Hi everyone! So after 3 natural modified cycles we managed to get 3 embryos and had one blastocyst grade 3BB put back. I’ve just finished my tww and sadly started bleeding 2 days ago and it’s ended
In a BFN.
We’ve got a day 3 6cell grade 1 embryo and a day 5 blastocyst grade 4BB so before the next transfer we are going to talk to the consultant to check what options are available.
I’ve had thyroid checked back in May 2021 alongside vitamin levels b12 folate Vit D. My lining was triple layer and nice and thick. I’ve got 2 small endometriomas on the left ovary but no endo anywhere else. I’ve had a hycosy in September 2021 and both tubes are open.
Blood flow to ovaries and follicles in each cycle have been good.
I wanted ask does anyone have any tips or suggestions for tests they did after a few failed transfers that’s helped for next cycles? Thank you so much 😊 xxx
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Nane22
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Hello,I'm sorry to hear you last transfer didn't work.
I wanted to say I've been in a similar situation, with 3 failed transfers, except that we didn't have any embryos left so had to start afresh and had an inconclusive Hycosy. Our 4rth try was successful, so don't lose hope. We were considering doing the following (in order of priority): PGT testing, ERA, implantation tests. I can't comment on natural FET, we had medicated as I have PCOS and irregular cycles.
In the end I booked a follow up with the hospital consultant who did our hycosy to get a second opinion (you can do that!). She was such good advice and recommended trying one last time, which we did and it worked.
We think that we had better quality with this new batch, and that was that. We tested all the embryos on this round and the aneuploidy ratio was in the norm.
There are a few questions that might be useful to ask yourself: does your partner have male factor, was your fertilisation rate in the norm (80%), and how old are you.
We had the first 2 which pointed to a quality issue.
Our clinic told us that the main reason for transfer failure is quality, so it might be worth ruling that out first.
If I was you I would probably do a double transfer with the remaining embryos (provided you would be happy with twins), and if it doesn't work see if a fresh cycle makes a difference to quality/ test the embryos.
You could also test your 2 frosties now, but perhaps consider the extra cost for defrosting, and their quality first. Your Embryologist will be able to advise if they are candidates for testing.
This is just my view, but you might prefer a different approach, and others might offer other perspectives.
Thank you for your detailed reply that’s really helpful. Me and hubby did discuss genetic testing on the two as the embryologist said they can be tested but we are undecided due to cost and there are just 2….
I am 39 and we have done ICSI on all 3 rounds as there is slightly elevated DNA fragmentation in sperm.
First round got 2 eggs and both fertilised. Second round 1 egg which fertilised.
Third round 3 eggs none fertilised.
I will definitely ask about a double transfer.
Thank you you’ve been super helpful and I wish you all the best xxx
Thank you. I know exactly what you mean we really hesitated between that and doing double transfers but ended up testing the lot. It was £400/500 per embryo, an extra 200 if defrosting.
We had to have ICSI too, which pointed to quality issue. The good thing is that things can vary a lot from one cycle to the next. I don't know if you're partner is on supplements, but my partner moved to Impryl and it really helped his mobility, and fertilisation went up by 30%. It could be something else of course.
Absolutely, it's worth discussing a double transfer especially if finances or time are a consideration. The only thing we were told is that they normally transfer similar quality embryos, and if the conditions are not optimal you risk wasting one.
Other people test ERA to check the implantation window...
Good luck deciding what is best for you. All the best for your next try xxx
Yes hubby is taking proxeed since last august Ah that’s good to know I wonder if Impryl is different to proxeed. I’ve been taking supplements too and did acupuncture alongside all rounds and transfer too.
We switched from Proxeed to Impryl and it helped us (we think).
Millbanks is right below about PGT and numbers, we told ourselves we would only do it if we got 4 or more. Last time we got only 3, this time we got 7, transferred 1, tested 6, 4 were normal. It's a personal decision, you have to take it all in and do what's best for you. It cost us 3k and I questioned our decision.
PGS and double transfer don't improve your chances, they just help you get there quicker. So they might be useful if you find transfers are taking a toll on you, or you have limited time or resources.
Definitely take the opportunity to quiz your consultant tomorrow. Ask about all of these things, and don't be shy to question their suggestions. It will help you form an opinion. Clinic's have different views/approaches.
I was really keen on doing NK cells/steroids and we weren't sure on PGT at all.
My clinic was the opposite. They had zero belief in NK cell, but recommended PGT. Both technics are classed as red/unproven on the HFEA website 🙃
I just saw your mention of progesterone. I really wanted to test mine too but my clinic said research doesn't show how much is the right amount, and the potential impact of too much. I wish I'd pushed, and it might be worth you asking for it. I think it's only £50 a test. On our successful round, they'd just switched everyone from Utrogestan to Cyclogest, which is a higher dose...
Ah that’s good to know about the impryl as we currently ran out of proxeed and I was going to order some more today so I’ll have a look into impryl too.
Yes I think we are swinging towards leaving the pgt testing for now. Hopefully we won’t need another cycle and one of the Frosties left will be successful but if not then we may look at it next time depending on the number of embryos.
Did you do the same protocol the second time round?
I’m feeling a little under pressure with time because I’m 40 end of the year and when you look at all the figures it scares you. Yes I’m currently making my list now so I don’t forget anything. My gut is saying to me check progesterone so as you say I might just push them to do it for my own peace of mind even if they feel there’s no need. I was on utrogestan this time my first transfer I was on cyclogest.
Aw thank you and pls don’t apologise. You weren’t rambling.. You’ve been really helpful xxx
We had 5 failed FETs before having a positive on our 6th.
Things that we tested over time were:
1) Progesterone levels on day of transfer (increased to 2 x lubion & 3 x cyclogest a day)
2) ERA for precise timing of transfer (mine was out by 24 hours)
3) PGS testing of embryos (6 of 8 were normal)
4) Immune blood tests (showed high NK cells)
I was on blood thinners and aspirin for all 6 transfers - so not sure this really had an impact.
The 6th transfer was the first time we'd tried steroids & intralipids so I do think they played a big part.
PGS testing is a tricky one, and I think only really worth it if you have lots of embryos - we were always fortunately to get a few from each egg collection so it made sense. But I think a lot of others don't like the idea of it.
I had double and single transfers and it made no difference - the 6th FET was a singleton.
Hi hun aww congratulations!! Hope your pregnancy is going well!
Thank you for your reply.
I did ask them on my last transfer if I should have a progesterone check but they said I didn’t need to but my gut feeling is that I should have it checked. I always start bleeding a few days before test date . I have no idea if that’s related to progesterone levels but I’ll ask again.
I’ll ask about ERA too.
Yes that’s what we aren’t sure about with the PGS due to the fact that there’s only 2 embryos, we kinda thinking shall we just got for it and see what happens. I agree if we had more embryos I think we would test them for sure.
Ah yes NK cells I’ll ask about too. Were the steroids due to the high NK cells?
Thank you for taking time to reply.. wish you all the best hun xxx
Thank you! Only 7 weeks to go and to be honest I still can't actually believe it - I guess the IVF journey does that to you...
I bled early on my first 2ww which they did think was due to low progesterone. I know that I have an issue with it anyway as aside from IVF my body doesn't produce it much - or at least it drops off really quickly which means the lining sheds really early. So if you can, I would ask for a test on transfer day - there is enough time for them to up your meds then if needs be.
ERA is helpful - especially after recurrent implantation failure (classed as 3 failed transfers) - it was the first thing I wanted to check.
Yes my NK cells were 60 times what they should be! Which is crazy but even if they are a little high the steroids can definitely help. If you think about it logically, your body is trying to accept 50% foreign DNA - and naturally it lowers it's immune system during conception to allow this to happen. My thoughts are though, that the reason a lot of us aren't successful is just that our bodies aren't able to lower the immune system enough - and therefore just reject the embryos. Hence the steroids doing the job for us.
I could be talking complete b******s but it made sense to me that this could happen.
Haha I know right - I feel like I know more about IVF than most of the clinicians 😂(obviously not really..)
It sounds like its definitely worth checking your progesterone - early bleeding shouldn't really happen.
The ERA test was waaaaaaay better than I was expecting. I was so worried it was going to be excruciating, but it was a few seconds of discomfort then it was done.
I took 2 paracetamols before hand to take the edge off too.
My lining was a bit hit and miss. I had one where we thought we may have to cancel as it just wouldn't play ball, but at the last minute it picked up.
For our successful one it got to 8mm and was triple lined.
I didn't have a mock transfer - I don't think the clinic ever really felt it was needed as we'd had so many anyway! xx
I had the same thoughts as you searching for anything or any test I could do to help my embryos implant after 3 failed transfers with no apparent reasons (I can only do 3rd day transfers) and my doctor told me it's really about the embryos sometimes and she was right cause I am now pregnant from my fourth transfer.
Aw congratulations Jana! That’s amazing news! Thank you 😊hopefully you’re right and I won’t have too many more transfers before rainbow baby comes along.
I am so sorry about your BFN. We tried to do something different each time we fail/had bad news and did lots of different testing. I also suffer from endometriosis like you (and adenomyosis) and have bilateral endometriomas. I was told endometriosis can affect the quality of the eggs and in my case, I am sure this is the case. I had a laparoscopy for excision of endometriosis, but mine is quite severe and everywhere, unfortunately.
I think we did most of the tests the lovely ladies here have recommended and maybe a couple more (PGT testing, ERA/EMMA/ALICE, autoimmune blood tests, blood clotting screening, Karyotyping, etc.) and changed to a natural FET last time (we were successful!), even if I have really bad PCOS and irregular cycles, so it wasn't easy. I also had a 3D scan of my uterus and a hysteroscopy, which showed I had a T-shaped uterus. This hadn't been seen before by any of all the different fertility specialists I had seen...
For me, probably doing the ERA/EMMA/ALICE was the best decision we could have made. My EMMA and ALICE came back really abnormal and apparently that can cause implantation failure and miscarriages. I was put on antibiotics and probiotics before my last (successful!) transfer.
We also took different vitamins (my husband has teratozoospermia and we had to do ICSI) and I did acupuncture.
Infertility/IVF is such a physical and emotional rollercoaster! I am here if you need to chat or ask any questions about any of the tests we did xx
Aw congratulations that’s amazing news in your success! Gives me a lot of hope. 😊 I’ve found that I’m responding better to a natural modified cycle compared to short and long protocol cycles. Did you down regulate before your frozen transfer?
I’ve had a hysteroscopy too and have a retroverted uterus and a mild heart shaped uterus but not bad enough to have required more treatment.
So this transfer was meant to have been a fresh one but none the 3 eggs on this round fertilised so they thawed an embryo that had been frozen from the first round and popped that one in instead. I did have a few days of antibiotics and had probiotics because my digestive system doesn’t respond well to antibiotics. I’ve not heard of EMMA or ALICE so will definitely have a look at that.
I did acupuncture too and taking all the vitamins.. I’m going to try more yoga too this time 😊
Thank you hun that’s super helpful xxx
I’ve had a chat with the consultant this morning so will pop an update below
Yes, I was on Decapeptyl for 3 months and then Zoladex before my transfer, as they wanted to calm down my endometriosis and adenomyosis. My body doesn't react well to oestrogen and most hormones (because of my endo/adeno), so that is why I decided to go for a natural FET, although my consultant told me the chances of success were lower (I have PCOS and my lining can be a bit hit and miss too!). I only added progesterone, as I had the levels checked and were very low. That is another thing we tested and I forgot to mention in my previous post. I did meditation and mindfulness too
Great news that you didn't need further treatment for your uterus!
Yes, please, let me know how you get on and all the best with the consultant today! xx
Thank you all for your help. I had a really detailed talk with my consultant today and between us we came to the following recommendations.
1. Due to low ovarian reserve it’s been recommended to try a couple more natural modified cycles to get some more embryos now rather than waiting due to age. There is a chance one or both of the two Frosties could work but each one has a 25% chance success so as there are only 2 she suggested to try and bank a few more first. So I’m happy to do that first. The natural modified cycles are very light on the body and I do about 5 days of injections. So it’s not
too gruelling.
2. My frozen transfer I’ve been advised to down regulate for 2 months first with zolodex and buserelin. They will check my progesterone 2 days before transfer.
3. I’ll be given a low dose steroid and aspirin.
4. In the meantime I’m having blood tests for thyroid and blood clotting agents.
5. She said double transfer wouldn’t make any difference for me.
So we are having a month off treatment and will give a good shot to try naturally.. you never know eh 😃
Hopefully one day I’ll be able to do a BFP post 🙏🏽
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