What do I do?

[AnnieAnnie]

So i aoologise now, this is long!!

So I am now 3 ivf cycles down, the final 2 nhs rounds were with icsi. I have low AMH and I am a carrier of the C4M2 mutation (which means my blood could be too think for implantation or could cause early miscarriage) which I take Clexane for to thin my blood. My husband's SA is above average. I have taken dhea, ubiquinol, pregnacare conception, vit d and royal jelly for 6 months and lost a stone in weight (even though I wasn't overweight). I started acupuncture and have been walking for miles each day.

The issue is on the last 2 nhs cycles of ivf I have had 1 and 2 eggs collected on the highest dose of menopur and gonal-f. The clinic has said that my eggs have not been good quality. My concern is that they have given me too much meds, my body hasn't even felt a thing and I had better results when I took clomid and a lower dose of menopur (6 eggs collected and 5 fertilised without icsi) I had cramping etc on stims. My clinic seems to discount my first cycle at my private clinic which I only had 10 months before my first nhs round.

At my last follow up my clinic told me that their advice would be to go for doner egg and if I really felt the need to try with my own eggs again and because I'm concerned about the high dose meds they used, that I could try a natural cycle. They were very anti using my eggs and very pro doner eggs. I really more than anything want to try with my own eggs and feel that the clinic didn't work with my body but their own timescales and when staff were available.

The issue now is that my husband feels like the ivf cycles have taken a toll on him (he works away 2 weeks and is home 2 weeks) and has missed many of my scans, injections (which I have to do anyway) and usually is home in time for egg collection and to do his part. I want to forge on and keep going as soon as possible, I do all the hard part on my own anyway, and as I've just turned 35 and we have now been ttc for over 6 years, I feel like if we stop now, that will be it.

Does anyone have any advice on what to do please?

Hope you have all had a great Christmas and here is to a happy and healthy New Year. I hope 2019 is our time xxxx

[TRYING2016]

Im sorry I don’t have any advice but you are one strong lady with great determination. Wish you all the best xxxx

[AnnieAnnie in reply to TRYING2016]

Thank you so much. Good luck to you where ever you are in your journey xx

[WeeMrsH]

Hi Annie, I understand your frustrations. Mine is a similar story:

3 cycles NHS IVF = 3 BFPs but sadly miscarriages.

1st round, age 33, 8 eggs collected and 5 fertilised - also longest pregnancy out of all the “NHS” ones which got to 16 weeks.

2nd and 3rd rounds age 34/35, only one egg collected each time despite many follicles, which did fertilise and give BFP but mc at 6 weeks. In both cases my blood tests showed I was perfectly capable of producing eggs (of course they can’t test egg quality).

I can’t remember my exact dosages but it was menopur and the 3rd round dosage was increased due to poor response of 2nd cycle, which made no difference to the 3rd. I think I was 300 1st /2nd cycle and 450 the 3rd but can’t be sure - it was the lowest dosage then upped to next dose up so not really high.

We had lots of other tests such as chromosomal karotyping on us both (all fine) NK cells on my womb (all fine) an endo scratch on one cycle, and removal of endometriosis (after 3 cycles already which angered me as this could have made a difference to our egg success in the NHS cycles had it been caught).

Essentially, what it then came down to for us, having exhausted our NHS entitlement, was weighing up the funds we had for a private cycle, against what would give us best chance of success. We had funds for only one cycle, and going on outcomes decided that using my own eggs was too much of a risk. So opted for donor eggs overseas; we went to Greece.

I am now 37 weeks pregnant!

I know it’s a very tough decision but pragmatism alongside my urge to have a baby, overruled any feelings that it had to be my egg. It took time to get there, several months of soul searching and research - but it was the best result for us in the end and the protective, loving and maternal instinct I have for the baby growing inside me is as strong as if it were my own egg. We will never know if one last attempt with my eggs might have also eventually worked, but we have a growing baby and that’s enough.

I hope this has helped. Good luck in whatever you decide xx

[AnnieAnnie in reply to WeeMrsH]

Thank you for your reply. Wow you have been through so much. I am sorry for all of your mc's must have been a horrendous time for you. You are very brave. I think the thing that's getting to me is the what if. I'm finding it hard because I've told myself for a long time that if after my 2 nhs goes it hasn't worked, I need to try one more time with my own eggs and then think about the next stage (whether that be doner eggs or adoption). And to hear the counsellor and the consultant talk about doner eggs, and for my husband to agree, I kind of feel that there is no one fighting my corner with me and I am alone In it. I wasn't expecting all these people to say this and although I probably know it deep inside, I wasn't prepared for them to say and for me to accept my eggs are rubbish. It's disappointing, on my first round (private) I had a 4AB blastie and if I would have known then what I know now, maybe things would have been a bit different for that embryo.

I am so pleased that all is working out for you and, especially after all you've been through, makes it all that more special. You haven't got long now and I bet you can't wait to have your precious baby in your arms. Good luck for the coming weeks and thank you xx

[Steadman80]

Oh Annie I feel for you. I’ve had 2 lots of IVF on maximum drugs. First response 2 eggs both fertilised and I ended up with a missed miscarriage. The second round I had a better response in number of eggs as I got 5, the only thing I did different was take DHEA for 3 months prior, but this didn’t help my quality. One one made it to transfer and this was a morula. My AMH is 3.5 last recorded one anyway and I’ve just turned 38. My consultant continuously tells me I have rubbish eggs, I don’t think they all can be bad!!

I’ve had 7 pregnancies in total, don’t seem to get very far. I feel the same as you in wanting to try with my own eggs. I’m currently going through a really slow miscarriage with my levels dropping so slowly. I started taking letrozole last October and have been pregnant in my last 3 cycles. I’ve had two rounds so far and can have 6 in total. I’ve responded better to this drug. I’ve been looking at natural modified IVF if that doesn’t work with my own eggs, I don’t know what area you like but there are some clinics in the north west where I have heard some positive stories. However, I am seriously considering donor eggs now, I know a few people personally who are pregnant using clinics abroad. For me after 7 losses, I think trying a young healthy egg may be my best option. I was so against donor eggs at the beginning, even telling my husband I would never ever consider it. Now, I’ve been researching the clinics abroad.

Only you will know what to do Annie but I wish you all the best - this fertility journey can really suck! I’m just glad it’s the start of a new year, feeling positive I can do this xx

[AnnieAnnie in reply to Steadman80]

Another truely brave lady. I am so sorry for your losses.

I feel like the NHS clinic put me on such a high dose - 450 menopur and then 450 gonal-f with stimming for 10 days and 7 days, each time I had a follicle getting to 18mm. To me this is clearly too much stims causing my eggs to grow too quickly over a short period of time. I've read that too higher dose can have an impact on egg quality and unluckily for me I already have crap quality eggs so I'm told. We even discussed with the consultant just trying naturally, using my left over clexane but the consultant said how do we know if I actually release an egg. She said I may get a surge on my opk but that doesn't mean I'm releasing an egg and she would recommend a natural round of ivf over trying naturally. Decisions hey.

I will get there, I know I will but I'm not ready yet.

I hope you find the right clinic for you sounds like you are off to a positive start to the New Year xx

[Hidden]

Hey I am so sorry for your experience to date, must be exhausting

I am sure they have but have your clinic mixed between short and long protocol? My egg numbers and egg quality changed dramatically when I tried one compared to the other xx

[AnnieAnnie in reply to Hidden]

I've always been put on a short protocol because of my low AMH. Apparently it's supposed to work better for low AMH. I would definitely like to try lower stims over a longer period of time. It would be interesting to know if anyone has experience of this xx

[Hidden in reply to AnnieAnnie]

Its interesting, I am no medical expert but my consultant basically said long suits some people short suits some people and there was no definitive you have xyz so that's the one that you should have. I would be very tempted to go back to your original clinic who clearly had more success and ask their opinion and see about lower meds but longer cycles or any other ideas. I feel like because you had a better first round it shouldn't be a case of 'donor or nothing' because your first cycle proves that wrong. As I say I am no expert but I feel like you deserve more positive thinking and alternatives rather than such an abrupt opinion. Good luck x

[hannahding]

I honestly think you shouldn't lose hope. If you think that things might work with low dosage switch to a different doctor. This is what I have done the clinic I was previously visiting wasn't paying full attention to us. Literally, I feel like we wasted time by visiting them. All my IUI and an IVF cycle failed with them. So now we are visiting another clinic for IVF. We are taking a fresh start and hoping for the best. Good luck to you.

[AnnieAnnie in reply to hannahding]

I'm thinking of dicussing with my husband when he is back home from work again in just over 2 weeks whether we have a consultation with our first clinic (private) and just get their opinion on everything that has gone on in our 2 nhs cycles. We've learnt a lot more about my body since our first cycle. It would be good to have fresh eyes look at it all and no bias as to which way we should go. Thank you. Good luck to you too xx

[Olderwiser]

Ah I sympathise... This journey is so hard and there’s countless opinions on what you should do and shouldn’t do but no one has a crystal ball. I’d say you need to listen to your gut and do what you want to do to move forward to a place that you a happy with. We decided on one final try with very high drugs (600)... only one follicle appeared, my clinic cancelled the round. Then they advised that the only last thing to try was a natural cycle but warned the success is low as it’s riding on one egg in general. My husband wasn’t keen. Then I saw a quote on the internet which made me feel I had to give it a try “Note to self, this is about you, do this for you, live for you, honour you, never lose sight of that” I said to my husband if we are going to decide together to give up on ivf, I need to do this natural round, so I can look back when I’m eighty and have no regrets. This time I got three eggs, two fertilised normally and were put back on day 2 and amazingly I’m pregnant (with my fingers and toes firmly crossed) I think if you do a natural cycle you have to be realistic that the odds are low but if you need to do it just to know that donor eggs are the next step for you then that peace of mind is also important. Good luck for 2019 x