3 failed transfers - 2 OE and 1 DE - should I be testing immune or infection?

[Babymagic37]

Hi all,

So sadly we experienced a chemical pregnancy after our first transfer with donor eggs. The blastocyst was graded as a 5AA so we were devastated that it didn’t work. This was our third transfer in total (our previous 2 transfers were with 3 day own egg embryos which resulted in 2x BFN).

I’m just wondering if anyone would advise any testing at this stage? I hear lots about NK cells, Alice, Emma etc. I’m so worried it’s my endometrium or something wrong with my body that stopped the pregnancy from developing. Im scared this will happen again.

Also, my lining on day of transfer was 7.5mm which I was disappointed with.

Any advice / info / similar success stories would be much appreciated. Thank you x x

[Kitkat10]

I’m sorry this happened, it took me 4 transfers to get a BFP so I know how it feels when transfers are not successful. For my 4th transfer I added Lubion in so that I was on both cyclogest and lubion and my lining was better with this combination. Whether this made the difference, I don’t know ? 🍀

[Babymagic37 in reply to Kitkat10]

Hi Kitkat10 thank you for your response. So my clinic put me on cyclogest (800mg) and lentogest (injected twice a week) which is injectable progesterone. I asked about lubion but they said I didn’t need it due to the lentogest. I don’t know the difference tbh!! Did you have any testing done after your failed transfers? x x

[Kitkat10 in reply to Babymagic37]

No I didn’t have any testing. They said that the most common reason for failure is the embryo. I was 40 so I think on average only 1 in 6 of my eggs was likely to be genetically normal so I put it down to that. I think timing of transfer and receptivity of the endometrium must also play a role, I think my lining was 11mm when on both drugs. It’s such a hard process because I wanted answers to questions for which there often aren’t any. It feels out of control and I remember exactly how it feels, but stay positive 🍀

[Babymagic37 in reply to Kitkat10]

Hi Kitkat10, can I ask what grade your embryos were when you transferred? The last one we transferred was a 5AA so it feels like the problem is more with me than the embryo x x

[Kitkat10 in reply to Babymagic37]

Hi, I had a 5aa, and 2 day 3’s not sure what grade they were. None of them implanted, then a 5aa and the pessaries + lubion and that one was a BFP.

[Babymagic37 in reply to Kitkat10]

Thanks for this Kitkat10. That is exactly the same for me, except my 5AA blasto was from donor eggs and I had a chemical pregnancy from this. I had to accept after 5 rounds of ivf with my own eggs that it wasn’t going to work. Really hoped donor eggs would solve the problem! Hopefully next time will be our time 🤞🏼 Best of luck with your journey x x

[Kit12345]

Hi, wanted to share my story incase it helps … I was trying for 3 years, had 2 failed transfer (one with 2x 5AA & one with 1x4AA). I knew from then it must be my uterus that’s the issue… turns out I had Ureaplasma parvum injection, which makes sense why my husband motility also wasn’t the best. It’s really treatable - only 2 weeks of antibiotics. I also tested for thrombophila & was positive - two protein deficiencies and 1 MTHR mutation - also treatable with blood thinners. Skipping forward to my 3rd transfer of 1X 3AB, I’m now pregnant - although looks like it may end in a chemical due to low HCG levels, however at least it’s progress! If I could turn back time, I would have tested for everything prior to even doing IVF! All the best with your journey

[Kit12345]

Sorry I missed to mention that I was also put on 15mg prednisone on my third transfer - this is the immune suppressant for high NKC.

[Babymagic37 in reply to Kit12345]

Hi Kit12345 thank you for your response and congratulations on your pregnancy! I’m hoping it works out for you 🤞🏼🤞🏼 Can you tell me what tests you had (and where if possible) to test for all the things you got treated for? I’m struggling to know what tests I may need! Thank you x x

[Kit12345 in reply to Babymagic37]

Hi Babymagic,One was called a full Thrombophila screening - it’s a blood test. I live in Dubai (but I’m from the UK) and these tests are easily available in all clinics by request from your doc, it cost me around £800. FYI Thrombophila is where blood clots too easy, it usually causes a chemical or early miscarriage but there are studies to show it causes recurrent implantation failure. Ureaplasma is an STI, easy to test for by swab or pee test, for this I did a full STI screening (they tested for many things I’d never heard of as well as the common we all hear about) this cost me £200 - this should be very easy to get at any doctors surgery. For Ureaplasma I had no symptoms at all, I assume I’ve had it for years, as I’ve been with my husband for 8! When I had a hysteroscopy after my first failed transfer, she saw some adhesions which is sign of infection, so for sure my uterus was hostile towards an embryo. Annoyingly I didn’t do the STI test until my second failed transfer!

For the NKC, actually I didn’t test for this but I asked my doc to put me on the meds anyway because high NCK runs in my family & the test is around £2000. So I thought why not just go on the meds anyway.

I would recommend getting everything you can at this point:

Thrombophila

Full STI/STD

NKC

Endometritis

Endometriosis

Pelvic MRI

Hysteroscopy - where they put a camera in the uterus to see if it looks ok. I’ actually did an MRI before this which is recommended to check the shape before they do the camera. MRI will also show fibroids etc which is important to see, as can effect implantation

In Dubai everything is very easily available, I’m not sure if it’s the same in the UK

There’s also a test to check your implantation window. This was going to be my next step… although I’m not sure it’s available in UK. Even in Dubai they send the biopsy to Spain.

Really hope this helps!

[Babymagic37 in reply to Kit12345]

Hi Kit12345 thank you for your response and all that really helpful information. So I’ve had tests for blood clotting and basic immunity tests and all came back as normal. I’ve had a HSG and my Fallopian tubes are fine. I would like a hysteroscopy but it’s so expensive! And I’d wait at least 6 months for nhs to see me. I was wondering if a saline scan may be useful? Its not as thorough as a hysteroscopy but still investigates the endometrial cavity and lining. Its really interesting what you said about ureaplasma! And how strange it’s something you may have had for a while but was symptomless. I’m considering a microbiome test that looks at infections and general bacteria. I’ve been researching Fertilysis who quite a lot of people seem to recommend.

I think you’re lucky having all these tests so accessible, I feel like I’m constantly researching what these things are and who can provide them!!

The ERA that you talked about, this looks at the window of implantation - our clinic have said I don’t need this because we had implantation with our chemical. What are your thoughts on this? x x

[Kit12345 in reply to Babymagic37]

I would highly recommend getting the hysteroscopy… and they can do a biopsy at the same time. For me, the MRI didn’t show anything abnormal and same for the usual scan. She wanted to do the hysteroscopy anyway with the plan to do some scratching at the same time…she told me I’d be under for 5 mins max and ended up being 2 hours, cutting away adhesion and also a polyp - total shetook out was 3cm of tissue & said it filled my whole uterus! I think for piece of mind I’d do it, they might see something they can’t see on other methods. Also you could request the scratching too - which apparently helps your chances.

I think maybe the doc in right on the ERA - If you had implantation already, maybe it’s ok.

Some docs outside of UK recommend 2 weeks of doxycycline antibiotics anyway, without testing positive for anything, just to kill all potential STI/STD/common bacteria, if there’s recurrent loss or failed implantation. Just to see if it helps - a bit like what I’ve done with NKCs - I’m not the meds but not tested. Not saying it’s necessarily the right approach but it does save you time and money

[Babymagic37 in reply to Kit12345]

Thanks for this Kit12345, I’m going to talk my doctor about a hysteroscopy and see if they can put me on the waiting list. If we could afford it we’d have everything done but atm we’ve got to pick and choose unfortunately.

I wish the uk had the same approach with meds and antibiotics, I would literally take anything if I thought it would improve my chances! It’s strange, there’s seems to be more reluctance here to do that.

I read your post on your beta numbers! Congratulations 🎉 bring on your first scan! x x

[Boo718 in reply to Babymagic37]

Hiya I was just reading through your messages. I had 2 chemicals then they did the era and it’s come back saying I need an extra day of progesterone so it might be worth getting that checked xxx

[Babymagic37 in reply to Boo718]

Hi Boo718, thanks for your reply. I’m really confused with this because my clinic said we didn’t need an era because we had implantation. I thought an era may be more useful if there’s implantation failure? It’s so confusing!Did you have any further testing after your chemicals? X x

[Boo718 in reply to Babymagic37]

Yeh, we did the Alice and Emma tests checking for bacteria and infections so they just did the era at the same time. They werent going to do it coz we had implantation so I was quite surprised when it came back saying we were a day out. We’re going to change the day next transfer who knows if it will work but it’s worth a shot xxx

[Kit12345]

I would also highly recommend getting all embryos genetically tested. I know of a 40 yr old lady who had 10 embryos, 5 of them were 5AA / 4AA & the rest ABs… all 10 embryos after being tested were abnormal and discarded. Imagine going through all those transfers to find out each time that it was unsuccessful. I was 32 when I did my round of IVF & my doc said testing was unnecessary but now after hearing that story I will definitely test my embryos if I do IVF again