Me or the embryos?

[Ytrewq123]

Hi ladies, I’d be really grateful for anyone’s thoughts. We’ve just had multiple FET failures with top quality blastocysts. Over the past few years I’ve had 4 chemicals (always before 5 weeks), maybe 6 (single faint positive with the additional 2).

I want to look in to embryo testing and immune testing, but not sure I can afford both.

Does this sound like more of an embryo problem, or a maternal/womb issue?

As my chemicals always follow a similar pattern, I’ve had no MMCs before, deep down it doesn’t feel like a chromosome thing, surely this would mean you’d have MCs at varying stages?

I read a quote from a well known consultant that said “the most common reason for a miscarriage is chromosome anomalies, but it is not the most common reason for recurrent miscarriage”.

Does this sound like an embryo or womb issue to you?

The only other things we haven’t tested are sperm DNA fragmentation and karotyping.

Thank you xx

[Orangeflowers]

Hello, navigating the costs of all this is expensive. My recommendation would be to avoid ALICE/EMMA and ERA and instead have a dEFT with Prof Bronsen at the Coventry Implantation clinic. Far cheaper than the combined costs of the other things (for which there is limited and questionable evidence), yet still likely to identify if any issues.

Once you have done that, if all is clear, I'd either do PGTA (if finances allow) or continue, transferring 2 embryos at a time. PGTA can't actually sort any issues only might speed time to pregnancy if you are getting a lot of blastocysts. At CARE if you use embryoscope it costs a few hundred on top of that.

Also recommend treatment abroad - cheaper and quicker.

All the best 🤞🙏xx

[Ytrewq123 in reply to Orangeflowers]

Thank you so much, really helpful to read this. My Coventry results were all normal, which surprised me, but a good things nonetheless!

[Boo718]

hello, I had a number of chemicals always 5 weeks ish so we did the Emma Alice and era tests it came back that I needed an extra days medication before transfer. So I transferred on day 6 instead of day 5. That transfer is asleep as I type xxx good luck xxx

[Chel91]

Hi, this sounds a lot like me before my successful cycle. I've had countless chemicals, one MC, 10 embryos that failed (including one PGT-A tested normal / euploid). As far as I'm aware honestly the best answer to your question is dependant on your age most of all. If you are say around 38+ it's a lot more likely it's embryo related.

That being said, I totally agree with you. A lot of doctors will fob you off saying it's embryo related, but it's definitely not the only cause. PGT-A is very expensive and only reduces the number of transferable embryos. Studies find it can lower success rates, so I'm not big on recommending it.

I would definitely lean towards immune issues, endometriosis, endometritis (infection / inflammation), or blood clotting disorder. Also want to rule out hydrosalpinx, fibroids and polyps. What tests and such have you already done? xx

[Ytrewq123 in reply to Chel91]

Thanks very much for your thoughts. I appreciate it! Although I want to look into embryo testing, deep down I feel there must be more at play. I’m so torn, and don’t want to do another transfer until I’ve ruled more things out, I’m worried I could have wasted top quality embryos for nothing. I have a hysteroscopy booked and planning to look into immune testing too. Could I please ask what did you change that enabled you to have a successful transfer?

[Chel91 in reply to Ytrewq123]

I did several changes. I had a lap surgery where they found and removed endometriosis (I personally think this was most helpful to me, but I'm not sure). I used IVIG. I also did keto diet change. Double antibiotic treatment. Plus blood thinners. Prednisone, hydroxychloroquine, immune treatment. Extra progesterone and estradiol monitoring. I threw everything at it after 10 I was almost done. xx