Have I left a stone unturned?

[Darcy1996]

Hi all,

hope all are well and embracing this season of change - I LOVE autumn and cosy soup weather.

I have recently turned 43 and just had our third round of IVF with PICSI - we took a break for Glastonbury to let off steam after 2 rounds, and to get (and implement) expert supplement and nutrition advice before this last round.

and yet....we had our lowest numbers yet, highest fertilization rate % but still look like we will finish this round with no embryos in the freezer and nothing to transfer. So I have never got to a transfer over the 3 rounds to even know how I'd react. We had a perfect 5AA in round 2, but the PGTA testing showed any baby would have been "incompatible with life").

We have had 10, then 17, then 9 eggs so far and only 1 got to PGTA stage. So not bad numbers at EC at all.

I know the clinic may say DE or double-donor now or just stop.

Cruelly, this round has shown me more than ever that I do want to carry our child (where previously the pregnancy was less important to me than the outcome, so I would have been ok with surrogacy, adoption and other wonderful paths to parenthood), and I would ideally like that to be with OE.

Time and finances are against us - I actually don't even know if we can go again, we have some bank-robbing, card-scratching chats to have.

I have tried -

- Tommy's charity biopsies for implantation failure but now cannot get to implantation

- acupuncture which was scrumptious if not scientifically proven

- Mediterranean diet and so many seeds and antioxidants that I rattle..

- ££ supplement overhaul for us both incl all the CoQ10 and good stuff

- reduced/nil alcohol

- vaginal microbiome tests but again, cannot get to implantation stage to affect that.

- starting stims earlier in luteal phase - this gave us our highest haul at 17 eggs in June (12 mature), and then also just now our lowest at 9 (3 mature)

- growth hormone every other day during stims - this time I had follicles not react and some over-react. No Goldilocks sweet spot.

We have not tried -

- going abroad - I love that my clinic is close by and scans me every 48 hours during stims

- DNA frag test for my partner (issue there is morphology, which he's doubled now with supplements and diet - v proud 💜) - as the clinic said if discovered to be the case, the recommendation would be ICSI which we are already doing. Plus we don't have time to see results now (shoulda woulda coulda?).

- DHEA - I read so many conflicting reports and research and some papers saying to have levels tested regularly - my clinic don't back it.

Other than becoming a Shaman, spending more money on reflexology, or quitting work and lying in a field of daisies surrounded by Disney woodland creatures and zero stress, what am I missing?

I'm jesting in tone, serious in nature for any suggestions I've missed, magic potions to buy. I have all of the books...what am I missing? x

[Crazycatlady007]

what a journey you’ve been on! It looks like you’ve thought about this a lot but I just wondered if you’d been on the same protocol for your cycles?

I’ve had a similar response to stims ie varied but we’ve played around with the cycles and amounts of medication etc. x

[Darcy1996 in reply to Crazycatlady007]

what a wonderful name you have!

Between round 1 and round 2 we changed our Stims from Gonal-F to Pergoveris, and then added the Zomacton for the growth hormone, and dropped Meriofert.

Round 3 we had the same meds and dose as round 2 - I do wonder if meds should change doses...

Timings-wise - in round 1 we started on cycle day 2.

Round 2 we started earlier in the luteal phase, on cycle day 21 of the cycle before, and round 3, even earlier on cycle day 18.

Did you/have you found your golden mix yet?

[Crazycatlady007 in reply to Darcy1996]

Haha thanks! Hopefully I won’t only be surrounded by cats for my whole life 😂😂😂

I did manage to get pregnant last cycle but had a miscarriage but I am treating it as a positive that it worked! My consultant is too but we’re making some slight tweaks to try and get more eggs and better quality which is essentially a hybrid of my last two cycles.

I wish I knew all the ins and outs of all the different medications and why they’re prescribed to different people.

I’ve always had rekovelle but in different amounts and then the last two cycles I’ve added meriofert as well. This time we are upping the doses slightly and then having a mixed trigger which I’ve not had before.

Maybe have a chat to them about dosage then and see what they say?

Would you consider changing clinics but in this country? X

[Darcy1996 in reply to Crazycatlady007]

I am so very sorry to hear about your miscarriage...that's altogether a v different trauma to get over, I hope you're "ok", or at least on the way there or en route to some acceptance.

I would consider changing clinics if there were strong arguments for it and reviews from a similar age-group - I follow a lady who had a modified natural round and a successful pregnancy at another clinic, and she was a year older than I am now. She found fewer meds gave her better quality. I do like my clinic and I think I finally trust them, but my fear is they'll say DE now. x

This might all be academic if the bank heist doesn't come off tho.

Side note - I have a cute "Cat Lady" jumper from Joanie but I worried it sent off "I don't care about babies I have fur babies" vibes so didn't wear to scans.

[Crazycatlady007]

yeah acceptance is probably the right word. Onwards and upwards!

lol if you figure out the secret to a money tree then please let me know too!

Maybe I should tweak my advice to wear the jumper 🤣🤣🤣 xx

[LiveandLoveNutrtn]

Hi Darcy1996,

Your post got me. I'm only throwing out ideas for you to consider in an effort to answer your question and help, as I feel like I hear you in jest and in seriousness. Have you and your partner had your nutrition assessed to see if you are deficient or overexposed to certain nutrients? Testing for autoimmune conditions? BMI level? Toxin level assessment? Improving sperm parameters, including DNA fragmentation is always a good thing to do and can be measured easily. you can message me directly if prefer to chat offline. x

[Darcy1996 in reply to LiveandLoveNutrtn]

Thank you so much. We really worked on our diet but no we didn’t have bloods done for nutrition for some time…I asked clinic about DNA frag and they just said the outcome / treatment would be the same - ICSI, but I do believe if we know an issue at a cellular level maybe we can improve it…but now I fear we don’t have the time?

I do have asthma/eczema/hayfever & food allergies so I’ve always worried that I’ve got some type of allergic personality 🤣🤷🏻‍♀️ I have been recommended steroids pre FET for this reason but haven’t got there.

Argh it’s all so confusing and expensive and hard and time consuming. But I’m so grateful for everyone here, so so grateful 💜

[LiveandLoveNutrtn in reply to Darcy1996]

❤️. It is hard and expensive and long...I wouldn't allergic personality ❤️ but instead maybe autoimmune or intolerances. We all have something, eh? I wish you all the best.

[JellyPenguin]

sorry to hear what you’ve been through. We were similar in that we could t make embryos. Fertilisation was an issue too. We used double calcium ionophore with our clinic which improved fertilisation rates. We used 3 clinics over our 6 rounds and always asked what new things they could try for us. One of them was with Dr George in Greece with ArkIVF who are fantastic and half the price of our uk treatment.

We worked with a fertility coach (verity Paz in Wokingham. Highly recommend. She will do online coaching calls) to make sure you haven’t missed anything. And I know she will tell you that sperm testing is the number 1 thing to do. DNA frag is really important. I was tested in every which way with HyCoSy, MRI, and Hysteroscopy but nobody really checked my husband well enough until a few years down the line. We saw Mr Ramsay. Turned out my husband had a varicocele and low quality sperm so he had an embolisation operation. The next dna frag showed huge improvement 4 months later. Our subsequent IVF round got us one embryo. Which by magic a year later worked for us.

So my advice is to speak to a coach like Verity who is the fraction of clinic costs who will check you’ve covered everything. And Sperm is key. Also I would research PGA testing. There are studies that are against it in that it can damage the embryo and isn’t always accurate. As we only had one embryo we didn’t see the benefit in testing it either so went straight into transfer. I think it’s more beneficial to test if you have loads of embryos and need to know which to transfer personally. But see what you think.

Hope something there helps! We had 6 egg collections in total. 80 eggs collected. And just 2 embryos that weren’t great quality. But I’m now in my second trimester from the embryo we made in round 3. So there is hope. Our clinic in that round also used letrazole and I took melatonin. There are always new things to try.

Another quick note, we had our worst round ever after our nutrition change too. I think it maybe shocked our body’s as we changed so much. We went into the next round too quickly after maybe and our body’s were still adjusting. After that we focused more on mental health with therapy and ate well but happily. I think that can be more important sometimes.

All the best! Xxx

[Darcy1996 in reply to JellyPenguin]

Thank you so very much, there’s lots here for me to try/look into. I feel like I’ve been at the end of the road without any lights on to guide a way forward.

I do wonder re the testing - we went for it due to my age but then we have only had 1 egg strong enough to test over 3 rounds, and it ended up being worth it as there was a “hidden” chromosomal issue but…might an a different earlier morula have been ok if we weren’t focused on getting to testing 🤷🏻‍♀️

Thank you, wish we could clone Jonathan Ramsay, his waiting list is so long

[Twiglet2]

hey lovely- this probably isn’t helpful or what you want to hear but I had to just keep going with the egg collections to find that one embryo. It came from my lowest number of egg collected so I’m not so sure anymore that the ‘quantity’ matters all that much! Although it’s all I worried about and focused on when I was comparing rounds. We did change up the stims though as much as possible and had a combination of gonal f (synthetic version of the hormone) and menopur (natural version of the hormone) as some people and follicles respond better to the different types was my clinics advise to ‘throw everything at it’. I was also quite actively NOT following any diet or alcohol changes at that time. I know it’s pretty basic but I really think making sure my vitimins D levels were up and good old folic acid did help me. I doubled the dose and also escaped on holiday a few times too to see the ‘real’ sun before egg collection. It could be absolutely nothing I did that worked of course … except perseverance with my own eggs despite the clinic saying otherwise. I defo think if there is an itch you haven’t scratched it may be worth trying it though before considering donor, although DE could of course be quicker for you Xx

[Darcy1996 in reply to Twiglet2]

No it is helpful, thank you 💜 we certainly don’t get enough vitamin D in the UK do we! And holidays have been off the cards since we started IVF so I’m desperate for one, we both are. Thank you, I’m dreading the follow up with clinic atm in case they say already tried the works x

[Twiglet2 in reply to Darcy1996]

Yeah I heard that a couple of rounds ago but I did push on regardless anyways! Do you have one away for PGTA or did I read that wrong? Xx

[Darcy1996 in reply to Twiglet2]

We had 1 tested in round 2, but this round we have 1 left still, waiting on the call to know if we can freeze as embryologist said yesterday it couldn’t be biopsied but she wasn’t hopeful it was increasing cell numbers at the rate needed. It’s already day 7 so the last day we can make that choice

[Twiglet2 in reply to Darcy1996]

Ah I see fingers crossed for it though xx

[Darcy1996 in reply to Twiglet2]

thank you so much - I have a teeny bit of hope still. A little candle flicker!

[skygreen]

I think melatonin (3g at night) and Optibac pregnancy probiotics made a big difference for me. Also high protein diet. Ovum supplements for me and procieve for him. Beetroot/pomegranate juice for womb lining/thickness.

Each round I have done is so different in terms of fertilisation/day 5 embryos. But the last round I did the above and got 2 euploid embryos - one of those is now 5 weeks old and hiccuping on my shoulder. I also have an ICSI 4 year old where I drank a bit and ate terribly through that time so 🤷🏼‍♀️. It took us 5 rounds and a bit of experimenting with meds/protocols for over 40's this time - combination of Gonal F and menopur.

My Dr was up on the latest research and was great. Change clinics if you're not happy!

Wishing you all the best!!! X

[Darcy1996 in reply to skygreen]

Congratulations on your new addition! I really rate Ovum, such a great company!

[Sja1981]

Have you got any insights on who your embryologist is?Sounds like you're on a call protocol as you're producing, but they're just not growing.

My acupuncturist would probably say to double check the sperm. Surprised that PICSI didn't help, what about adding in calcium ionophore too? They're the two I'm considering to ease the pressure off my 43 year old eggs having to repair any issues with the sperm.

Not sure you mentioned your age? I'm 43

[Darcy1996 in reply to Sja1981]

I'm 43 as well 💜 - we had better fertilisation round 2 vs round 1 with PICSI instead of ICSI, just the numbers in round 3 are low and drop-off feels so high.

I am going to ask about calcium ionophore for sure...I just fear they'll say nothing more as stats so low - what older patient doesn't know that!! They are v good, I sound exaspertated with them but it's just the outcomes rather than the clinic - I don't know the embryologist no - we just get to day 5 and then it's wipe-out. In the last round we had 6 great blastocysts at day 5 and then wallop - down to 1 (which I am glad we tested afterall as it would have had Turner's syndrome) but so v frustrating as it feels like the answer isn't known - although maybe it absolutely is both of us not helping and thigs we need to do on both sides.

Where are you at in your treatment/journey atm?

[Sja1981 in reply to Darcy1996]

6 at day 5 is brilliant!

I had 3 at day 6 which were sampled and PGTA said all abnormal and not usable. Clinic never prepared me for such an outcome. Then I got the donor spiel, and that the protocol is "perfect".

Moved clinic to a new protocol and now I've got 9 follicles at baseline last Thursday and starting Meriofert today.

I've primed with HGH this time.

All my journey is here:

Instagram.com/solofertility40s

[Darcy1996 in reply to Sja1981]

6 at day 5 was fantastic, I was delighted...and then how quickly that turned to disappointment and feeling absolutely gutted from being so so hopeful.

Best of luck to you with this new round I have just followed you too

[Endofitall]

I’m not sure I have much wisdom for you but your bit about the quitting your job and lying in a field of daises with Disney woodland creatures really tickled me - thanks for the laugh today. Can you prescribe that for me? 🤣

I would second the checking DFI for sperm. There is a urologist we were recommend in London Mr Tet Yap - we didn’t end up seeing him but we did enquire and he had appts a little sooner as at the time Mr Ramsey was off work - may be worth exploring if you did need urologist. We had the test done via Fertility Solutions though and then consult with the andrologist who is part of MDT with Mr Ramsay - and they weren’t at all money grabbing, they said we didn’t need to see urologist. Which they could have easily peddled us more tests or appts.

As you’ll see from recent posts I’ve just had a disastrous 4th cycle with no embryos for first time. So I’m really feeling you. I’m 37 but have low AMH secondary to endo. Always has low numbers of eggs with good conversion rate and good blasts - it was recurrent implantation failure that was our issue - before so this cycle was a shock. We never did PGTA as clinic said I was too young with too few eggs so who knows. Now am 37 I’d do it but no embryos 🙈

I am currently trying melatonin for egg quality and higher dose vitamin D. I’ve just started stims again this week for 5th egg collection.

I tried DHEA for our round 3 but it did me no good really flared my endometriosis. Clinic did suggest it but did no bloods. If you don’t have endometriosis maybe something to look at testing and trying?

Really hope you’ve had good news today xx

[Darcy1996 in reply to Endofitall]

I am very glad my Disney scenario tickled you, you’ve got to smile in this BS haven’t you!

I’m really sorry re your disastrous round…we had bad news today too. Nothing to freeze, transfer or test as our last embryo wasn’t growing at the right rate and so it had to be let go. gutted after 3 rounds and nada.

I tried melatonin at night for week of stims - have you been taking it longer?

I’ve been looking at FS…we just need to get the strength & pennies to go again…maybe Disney will help there too. All the best with this next stims round!

[Endofitall in reply to Darcy1996]

I’m so sorry - it’s really gutting. I hope you have some space to grieve whatever way you need to.

I have been taking it for about a month now (certainly will be by time reach trigger) so hoping it might help with this 5th egg collection but I have just revamped my supplements after the last cycle and just wanted to crack on with this one. But if it doesn’t work, at least I’ll feel I’m well into 3 month plan to make sure covered every possible base. I will allow a full 3 months of taking it to see if that helps before doing our 6th cycle abroad in new year. I hope don’t have to get to that though. But being realistic too.

Strength and pennies not at all easy!

[Darcy1996 in reply to Endofitall]

Strength & pennies are not easy at all! Feeling pressure of both atm

You’re bound to have made positive change, even if it’s your own resilience & positive physical changes for your journey & next chapters 👏🏻👏🏻