2nd failed transfer - thinking about next steps and additional tests

[PenguinBlue]

Hi everyone, so unfortunately my second fresh transfer ended in a BFN. I tested last week at 9dp5dt but carried on with meds til today. I’m trying to be hopeful, think of next steps but I’m also feeling quite frustrated and whether it will work for me at all. We have unexplained infertility but this cycle, everything seemed to go well, I lost around 4/5kgs before my cycle started (compared to my last one) and we had two great quality embryos transferred, I was relaxed and took it easy during the cycle and we are both young (early 30’s) so all the doctors say ‘it will definitely happen’ which means I now am not as trusting of what they’re telling me!

I have sub clinical hypothyroidism which I’m treating so I want to make sure that’s under control before my next transfer but I wanted to ask at what point did you ladies do more investigations, tests (ERA, hysterscopy etc)?

I’ve only had fresh transfers so I hope a FET (I have 7 embryos frozen) may be easier on my body but should I go for a FET first and then start thinking about doing further tests? Or do tests first before continuing with transfers? It feels like a huge minefield of information and I feel a bit overwhelmed!

Thank you very much in advance for any advice you can offer xxx

[Peanutchips]

Hey Penguin, I’m really sorry your second fresh transfer didn’t work. It’s really exhausting and depressing after all the effort that goes into this. I hope you’re doing alright. It’s great that you have 5 embryos in the freezer, a FET could be just what you need with less hormones in your body. Were your oestrogen levels checked before transfer in your fresh cycles? Sometimes too much oestrogen can be detrimental to implantation. Given you created a lot of blasts, I imagine this might’ve been on the high side for you. If I was you, I’d try a FET before lengthy investigations. Definitely worth checking your thyroid levels are under control before starting and also asking that they check your progesterone levels are low before they add this in synthetically. I’d also get this checked again on the day of transfer to make sure they’re optimal (can add in injections if not). Your super young so chances are many of your embryos are good quality xxx

[PenguinBlue in reply to Peanutchips]

Thank you peanut!! Tbh they didn’t mention my oestrogen level, they just said progesterone was very good and that was it! It’s sooo frustrating to not be told any of this by the clinic 🙄 honestly don’t know what I’d do without all the knowledgeable ladies on here!!

I had my thyroid checked around 2 weeks before my transfer and TSH was 2.92 so I had to push for them to change my meds but definitely need to get bloods done either end of this month or early in the new year to check where it’s at.

Thank you for all your advice hun, definitely making notes to take to my clinic! Xxx

[Sparklylife]

Oh I am sorry 😔

Hopefully you get some good replies from others who may have more knowledge about this. Look after yourself and hopefully a frozen transfer will have success! Whatever you decide to do - I wish you all the best!! 💛

[PenguinBlue in reply to Sparklylife]

Thank you lovely, your words are very appreciated! Hope You’re doing well and the little bean too 🥰 xxx

[Millbanks]

Hi penguin, it’s always a very personal choice but I’m about to do my 4th transfer and if I had known we’d still be transferring 1.5 years after starting ivf I think I would have made some different decisions. Obviously covid has got in the way too but after 3 failed frozens I had the ERA/ALICE/EMMA test which showed I need a full extra day of progesterone for my uterus to be receptive. So that’s 3 transfers simply at the wrong time. Of course there could have been other issues too, but I had a hunch that my progesterone was out because I have a short luteal phase. You have lots of embryos which is great, but it’s time that gets in the way! Are you private or NHS? As this can affect your choices too xxx

[PenguinBlue in reply to Millbanks]

Hi millbanks, thanks for your reply! Ah I know, it’s actually not hit me I’ll now be going into my 3rd transfer 🙄 were your progesterone levels always low at your transfer days? I do have a short luteal phase normally but my progesterone levels are quite high at the day of transfer so I wonder if I’m post receptive and should transfer earlier 🤷🏽‍♀️ It’s a minefield sometimes!!

My first cycle was private as covid delayed everything and mentally I was not able to wait but my second cycle was nhs and we are willing to go private as in the pack they gave me, it says if it’s negative they’ll arrange a follow up for 2-3 months time which seems insane to me! My nhs clinic do use a private clinic for collection, transfer and storage so I would be able to move easily if I needed to

How are you doing? Very exciting for your upcoming transfer ✨🍀 xxx

[Millbanks in reply to PenguinBlue]

I did the classic “it’ll work first time” then was BLOWN away when it didn’t work. We were NHS first; transfer failed last November and follow up was March!!! Insane amount of time to wait! It’s hard enough without all the waiting. Then covid hit which is why we went privately.

The nhs didn’t test for progesterone but I spotted towards the end of my first so I’m assuming so. It was low on transfer day on my second so they added lubion injections, 3rd transfer I was on 2x lubion and 2x cyclogest and that was about right.

That’s interesting about your short luteal phase. I think either way it’s shows something is not quite right timing wise.. I would definitely recommend the ERA test if you suspect something.

I am excited as we’re doing our first fresh transfer tomorrow. I’ve always had to freeze all. Unfortunately though we can’t use the ERA information for a fresh but I just want to try it anyway. And if not the hopefully FET in Jan.

I’m kind of at peace now with the fact it might take multiple transfers, I actually think it gets easier after 3!! 🤦🏼‍♀️ xxx

[PenguinBlue in reply to Millbanks]

Omg your nhs follow up was nearly 4 months?! I dread to think what it’s going to be like now. I called my clinic to let them know it was negative and they haven’t even called me back so I’m calling my private clinic tomorrow - the wait is so agonising (and I’m also getting v hormonal as I think I’m going to bleed soon 🙄). Oh and I was definitely the same as you, I assumed it would work first time and when it didn’t I was like ‘oh it’ll definitely work this time” and now I don’t know what to think!

Yep I’m definitely going to ask about an ERA and see what the doctor recommends when I get an appointment. It seems crazy that some clinics don’t check progesteronewhen there seem to be so many ladies on here who bleed before transfer day!

How was your transfer today lovely? Hope it went well and you’re recovering well! Wishing you all the positive vibes for the next few weeks!

Oh I hope it does get easier, I do seem to surprise myself that I manage to keep going after the negatives but this process just shows what strong women we are! Xxx

[Millbanks in reply to PenguinBlue]

Yes! Although we did get a cancellation earlier so saw him in Feb, I was just about to start FET 2 when covid hit...

That’s so awful that they’ve not called you back. Sometimes I really don’t get how insensitive clinics can be with patients in a highly emotional situation! It’s no better in the private sector either. Having said that, going privately was the best move we made as I couldn’t cope with all the waiting. It’s the hope that keeps me going and when you’ve got to wait 4 months to even talk to someone it’s just awful.

The progesterone thing is a mystery isn’t it! Why do some clinics prioritise and some don’t think it matters?!?

And you are right, no matter how shit we feel we always manage to find a reserve of strength from somewhere! We are amazing xxxx

[PenguinBlue in reply to Millbanks]

Covid really did a number on us all - I had finished downreg in March when everything got cancelled!

I’ve managed to get an appointment privately at the end of this month and my nhs clinic have booked me in mid Jan which was much earlier than I expected so I’m going to start the process in both and then work out which one is going to be quicker and better for us (I’m assuming it’ll be the private one!) and go from there.

I am honestly blown away that some clinics don’t test it but I’m glad your current clinic are on top of it!!

How are you feeling now you’re a few days into your transfer? Xxx

[Millbanks in reply to PenguinBlue]

That sounds positive! I think we just have to become experts on waiting....

I’m alright thanks. Had a bit of spotting and cramping yesterday but trying not to read in to it at all xxx

[PenguinBlue in reply to Millbanks]

I know, waiting is the worst - I’m just planning to get into Christmas and hope the next few weeks just hurry past!

Ah sounds positive, keeping everything crossed for you and look forward to hearing your update in a couple weeks xxx

[Millbanks in reply to PenguinBlue]

❤️❤️❤️

[Sas1101]

I'm so sorry Penguin 💔 unfortunately I don't have any advice but wanted to reach out and give you a big virtual hug. Look after yourself and get stuck into Xmas (that's what I'm doing). Here if you need to chat ❤️ xx

[PenguinBlue in reply to Sas1101]

Oh Sas you’re so sweet, thank you for your message. How are you doing lovely? Sending a big hug right back and hope you’re doing okay and taking it one day at a time ❤️ I was telling a friend that there is a plus to having Xmas to distract but it’s so hard as well. Definitely now looking forward to picking out some good gooey cheese to have over Xmas as a treat lol. And likewise to you hun, my inbox is open xxxx

[Sas1101 in reply to PenguinBlue]

Oh my gooey cheese and bread = heaven 🤤 There's definitely an upside. I've not been drinking much this year so I reckon I'll be drink after one glass of prosecco at Xmas 🙈

I'm doing ok, have got my head around things now but I have to go back for one more scan next week before they diagnose me which is a pain. They could see a yolk sac yesterday but that's it. She wasn't sure if it was there last week as the report from the other nurse was shocking! She apologised as she could tell I just want to move forward but one more week it shall be. They've recommended medical management rather than surgical due to Covid. I'm going to try my best to get them to do surgica though. The quicker this is over the quicker I can move on. Xx

[PenguinBlue in reply to Sas1101]

Haha yes, can’t wait for the Brie! Omg I’m the same, I had a glass of wine on Sunday and I was definitely feeling it! Lol

Aww my love, I’m so sorry that they are asking you to come back again next week. It must be really hard but you’re definitely a warrior. Will be thinking of you over the coming week and pray you have a definitive answer then. Also why am I not surprised the report from the nurse last week was shocking 🙄 I hope you complained about her - I can’t get over it. Sending you lots of love xxx

[Ranchu90]

I am really sorry to hear that you had another negative result, it is so frustrating. I also had 3 chemicals and I am looking now to do some tests. I kind of regretting for not doing any tests after 2 chemicals but I thought we had them because of the embryo quality, which proves that we were wrong. My suggestion it is to not go ahead without any tests done. Start with ERA as you have so many embryos left. Also there are tests for recurrent failures, ask your doctor to recommend them to you as they have better knowledge. Also if you have the possibility do a hysteroscopy, the waiting list is quite long on NHS so better jump into it now, better to cancel in case you will not need. I wish you good luck and take care 🤗❤️

[PenguinBlue in reply to Ranchu90]

Hi ranchu, thank you for your message and advice ❤️ I am definitely armed with questions now for the doctor when I get an appointment. Ivf is such a minefield so it’s great to pick all of your brains and get more advice and info! What are your next steps? Wishing you lots of luck for your next steps xxx

[Ranchu90 in reply to PenguinBlue]

My steps are nail baiting 🤯🙄😤 I had some blood tests done for clothing and thrombophilia, all came back normal so far. I had a week ago biopsy done for NK cells and endometritis (inflammation of uterine lining), need to wait 3-4 weeks for results. Also need to call again tomorrow at the hospital to find out about my hysteroscopy. If waiting list is too long (website says 45weeks 😠) I might fly to Spain to have it done. Transfer booked in 2 months time if everything goes well. Hope you don't need to wait too long until your appointment 🤞♥️

[PenguinBlue in reply to Ranchu90]

Wow what long wait times for the hysteroscopy! 😱glad to hear your blood tests have come back normal and all the best for your biopsy results! Have everything crossed for your next transfer too! Thank you Ranchu ❤️🤞🏽 X

[Ranchu90 in reply to PenguinBlue]

Thank you so much! Good luck to you also! Hope we will both have more luck next time 😘💪🤗

[Hidden]

Im sorry to ready this Lovely. Hope you are surrounded by love💐❤️💔. Great to read you have couple of embryos on ice. You could continue with another transfer and see if it was just bad luck.

Im not successful yet but After 3 failed transfers though i did focussed on getting my thyroid under 1. I am also going for a hysteroscopy next and have tests to help identify any clotting issues. After that if possible im looking into nk testing. Some of us will always stay unexplained but i need some answers or just rule things out as i cant deal with the heartbreak xxx

[PenguinBlue in reply to Hidden]

Oh thank you Mimi, ❤️ I’ve been very lucky to have been surrounded by love but am also eating my feelings a bit 🙈

Were you told to get your thyroid below 1? The thyroid U.K. website mentions it should be between 0.4-2.5 but I do wonder if that’s still on the high side! Did you speak to a fertility endocrinologist? I think it’s a good idea to rule out what we can to help us for the next transfer. At least then we know what it definitely isn’t and puts your mind at ease! Good luck for your hysteroscopy - the wait times sound really long but hopefully won’t be the case for you!

I definitely feel more armed to speak to the doctor about next steps so will see what they say/advise!

This journey is so exhausting - hope you’re doing okay Mimi xxx

[Hidden]

Glad you thinking of next steps lovely!

I went to a private endocrinologist and he said that below 1 is ‘perfect’. Im around 0.5 now.

People fall pregnant with tsh of 5 so im not sure why i keep stressing my thryoid levels. BUt this is the little i can influence xxxx

[PenguinBlue in reply to Hidden]

Next steps seems to be the only thing to get me through! I’ve luckily been able to book a private consult for the end of this month and my nhs follow up is in mid Jan, so the timings are better than expected and hopefully can work out which one will be better suited for our next go / tests!

That’s really good to know, i am going to looo into finding an endocrinologist to speak to as well as I don’t think fertility clinics seem to really be concerned about my thyroid! I feel the same - knowing we have full control of at least one of these things definitely provides some peace in this journey

What are the next steps for you lovely? xxxx