After getting a whopping 32 eggs at egg collection last week, we are down to three day 5 embryos at blastocyst stage. There are a few still developing that my clinic wants to see if they develop into day 6 blasts - but am feeling quite shocked at how huge our drop-off has been. We are sending our embryos off for PGT-a testing, too, so I expect another drop-off there.
My dilemma is - I was hoping to have a larger handful of embryos to freeze and transfer if needed. Try one and see, and if that doesn't work, go for reproductive immunology testing before another FET. But with likely fewer than 3 embryos now after testing, should I do these tests beforehand?
Background - I have psoriatic arthritis, which is an autoimmune disorder. I also have elevated thyroid TPO antibodies (142 when measured last year, have since cut gluten out and have just ordered an at-home test kit to see how I am doing.) I am on 50mcg levothyroxine as my TSH was previously hovering about 4. I also have a slight vitamin b12 deficiency because of the meds I take for arthritis. I also have mild adenomyosis, suspected endo and polycystic ovaries (but not PCOS). I have also battled with recurrent BV and ureaplasma in my vaginal microbiome.
With all of the above (it sounds a lot when I type it out!) I worry that I may be susceptible to uNK cells or endometrial issues, or god knows what else immune related. I read so much about how women were put on steroids and many other meds and were finally able to have their babies after intervention. Neither my GP nor my clinic are fussed about the above but I know the NHS is behind on many of these investigations.
Am I overworrying or is it advisable to seek investigation first, before having an FET with maybe just one embryo?
Sorry this was mad rambling, I'm just unsure what to do. I had a miscarriage last year at 7 weeks where the fetus was growing well behind schedule and never had a heartbeat, so no idea if it was a chromosonal issue or something more sinister in me.
I can't help but shake the feeling that me and my body is the problem.
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orangecatmum
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I hope your embryos develop well and come back normal.
Please remember that the sperm is the other half of the equation. Maybe the embryologist can tell you when the embryos started to decline, there are some clues that help them guess if it is an egg or a sperm issue. But a lot of things aren't clear with IVF.
It sounds like there's a lot you want to explore so maybe a second opinion wouldn't harm, while waiting for embryos to be tested. But generally clinics usually do further investigations after a number of failures. It's counterintuitive but the general approach is transferring embryos as for most women repeated transfers will lead to success.
As for the autoimmune factor, I have an autoinflammatory condition. My egg quality is crap but still no doctor has confidently said that my condition affected the egg quality and infertility I believe it has but I will never know . Sometimes autoimmune issues are blamed for inferility problems but again I don't think the connection is as simple. For reference my sister in law has the exact same condition as you psoriatic arthritis and thyroid problems and other gynae issues and didn't have any difficulties conceiving and carrying full term.
Thanks for this! It is good to hear someone with my conditions was able to have a baby. My concern is more - do I have NK cells or other immune/antibody issues that will prevent me from getting pregnant and staying pregnant? I can't help but shift this gut feeling (I had a gut feeling I was going to struggle with fertility and also miscarry - I was right both times) but also I am so aware I have read the accounts of hundreds of other women online so have inhaled all of their diagnoses too.
But the autoimmune disease issue, I can't shake the feeling. I have looked into the Era, Emma, Alive and NK cells tests - but I have only had one pregancy and one MC so I don't appear eligible for most testing. The majority of immune-based tests seem to be for those with recurrent MC or implantation failure.
But I want to get ahead of the game and eliminate my chances before I waste any embryos... I can't decide if this is a normal mindset or not, ha.
It makes sense to test for as many possible things before transfer but clinics don't usually do this. It is a very normal mindset to want to avoid failures. As far as I know GPs and NHS don't offer any of these you mentioned.
Ultimately it's your decision if you'll have the tests. The doctor can advise you if they think you should or not. I am confident that the clinics who perfume tests will gladly let anyone with the slightest hint of immune issues to have them.
There are also online labs that offer alternative less invasive methods of testing immune issues.
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