WTAF do we do now, what do I ask for?

[Darcy1996]

Sorry for a long post. Feeling more than a little fragile, defeated and lost. We just heard from our clinic's counsellor as our PGT test results came back - our 1 embryo from our 2nd round is missing a chromosome and would not have been a viable pregnancy - and all they can say is it is sporadic and no known reason why it would occur.

In our first round we had 10 eggs and got 1 to blastocyst but not to biopsy stage.

This was our second round and from 17 eggs, we had 12 mature, 6 fertilize with PICSI and 3 got to blastocyst but then 2 were not able to be biopsied and started to degenerate. This was our only little fellow to get to biopsy and was a good-looking little 5AA. I was trying to be realistic that 1 might not be enough, but I was not-so-secretly holding onto hope that this was the 1, that we would join the "it only takes 1" brigade.

We are 42 and 51 so I feel battered by the constant chat about my age, as if I don't know I'm pushing my luck! have been TTC for 3 years and we had 2 MMC last year naturally - I have had a hysteroscopy, and my fibroids checked, made big lifestyle changes and lost 14kg, and my partner has given up smoking for over a year now too. We take all of the supplements and I have spent so much money and time on acupuncture and counselling.

We have been to the recurrent miscarriage unit at Tommy's and have a plan for steroids but I cannot get that far, to need to take them for a FET.

We changed our protocol from round 1 to round 2 to increase numbers and quality and added Zomacton (with Pergoveris and Fyremadel) and we had better numbers this time, but still just 1 blastocyst to test.

Partner has low morphology but good numbers and no further tests have been discussed for him, just having a good lifestyle and using PICSI.

We only have 1 round left of financing with Gaia, and I just can't get it out of my head that it might not be enough. That we might not be able to boost our chances enough to be successful given how much we have thrown at this.

I don't think I am ready to talk about donor eggs or sperm either, or can afford either and I am worried that might be the team's only suggestion now.

What would you ask at the follow-up as I cannot get past "wtaf?" and "help".

thanks all

[Millbanks]

Ah love, I'm so sorry to hear this - the PGT-A wait is as bad as the 2ww / scan wait.

I know it's awful to have that news but better to not have transferred and suffer a miscarriage or worse later down the line. Although I know this is probably not what you want to hear right now.

I really feel for you - you've made so many changes and nothing seems to help - it's relentless.

And I'm so sorry to hear about your mmcs - just horrendous. For what it's worth I don't think you're too old - there are plenty of ladies on here over 40 having success.

There are a few things you can both try to help with egg / sperm quality that might be worth looking in to (if you've not already) if you are thinking of having another egg collection.

High quality ubiquinol (600mg a day) and 1800mg a day of NAC really helped me, I took it for 3 months before egg collection and we had a lower number of eggs but a higher rate of blasts. It's not cheap (of course, what in IVF is....) but for me it was worth it. Both supplements give your cells more energy to divide and split in a healthy way so it really helps with the building blocks of eggs / sperm.

A diet high in antioxidents can help too - I had a daily smoothie of 250ml whole milk, 1 tablespoon of flaxseed powder, 1 tablespoon of chia seeds, 1 banana and a tablespoon of dried blueberry powder.

Lots of green veg, watercress, protein and beans / lentils.....

Sorry if this all sounds a bit pedestrian, I know it would be so nice to have a silver bullet to just make it all ok, but I do believe there is still lots of hope for you.

Sending a massive hug to you xx

[Darcy1996 in reply to Millbanks]

oh goodness, thank you so very much Millbanks you are ridiculously kind, always. I have upped my blueberry, flaxseed and chia seed intake but only with my yogurt in the morning so perhaps I need more. I take Ovum which seems a great quality and well researched multi-vitamin and it has 600mg a day of NAC so thank you, that is new to me and I am going to look at topping that up to 1800mg. It has their own form of high quality coQ10 and then I top that up too. I am super on the fence about DHEA - is that something you ever took?

thank you thank you. Never pedestrian, always super informative and kind x x

[Millbanks in reply to Darcy1996]

I never took DHEA as I was never completely sure what it did - but having had a quick Google it might well be worth a try?

I used the Pharma Nord ubiquinol which is fairly pricey but I think very good quality - and the NAC I do think you need a particularly high dose. Ovum sounds good!

Is your partner taking this stuff too? I made my husband take it even though no sperm issues and we never tested to see if it helped but I'm sure if it is helping egg quality it can help sperm too. Or at least protect it from harm - I think that's what the antioxidents really help with.

I did go to see a fertility nutritionist specialist who basically gave me most of this info (some I just researched) so (and I know it's yet another expense) if you fancy talking to her about this then I can give you her name.

xxx

[Darcy1996 in reply to Millbanks]

I feel the same re DHEA, plus the jury seems out on whether or not there should be regular testing to check levels. My clinic is supportive of it, but neither suggested it nor prescribed it.

yes my OH is on CoQ10 and also moved him recently onto the TestHim multivitamin - not the fish oil tho which I am sure isn't a bad addition.

I think that would be a great idea re the nutritionist, so if ok, I will message you now. Thanks for answering my emotional outburst!

[Millbanks in reply to Darcy1996]

Oh love I’ve had so many of them!! (Emotional outbursts)… it’s so frustrating when you’re doing all the right things.

Hopefully something will help! Xx

[Sja1981 in reply to Darcy1996]

I am taking DHEA purchased from Biovea, if came from the US.

My clinic said I don't need to test before taking it, although other clinics insist on it, so?

I'm taking 25mg 3 times per day. That egg book seems to be supportive of it.

Also coq10, magnesium, Proceive, Proceive Omega, folic acid, evening primrose oil, melatonin, shatavari, tissue salts combination 12. I'm rattling!

I just turned 43 so am trying to improve egg quality. I'll look into ubiquinol and NAC.

Also I'm a Qigong instructor so have my own daily practice and it's helping with all the anxiety. I dont have any partner helping me, or family support.

My friend did DD and has a beautiful daughter. I didnt think I could ever be open to it but I am now. We are both with Clinica Tambre.

Wishing you all the best xx

[Darcy1996 in reply to Sja1981]

thank yo so much and my goodness you must be rattling - how do you feel on it all? I was taking extra iron and it really did not agree with my gut, no matter if I had with yogurts or orange juice for intense vitamin C. I also have IBS so trying to avoid additional inflammation...so much to watch out for and be mindful of

[DianeArnold Partner Nurse Fertility Network UK]

Hi Darcy. Reading on, there is lots of good dietary advice to follow, from one of the warriors. Medically wise, with apologies if already doing. Have you has your Fallopian tubes checked for blockage, as you don’t want any toxic fluid dripping into your womb, preventing implantation. Also, have you had a hysteroscopy to check out your womb and biopsy the lining . Not too many vitamins unless you need specific ones. They can overload your liver. See what others have to say. Thinking of you. Diane

[Darcy1996 in reply to DianeArnold]

Hi Diane, thank you for these thoughts. I have had a hysteroscopy, many scans and a hysterosalpingogram and all was clear (bar the fibroids but they are not intruding into the cavity). Do you think there are other tests I can try or ask for? I have had an endometrial biopsy taken twice too.

I find it so confusing re vitamins and supplements and the "It starts with the egg" book is pretty overwhelming - I am taking Ovum which seems to be a really good quality fertility multi vitamin and I add Omega 3 fish oil and extra CoQ10 to supplement but I have read so much for and against DHEA, is that recommended too? I just don't know anymore <3

[Lovkat86]

Unfortunately, sperm morphology is almost more important than numbers and can absolutely contribute to low numbers of blasts and embryo aneuploidy. This is because you're looking at the form/structure/quality (morphology) of the sperm itself.

Have your specialists discussed ways to improve the morphological percentage of the sperm? Smoking can affect sperm quality, so it's good he has already stopped (I am not knowledgeable on the possible longterm effects it could have on sperm, how long he's smoked for, or how age would also factor into this).

If you might only have one more shot, I'd really take my time to become educated on the various factors you do have control over (diets/meds/exercise/overall lifestyle) and make every effort to address what you can.

[Darcy1996 in reply to Lovkat86]

Thank you Lovkat86 - we have our follow up on Tuesday & I feel like the clinic haven’t brought much to the table re his side, just supplements & treating with PICSI rather than treating him months before.

I’ve had so many biopsies, specialists, scans & x-rays but nothing on his side which is so frustrating.

We don’t have much time & only one more attempt so I’m really tempted to book both urology for him and a nutritionist for us both. I know it’ll be so expensive to do, but potentially so much more to lose if we don’t. I don’t want to think we left something we didn’t try 😟

[Lovkat86 in reply to Darcy1996]

Do what you can in the meantime!

I'd definitely book a nutritionist.

I just saw in another response that you indicated you were vegetarian, so I'd look at making sure you're both getting enough micronutrients as deficiencies can affect fertility.

Best of luck!

ncbi.nlm.nih.gov/pmc/articl...

"Although more high quality evidence is needed, balanced plant-based diets rich in fibers and low in fat are considered to be protective against poor pregnancy outcomes such as PE, DG, and preterm delivery. However, these protective effects disappear if micronutrients deficiencies emerge. Moreover unbalanced dietary patterns with lack of macro- and micronutrients such as proteins, vitamin B12, vitamin D, calcium, DHA, and iron are at more risk of fetal impairment (low BW, neurological disabilities, and fetal malformations). Maternal undernutrition may potentially alter fetal growth trajectory by modifying placental weight and nutrient transfer capacity; depending on the severity of the nutritional deprivation and on the timing of depletion. Thus, plant-based diets during pregnancy and lactation require a strong awareness for a complete intake of essential key nutrients and vitamin supplements, according to international guidelines."

[Darcy1996 in reply to Lovkat86]

thank you so much - I think I am going to book in with someone for an overhaul - I need a fertility supermarket of services to select off the shelf and then pick and choose what I need <3

[Rubylou01]

Hi Darcy - am sorry to hear of your struggles. Am just about to go for second egg collection myself at 44 and everything I do is around egg quality - it's exhausting and expensive. Just wondering if you have had all your bloods tested for testosterone, TSH, etc and they are all in the correct range? As DHEA would potentially depend on your DHEA-S and testosterone levels and have heard that TSH should be below a certain level as well for optimising everything (My 1st clinic dismissive of low testosterone but with no medical expertise: I think your body should be working in sync with all hormones as think you want everything at correct levels so body focusses on eggs!). I don't know if it's helpful but I'm also taking strains of probiotics and prebiotics (kefir, sauerkraut, greek yoghurt, miso, etc) for optimising gut health to make sure I am absorbing everything I put in my body. I have no idea if it will work either but very hopeful xx

[Darcy1996 in reply to Rubylou01]

thank you Rubylou01 there are some great ideas here and I am sure gut health - for both of us - is something we need to optimise. I am on Probiotics but he isn't. My clinic was open to me being on DHEA but didn't test to help understand or suggest a dosage. I know my TSH level was an issue, but repeat tests last year saw it back in a "normal" range so I hoped that was ok but goodness knows - i completely agree that all factors need to be optimised - atm I think my body is focusing on work stress and not on beautiful-egg-creation

[Darcy1996 in reply to Rubylou01]

and best of luck to you - sounds like a lot of great changes <3

[Conceivingblee]

Hi Darcy1996Is development arresting day 3 onwards?

If so maybe its deffo worth doing an sos test or ordther DNA fragmentation test on sperm. My Clinic recommended vit A and C for my husband to help improve his as well as lifestyle changes and this did help his sperm quality improve by triple.

I stopped using my own eggs at 42. I felt I had had enough trauma and the end result for me was to have a healthy baby in my arms so chose DE at this point.

Good luck with your journey.

Xx

[Darcy1996 in reply to Conceivingblee]

thank you for your message.

Yes, the development is around day 5. For both rounds the fertilised egg numbers we have on day 1 are still the same at day 3, and then half that or worse to biopsy by day 5.

I do wonder if DE will be the only way we get that desired outcome - atm I think I need time on that decision but time is not a luxury that I have either, so it is incredibly hard. I feel like there is still so much to see and test - e.g. like DNA fragmentation and am contemplating seeing a urologist for him before we proceed - maybe we even need double donor..

I am so grateful for the suggestions - thank you

[skygreen]

Has your consultant mentioned melatonin?

I did two banking cycles last year trying for my second IVF/ICSI baby (I was under 40 during whilst trying for my first baby). The first cycle last year resulted in 6 embryos, 2 day 5, none after PGTA so none available for transfer. The second cycle my Dr added melatonin, changed drugs slightly to a combo of menopur and gonal-f. We got 2 PGTA euploid and am now 6 months pregnant.

It's been a 10 year journey to get here and we've tried everything but I really think tweaks to the actual IVF drugs can make a huge difference. See what your Dr can suggest.

Ovum worked well for me too as did no alcohol at all, no caffeine, collagen powder added to everything!

Good luck 🤞🤞🤞

[Darcy1996 in reply to skygreen]

thank you - caffeine I am struggling with tbh! I have one a day most days and went onto decaf during stims pre EC - and collagen I need to look at - I am not convinced of the efficacy of vegetarian ones (although I have curbed my vegetarianism for the fish oil if that is what the eggs need!).

Do you think Ovum helped? I think they did for me between round 1 and 2, with the changes to the drugs as well. It's hard to know what was the one thing that helped

No, they hadn't suggested melatonin so I will add that to the questions for Tuesday - do you remember how much you took?

congratulations btw x

[Choots]

Hiya,

Sorry for the short message but I really wanted to just suggest DHEA for you, along with proxeed plus for your husband. Best of luck to you both xx

[Darcy1996 in reply to Choots]

thank you Choots - have you taken DHEA as I find a lot of mixed information on dosage online!

[Choots in reply to Darcy1996]

I did take dhea, I took 25mg 3 times a day. If you get micronised it easier to be absorbed apparently

[Darcy1996 in reply to Choots]

thank you Choots

[Skittles11]

Hi Darcy. Just on the DHEA front, I believe it is usually suggested for women with low ovarian reserve. For example it is not good to take if you have PCOS. It is a hormone and I wouldn't personally want to take it without the support / recommendation of a doctor as it can have side effects and you want to ensure it is suitable in your particular case. My first clinic weren't bothered about testing levels but my second clinic were. You can test yourself through Medichecks if you want to but make sure you test for both DHEA and Testosterone x x

[Darcy1996 in reply to Skittles11]

thank you Skittles11 - I did read the same - tbh I find everything around DHEA unclear, although I'm definitely interested to know if it is an option to improve the qlty of the last few eggs we might get, if the clinic agree we can go again with our own. I don't know any more but thank you - I am going to look into Medicheck, thank you - the clinic didn't give me any levels to know what to look for, so I will definitely be asking for direction at our follow-up <3