Conflicting advice - do we do extra t... - Fertility Network UK

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Conflicting advice - do we do extra tests or not?

RedFox23 profile image
12 Replies

Weve transferred 3 top quality embryos without success. 2 did not implant and 1 ended in mmc.

Our current clinic has said it’s just bad luck and to go for a new cycle. The fact that one implanted means it’ll happen eventually.

Today we got a second opinion. He said he would class me as having recurrent implantation failure. The new clinic recommended a series of tests before a new cycle - Emma and Alice, decidual testing, hysteroscopy and a sperm investigation. The costs really stack up , almost £5k!

We’re in two minds about what to do - the tests are pricey but may save us having repeat failures in the future? Or is it just a numbers game?

Not really sure what I’m asking here but this forum is just a good place to share and get advice x

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Here4ivfinfo profile image
Here4ivfinfo

Sorry to hear things haven't worked out. I don't have advice because it's such a personal choice.

I'm potentially in a similar position depending on the results of my latest transfer. We had 6 embryos to start and we've used 4 now over 3 transfers. Our remaining two are our worst options and we have no clue if they are "normal". If this fails we know we're opting to go private and will PGTA test and use a different ICSI method too and do sperm defragmentation tests. It's going to cost us FORTUNES if this cycle has failed.

I don't know about the other tests you mentioned or how worthwhile they are. Are they considered "add ons"? What sperm test do they want to do? Sperm defragmentation? What I know about sperm is that if your embryos die later on in the process of growing them as in days 3-5 it's more likely to be a sperm issue. If they die earlier it's more likely the egg. So for me, I had 22 fertilised eggs that all reached day 3 and then most of them died which indicates very strongly that my partner is the issue (we knew this anyway). That said if the two embryos we've used this time don't stick I will be quite easy to persuade into doing more tests (if I think they are worthwhile and I think some of them probably aren't). It's so confusing isn't it?!!

Doodlebug23 profile image
Doodlebug23

You know my story and POV. My one was transfer number 7 and embryo number 10 after 5 BFN and a chemical. My clinic also said it’s a numbers game but added clexane and prednisolone and just skipped the expensive tests and added on the likely treatments. Modified natural too which means my body was producing progesterone.

I’m sure there will be lots if differing opinions and it’s a hard decision to make! Xx

CyclingAddict profile image
CyclingAddict

I had repeated failed transfers (4 failed and 1 chemical) and opted for Alice, Era and Emma testing (plus PGT-A testing). Yes, it was expensive, but they found out a lot of information and adjusted my next cycle based on the results. They found out I needed extra progesterone and I needed to take vaginal probiotics prior to transfer. They also did loads of extra blood tests and discovered I had an autoimmune condition that needed treatment prior and after transfer. I'm now 31 weeks pregnant. For us, it was worth it. The constant trying, the time passing, and not knowing why it was failing made us go for it. Of course there's absolutely no guarantees that extra testing will get you the result you want but, for us, we just needed some answers. Even if the results came back and everything was normal I suppose we could then rule those things out. If you've got the money or can budget to get the money I'd say it's worth it (based on my experience).

Sending you luck X

Londonlady2024 profile image
Londonlady2024

Hi, I had 4 failed fresh transfers... NHS clinic suggested hyCosy and if they found anything I would need hysteroscopy. Got all clear after test and transferred my 2 frozen embryos. One stuck and I had my rainbow baby boy in July last month. I'm 44 next week and my boy was born 4 weeks early to prevent another stillbirth (my first little baby boy was stillborn at 39+5 in 2020).

My opinion...it could take several transfers before it happens... Also, frozen is better than fresh...for me anyway because I was a strong responder to meds making it difficult to implant following egg collection due to all the hormones. My embryos were frozen due to ohss risk...and they wouldn't allow a fresh transfer at the time. This eventually turned into a frozen transfer a year later and I have my little boy - my NHS clinic gave me free storage for a year due to ohss risk. We tried another 2 fresh transfers with add ons ie aspirin , clexane, lubion and prednisolone however neither worked. Had my hyCosy in September 2023 last year followed double transfer in November 2023... medicated cycle with estrogen priming... everything basically in sync for a day 3 transfer (I had 3 fertilised and my clinic's policy was to freeze immediately at pro nuclei stage). By day 3, only 2 survived; one at 7 cell and the other at 8 cell - we told the embryos were "beautiful" by the embryologist.

Make sure you are taking all the supplements including taking care of your vaginal health and blood flow. My transfer was in winter so I had to do a lot of walking for blood flow.

Ultimately it's your decision and as you have had a mmc, I would suggest weighing up your options before going a transfer. Low quality embryos do produce healthy babies as well as I'm sure you have read.

All the best and wishing you success xx

Newbies1 profile image
Newbies1

Hi I’m sorry things haven’t worked out for you so far. I was in a similar situation and our clinic said the same after my first transfer failed and second ended in a chemical. I didn’t feel comfortable going again without doing some more tests. For me I opted for the EMMA, ALICE, ERA. These tests costs me just under £1000 but identified two issues that needed addressing. First was I didn’t have enough good bacteria so I took a course of antibiotics followed by probiotics and it also identified that I needed an extra day of progesterone before transfer. After completing the antibiotics and probiotics I did another transfer using the new protocol and thankfully this worked and I had a little boy from this transfer. So for me those tests were worth the extra cost. Wishing you all the best for your next transfer xxx

Twiglet2 profile image
Twiglet2

my clinic don’t do the extra tests but I debated getting them elsewhere. We added clexane and extra lubion rather than doing tests and that seemed to help implantation. I also just did probiotics myself no harm doing them at any time for good balance down there. In the end I opted to just keep trying to find the embryo that would work (currently 9 weeks and hoping it’s this one) took us 5 egg collections and 13 embryos though! But I am over 40 so takes a little longer to make a healthy embryo. I had also had a baby through IVF before so the chances of these tests showing something was lower as I hadn’t needed them the last time.

It absolutely is a numbers game and is usually just a case of keep going to find the ‘one’ BUT for some people they might be wasting embryos if these tests did show something so it’s a really personal choice whether or not to just keep trying or spend £5k which might show something! In the end I didn’t as it was a lot of hassle and money but I was very tempted! Ps the implantation last time is a really good sign and probs shows that your timing of the transfer is right so perhaps you could rule out the need for those tests at least? Maybe ask your new clinic about that? Xx

Toffeepudding99 profile image
Toffeepudding99

It’s really difficult making any decision in IVF when every treatment comes with such a massive outlay.

For me I had my first round achieving one PGTA tested euploid which was transferred but ended in miscarriage. We were only ever going to do one round as I’m 40 and we didn’t want a huge knock on effect on our family (have one son aged 12 conceived naturally) both financially and emotionally - but, the fact the embryo implanted left us with a “what if” and so we upgraded our package to a multicycle (3 rounds)

For my second round, again we achieved one euploid and I was advised to have further implantation tests but I just felt my body could do this, I felt positive but also concerned that the costs of the additional tests was the costs of my meds if we needed a third round and I would consider it then. I looked on the HFEA website about all of the add ons which didn’t give me much faith that the add ons were necessary and spoke to the embryologist at the clinic who was most positive that the euploid from my first round had implanted. So I decided to instead change my whole diet to eat clean, drink a fountain of water a day and asked my clinic to prescribe me with the meds that I “might have” been prescribed if something was detected by implantation tests. These were clexane and aspirin. I was told there is also a steroid for natural killer cells but they would not prescribe this in the absence of knowing whether this was actually needed, as taking it when it isn’t can be more detrimental.

I’m happy to say I’m now 17 weeks pregnant.

I actually had the mind set of your clinic - it was just bad luck and I didn’t feel like I fitted into the box of “recurrent” miscarriage.

Whatever you decide I wish you all the best 🌹

Tinkertinkerbell profile image
Tinkertinkerbell

Hi, I had 4 failed transfers and had one embryo left. My clinic didn’t suggest any extra tests - they were going to let me go ahead with the same protocol for my last embryo and said it was ‘luck’. I asked to have the EMA, Alice and ERA because I had read about it. They agreed. I’m so glad I did it. It found I had no good bacteria and needed lots of probiotics. It also found I needed an extra 30 hours of progesterone as I didn’t have the average implantation window. This was crucial - otherwise my embryo would have been transferred too early again and been wasted. But with these changes my 5th transfer worked! x

ClaireB24 profile image
ClaireB24

I’m sorry to hear you’re in this position. We had 3 failed transfers and decided to investigate further as similar to you our embryos were good quality. We opted for a hysteroscopy and NK cell biopsy (cost £1600). This showed I had high levels of uterine natural killer cells and we were advised I take steroids for our next round as well as adding in Lubion which resulted in a successful pregnancy. This seems to be a winning formula for us but I know it doesn’t work for everyone. We just felt we needed some answers before doing anymore transfers. Unexplained infertility is just so so infuriating. I hope you get some answers xxx

Victoria357 profile image
Victoria357

have you looked into fertylsis? Similar to Emma Alice but a fraction of the price! They test using your menstrual blood. I lost my baby at 24 weeks and since then have had 3 miscarriages, had multiple testing done and no obvious causes and then finally I had a fertilysis microbiome test anf it flagged up a whole load of issues (Endometritis NOT endometriosis) all usually can be sorted by a simple round of antibiotics and some probiotics. This is the only potential answer for my miscarriages we have got. Currently doing treatment ready for our transfer (hopefully) if our embryos make it through pgta testing 🤞🏽

Thierry101 profile image
Thierry101

hi lovely, we are in a really similar situation. We have had 3 transfers (5 embryos) and none has stuck.

We have opted to PGTA test embryos from a new round. They have ruled out a couple of non viable embryos but not identified any genetic issues. Also did immune testing, which covers NK cells etc and all came back normal,

We are now thousands down + still no answer as to why it’s not worked, which has weirdly made me feel worse! Now unsure if we should get the EMMA/ ALICE / ERA tests or just got for another transfer.

Sending loads of love xx

RedFox23 profile image
RedFox23

Thank you everyone! Sometimes making these decisions is exhausting and it’s nice to get others opinions and support! Xxx

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