Advice on embryos to transfer for FET etc

[Aussie83]

Hiya 👋 Please could you guys give me some advice as I am doing my head in thinking about that this! (Sorry for long post)

I have started down reg for my FET next month and I was accepting of my doctors plan until I spoke to a counsellor today and she made me question a couple things - now I’m more confused than I was before my session!

This will be my 5th transfer. I’ve had two fails with day 5’s and 2 fails with day 3’s. I seem to have an issue with my body absorbing progesterone pessaries and my last fail my progesterone was almost zero on test day.

I’ve also spent over a year finding a protocol that actually produces good quality eggs/embryos and my last one was the first time I’ve had anything to freeze/good quality blasts (we got 7).

Anyway, my dr said for this FET she would put back two embryos - the two top graded ones.

My counsellor questioned why she would do that and not put back one high grade and one low grade instead... That had been a thought I had also had but when I asked my dr she said they’d do that to give me the best chance of success.

I would like to try a double transfer at this point but am worried if it doesn’t work I will have lost both top graded ones..

Not sure what’s the best thing to do is??

I also thought it’d be time for an ERA now but my dr said I should try a FET first, where they will monitor my progesterone daily and give me Lubion, and if needed intramuscular injections. Her logic for that was due to me only having had two failures from day 5 embryos - she didn’t rate the quality of the two 3 day embryos at all so doesn’t include them so therefore Ive only had two ‘proper’ fails In her eyes I suppose.

I feel really confused as to what to do now.

My partner wants to go ahead with the FET and leave the ERA til later because he trusts the dr, and because of the money (always one of his issues with this stuff and to push him on it causes arguments where I just end up upset).

This whole journey is making my head explode and I question my judgement so I decided I’d ask you all what you would do in my position!? X

[Joanna-Arabella1984]

My feelings is you’ve chosen the clinic because you trust the medics! I’d trust your doctor, they are what you are paying for, but maybe chat through your concerns with them.

[Aussie83 in reply to Joanna-Arabella1984]

Yes thank you, exactly what my partner said!

[Joanna-Arabella1984 in reply to Aussie83]

Also you’ve got 7 embryos frozen! That’s bloody amazing odds! I had this technique called scratching , which helped me second time round

[Aussie83 in reply to Joanna-Arabella1984]

I know, it took us a year and half but we were so fortunate to get them all!

Ahh interesting, I’ll look into that thanks x

[km307]

It's such a tough journey, but I'd agree with PP and say trust your doctor. I recently had two embryos put back in a FET and asked the same question about using my two top graded. My consultant and the embryologist both said using different graded embryos can have a negative impact on both. I had a look online and found studies that supported this idea, so decided to go ahead with two top rated. I got my BFP last week, so fingers crossed this one works. Good luck xx

[Aussie83 in reply to km307]

Oh wow, congratulations 🥰 That’s really interesting actually and gives me some hope! Thank you for the advice x

[bearblue]

This can be such a rollercoaster and take such an emotional toll that you end up losing your bearings. You can start questioning and re-questioning every thing / including yourself and your doctor. My clinic has a policy of only putting in a single embryo at a time / which at least means the decision is out of my hands. The best placed person to give you advice is your Fertility Doctor I’m afraid. Each woman is different and they have a different ivf journey so what works for one won’t work for another ; it depends on so many things that hopefully your doctor has considered. But never ever be afraid to ask your Dr questions and they shouldn’t make you feel bad for doing so. I’m always intimidated by doctors and when I’m too scared I get my partner to do it. Tell your doctor about your concerns and see if that help. Doctors do this so often then they can forget that there’s a frightened human behind this so just try and ask them again. Don’t forget you’re the client - you have every right to just ask.

[Aussie83 in reply to bearblue]

Thank you, that is so true. I really have gotten to the point of mass confusion with this journey. I almost wish my clinic had that policy too so I didn’t have to decide!

You’re right, I will speak to my dr again just to clear my head.

I really wish my counsellor hadn’t put these thoughts in my head..I know she is trying to support me but geez, not helpful at all mentally! x

[bearblue in reply to Aussie83]

I know right. She may have been trying to help but unless she’s medically qualified fertility doctor she might need to learn to keep her opinions to herself. She had to realise we are ALL on high alert and very sensitive at this point.Anyway I’m honestly wishing you the best of luck. We are rooting for you !

[Aussie83 in reply to bearblue]

Yes definately, am questioning now if she is the right counsellor for me (was my first time). Aww thank you so much 😊

[Karney1]

You need to speak with your Consultant and put all them questions/concerns to her. It can all be really confusing and it is natural to second guess decisions that are made for us on meds etc due to this whole IVF process being so vital to get right for each of us. I know in the past when I was unsettled about decisions my Consultant made, finding out exactly why/how he came to making them, helped me alot.If you come to a stage where you cannot see/understand your Consultants logic, there will be trust issues and time for you to seek out another Consultant/Clinic.

Best of luck to you. It is a very tough road we are all on xx

[Aussie83 in reply to Karney1]

Thank you, you are most definately right! And I do trust her, the counsellor just made me question everything which I’m not sure is that helpful really.. thanks for the advice x

[DJ202]

Hi Aussie, I'm not surprised you're stressed, it's such a touch journey! I agree with the posters above - have open conversations with the doctor. Recent research shows that if you were to put back two embryos of different qualities it's possible that your body might focus on the lower quality embryo and should it be non-viable, this may lead to losing both. You have higher chances of two similar quality embryos being put back in together. I agree at this point try and trust your doctor. It's so hard, I know it from experience, but I think one of the key lessons infertility and IVF teaches us is surrender. Easy to say for someone who likes to be in control! Keeping my fingers crossed for you - keep us posted! x

[Aussie83 in reply to DJ202]

Yes that’s it, surrendering is so tough!!

Wow if that’s the case it sounds like my dr is correct... I mean I do trust her and know she’s doing the best thing but when people put in their two cents it makes you second guess everything, grr!

I want to give my embryos the best chance of success.

Really appreciate the kind words and advice - I feel a weight lifted after getting everyone’s advice x

[Trying6years]

Not sure about embryo grading and putting 2 back in (bit naughty of the counsellor to be asking those questions, she is not medical) but just wanted to say my consultant really seems to rate Lubion injections - I will be on it as well as pessaries for my first FET all being well. There has never been issues with progesterone he just likes to cover all bases - I hope it does the trick for us both!Good luck x

[Aussie83 in reply to Trying6years]

Thank you! I hope lubion works for you too, I’ve heard it can really make a difference for absorption.

Yes I know, bit naughty for sure 😉.

Good luck to you too x

[singleswimmer]

Heya! Sorry you’re stuck in this decision making overload situation - I have been there too. Can I check what your embryo grades are? And also what protocol switch you did? 7 blasts is great! And I can’t quite understand the logic of switching away from a single transfer at this point in your treatment.. do you mind having twins?

[Aussie83 in reply to singleswimmer]

Thank you. Yeah for sure, i have 5bb, 5bb, 2aa, 4bb, 3bb, 3ab and 3bb.

We switched to the med Pergoveris which seemed to make all the difference for us. It’s super expensive but worth it. Can give you more details if you like.

Yeah I think my dr wanted to try a double because I’ve had so many failures. I keep going back and forth about it tbh!

[singleswimmer in reply to Aussie83]

👍🏻👍🏻👍🏻From the studies I’ve read they all sound like they fit into the “good quality” category except the 2AA (which I understand could change into a 5AA overnight) and from what I’ve read there isn’t a big difference in implantation rates between all of them, even compared to “excellent quality” ones >3AA. So I think you’re in a very strong position - yay for that gold protocol! This study supports single embryo transfers in good quality ones but your specialist should have more up to date and comprehensive data behind their recommendation ncbi.nlm.nih.gov/pmc/articl...