What would you do in these circumstances - Cancel or continue with cycle?

[Skittles11]

Hi everyone

Sorry, I feel like I'm posting a lot recently. Have so much going around in my head and many decisions to be made.

I'm in the middle of what I suspect will be my last fresh attempt with my own eggs and a couple of things have happened which have made me question if to continue or cancel.

The first thing is my FSH. I discovered it was quite high on Day 2 when I was given the okay to start. It was at about 14. That really bothers me. Im only 36. Three months ago it was 9. Makes me think any eggs I get will be poor anyway. But clinic gave me go ahead to proceed and they said nothing about the result, I just happened to stumble upon it yesterday.

The second thing is my TSH. I had it retested yesterday, day 8 of cycle. It was just over 4. I know it needs be be under 2.5 before a transfer but is this an issue at the stimming stage? My doctor says she is not worried because I'm already supplementing and has told me to increase the dose. I however am concerned this is far from optimal. (Note I am NOT doing a fresh transfer so if this is only a problem for implantation I will have time to lower it for a later frozen transfer).

I wanted everything to be as optimal as possible before proceeding and feel everything has already gone wrong. And finding it really hard to balance my own beliefs (that I think this is not a viable cycle) against doctors advice (that we can continue as per plan)

Can anyone share insights on any of the above? Xx

[Sunflower35]

Hi Skittles11! My FSH is always high (I seem to remember it was 19?) and we were successful, so if the doctors aren’t concerned, it may be because those two values are not deal breakers? I wish you all the best if you decide to go ahead!

[Skittles11 in reply to Sunflower35]

Thank you my lovely. I'm feeling ever so overwhelmed and so just getting your response was ever so appreciated. I thought I was "over" all the worrying and anxiety in cycling but last couple of days getting really quite stressed with these results and not knowing what to do have shown me I am not. X

[Hidden]

I am so sorry I don’t know about these metrics but just wanted to send you a big hug and say I think you have to trust your clinic so if they aren’t worried you should try not to be. Easier said than done. Heaps of luck xx

[Skittles11 in reply to Hidden]

Thanks Daisy. I know you can empathise with these road blocks that are sent to test us. Easier said than done, think I find it very hard to put my trust in clinics which is sad but true xx

[Tarasunny]

Was googling something similar for myself and found this about TSH. Not sure if its any help and obviously only 1 study.

thyroid.org/patient-thyroid...

[Skittles11 in reply to Tarasunny]

Thank you, I will have a look at the link xx

[Hidden]

Hi I am in similar positions as you, but my clinic not even let me start the stims. My first TSH was 4.1, my second 4.6 so they put me on Levothyroxine 50mg as it has to be under 2.5. My doctor said that over 2.5 there are biggest risks of miscarriage. So I am going to do the tsh blood test again in 3 or 4 weeks.

It's better waiting little longer with everything ok than hurry up and disappointed after, because ivf can not work even when everything is fine.

[Skittles11 in reply to Hidden]

Hey thanks for your reply. I think the issue I have is that it was considered low enough to start the stims being just higher of 2.5 but starting the stims seems to have pushed it up further. Although I've been taking increased Thyroxine to try and counteract this it hasn't been enough. Stopping a cycle mid way through is the difficulty I'm having because my doctors are telling me to press on. So if I decide to cancel it would be against professional opinion. Difficult as different doctors and different clinics say different things xx

[Hidden in reply to Skittles11]

Oh I got it. So listening your doctors they know what they are doing. Trust them, pray and see what happens. Good lucky xxx

[Cinderella5]

So I'm no expert but as far as I'm aware the thyroid issue is more to do with implantation. I can't really comment on the FSH levels, well not really....my FSH was ok and I didnt get very far with my OE but others have.....but sadly I do know you can't do much for it.😕 I think you can only go with your gut sweety!xxx

[Skittles11 in reply to Cinderella5]

Your understanding was similar to my understanding but I'm wholly confused TBH. My doctor said a few months ago she wanted it below 1 but at what stage?! I know the FSH is what it is but I've also seen other clinics doing day 2 testing won't proceed until a following month when FSH is slightly better as they believe that will increase the odds and the FSH will fluctuate somewhat. Again, am wholly confused! Xx thanks for replying

[Cinderella5 in reply to Skittles11]

Sorry I can't be of more help but I know for transfer you'd want your TSH under 2.xxx

[Infragilis]

Hi Skittles, what I can tell you is my experience. I just had a cycle which ended in no embryos. I had a feeling it wasn't a good one but went ahead as I followed doctors advice. My case was at day 2 of cycle I already had a follicle of around 9.7mm. I have low amh and I am a poor responder so I only get 1-2 follicles per cycle. They tested my E2 which was 70pg/ml on day 2, FSH 11 and progesterone 2.34 NMOL/L. I wish I listened to my gut feeling. I have had higher FSH than 11 on days 2 and 3 and had better cycles than this one. I think in my case the fact that I started with such a large follicle on day 2 and my E2 being high, was what made the Cycle a failure. I wish I had listened to my gut as we wasted a lot of money. Do what you feel is the right choice for you. I wish I had waited a few more months till my body was maybe in a better state although it may never be better. This IVF journey is very confusing and that was our 9th Cycle so we have experience. Every Cycle is different and has its own challenges but from my experience in all these Cycles I have learnt to value my opinion as well as the doctors as sometimes we know our bodies better than they do!

[Skittles11 in reply to Infragilis]

Hey, thank you so much for all of this. I can see from reading your reply that we are in somewhat similar positions with low reserve and several cycles behind us. I wouldn't wish it on anyone but it is reassuring not to be so alone.

It's such a dilemma when you have abgut feeling which goes against the doctors. My previous cycle I went ahead as per the doctors advice and only got 2 eggs and although both fertilised they were poor quality and had problems developing. Id also already ovulated 2 eggs. I felt there were warning signs in the cycle and went ahead because the doctor advised me to and my husband thought it was best to as well. I felt afterwards I knew my body best and felt so numb at everything. I guess the main difficulty is not knowing if it would be better on a different month or not or whether it is best to proceed as each month is precious and delays could cause a worse result.

Have you had a lot of variance on your cycles? Mine have been so hit and miss I really don't know why xx

[Anjalichaudhary]

Hi, when my ET was done my tsh was like 13, so i think tsh might not be a problem, and currently i am 21 weeks so be positive and everything will be alright don't stress out and don't do overthinking, it helps me may be help you too

[Skittles11 in reply to Anjalichaudhary]

Oh wow congratulations. Thanks for the supportive words xx

[PaulaDag]

Hi, my consultant told me high TSH can effect egg quality during collection but that it would need to be a lot higher than mine was at the time - just under 3. She also said what matters is the starting level, as during a cycle it elevates and they expect that due to the meds, so it's more about the pre cycle values they take into account. Hope helpful. xx

[Skittles11 in reply to PaulaDag]

Thank you for this Paula. That's what I was concerned about, the egg quality is always a bit of an issue for me anyway and I didn't want to press on if there was something like the TSH which could be much better. My starting level was just shy of 3, it was sitting at 2.9. So I then immediately went up by 25mcg but it seems it wasn't enough to counteract the elevation caused by meds. It seems they are raising my TSH but not doing much at all to the follicles 😔 thank you for taking the time to write xx

[Skittles11]

Thank you to everyone who replied to this post. Just for completeness I thought I'd update that my cycle has been cancelled. Poor follicle development. I'm feeling okay about it at the moment as would rather cancel than proceed based on what I was seeing on scans but it's still disappointing. Xx

[Hidden in reply to Skittles11]

Sorry to hear this Skittles - hope they have some ideas to improve things next time xx

[Skittles11 in reply to Hidden]

Thank you lovely lady. Who knows what they will suggest. I had a gut feeling from various results this time that this was not looking good so think I was prepared for this outcome although it's never the one you want. Back to the drawing board I think - I don't know what I have left in me now. I am beginning to think more seriously about donor eggs at this point but have a long way to go in terms of my knowledge and my feeling at ease with it. Any tips you can give me on this front much aopreciated! xx