1. Attend for review with your Specialist/Consultant and ask specific questions:

• His or her opinion on possible causes responsible for treatment failure

• What further tests should be performed to throw more light on possible underlying causes

• Was the endometrial thickness adequate durng treatment cycles?

• Was embryo development satisfactory

• If Blastocyst culture indicated?

• Would seeking a second opinion help?

2. Investigations to Consider:

• Blood test for Thyroid Function - TSH, Thyroxine, Thyroglobulin Antibodies, Thyroid Peroxidase antibodies

• Full Blood Count - Haemoglobin level and other indices

• Blood test for Vitamin D & Calcium levels

• Infection screen

• 3D Pelvic Ultrasound scan

3. Other Specialist Investigations To Consider:

• Blood test for Immunological factor - Checking for Natural killer (NK) Cell activity

• Laparoscopy to exclude Hydrosalpinx which will require Salpingectomy

• Hysteroscopy to exclude endometrial polyp and also to take a biopsy to check for underlying inflammatory pathology

• Uterine artery doppler studies

• DNA fragmentation test on semen sample

This list is not exhaustive . It is unlikely that you will require all the tests above. Your specialist will decide which ones are appropriate based on your history and findings.