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.