What would you do next

[Poppygarden]

Hello all,

I’d really appreciate your advice on what to do next. I’m feeling lost and so worried that I will waste even more time.

My story so far;

We’ve been TTC for 3.5 years. Never had a natural pregnancy and I’m about to turn 33

Our sperm has low metrics for volume/ shape etc but the dna and chromosomes have been checked and are normal. So we went straight to Icsi

We’ve used up ourNHS funding and can still use the clinic going forward privately but we can’t access additional testing or we could move clinics to somewhere who can provide additional tests on me / our embryos.

We’ve had 1 egg collection, where I had OHS (44 folicals, 14 mature eggs and 5 embryos remaining on day 5/6) I was on the lowest dose of stimulation drugs on the long protocol and I had to take drugs to prevent ohs before egg collection and coast on stimulation drugs for 3 days. ( this is where I think our problem may be, as the embryoscope suggested high dna damage for the embryos which didn’t make it, which they thought may have come from the eggs)

I’ve not got any known conditions at the moment and my hystoscopy was all clear. My AMH 1.5 years ago was 28

We’ve now had 3 transfers of 4 embryos. (Chemical, BFN, miscarriage)

What would you do in my situation?

Love to you all x

[Purpledoggy]

Sorry to hear of your two losses. As a chemical is technically an early miscarriage, I would personally pursue the testing that would be done after 3 miscarriages (I believe thrombophilia testing among other things). It's awful the NHS makes you wait until 3 before you are eligible to do it on the NHS. If you can afford to do it privately then it is worth looking into. Surely your clinic would be able to do those sorts of tests, since they are available on the NHS anyway? I'm a private patient at an NHS clinic and paid to have the full thrombophilia panel with them xx

[Poppygarden in reply to Purpledoggy]

Thank you for your thoughts. It’s really helpful. I’d like to go down the repeat miscarriage route but not sure if it’s an option through the NHS. Your right though, they do the tests for 3+ so I’ll ask my clinic about what I can pay to do through them rather than another clinic. Last time I spoke to the consultant they were suggesting embryos testing may be needed for us, but didn’t suggest any other tests. Thank you for sharing your thoughts it is really appreciated xxx

[jengi]

Firstly, I’m so so sorry this is happening to you. Have you spoken with the embryologist? What is the quality of your eggs? How are they cleaving & dividing when fertilised? What grades are the embryos? I found speaking to the embryologist really really helpful.

It takes just one good quality egg.

I have low AMH too & my eggs had thickened zona pellucida preventing sperm penetrating. When ICSI was done cleaving & division often went wrong very early on. Both these things are signs of poor egg quality. I never had any testing done. Our chances of success was less than 5% with my eggs. I guess if I were you, I’d want to understand if it’s mainly an egg quality issue & if it is what are the chances of achieving a pregnancy resulting in birth & not just a successful transfer /positive test.

[Poppygarden in reply to jengi]

Thank you for your reply. It’s really appreciated. I can’t remember asking about the quality of my eggs previously but I will add that to my list of questions going forward. I might not want to know the answer but it’s time I did. I’ll book an appointment with an embryologist as I think that will either give me reassurance or at least a clearer next step.

The embryos were 5ab chemical, 5ba bfn, and 4ab /3ab where I think 1 didn’t implant and 1 was a miscarriage.

Wishing you all the best with your treatment.

[jengi in reply to Poppygarden]

Best of luck. Those are good quality embryos. I’m so sorry you are having a really tough time. It really sucks. Xx

[Poppygarden in reply to jengi]

Thank you so much for your kindness xxx

[Tir-26]

sorry for your loss, it’s a tough journey. maybe get a full set of bloods taken ie LH, AMH, prolactin pool, FSH etc maybe NHS /Gp would arrange for you? Have you had your NHS review apt after the failure yet?.

If I was you, I would book a consultation with a private clinic, make sure to have all of your medical records available for them to look over and advise.

[Poppygarden in reply to Tir-26]

Thank you for your advice. I had all my bloods done about 18 months ago and the only 1 which came back as slightly raised was prolactin. It wasn’t deemed raised enough to be a problem though.

Your right about needing a second opinion from another clinic. I’d also like to move a bit quicker than the NHS can now too. I’ll most likely have my review appointment in 6 weeks. Hopefully the review appointment gives some answers.

Thank you