Any advise as to what to do next.....Experience with PGT-A testing

[Flowergirlhope]

Hello All,

Trust you are all keeping well and happy new year to you all. xxx

Just looking for advise really, and somewhere to write how i'm feeling, as always appreciate everyone's help to help me keep going!

Just had my clinic Lab call with the results of my PGT-A testing (we had 6x of our A's & B's Tested) and the lab has called to say they have all come back normal and they have stated they are all 'Chromosomally normal embryos '.

Don't get me wrong, as i am VERY VERY thankful that this is the case, but also feeling very low and 'Flat' about the results. Don't know if anyone else can relate?! but we were really hoping for some light to be shed as to why we have had repeated failed implantation, and therefore both of us and the consultant were very hopeful that this would show up why. However they are all normal!

So my question is - what else do we try now?! really do not know what to think. Just feel like we've wasted a lot of money only to be told they are all fine! 😪(however i know this sounds stupid and don't mean it insensitively, so hope you know what i mean)🤗

Any one had the same experience and have any further ideas?!

xx

[Kate-92]

Are these the results for the transfers that failed ? Or results for embryos you have remaining to transfer ? x

[Flowergirlhope in reply to Kate-92]

Hello Kate-92,

These are on the remaining embryos i have frozen ready to have transferred.

xx

[Kate-92 in reply to Flowergirlhope]

So the embryos you have transferred that unfortunately haven’t taken may not have been normal. I can understand why you are feeling a bit deflated as you don’t really have an answer to your questions, have they changed your protocol with any of your transfers ? X

[Flowergirlhope in reply to Kate-92]

Thanks - yes that could be the case. No, i did one Natural transfer and one medicated. BUt nothing other than that.

[Kate-92 in reply to Flowergirlhope]

I was going to suggest the NK cell testing that’s already been mentioned - Really wish you well on your journey and hope that you get some answers x 6 normal embryos is a wonderful number to have 🙏🏼🤞🏼

[Yellowlove in reply to Flowergirlhope]

I had two failed transfers and the third worked. There was no reason for the failed transfers (could have been untested embryos) and after the second I had an endometrial biopsy and testing got NK issues, all came back normal. Sometimes they don’t find a reason, it’s so very frustrating. Wishing you luck with the next transfer, 6 normal embryos is a great number to be working with xx

[Hopewhite]

hello flowergirl, happy new year!! I understand your frustration, but it's probably best to focus on the positives, potentially the ones that failed weren't normal but now you've got many opportunities to try again knowing they are good embryos.

I know it's hard as we'd like to get some control over it, but sometimes it's just a trial an error, there's too many variables to be perfectly aligned for the miracle to happen. I can relate to you so far we have had a MMC and a BFN, In our case the consultant just advised to try another FET with our last embryo without changing anything... he said it was up to us to do any further tests as he'd not see anything that suggested further investigation was needed. His only advise was pgta test if we had to do another fresh round. I also feel we have been left without any answers to root causes. Not sure if you've heard about the Warwick implantation clinic, they have some research tests available, our consultant said he could not see an obvious reason to do these, plus highlighted they are research, but left it as a personal choice if we wanted to go for it. We have decided to go ahead with last embryo FET and try our luck. warwick.ac.uk/fac/sci/med/r...

I know it's hard, but try to stay positive, it's not uncommon to have a few FET before the lucky one xx wishing you all the best for your journey!

[Flowergirlhope in reply to Hopewhite]

Thanks so much Hopwhite for your message and words of encouragement! 🥰🤗

Yes i have heard of the Coventry Clinic, but like your consultant said, my consultant said its not really proved successful (although alot of people on here have found some answers, but guess just depends) And he said they used to do the same testing at the clinic but then stopped as found out that it wasn't proving to be successful and the Embryo testing was far more successful as far more likely to be failed implantation due to faulty Chromosomes.

I have got complications due to having Endo (which i have had surgery for) then after my first transfer failed i had an Hemorrhaging Cyst, but i asked him last time and even though scans dont show everything, he suggested that i wouldn't necessarily benefit from the Coventry testing as as far as they could see everything looked really good inside and nothing to suggest the Endo had come back?!

So now in a quandary as to do we forget more tests and go onto another transfer or do we go ahead with more tests (although i cant face it, as seem to have spent the last 7 yrs constantly going for tests!😪)

xx

[Hopewhite in reply to Flowergirlhope]

I’m so sorry , it is a tough ride , but hopefully we are getting closer to having our dream come true !

If the doctors have checked most things and you feel ready, maybe having an FTE could be a good step to try luck again 🤞🏼 hopefully you’ll get lucky next time xx

[Habibi87]

Hi love, we had all our embryos tested before any transfers but despite this our first two transferred failed. One was a chemical and the other a BFN. I had lost all hope at that point as we had run all tests on me and on the embryos! The third time however it worked! We teansferred 2 embryos and one of them is now my adored 8 month old daughter 💕 sometimes it really is a matter of luck! The only thing that I added on third transfer was a 3 d hycosy beforehand and a double transfer . Sending you love x

[Doodlebug23 in reply to Habibi87]

Intrrested to read your success with double transfer. My clinic refused at first but after 4 failed (3 BFN 1 chemical) single transfers they agreed to try double. It was still a BFN but they are now ok for me to keep going with double transfers. I’ve read people being told that one failing can affect the other embryo so your happy ending has given me hope 😊

[Millbanks]

Hey lovely, I can completely understand how you are feeling.

We had 8 embryos tested (after 5 failed FETs) and 6 came back normal - and although I was very happy that we had normal embryos, it also meant that it was likely that at least some of the previous embryos transferred were normal too, So like you I felt a bit deflated.

But I had bloods taken to test my immune system / NK cells and it turned out they were high. So the next transfer I had steroids and intralipids with a PGT-A embryo and it worked. Our little boy is 22 months.

So although it can be frustrating, you're in a really good position xx

[Flowergirlhope in reply to Millbanks]

Aw thanks Millbanks - this is so helpful!

This afternoon i asked about Autoimmune tests (as i have Autoimmune problems in my family) and they say they only do the Antiphospolipid antibody blood test, which tests for the following:

- anticardiolipin antibodies

- lupus anticoagulant

- beta-2 glycoprotein

Otherwise she said If i am interested in the uterine natural killer cell tests- they would advise for patient to self refer to Professor Siobhan Quenby's clinic.

Can I ask do you know which Autoimmune blood tests you had please?Also for your NK cells was this a blood test and who did you go to for this?

Thanks so much. so helpful and gives me a tiny bit of hope and thanks for your encouragment🙏🥰

XX

[Millbanks in reply to Flowergirlhope]

So I had the full immune blood count done - cytokines / NK cells etc...

Yes it was a blood test - my clinic do offer a uterine test too but I had already had an ERA test done and didn't want to have another biopsy.... I just had it at my clinic - they send the bloods off to Chicago (they are named the Chicago bloods) and they aren't cheap, but for me it was well worth it.

I don't have an autoimmune disease myself but both of my parents had psoriasis so it was a bit of a red flag to me. It turns out my NK cells were at a much higher level than they should be. The steroids brought them low enough for my body to accept the embryo.

I really hope you get some answers soon as those lovely PGT-A tested embryos are waiting! xx

[Flowergirlhope in reply to Millbanks]

Thanks so much millbanks thats very helpful. Maybe i need to contact the clinic they said about and ask for the full immune blood count to be done.

aw - thanks 🥰🙏Really hope something can be done xx

Thanks againxx

[Chel91]

I was in a similar situation. For me it turned out to be endo and immune. Definitely recommend further testing / treatment for those. I "wasted" 10 embryos just continually transferring, but to be fair I was a complicated case and it took a lot of trying different things / testing before we found what works. You will get there in the end! At least you know you have lots of euploids now so you can focus on everything else xx

[Doodlebug23]

I asked my clinic about additional tests and they said they didn’t recommend as they are all still research (my clinics are heavily involved in lots of research and also have a recurrent implantation failure unit) but I could do them if I wanted at my own cost. They are saying it’s a numbers game, but after 5 transfers (6 embryos) they are adding steroids and a few other things anyway this time x

[happypupp]

How old are you? My clinic told me over a certain age they recommend heparin/clexane for FET

[Wishinandahopin]

Firstly- great news that they are normal!

It’s hard to know for sure that the ones that failed were or weren’t normal.

I had my embryos tested before my first transfer and my first and second transfer were with ‘normal’ tested embryos and both were unsuccessful- so I knew it was unlikely the embryo that was the issue after that.

We had lots of tests done after this as we only had mosaic tested embryos left so we wanted to make sure we gave our best chances of one of these working.

I had ALICE/EMMA testing (both were fine but I had done some vaginal probiotics the summer before the test due to a bad vaginal microbiome test).

I had an hysteroscopy - everything had always looked fine on scans but in the hysteroscopy they found I had a narrow uterus due to fibrous tissue that they were able to reduce.

I did immune testing, my clinic didn’t do NK cell testing as there is not enough evidence behind it, but they tested for blood clotting disorders, and autoimmune disorders etc, they also tested KIR/HLA compatibility with me and my partner. It was this test we found out our chances of implantation failure and miscarriage was super high! They also found out I had MTHFR gene mutation (which increases chances of clotting).

They put me on various medications for all this including steroids and blood thinners. And a special one for the incompatibility issue.

I also did a completely different FET protocol this time round.

Anyway after all that we had one of our mosaic tested embryos transferred and luckily it took and I’m now 30 weeks and so grateful we did all those tests.

That said that was after trying two normal embryo transfers so we knew it wasn’t the embryos.

It’s true that it’s more often the embryos that are the issue but there will always be people that fall into the gaps - we were one of them. And immune testing shouldn’t be offered to everyone as a first measure but it’s something that is definitely worth looking into after a few failures.

Sending lots of luck and I really hope your next one works for you!