IVF Round 3 Changed Protocol - Your Thoughts?

[Krystal_43]

Happy New Year All

After my BFN in December (second failed round), I finally had my WTF app with the clinic yesterday. The consultant seems to think that embryo quality is the main reason while my two good quality blasts have not implanted, and didn't see any merit in exploring endometrial issues. We have unexplained unfertility (though my AFC and AMH are low for my age, 35).

She has suggested upping my stims from 300 to 450 meriofert & increasing my progesterone for the next cycle (injections in the morning, pessaries at night whereas previously I just had pessaries). I'm a little worried about this increase in medication - has anyone else had success with similar? did you see more side effects [progesterone really messes with my mood]?

K X

[Purple276]

Hi Krystal,Happy new year to you and sorry to hear about your second round.

We have lots of similarities as i'm in a similar position with my second failed round in November but still waiting for my review meeting (definitely a WTF! And so annoying I have to wait so long due to availability)

I was on a different protocol but it was the highest stims and actually didn't get too many side effects. I understand though that the higher drugs help with quantity rather than quality but no direct experience with your stim drugs.

The increased progesterone is a good idea especially if you bleed before otd. My cycle is also really short and I'm going to ask the same at my review as they dont check levels at my clinic.

Saw you got a good number of embryos for low AFC so could just be those transfered had an abnormality which I appreciate is not helpful or what you want to hear. I feel a little like it's just trial and error and the consultants can eliminate as much as they can but there's no easy answer I'm afraid - which is really shit when it costs as much as it does for each fresh round.

How soon did they say you can start your next round?

[Krystal_43 in reply to Purple276]

Sorry to hear your second transfer failed too. It really sucks doesn’t it? It’s especially frustrating when you are producing so few embryos per cycle and have to go through the whole thing again.

Yeah, our doctor seems to be of the view that the embryos just contained abnormalities/we were unlucky, which is why she hasn’t suggested any endometrial investigations at this stage. I was just confused by the increased stuns dose as I thought the emphasis was on quality not quantity. I understand the upping of the progesterone though as the bleeding is a concern of mine. Have they changed your drugs much between cycles,

I can start my next round on my second period after my withdrawal bleed (so end of jan, hopefully).

[Jane8412]

Hey- I don't have any experience with your stims but just wanted to wish you luck for your next round! Did your consultant say anything about DHEA supplements? I asked mine about it recently due to my low AMH/AFC but they didn't seem to think it was proven to help. xx

[Krystal_43 in reply to Jane8412]

My consultant seems to be of the opinion that only vit D and folic acid supplementation have sufficient evidence for supporting fertility. I do take a few other supplements in addition to that though (omega 3 and Coq10) as I think omega 3 is good all round, and I managed to find some studies supporting coq10 in fertility treatment on google scholar (I work in public health research so have some grasp of the research, but this is definitely not my field!). Both also seemed low risk.

However, I've resisted taking DHEA because of it not being approved as a diet supplement in UK, lack of studies on google scholar and some forum posts of women saying they experienced side effects. But then some women swear by it ?!If I did start taking it, I'd want to get my testosterone levels checked first. Have you started taking it?

[Jane8412 in reply to Krystal_43]

Thank you- that's really interesting. I take so many supplements these days including omega 3 and Co-Q-10 as well. Seems like most people think they are both good for TTC so no harm in taking them. I haven't started on DHEA since my clinic did not recommend it. If I were to take it I would have to buy it from the US since it is not sold here without a prescription. I am wary of taking anything that isn't prescribed and monitored by a doctor. I had my hormones tested by my naturopath and they came back with low testosterone, which is why I wanted my clinic to do a blood test, but they haven't come back to me yet saying whether they will look into it. They don't seem particularly keen.I guess it is something to keep in mind for the future. I have just shelled out for a 3 round package at my current clinic so if that is unsuccessful I may look at going to a clinic that focuses on treating women with low AMH. Good luck to you xx

[minnesota_girl in reply to Krystal_43]

DHEA is interesting isn't it - I've had two consultants and one nurse give opinions on DHEA - and interestingly the female consultant and nurse advocated it and the male consultant didn't trust it. I don't know if there's anything to that, but I have found that the female medical folk I've discussed it with seem to put more stock in what you can do to improve egg quality overall. In terms of side effects I get a bit of greasy skin but not crazy - and i was advised to take it for 3 months before then going off it before stims xx

[BBHH1]

Read this on DHEA

ncbi.nlm.nih.gov/pmc/articl...

Best,