Questions after a Chemical

[Sage5]

Hi all.

A bit of history:

Jan - IUI BFN

May - IVF 11 eggs, 9 fertilised, 5 5-day blastocysts. Fresh transfer BFN.

August - 1st FET BFP on 8dpt (Tuesday) and 11dpt (Friday) but beta on 14dpt (Monday/yesterday) was 8. I have another blood test tomorrow (I'll be 5 weeks exactly) to confirm it's a chemical pregnancy. I can then stop the medication and wait for the early miscarriage to happen. The waiting is the worst part.

What question(s) should I ask the consultant after all this is over?

Given I have had two failed transfers, should I be asking for more tests e.g. clotting/immune?

Is it worth getting an ERA given that I was somewhat successful with implantation this last time?

A part of me is beating myself up for not going with PGT-A testing because now I'm going over in my head whether I was just unlucky to transfer to abnormal blasts.

On a separate note, any help/advice on how to emotionally navigate these next few days would also be greatly appreciated. Much love to everyone x

[MrsOrangejuice]

Sorry you are going through this. I asked something similar after my two chemicals from fresh rounds as I felt so lost.

All I can say for our situation is I had thyroid, thrombophilia, and progesterone, plus full blood count. My consultant suggested a 3D/aqua scan after the last chemical but then when I said I'd had a hysteroscopy years ago, and two laparoscopies, he said no need. We considered PGS testing and DNA fragmentation but out consultant said it's unlikely to be an issue with our ages. Asked about ERA etc and he said no because we were getting implantation. NHS and private clinics said they don't think NK cells are a genuine thing and again felt even if they were we were getting implantation which suggests it's not that - I asked if it would harm to try steroids and was told yes, and unless there's a confirmed auto immune issue, they won't prescribe them.

Not saying any of the above is correct and lots of women on here have had successes after NK cell treatment in particular, just that I asked and didn't really get anywhere.

I am convinced because of past medical history that my issue is something to do with oestrogen dominance and progesterone resistance, and that I don't absorb progesterone properly. Consultant was up for that theory (possibly to placate me!) and for my first FET put me on Ultrogestan vaginally (apparently better absorbed in womb), reduced oestrogen, lubion injections and they've said I can add in cyclogest if i'm concerned. I also changed my supplements and have been taking aspirin (consultant said he wouldn't endorse but it won't hurt).

It may be pure chance or because on my fresh round I stimmed for 17 days and that affected the conditions, but I have been getting BFPs since 3dp5dt on this FET and so far HCG has been more than doubling every couple of days. I didn't get much beyond OTD the last two times and the HCG was low or didn't rise, so even if this doesn't work it is at least better than the last two.

Re emotion and coping, I was devastated after the first chemical as I naively thought that it was a done deal. Second I was upset but sort of knew what was happening and I had lower expectations. The only way I have been able to cope is to go straight back in as I need something to work towards/hope for, but maybe this doesn't give time to process and grieve and will all catch up with me. I probably shut off a bit from people and colleagues as just concentrated on what I needed to do, and ignored all the usual 'noise'. Some situations were especially hard though. If we do end up with a happy outcome maybe all that will fall away but at the time it's pretty raw, so I am sorry. You've got frosties and everything to hope for so best of luck x

[Sage5 in reply to MrsOrangejuice]

Thank you for your reply. I have everything crossed for you this time around. I can't tell you how much your last paragraph resonated with me. x

[Twiglet2]

So sorry that you had a chemical, I had the same and it was personally even harder for me than the straight up negative at first. I had the same with my IVF cycle after failed IUIs. Fresh was negative, double frozen was chemical but then the next single transfer worked for us. Didn’t do anything different at all (except chill out a bit lol). After the bleeding with the chemical I actually felt more positive than I ever had as I realised my body could do the getting pregnant part (so timing lining etc probs all okay), it was just that that embryo was not to be.

Not sure if that helps you at all but just wanted to give you some hope that your results so far might not be the same for your 2 remaining embryos. One off them could defo still be the ‘one’ without you having to do anything different 🤗 xx

[Sage5 in reply to Twiglet2]

So pleased to hear you have had a successful transfer. Really reassuring to hear from someone further ahead on a really similar journey to mine it sounds. I am finding this time around harder for sure, seeing the positive and then having it taken away less than a week later. I'm hoping to feel the same positivity once the bleeding begins and ends. Thank you x

[DianeArnold Partner Nurse Fertility Network UK]

Hi Sage. Oh dear you've had lots to be concerned about. it might be an idea to mention trying low dose soluble aspirin and/or heparin next time to ensure a nice even blood flow to your womb ande its lining. Also helps to prevent clot formation. Lots of ladies eat pineapple core too which is believed to have a similar effect. make sure you accept any offers of counselling if available, to talk thin gs over, and try and keep busy. Thinking of you. Diane

[Sage5 in reply to DianeArnold]

Thanks so much for your reply, I will mention that for sure x

[Fertilityjourney]

Hello. I'm really sorry you're going through this.

I had a chemical pregnancy on my first transfer and then an early miscarriage on my second. Everyone told me it was positive that I got pregnant so after my chemical I was feeling very sad but optimistic, but after the mc I felt devestated.

I also had some immune testing and will be taking immune therapy to calm inflammation down so 🤞 that works. So I definitely recommend asking your doc about immune/NK cell testing.

The ERA - I'm not sure if you need that as your embryo did implant? But your doc will know.

I think feel what you feel over the next few days - let your emotions out and try some Counselling as we have found that really helpful.

Two doctors I have seen were encouraging about me getting positive pregnancy tests. So I do feel hopeful that with time and the right embryo it will happen. And I hope that's the case for you too.

Big hugs.

Xxx