File note

Dear Doctor,

Re: A and D

Diagnosis:
1. Fourth unsuccessful IVF cycle
2. Primary infertility secondary to azoospermia post vasectomy reversal
3. Hypertrophic obstructive cardiomyopathy, treated cardiac septal ablation, 1998 and 1999, second procedure complicated by vascular injury requiring double bypass graft
4. Allergy to aspirin and ibuprofen
5. Dysmenorrhoea, possibly due to endometriosis
6. Short menstrual cycle

A and D were seen for review following their recent unsuccessful IVF cycle. During this cycle A had ovarian stimulation with Elonva followed by 300 units of puregon. Subsequently 12 eggs were collected; nine of these were able to be injected with sperm obtained by testicular biopsy however only three eggs fertilised and A went on to have two embryos transferred; one at six cells and one at seven cells. There were no embryos suitable for freezing. A pregnancy has not occurred. A and D are understandably disappointed at the outcome of treatment. At this stage they do not feel ready to end their fertility journey however I have advised them to take a couple of months to think about this. They will be in touch with us in the new year should they wish to proceed to further treatment.

Yours sincerely...