As I understand you had several transfers, you are 35 years old, and I have no information if your couple has a male factor also because when we talk about recurrent implantation failure and unfortunately, it’s your case, we shouldn’t focus only on endometriosis, we should focus on all these details, we should consider if the embryo is good, so for sure I would recommend doing pre-implantation genetic testing of the embryos, without a doubt. Another thing, I would do hysteroscopy to assess if the condition of the uterus is good. A very good thing that you already had biochemical pregnancy, biochemical pregnancy is like the first meeting and the first interaction between embryo and endometrium. If you already had a positive HCG level, it’s very likely to get pregnant, we just have to find the small features, small problems, which certainly can be fixed, but we should do our best to find it. Also, you should understand that there is some concomitant pathology that can diminish your chances to get pregnant. The first line is the thyroid, but also we assess our blood condition and so on.
I would recommend assessing the embryos, the condition of the endometrium and to assess if you have some risky points like concomitant pathology, but I want to inspire you that as you already have biochemical pregnancy for sure, you’re able to get pregnant and to carry the pregnancy, so just wait for a Little, natural cycle it’s a very good thing. I love natural cycles, it’s not the kind that they are better than hormonal replacement therapy because talking about big data and great trials and large meta-analyses, the outcomes, and pregnancy rates it’s just quite the same. Natural cycles allow us to diminish our hormonal stress, we don’t have to prescribe a lot of medication. That’s why I love natural cycles, but unfortunately, we should assess if it’s applicable personally for you because in some cases, the natural cycle is not a good thing, so it depends if it’s applicable for you. Such cycles, allow us to diminish our intervention, but sometimes it’s better to prescribe medication. In terms of endometriosis, we are not talking about the total natural cycle because we have to support the pregnancy properly so we have to add medications of progesterone, but the natural cycle as an idea is a good sign. I would recommend spending some time on diagnosis, you should understand the reason for negative transfers, and only after fixing this problem or enhancing the conditions, move on with the embryo transfer maybe with a natural cycle.