure Low AMH (Anti-Mullerian Hormone): Indicates diminished ovarian reserve. Often leads to fewer eggs retrieved and lower-quality embryos. Endometriosis: Can cause inflammation and immune dysregulation in the uterus. Alters endometrial receptivity (uterus lining may not support implantation well). PCOD (Polycystic Ovarian Disease): Causes hormonal imbalance and poor egg quality. Associated with insulin resistance, which may affect implantation. Thyroid Disorders (especially hypothyroidism): Even mild imbalances in TSH can reduce chances of successful implantation. Target TSH before and during pregnancy: <2.5 mIU/L Uterine Environment: Endometriosis or prior surgeries may cause scarring or poor blood supply. Thin or non-receptive endometrial lining could be a cause. May need Doppler and hysteroscopy assessment. Immunological Factors / Genetic Compatibility: Abnormal NK cell activity or immune rejection. Embryo genetics (aneuploidy) or HLA compatibility issues. Recommended Next Steps Investigations: Endometrial Receptivity Assay (ERA Test) – to check the optimal implantation window. Hysteroscopy – to directly assess uterine cavity for adhesions, scarring, endometriotic lesions. Thrombophilia Profile – rule out clotting disorders affecting blood supply to embryo. Autoimmune panel – ANA, antiphospholipid antibodies, thyroid antibodies. Karyotyping (you and partner) – rule out chromosomal translocation. Treatment Considerations: Frozen Embryo Transfer (FET) – in a hormonally controlled cycle after correcting thyroid, lining, etc. Use of donor eggs – may be considered due to low AMH and repeated IVF failure (if egg quality is a concern). Endometrial scratch or PRP therapy – may improve implantation rates in some patients. Immunotherapy (under guidance) – low-dose steroids, intralipid infusions if immune factors suspected. Lifestyle optimization – insulin resistance control (Metformin), thyroid strict control, anti-inflammatory diet. * Please give me your valueable review. Dr Shayeque Reza MD 9800280276