EZS 3rd transfer negative - reasons?

    Hello dear experts,

    I am hoping for an idea and assessment. Our situation is as follows:

    She 43, he 45, OAT 3

    AMH at 5.2, no PCOS, always high mucosal build-up, genetic assessment unremarkable, fallopian tubes passable....

    - 2019: Birth of our daughter, spontaneous gestational week

    - 2020: MA 12 week due to trisomy 21 (Nipt test), spontaneous pregnancy week

    - 2023: Silent birth 18 week due to trisomy 21, ICSI

    - 2024: MA 9 week, spontaneous gestation, natural birth

    - 2024: Change to EZS, 3 transfers negative (1 x brief positive urine test, then negative again). Donor was 28, already has 2 children of her own and the same blood group as me.

    What could be the reason for our lack of success so far?

    Thank you very much for your feedback :)

    Best wishes to the world

    An addendum: the clinic says that there are cases that are not successful despite the best conditions. I can't accept this (yet) because I've already been pregnant four times and my body has kept the pregnancies going

  • Marli March 5, 2025 at 4:58 PM

    Changed the title of the thread from “EZS 3. Transfer negativ - Gründe?” to “EZS 3. Transfer negativ - Was weiter untersuchen?”.

    Dear experts,

    What is your experience of similar cases?

    What tests would you recommend?

    I downregulated with Synarel for the first EZS and then took Estrifam and utrogest. The next two cycles were natural cycles with Utrogest. I found this protocol to be the most sensible. This is also how I got pregnant with ICSi.

    Which protocol do you recommend?


    Thank you very much for your feedback.


    Kind regards

    Hello Marli first of all, good luck on this journey. Looking at your story, it must have been very difficult.

    It's true that there are many causes with fertility, including unknown ones, but after two negative pregnancy tests and a possible biochemical miscarriage, we should consider all possibilities. Even if you don't meet the criteria for an implantation failure, we could consider everything and then decide with your doctor:

    1. PGTA. Although the donors are under 35 years old, so the embryos are usually chromosomally normal, there is a percentage - 20-35% depending on age - of possible aneuploidy. Although aneuploidy is usually due to an oocyte, the sperm factor must also be considered and it is possible to examine sperm fragmentation and perform a microfluidic or zymot selection technique if the sperm allows it.

    2. the uterus should be examined:

    -Uteroscopy: Is the endometrium well grown and are there any adhesions? Sometimes the uterine lining can be damaged after miscarriages. The cavity must be checked. If the endometrium is not growing properly or if atrophy is detected, treatment to regenerate the endometrium (PRP) may be considered.

    -Endometrial biopsies: examination of endometrial receptivity, immunology, endometritis and pathological anatomy.

    3. Thrombophilic diseases: analytical examination to identify diseases that can lead to miscarriages or implantation disorders: Antiphospholipid syndrome, Leyden factor V, etc. It is usually treated with Adiro and heparin.

    4. immunologic tests in the blood such as:

    -KIR-HLA: If your KIR (natural killer receptor) is AA type, you need a donor with HLA C1C1. If this is not the case, the probability of pregnancy decreases considerably and pregnancy complications such as CIR or pre-eclampsia may occur.

    -Other studies.

    In your case, it is important to perform a CIR when selecting the donor and, on the other hand, to assess the endometrium and, if necessary, check that everything is in order. I think it might be worth doing an ICSI with zymot and PGTA considering what you have been through.

    It is true that there is still a lot of research to be done in the field of assisted reproduction, and even if everything is perfect, we may not get the expected positive result.

    Nevertheless, we would like to encourage you and if you would like an assessment from Vida Fertility, we are at your disposal to inform you about everything and carry out a personalized treatment.

    With best regards.

    Dr. Alejandra García-Villalba :)

    Ihr Vida Fertility Team <3

Du stehst vor medizinischen Entscheidungen in deiner Kinderwunschreise und suchst fundierten Rat? Im Bereich „Reproduktionsmediziner beantworten eure Fragen“ des Kinderwunschforums hast du die Möglichkeit, deine Fragen direkt an erfahrene Reproduktionsmediziner zu stellen – kostenlos, anonym und ohne Termin. Hier antworten Fachärzte vom Vida Fertility Institute auf deine ganz persönlichen Anliegen. Ob du gerade erst beginnst, dich mit dem Thema Kinderwunsch auseinanderzusetzen, oder schon mitten in einer Behandlung bist – dieser Forenbereich ist speziell dafür gedacht, medizinische Informationen zugänglich und verständlich zu machen. Du kannst Fragen stellen zu: IVF, ICSI, Kryotransfer und anderen Methoden Interpretation von Labor- oder Hormonwerten Ursachen unerfüllten Kinderwunsches medikamentöser Unterstützung oder Behandlungsverläufen individuellen Befunden oder Empfehlungen Besonders hilfreich ist: Auch andere Nutzer profitieren von den Antworten, da alle Beiträge öffentlich einsehbar sind – so entsteht ein wachsendes Archiv medizinischen Wissens speziell zum Thema Reproduktionsmedizin. Wenn du eine verlässliche medizinische Zweitmeinung brauchst oder einfach nur Klarheit in einem unsicheren Moment suchst, bist du hier genau richtig. Formuliere deine Frage, gib alle relevanten Infos an – und erhalte eine Antwort von Profis, die sich jeden Tag mit genau diesen Themen beschäftigen.