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Possible cause of transfer failure, lack of integrin expression, fixable with letrozole

liljoy-2liljoy-2 member
edited March 2017 in Infertility
This is a very interesting study that shows implantation failure is also due to lack of integrin, usually in women with endometriosis. It looks fixable with letrozole before FET, according to this. The two REs I've seen are all proponents of this and have all their patients on letrozole. Thoughts?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279128
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Re: Possible cause of transfer failure, lack of integrin expression, fixable with letrozole

  • notamyrtlenotamyrtle member
    interesting! Thanks for posting...
    Me - 35 (DH - 33). 
    TTC since May 2015.
    Saw RE in July 2016.
    11/16: IUI #1=  BFN.
    1/17: IUI #2 = BFN.
    5/17: IVF #1. 'long lupron' protocol. E2 = 4800, 'freeze-all', 8R, 7M, 4F, 4B.
    8/17: FET #1.
    Thus far - 'unexplained'.
    Report Reply
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  • JamieH2000JamieH2000 member
    I have wondered about implantation issues since I have mild endo... I tried to open the link but it couldn't find the study. Have you asked your RE? I have DOR so they think it's an embryo issue and not an implantation issue but I still wonder 
    History in Spoiler

    Age: 32 (same with DH). Together since 2006, Married June 2013 and TTC since August 2015
    Diagnosis: Mild Endo, DOR (AMH of 1.5), Poor Quality Eggs/embryos, Displaced Window of Implantation (ERA Post Receptive)
    March-May 2016: 1 TI and 2 IUIs- BFN 
    June 2016- Laproscopy- found/removed mild endo and confirmed only 1 normal healthy ovary.
    August 2016- IVF #1 with Antagonist Protocol- Cancelled (2 lead follies), converted to IUI- BFN
    Oct-Nov 2016- IVF #2 with Estrogen Priming Micro Lupron Protocol, 2 eggs retrieved, day 3 transfer of 1- BFN
    January 2017- New RE, IVF#3 with Estrogen Priming Antagonist Protocol, 12 eggs, 8 mature, 6 fertilized, 2 day 5 early blasts transferred (none to freeze :(), BFN
    May 2017- Sept 2017- Starting Donor Egg process! Waiting for donor to be available... and then she is pregnant at baseline :(
    Oct 2017- Donor #2: 25R, 22M,18F, 12 blasts frozen! Fresh transfer cancelled due to thin lining with fluid :(
    Nov 2017- Hysterscopy to remove polyp
    Dec 2017- DE FET #1 on 12/8 on 2 perfect blasts- BFN and devastated
    Jan-Mar 2018- ERA #1- Post receptive by 24 hours, ERA #2 RECEPTIVE with 4 days of Progesterone
    Apr 2018- DE FET cancelled for lining issues :(
    Jun 2018- DE FET #2 of two 1AA blasts- first BFP ever! Beta 10dp5dt- 378, Beta 14dp5dt- 2840, Beta 16dp5dt- 4035, beta 18dp5dt- 10916. Due on 2/20 with one baby after a vanishing twin
    Baby Born born early @ 33.5 weeks due to Pre-e
    Back for # 2!
    Report Reply
  • AngryBullAngryBull member
    @bestofjoy Thanks for sharing this article! Did the REs you spoke with say how they are using Letrozole in their FET protocols (certain days or doses)? I'm curious. If I read the article correctly it seems like the study looked at the use of Letrozole in fresh transfers so I'd be interested in knowing if they think it's also effective in frozen transfers.  I think I'll ask my RE the next time I talk to him.

    @JamieH2000 I also couldn't get the link to work. But if you type in the article number (3279128) in the search box on the page that does come up it will return a link to the article.
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  • liljoy-2liljoy-2 member
    @JamieH2000 Fixed the link. Yes, RE has all women on letrozole for implantation, just in case they have endo and they don't know. This is relevant especially for women who have implantation failure and PGS normals. 
    Report Reply
  • liljoy-2liljoy-2 member
    @AngryBull Yes, for FETs too. It's the usual 5mg day 2-7 routine. 
    Report Reply
  • JamieH2000JamieH2000 member
    @bestofjoy- thanks for fixing it! I wonder if this means you shouldn't do fresh transfers if you have endo you can take the letrozole. Best wishes to you on your nezt cycle!!
    History in Spoiler

    Age: 32 (same with DH). Together since 2006, Married June 2013 and TTC since August 2015
    Diagnosis: Mild Endo, DOR (AMH of 1.5), Poor Quality Eggs/embryos, Displaced Window of Implantation (ERA Post Receptive)
    March-May 2016: 1 TI and 2 IUIs- BFN 
    June 2016- Laproscopy- found/removed mild endo and confirmed only 1 normal healthy ovary.
    August 2016- IVF #1 with Antagonist Protocol- Cancelled (2 lead follies), converted to IUI- BFN
    Oct-Nov 2016- IVF #2 with Estrogen Priming Micro Lupron Protocol, 2 eggs retrieved, day 3 transfer of 1- BFN
    January 2017- New RE, IVF#3 with Estrogen Priming Antagonist Protocol, 12 eggs, 8 mature, 6 fertilized, 2 day 5 early blasts transferred (none to freeze :(), BFN
    May 2017- Sept 2017- Starting Donor Egg process! Waiting for donor to be available... and then she is pregnant at baseline :(
    Oct 2017- Donor #2: 25R, 22M,18F, 12 blasts frozen! Fresh transfer cancelled due to thin lining with fluid :(
    Nov 2017- Hysterscopy to remove polyp
    Dec 2017- DE FET #1 on 12/8 on 2 perfect blasts- BFN and devastated
    Jan-Mar 2018- ERA #1- Post receptive by 24 hours, ERA #2 RECEPTIVE with 4 days of Progesterone
    Apr 2018- DE FET cancelled for lining issues :(
    Jun 2018- DE FET #2 of two 1AA blasts- first BFP ever! Beta 10dp5dt- 378, Beta 14dp5dt- 2840, Beta 16dp5dt- 4035, beta 18dp5dt- 10916. Due on 2/20 with one baby after a vanishing twin
    Baby Born born early @ 33.5 weeks due to Pre-e
    Back for # 2!
    Report Reply
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