What should I be asking at follow up appointment?

Hi I don't post much but really need advice! I'll give you my history of my IVF journey so far! I've had three full icsi cycles first two were short protocol third long protocol, from first cycle two embryos transferred but failed second cycle two embryos one transferred which failed one frozen, frozen worked but MMC at nine weeks! Had d&c for that one and tested which was a partial molar pregnancy which I think was chromosome abnormality related! Third icsi cycle on long protocol only left with one embryo which worked but MMC at 8 weeks which was recent had d&c on 9th January this year! It was sent for testing but won't find out for a while yet! At our 7 week scan for this one growth was small but good heartbeat so I'm not sure if it will be a similar outcome to last MMC! So I need help with what to ask at follow up as we want answers possible tests to find out why it keeps happening! Losing hope with NHS feel they don't discuss their decisions to change or introduce new things to our last cycle! Ie from shirt to long protocol and they used something to boost fertilisation which we didn't know about till on the day if egg collection! Sorry for long post but feel lost and confused xxx

[Cinderella5]

Im so sorry to hear about your losses. There is a nurse on here called DianeArnold , if you contact her she can email you a list of questions that you could take along to clinic with you. Some may not be relevant but it covers a lot of topics. The only thing that I can comment on is molar pregnancy is a very rare thing, in a partial molar pregnancy there are 3 sets of chromosomes in the pregnancy, 2 from dad and 1 from mum. Sadly these pregnancies always certainly end on miscarriage as the baby cant survive with the extra set of chromosomes......apologies if you already know that. It may be completely down to bad luck that you have gone on to have a second loss afterwards and is completely heartbreaking. You could perhaps have tests done to check for blood clotting issues, it might be an option to try a blood thinner (baby aspirin or clexane) on your next cycle to improve blood flow to the uterus. I also felt that the NHS has a one size fits all approach unfortunately and they didnt really think outside of the box. Hugs, you've been through so much.xx

[Hidden in reply to Cinderella5]

Thank you for replying means alot! Will definitely ask about the blood clotting issues! Also forgot to mention that on my last cycle three or the embryos developed triploid which again was explained was a chromosome issue so I'm worried why three out of five developed this?! Embryologist said he was baffled as it was very rare! 😔 Xxx

[Cinderella5 in reply to Hidden]

Goodness that does sound like a high percentage that have developed triploidy, Im so sorry! I know there is such a thing as diploid sperm but Im not overly clued up on this....the embryologist maybe able to help answer some questions regarding this and see if there is a way to avoid this? Or could this be an egg issue...you didnt mention your age? Are there any tests that can be done to rule out sperm issue like FISH studies? Im not sure what they did regarding improving fertilisation but might be worth asking for more info regarding that too.xx

[Hidden in reply to Cinderella5]

I'm 37 soon to be 38! The stuff used to boost fertilisation was suggested by consultant but was never mentioned to us untill in the day if egg collection! I do think there is issue with either egg or sperm but they have never ever mentioned either just say mature eggs and good sperm were used! Do think more needs to be investigated to prevent future MC and distress xxx

[Cinderella5 in reply to Hidden]

Im not sure what tests are available especially on the NHS. I got told that there were no tests available for testing egg quality when I had my NHS cycles and that seems to be echoed elsewhere. However I think there may be regarding sperm. I would definitely ask at your review appt and even ask if you can speak to the embryologist and even if they cant offer further testing could they recommend other tests that you could see about privately?xx

[Leesara]

I don’t know much about chronosone side but smaller growth but heart beat is still so positive. Try to keep positive if you can. Fingers crossed for you u xx

[Lojane]

I’m so sorry that you are going through this.

Chromosomal aneuploidy ( extra chromosome or missing chromosome) is the most common cause of miscarriage. This is usually from the egg. The percentage of aneuploid eggs increases with age from about 25% at age 28 to 90% at 44,. So it is a case of finding the good egg. This is why the success rate of IVF varies with age .

There is a very small chance( 5% ) that this type of chromosomal issue could be carried by one of the parents . You could ask about karyotyping blood test to check. I think that this is available on the NHS

With PGS (pre implantation genetic screening ) you find out before transfer which embryos are euploid ( normal) and only those are transferred.

PGS is not available on the NHS and is no guarantee of success but it does reduce the chance of miscarriage.

My daughter had three miscarriages, and a termination for severe chromosomal abnormality. PGS screening gave her peace of mind that only normal embryos would be transferred in future She is now 7 months pregnant.

I only wish that PGS had been offered at the beginning of her journey and I believe it should be available to all on the NHS to save the heartbreak of inevitable miscarriages.

[Hidden in reply to Lojane]

Thank you! X

[Lojane]

Wishing you all the best x