FET- advice sought!

[Nes1005]

Hello all ❤️

Sadly, this is far from my first ivf experience, but I am about to embark on what will be my first FET. None of my embryos were ever good enough to freeze on the 5th/6th day according to my UK clinic so always had The fresh transfer and that was that. However, moved to a clinic in Cyprus in November last year to save the pennies as literally have nothing left. I had a fresh day 3 transfer which failed but had two frozen embryos left which they froze on day 3 because my preference is to have my transfers on day 3.

So this month is supposed to be the frozen transfer, I’ve had no drugs and doing it naturally ( don’t think drugs agree with me plus I have reoccurring fibroids which don’t like estrogen!), the clinic weren’t enthusiastic about a natural FET.

So I had bloods in the uk on Friday which was only cycle day 10 and the results were pointing to me being close to ovulation which would be early for me, (usually day13/14) Clinic then asked Me to do a scan on Saturday morning which I did at 9.00am again pointing to imminent ovulation with a dominant follicle at 22, lining 6.7mm. Sent the scan results to Cyprus and they started saying might have to cancel and that ‘this is why they do not recommendnatural or modified natural FET’. Basically made me feel like it’s a hassle to them. They then said I MUST get another blood test Sunday without fail and get the results to then on Sunday as they felt I was going to ovulate Saturday night or Sunday. I tore my hair out to find a blood test on Sunday in London and managed to get them done at midday. I got The results back at 9.30am this Morning. LH has started to go down and estrogen has gone down so my interpretation is that ovulation has happened, I’ve sent the. Results over to the clinic and. Waiting to hear.

The clinic is saying they don’t want to guess re the ovulation and waste the embryos. Time is not on my side, I am 43 and this is a month lost if this doesn’t go ahead.

Having not done FET before I don’t really understand how precise it would have needed to be for the clinic to be happy. Unless you have 2 to 3 scans a day, surely you can’t get the exact moment of ovulation which is what to me, it feels like they are saying.

Would be grateful if anyone else who has done a natural FET and or ovulated early unexpectedly during that could give any advice or thoughts.

I’ve been through so much heartache over the last two years, it is very hard to raise myself and my belief but with the help of my trauma counsellor, I was actually feeling quite positive about this FET but now it seems it might come crashing down.

Thanks for reading and as ever my love and hugs to everyone going through this journey or struggling. I hear and feel you.xxx

[Millbanks]

Hello lovely, sorry to hear it's been so stressful.

I've not done a natural FET but when you do a medicated one, the window of implantation is critical for transfer timing.

For a FET, you start progesterone and then the transfer is calculated in hours (rather than days) so I assume for a natural transfer, you would need to similarly calculate it from the moment of ovulation (as that is when your body starts producing the progesterone).

If you clinic don't have much experience with natural transfers they may be worried about missing the window implantation?

I don't have any advice, just might explain why they are being so funny about it.

Really hope you get to have the transfer xxx

[Nes1005 in reply to Millbanks]

Thank you so so much for replying.

What you say is Super helpful, and I see what you mean about the progesterone and that dictating the transfer timing. How do they know exactly when you ovulated on a medicated cycle, is it because you have a trigger shot?

[Millbanks in reply to Nes1005]

So on a medicated cycle you don't ovulate at all. You start on the first day of your period, taking injections which suppress ovulation - the idea being that you don't really have a cycle.... You shed your womb lining, then take meds to build it up again - then when it's ready you start taking progesterone (which simulates ovulation) and then 5 or 6 days later you have your transfer.

I say 5 or 6 because everyone's window of implantation is different - most people are about 5 days but some are later / earlier. When doing medicated cycles its a good idea to have a test done to see when this is (mine is 6.5 days or 138 hours).

xx

[Nes1005 in reply to Millbanks]

Ah okay - that makes more sense, thanks so much for explaining it so clearly.

To make matters even harder- because it’s an embryo frozen on day 3, I think it has to back in on what would be day 3 so not much time to play with here!

Patiently /not patiently waiting for my co-ordinator in Cyprus to message me now with an answer one way or another.

Oh the waiting!!!!!!!!!!!!!

[Millbanks in reply to Nes1005]

Ah Gaaaaad! Yea that is super tricky. Really hope the timing works for you

xx

[raverg]

I’m currently doing a natural FET and my clinic has been very relaxed about it all. I think it’s because they do it quite often and they seem to operate 7 days a week, so they can be quite flexible with a natural FET. But most UK clinics seem to grumble when it comes to natural FET’s from what I’ve read and heard, and some just refuse to do it. They like the predictability of the medicated ones.

Here’s my timeline in case it helps. It’s for a day 5 blasto and I’m 36. So I went on day 9 and I was already having a dominant follicle, maybe at 17 mm and with lining of 7.1. Then I tested for the LH surge which was on day 14 in the morning (usual test line darker than control line), and then they booked me in for the FET on day 20 at noon. No blood tests, extra scans or even progesterone, being all natural. So I’m not sure if they were trying to hit a particular window, and they definitely didn’t look for it but they seemed to have a set protocol about doing the FET 6 days after the LH surge for a day 5 blasto.

Hope this helps, and maybe someone who’s done a natural FET with a day 3 embryo will be able to share their experience too. Good luck!

[Nes1005 in reply to raverg]

Ah thank you so much for all the info, I really appreciate it and I feel a bit reassured that the added progesterone is not so key when it comes to natural FET. Are you in your 2 week wait now?

The clinic has come back and said we can go ahead, I think between the scan on Saturday and the blood test on Sunday they have a small enough window of when ovulation occurred! I’m just trying to book a flight for tomorrow now- transfer Wednesday!

Thanks again for taking the time out to share, it really has helped. x

[raverg in reply to Nes1005]

I felt a bit "exposed" as well going into a FET without added progesterone, but I imagine that they would have recommended taking it if there were any flags. The way I'm trying to help the situation along is by doing acupuncture and hopefully that encourages progesterone naturally.

I've had my FET today actually! So the 2 week wait starts now yikes.

I'm surprised that the clinic went so hardcore with tests and scans, but didn't even ask you to do urine ovulation strips, just for another way to narrow down that window. My clinic only used ovulation strips and were very relaxed about that too. They said that if I miss it / can't find it, they'll just bring me in for a scan, so they weren't too bothered about it.

I'm pleased that you heard back from the clinic and you finally have some clarity and that you can go ahead! I'm also so pleased that I was able to help. Best of luck for Wed!!!

[Nes1005 in reply to raverg]

Aaaah good for you and huge huge positive vibes for the coming weeks, I’m be wishing you and all others waiting good luck and BFPs!!!! xxx

Between the two answers I got on medicated and natural , all is much clearer in my head now. It’s so nice to have this forum for support and knowledge!

Lots of love to everyone on the journey.xxx

[Fruitandflowers]

I didn't get as far as the natural FET but was about to have one as I don't seem to react normally or well to the synthetic hormones, and my lining and progesterone levels are always better naturally. Having said that I did have success with a medicated FET first time, so it definitely can work. For the natural FET, my clinic were ok to do it but after a lot of warnings, the main one being about timing and control, basically they don't have any and they said if the transfer day fell on a weekend it would be very difficult for them and Sundays were definitely out. They also said almost every single FET they did was medicated, in part because of the timing difficultly and risk of cancellation, whereas they said the success rates of medicated vs natural were roughly the same. My NHS clinic had always point blank refused to do a natural FET because they couldn't schedule them. So I think that's the main reason lots of clinics don't offer them or are reluctant. And I've heard that many clinics say it requires extra scans and monitoring to confirm ovulation but mine were happy for me to go off at-home urine ovulation tests (no bloods or scans), and once I had a positive, I should plan to come in 5 or 6 days later for transfer, so actuallya lot fewer appointments. They did also say I could start taking progesterone around then too, even though it wasn't necessary in their view on a natural cycle and my levels are OK. With the travel it's obviously a lot more difficult for you and it sounds like it's been a much bigger stress. I hope you are able to make it work as I know every month feels wasted and like everything's on hold x

[Nes1005]

Ah thanks so much for sharing your experience, now I understand much better, I can see exactly why as you say clinics prefer medicated so they plan and schedule better.

Up until my unexpected early ovulation it was feeling quite relaxed without any drugs involved! My clinic did warn me they would. Want bloods and scans regularly from day 10, just my body decided to go rogue and ovulate early which upset the plan a bit! All is well as they are happy to go ahead Wednesday so fingers crossed for then! Now just need to book a last minute flight!