Sorry I'm posting again, I feel I've posted a lot lately.
I'm having a complete brain fog about what our next steps should be.
For context - Last week we learnt both of our Day 5 blastocysts were abnormal.
We've been trying to bank normal embryos (via PGT-A testing) all year. It's been difficult with various road blockers including a cancelled cycle, and no embryos making it to blastocyst. We have one "normal" embryo from March (and an untested embryo from previous cycle).
We also had IVF cycles prior to trying the banking. One cycle we had no eggs collected. One cycle we transferred an embryo which did implant but resulted in TFMR loss after we discovered chromosomal issues where baby would not survive. We also had an early miscarriage from a natural pregnancy. So there have been many challenges and much heartbreak. We're trying to decide on next steps but finding it very difficult.
Our doctor's recommendation is to try another fresh cycle in search of that "normal" embryo if we have the emotional strength. She believes we still have a good chance of finding a euploid especially with the changes we made this time round which were quite personalised. This cycle was so much better than our previous two. What do people think of this recommendation? Is it worth persevering... again?
I struggle with this because we've had so many set backs. I don't know what to do.
Do we a) Go with doctor's recommendation. Or b) Try with a frozen
And why?
Thanks so much all xx
Sorry for long post, when you've had a long and complex history it's hard to condense it
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Skittles11
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I'm sorry you are going through so much and admire you for the strength you have!
If I would be in your shoes I would have a go with the 2 frozen embryos you already have. The worse which would happen will be that you are going to lose 2-3 months before your next fresh IVF, if no of this embryos will work. Your eggs will not go worse dramatically in next 2-3 months even though your AMH is low. But if this will work you won't need to go through another fresh IVF cycle. I can imagine how tired mentally and physically you are after this year. Good luck! x
Thank you for such a supportive reply and the reassurance that things won't get dramatically worse. I appreciate you sharing what you would do in my shoes, am feeling completely overwhelmed xx
It's never easy, right? Each step reveals some new hiccups. But you got it girl, I know it. I know that feeling being completely overwhelmed but still had to decide one way or another. An awful one. Sometimes the best to do is to trust your guts. I know it's not the best advice, as the outcome is so precious, but I feel sometimes it's best we can do! I send you a massive virtual hug xxx
Dear Skittles11, I am sorry you are feeling so utterly overwhelmed right now and I can very much relate to just needing something positive to look forward to. Sometimes a change is as good as the rest and perhaps now is an opportune time to be brave and face a new transfer with your tested embryo? I can only imagine the dread it must fill you with after your last transfer ended in losing your much loved baby in such a heartwrenching way.
I have only done two back to back embryo cycles and feel physically and mentally exhausted, I can only imagine how depleted you must be feeling after all your ECs this year. I found the relentless waiting for good news and whether we'd get over the next hurdle the worst, be that whether there will even be follicles detected on the first scan, how many will be growing and at what rate, not being able to plan anything while on stims as the EC date could shift, and then the agonising 5 day wait after collection, it is just a lot to go through again and again and again. I also completely understand being hesitant about putting all your chips on the table with your one euploid embryo and only you will know when is the right time to give it a go.
I knew from the start that I would only have two cycles available to me (for age and financial reasons) and that I would have my embryo(s) tested irrespective of how many will make it to Day 5 (similar to you). I am still waiting for my PGT-A results which should be with us sometime this week, eek. Personally, I found a lot of comfort in knowing there is a finality to it all in our case and having a rough idea of when we would be at the next junction in our decision tree if that makes sense? What I'm trying to say is that I knew I had to be happy with whatever our two cycles yielded in terms of Day 5 embryos and then move on to the next step of transfer in case we get a euploid one. I find it helps me to manage my anxiety around the uncertainty of the outcome of our IVF journey to have this clear path of "stages".
You will need to search within yourself to find out if your fear of losing your one euploid embryo in an unsuccessful transfer is greater than your aversion to enduring egg collection after egg collection. I don't know what other factors might play into your decision like finances or just generally wanting to get a sense of moving on with one's life again etc. And do you feel positive that you would be in a good position for a possible transfer in terms of all the tests having been done so you can feel confident that you'd be giving your euploid embryo the best chance of growing into the much longed for baby you get to hold in your arms at last? Perhaps focus for a while on checking off that test list with your consultant as chromosomal abnormalities are only one of many possible causes for failed implantation or early loss? Have you recently had your NK cells, endometrial microbiome and thyroid function checked? It might be a worthwhile distraction that can help you while making your decision? Wishing you so much luck, faith and strength, Skittles. X
So many valuable points here, thank you for taking the time to let me know your thoughts. Definitely it's very tiring and relentless waiting for news at each stage especially over and over again.
You're so right about establishing whether the anxiety of losing my euploid embryo is greater than multiple egg collections and I can also appreciate the value of a more specific plan / timeline. I think I have become seriously overwhelmed in the last few days and am feeling even more exhausted with it.
There are definitely additional tests I would like to have done before transferring anything. I have done a couple such as the thyroid but there are also ones I want to pursue. When you say endometrium microbiome test are you meaning the ERA, EMMA and ALICE?
Thanks so much once again and wishing you luck for the results of your PGT-A. Xx
Thank you for your good wishes, Skittles! Yes, the EMMA and ALICE test will give you some indication as to whether any infections are present and whether you suffer from chronic endometritis which is often asymptomatic and can be attributed to implantation failure or early loss. ERA would give you a view as to when your endometrium is most receptive to host your little embryo, my consultant thinks it's a worthwhile test for medicated FET cycles but probably less indicated if you've previously had success with embryos implanting or you go down the natural/modified natural FET route. It sounds as if you really need some mental time away from it all for a while to get some clarity on which option to pursue. Be kind to yourself and allow yourself some space if you can. X
I would follow the doctors advice - one final egg collection, then no more. Give it one more shot then draw a mental line under it. Tell yourself this is your last egg collection and then move on. Then you can start transferring and moving to plan a, b, c, d if needed. Keep reminding yourself that you will take home a baby however it works out. That’s what I would do x
So sorry for your loss 😞...first of all. I would like to mention few things to you from my experience in order to help you to take the right decision. I also opted for PGS testing and that was a great decision. I did one cycle when I was 29 years old (you will think, well, young enough!!) well unfortunately not, we had one blast only and that was mosaic. We decided to have another cycle on completely different medications than previous ones and for the first time we produced 4 blasts and 3 of them were normal and 1 abnormal.
All I want to say is that age doesn't mean everything, young is not = with good result and old is not = with poor results. I think protocol that you are using is the most important thing, right protocol can help you produce good quality eggs and chromosome normal embryos. Also it is important to use a clinic that is having good embriologists, there is so much help from them, unbelievable! Our embryologists helped us to have higher fertilization rate and therefore more chances for blasts embryos. We had 3 cycle were we produced only one embryo per cycle and I was between 27-29 years old.
In your situation I would probably try the option B and prepare for a FET, you have one normal embryo hence all the chances for a life birth. I would probably consider to transfer even both embryos you have available. If you been pregnant before your chances are increasing. Overall one pgs tested embryo is giving you over 75%-80% chances for success. My clinic is having 91% success rate with PGS normal embryos.
I wish you good luck whatever you decide and please be aware there is no right or wrong decision. Take care 💕😘
I’m so sorry you’re going through so much, you must be mentally spent. This journey can be so overwhelming that it can be difficult not to make decisions out of fear.
Whenever I’ve had a difficult decision to make during this process I’ve always gone back and forth and then back and forth again, and then there seems to come a point after a few wks when the next steps become clearer. I’m sure once you’ve processed all of this, your instincts will tell you what to do.
You’ve been through so much mentally and physically that I would consider pausing on having another cycle and use your frozen ones. I totally agree with Zytajones that in the grand scheme of things 2-3 months isn’t going to make a massive difference.
Just to give you a bit of context, I’ve been through 3 cycles, and 4 transfers with a recent MMC myself. I was torn between doing another cycle now due to my age (almost 42), or doing a FET as I have 2 frozen embryos. I’ve decided to do some additional testing (endometrial function testing, uNK cells) to give myself the best possible chance before moving on to another cycle.
Whatever you decide to do, keep hope and good luck. xx
Thank you, this is useful. Can I ask - do you mean you have decided not to do a fresh transfer or fet but instead to do additional testing for now? How did you know which tests to get done? And once that testing is done you mentioned moving on to another cycle, are you planning fresh or frozen at that point? Thanks again xx
Hi Skittles. Yes, for the moment I’ve decided not to do a fresh cycle or a FET. To be honest it’s been such a crazy 3 months I need to take a short step back to get stronger mentally & physically. After my MMC I was fearful and panicked and wanted to just press on with the next cycle or FET asap as I felt quite desperate.
Those feelings have quelled now and I thought it might be sensible to do some additional testing for peace of mind and to give my FET the best possible chance.
I came across the endometrial function test from posts from other ladies here and had a video consult a couple of wks ago. Just waiting for my next cycle to get the test done and then will use the protocol they give me (if they think I need it) alongside my next FET. I’m guessing it’s my egg quality that’s the issue due to my age but can’t hurt to get extra information.
I haven’t done the ERA or EMMA as trying to limit my costs at the moment but I had a Hysteroscopy earlier this year with a microbiome test and made changes after that.
Hope that helps and I hope the way forward for you is becoming clearer. Xx
This is such a tough decision to make Skittles. I can honestly say that I wouldn't know what to do if I were in your shoes either, but have provided my thoughts below, which may help.
I do think your consultant has a point about potentially doing another cycle to try and bank a least one more euploid. Given your age (from memory I think we're about the same age, but please correct me if I'm wrong) I think you were really unlucky that both of the good grade embryos you got from your last cycle tested abnormal. Women of our age have good odds of getting one euploid embryo from a single cycle. If you can get a couple of blasts from another cycle, I feel it'd be very unfortunate to not get a euploid out of that, but of course the outcome is never guaranteed.
The other thing to factor in is that if you were able to get another euploid, then it could take at least a little stress out of transferring, as at least you'd know you have a back up embryo should the first one fail. Also, if the first embryo didn't work then you wouldn't be left with the feeling that it's back to square one. It may be better to do another retrieval now rather than transfer and then potentially decide to do another retrieval should the transfer of the embryo you have not work out.
But having said that, I can well imagine that the thought of doing another egg retrieval after all the set backs you've had is a pretty scary prospect.
I think your decision will come down to which option you believe is the lesser of two evils. For some it may be easier psychologically to try another retrieval before a transfer, as even if it doesn't yield the hoped for results then at least there are less 'what ifs, buts and maybes'. For instance, would you be left wondering what would've happened had you done one last cycle? Whereas, it may be easier for others to opt to transfer their one embryo to avoid another retrieval and all the stress that comes with that process. The other thing to consider is how much time doing a transfer would set you back if it didn't work.
I hope you're able to get some clarity on what you want to do soon, but it's such a tough decision! Xx
so sorry for this massive struggle you’re facing. Just checking, are you sure your doctor isn’t chasing the money? I can imagine that the thoughts that you can have success are good. However, it is a business for them and in the end, it’s only what you really feel like you can manage. What would be the outcome if you tried the frozen and then tried for the naturals after that?
Don’t know if it helps but I changed it all up on my second FET (naturally modified) and did acupuncture and massage with the Chinese herbalist, cut out caffeine and tried to reduce the amount of food in plastics I ate (to avoid xeno oestrogens) and tried to lose a bit of weight. I had no idea if it helped but if I did it again I’d do it all again too.
It's a really personal decision, but if i were in your shoes, I would probably give the FET a go, before incurring the cost (financial and personal) of another egg collection. Our clinic gives euploid embryos a c.70% chance of success, which are great odds. If it doesn't work (and fingers crossed it will), as someone has said above, at tops you've lost 2-3 months.
Hi Skitties, you can post as much as you need. That’s why this forum exists so we get support.
I think the question is, why do you want to get another euploid embryo? Do you want to have a chance of two babies? And also if you have the means to do another round. Or if you only want one baby, how would you feel about other embryos left behind if you already have your baby.
Personally I would do the FET next. For all you know it could be the one. At this stage, a few months delay won't stop anything. It also means you can move on, should it not work you won't be looking back.
it’s such a tough decision I can see why you are in a dilemma. Did they give you any reasons for not trying with the 2 you have before going down another fresh cycle route? For me one in the hand is worth 2 in the bush and so would probably give them a go on my next couple of cycles, and then do another fresh if needed as it’s only really a couple of months. I totally get the ‘banking for testing’ approach but sounds like that wasn’t working for you in the way they hoped but you do have 2 nice embryos to try now. You have also been through quite a few collections lately so a wee break form collections might also do your mind and body some good 🤗 just my thoughts though and I can totally see why you might want to have the safety net of trying for a few more embryos xxx
I think I agree. Wouldn’t it be better to try with the 2 you have first? Unless there is any reason the doctor thinks it would be better to try once more. I think either way, you can’t go wrong. But to help with the stress and agony perhaps decide on plan A and then plan B so that you aren’t feeling overwhelmed and have a plan in place x
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