Herpes (or acyclovir usage) affecting implantation after ivf embryo transfer?

[Norregirl]

I have had herpes for about 10 years. I have noticed more outbreaks during stims. I've already had 2 failed transfers and am worried both that having herpes and /or taking acyclovir will affect implantation for my last transfer. I've read some conflicting studies on acyclovir and it's effect on implantation. Some say it increases implantation rates, some say it reduces. I'm already doing downregulation with zorodex for a few months, then considering prednisone and baby aspirin for the Fet as an immune protocol but worried about another outbreak complicating things.

Would love some advice.

[Seren0119]

Low dose acyclovir (200mg) a day will help reduce chance of an outbreak and also prevent NK cells from increasing, hope that helps x

[Norregirl in reply to Seren0119]

Yes! This was the info I was hoping for. Thank you!

When do you take it until?

[Seren0119 in reply to Norregirl]

Until the 12 week scan (when miscarriage rates are much lower) xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi Norregirl. This is unfortunate, but I feel it would be goo to treat the herpes more befor the FET. Before transferring your last embryo. You will b b est guided by your specialist I’m sure. Good luck? Diane

[Norregirl in reply to DianeArnold]

I'm downregulating for a couple of months so I could ask them. So you're saying its better to do before rather than taking it as part of my transfer cycle protocol?

[DianeArnold Partner Nurse Fertility Network UK in reply to Norregirl]

Hi. Hopefully the longer down regulation will help. Your specialist will be giving you the best chance. Diane

[Norregirl in reply to DianeArnold]

It's a good thing to ask them now while I'm downregulating with zorodex. Glad for your suggestion!

[lulubelly1983]

I’ve had herpes for over 20years now and have a very mild outbreak around twice a year, I wondered has your clinic said if an outbreak in early pregnancy could cause a miscarriage? I haven’t been able to find any info on it at all, are you taking the medication to avoid an outbreak during transfer? TIA

[Norregirl in reply to lulubelly1983]

Hi lulubelly I'm downregulating for a few months before my transfer so I'll ask my clinic whether an outbreak can cause a miscarriage. I know I asked my doctor this and she said no it doesn't affect the fetus but I'll check with my fertility clinic Dr as we as when I should start taking the antiviral. Will get back to you...

[lulubelly1983 in reply to Norregirl]

thank you it’s just I had a missed miscarriage (empty sac) at my 7wk scan and had very mild outbreak at around 4wks and I can’t help wonder if that’s why it happened or was that little egg always destined to not develop, fingers crossed for you make sure any prenatal vitamins you take don’t have L-arginine in, pregnacare plus does and with two days of started it I had an outbreak, I’ve been taking making my own beetroot, melon and ginger smoothies and have a glass a day this way you can get the same benefits that l-arginine provide without taking it 👍🏻

[Norregirl in reply to lulubelly1983]

Oh my gosh I'm so sorry. I know it's easy to wonder. I've had 2 failed transfers and also had a hard time with myself around things I didn't do or did do it's so hard mentally. Sending you 💓

[Norregirl in reply to lulubelly1983]

Hi lulubelly, I heard back from my fertility clinic on this and they didn't have an answer on this except that if I'm prone to outbreaks from the hormones, I should start taking acyclovir 2 weeks prior to my last transfer and for 2 weeks afterwards. Sorry I couldn't give you a more definite answer but I'm hoping you have another chance to add this to your protocol. 💜

[lulubelly1983 in reply to Norregirl]

Thank you good luck for you over the coming months, I’ve got my BFP and won’t be doing anymore cycles to just fingers crossed for my viability scan in a few weeks I’ve had again a very very mild outbreak around implantation and so nervous for my scan I’ve just never even thought to take anything for the herpes so was intrigued when they suggested to you to take a preventative to why they wanted you to thank you for getting back to me x

[LesBC in reply to lulubelly1983]

Hi did you get a hsg or sis ? I’m nervous about getting these tests while having our condition. Will it spread through the cervix ?

[GranolaHippo in reply to LesBC]

If it's a recurrence, not your first outbreak, it won't spread around your body.

f it's first outbreak (your initial one after infection) then you're best off waiting for any treatment that could spread it.

This was advice on the virus spreading (in general, not in context of IVF or fertility) from the Herpes Virus Association about 10yrs ago.

[LesBC in reply to GranolaHippo]

Okay, thank you! Had it for about 3 years now.

[GranolaHippo in reply to LesBC]

You'll be fine.

Unless you have some really severe autoimmune condition (as in full-blown AIDS not HIV) you cannot spread it around yourself, it is self-limiting.

It's basically a coldsore, just on a different mucous membrane. I find that a helpful way to think about it as you wouldn't worry about suddenly getting one on your eye rather than your lip etc.

If you're worried about the poking around causing an outbreak when you usually have it, you can ask for prophylactic acyclovir. No need to suffer an outbreak if you don't need to.

I used to get outbreaks with hormonal shifts (I have had recurrent miscarriages) and was eventually put on suppression for this. This actually led to our longest pregnancy. Not to do with the herpes but likely, as noted above, to be due to impact on NK cells, or just coincidence.

[LesBC in reply to GranolaHippo]

Wow , sorry to hear about your loss. Thank you soooo much for the information! I usually only get the tingling itchy feeling no real sores or blisters . Just finishing my menstrual I found one blister. My hsg is scheduled for Monday so I’ll have the doctor determine if we move forward or not

[GranolaHippo in reply to LesBC]

Thanks.

I imagine you'll be fine as it'll be all but over by Monday.

I had one blister when I was having my baseline scan in July, ahead of an FET in August. I told them in case they didn't want to scan me, but that didn't even cross their minds, to the extent that they just assumed I was telling them so that they could be cautious when scanning and not knock it and hurt me.

It's such a minor and common infection that no one in the medical world sees it as a big deal.

[Norregirl in reply to GranolaHippo]

Did they put you on prednisone for this?

[GranolaHippo in reply to Norregirl]

No. Prednisone would make herpes worse as it suppresses the immune response.

Neve had steroids for fertility and would be cautious of taking them without a compelling reason due to side effects, medium to long term impacts on the body and them potentially worsening implantation rates if NK cells are actually too low rather than too high.

Acyclovir is treatment for herpes outbreak or valacyclovir or famavir (sp?) if acyclovir is not effective.

[Norregirl in reply to GranolaHippo]

Oh I see. So by suppression therapy, you used acyclovir...?

[GranolaHippo in reply to Norregirl]

Suppression of herpes simplex virus, to avoid outbreaks (we were trying naturally until earlier this year and outbreaks interfered with this because my partner has not knowingly had the virus, so I avoid risk of passing on. Also outbreaks suck and i was regularly getting them as miscarrying regularly)

So not suppression of my general immune system for fertility purposes. As, for me, that isn't indicated

[Bridget77 in reply to lulubelly1983]

Hi, sorry I know this is an old post but I’ve just been diagnosed with genital herpes and I’m due to start my FET in April. Not sure if I should take antivirals and I wondered in your comment why not to take l-arginine as this is meant to help grow the lining? Thank you!

[lulubelly1983 in reply to Bridget77]

L-Arginine can cause a flare up of Herpes and I definitely found that is caused a flare up for myself when it was in a multivitamin I was taking it’s in a lot of prenatal vitamins so I had to find one that didn’t contain it

[Bridget77 in reply to lulubelly1983]

Thank you! It is in my prenatals and I was also taking 1000mg extra a day so I've now stopped that. It's hard to manage it alongside the IVF too.

[Norregirl]

Wow, amazing! Fingers crossed for your scan. Super good news 🙌

[lulubelly1983]

yes I’m chuffed I’m just trying to allow myself to get excited everywhere I’ve researched it says an recurrent outbreak does not effect pregnancy, and a blighted ovum egg can look normal but can have faulty chromosomes so will have its fate decided so I guess I have to just take this info and out it to bed 👍🏻