Consultation advice after failed IVf

[Mlove12]

Hi all,

We have a consultation coming up in the next couple of weeks after failed IVF

I was wondering if people have any advice on what are good questions to ask? I want to ask about progesterone and TSH levels to double check, and NK cell testing as i struggle with autoimmune issues.

So was wondering if there was anything else you recommend to ask? If anything else made the difference to a successful pregnancy and had you not have asked, wouldnt been in a positive position now?

Hope your all well 🤗

[Midsummer_daydream]

I've asked all questions based on your witness in previous round, whether progesterone level was not enough if you bled before you stopped it or whether they can suggest any test to be done to check your immune issues. I haven't had a success myself but I couldn't sit still until they tweak protocol for every round, I had 2 failed rounds. It shouldn't be the same. Don't settle even if it is a number game and a lucky draw.

I heard a lot about ERA to test optimal time for progesterone and blood test/ hysteroscopy for immune and NK cells. I am with the NHS, my clinic doesn't offer ERA, I've asked twice now so they proceed blood test and hysteroscopy for me on wait list.

[Mlove12 in reply to Midsummer_daydream]

Hi Midsummer,Thank you for your reply.

I completely agree with you regarding tweaking protocols.

I am also with NHS for second round. May i ask what ERA test is? Ive never heard of it

I hope you have a successful round next time lovely xx

[Midsummer_daydream in reply to Mlove12]

ERA test is endometrial receptivity array meaning testing for how many hours you need to be on progesterone for your endometrium to be ready for the embryo transfer. For me it could be a very useful test to ensure the timing of transfer, unfortunately the NHS clinic I am with not really offering any kinds of this test. Given my 2 implantation failures I have to push for them to get some ideas about my immune/ lining issue otherwise they said 3 failures/ recurring miscarriage before investigation.

[Mlove12 in reply to Midsummer_daydream]

Ahh i see thank your explaining. Ive never heard of this so definitely something I shall enquire about! Ive had autoimmune issues but not consistent, so I’m going to ask about NK cells as ive heard a lot about this, I’ve never had a positive pregnancy test so I’m going to assume it’s something to do with implantation as at egg retrieval, they said eggs were decent quality. Thank you for your advice and I hope your getting the answers you need for a successful transfer! X

[Tir-26]

It was suggested to me that we look at Sperm fragmentation as research indicates it’s a factor in recurrent loss and implantation. Might be worth mentioning to them

[Mlove12 in reply to Tir-26]

Hi Sjlrun,

Is this the case even if there is no sperm issues too? X

[Tir-26]

I had a lining biopsy, ERA, NK cells and a hysteroscopy done and all normal. We have no sperm issues that we know off, it was mentioned to us as something to ask our Clinic.

[Koala365]

I would also ask about thrombotic risk profile test and Emma/Alice test. These are also tests for implantation failure as well as sometimes also for recurrent miscarriage. Also vitamin d and Thyroid function. I would say I don't want to wait until I have had several IVF cycle failures to do these tests because by then it could be too late especially if you have run out of NHS cycles or money by then!

[Mlove12 in reply to Koala365]

Hi Koala,

Thanks for replying! Do you think these tests would be covered on NHS treatment or would have to pay for these seperately?

I definitely agree with you, want all bases covered before treatment! X x

[Koala365 in reply to Mlove12]

The thyroid and vitamin D tests are definitely available on the NHS as they can do these for anyone who is feeling tired and doesnt know why who isn't even having fertility treatment. I think the thrombotic risk profile test may be available otherwise too as I think it is to do with stickiness of your blood and can therefore be used to look at liklihood of thrombosis, stroke etc as well as having implications for fertility. I think the Emma/Alice test is unlikely to be available through a GP and may only be available privately. The Emma test looks at the microbiome of the womb as they found that people with some bacteria other than lactobaccillus have a higher incidence of miscarriage and I think also implantation issues. Some doctors just give vaginal probiotics to cover off that issue rather than do the expensive test. I would do your own research on this as what I say here may not be 100% correct. The ALICE test checks for endometriosis I think but am not certain. There are definitely some checks for endometriosis that would be available through NHS though I believe.