Failed 2nd FET and preparing for FET 3

[TazG101]

Hi Everyone,

I am 32, PCOS, no other known fertility issues. We collected 9 eggs back in May 2024 and we got 4 high quality embryos (not PGTA tested). We just suffered our 2nd failed embryo transfer before xmas.

My protocol was 150mg estrogen patches and my lining got to 7.3 prior to the last FET which was brilliant because my lining only got to 6.4 in the FET prior. The only other medication I was on was prolutex injections each morning and cyclogest pesseries.

Just wondering if there is any other medications I should be pushing for going into this next transfer? I asked about clexane prior to the last transfer but my consultant told me that its not the first protocol to put women on a blood thinner. Should I push for it this time to help with embryo implantation? I have done the beets, pomegranate, l-arginine etc.

Also should I push for hormone bloods the day prior to transfer? My progesterone pesseries never seem to absorb and I feel like the whole thing just ends up in my pad! So I would just wonder if my progesterone levels were high enough.

Any help would be brilliant. My heart goes out to all the other women on this journey.

Tara x

[Hidden]

I conceived on FET number 4 (our little girl) & number11 (14 weeks preg now). Keep faith! (No PGTA tested).

Firstly I always did cyclogest rectally- it all absorbs easily, no ness. Vaginally gave me terrible thrush on the 1 round I tried it.

I just had oestrogen & prgesterone…I tried loads of other drug protocols but never worked so I felt like less is more more me (all our tests were always perfect).

I did use vaginal probiotics prior to most rounds (deffo did the rounds that worked). I also had unprotected sex the night before round 10 & 11 (there’s a RCT study about this from 2023 I think-google it). Round 10 was a chemical & round 11 worked.

Good luck. This is the hardest thing ever xx

[Goldenfeather123 in reply to Hidden]

Hi, Congratulations for your 2nd pregnancy!

Wow! You have done 7 FETs to achieve the current pregnancy! The time spent would be 14 months if 1 transfer every two months and money spent would be ~£21,000 if £3000 every FET. My daughter has already spent more than 3 years and huge amount of money without success. She finds it's hard to manage both again.

What were the protocols you used? The reasons for those failed ones? Was a month gap between transfer essential? Where did you have your treatment done? Did you use some treatment packages to save money?

Thank you for reading. Any advice would be highly appreciated!

[Hidden in reply to Goldenfeather123]

Hi, sorry for delay, not on this forum so much these days. I was on oestrogen 3 times a day, lubion progesterone once a day & cyclogest progesterone PR once a day.

Who knows why the failed ones failed?I tried asprin, clexane, steroids, no help for me. I was really stressed in the 6 fails before the 7th (changed job & stress lits better for 7th transfer). Also had a scratch test after transfer 5 which I think helped as 6 was a chemical & 7 worked. Also had unprotected sex night before these 2 transfers as I read a 2023 RCT study which showed this helped.

Most of the time I had a failed transfer, waited for my bleed then started again on next day 1, scratch test there was a longer wait as scratch has to be done around day 21 so can’t do transfer that cycle.

We used a package of care so paid for 2 full cycles (though I was stil technically in first paid cycle as got 26 eggs, 11 embryos and all included in the package). Spent a small fortune on drugs though.

Good luck to your daughter x

[Goldenfeather123 in reply to Hidden]

Thank you so much! Really appreciated for your time!

Were your FET protocols natural/modified-natural, medicated, or mild-stimulated? Pros and cons?

Did you use steroids due to high NK cell activity in blood or uterus? Did you use it again for your FET #6 and #7 (although feeling wouldn't help)?

My daughter is doing another medicated FET. She has an endometrioma on her left ovary (size had been drained from 4.5cm to 2.5cm) and severe endometriosis (that stuck lower part of her womb to the bowel). However her consultant insists not using steroids because her endometrium biopsy showed normal uNK cell results.

She wants to push for steroids but at the same time worry about the side effects of steroids. It's a real dilemma. What's your opinion?

[Hidden in reply to Goldenfeather123]

All my cycles were medicated with oestrogen & progesterone, I never did a modified natural as our days would never align for a day we could be at the clinic for transfer (due to planned trips away or clinic being closed on weekends). I only ever did 2 egg collections in the whole 6 years we were doing IVF due to hyper stimulation (28 eggs-7 embryos, 26 eggs-11 embryos). None of our embryos were PGTA tested due to the cost of it.

We tried steroids just once as a ‘worth a shot’. I only used them on round 8 after 3 fails, 1 successful (our daughter), then 3 more fails. After the 1 round with steroids the consultant felt it was best to pare back. I was happy to not be on the drugs. I wanted to be on as little as poss which worked for our daughter. I decided against blood thinners as I was totally over injecting myself with no evidence & I felt I was slim/hydrated/active so not at high risk of a blood clot, which was the reason they predominantly wanted me on them. I don’t think there is harm in ‘throwing everything at it’ inc steroids, but it’s also good to have some autonomy & choose your own path. Good luck to her x

[Goldenfeather123 in reply to Hidden]

Thank you again! xx

[TazG101]

Thank you so much for the reply! I just keeping thinkin that maybe changing the protocol will increase chances but your right. I will ask my clinic about the clexane though - I historically have very poor circulation (I have Reynauds and often my feet and hands go numb). We probably just have to be patient with it, manage expectations for each transfer.

Can I ask what the vaginal probiotics are and what do they do for embryo? Good idea about the rectal pesseries. I might try that this cycle.

Thanks so much!

[Catlover89]

I’m so sorry to hear that it failed again for you. It’s so heartbreaking. I too had two failed transfers with high quality embryos, not PGTA tested. Before my 3rd transfer, I bought some probiotics (optibac for women) I also asked to do a progesterone test on the day of transfer (they hadn’t checked this on previous transfers) and it turned out to be too low so I was on 3cyclogest pessaries a day (rectally) and 1 lubion injection. Also Progynova 4tablets a day, this time round I had a positive test and I’m currently 9weeks. I also had a few sessions of acupuncture before the transfer and day of transfer as my circulation is also poor, so maybe that’s something to consider? It’s hard to know exactly what’s done the trick, but just passing on incase any of this helps you.

Good luck with your next try. Sending you all the luck and positive vibes xxx

[TazG101]

Thank you so much for the reply! How long did you take the priobiotics for? I am planning for another transfer mid February so just wondering if I should start now.

Yes I might start acupuncture again - I had tried it before my first fresh transfer (never went head as I got OHSS the day I was supposed to do the transfer) so for some reason I felt acupuncture was to blame but I know that probably wasn't the case!)

Will definitely push for a progesterone blood test. I dont think the clinic routinely do they but if they dont I might organize one through my GP just to know.

Thanks so much!

[Catlover89 in reply to TazG101]

I would purchase some now if you want to try them, I think iv read it’s good to start them at least a month before but whatever you can take beforehand is better than nothing.

Aww yes I know what you mean, I also had OHSS and everything had to be frozen. I wasn’t having acupuncture at that point so i know it wouldnt have been that that caused it, it will have been because your body was over responding to the stimulation meds. I was told it is more common in people with PCOS. I have some cysts on one of my ovaries (I don’t have PCOS) but they said there is a chance it could happen to me and it did.

Yes I would if you can. My first two transfers were nhs funded and they didn’t mention not even once that my progesterone could be low. I was concerned about my hormones because of my periods whilst trying naturally but when I asked they told me that the pessaries give more than my body produces so it should be fine. It’s only when I did my own research, I learned it can be still be low with the pessaries, I then asked about it on my 3rd one which was private, they just booked it in, didn’t even question it so it’s a bit odd that they don’t check it but I guess they didnt want to pay for it! Xx

[Goldenfeather123]

If you haven't done Progesterone blood test for your previous medicated FETs I would push for it.

My daughter had it tested the day before her last FET transfer day and P4 level was 38nmol/L, below the threshold of 50 nmol/L. Then 100mg Prontogest injection was added every other day. She took a test again two days after the 1st test and P4 =130nmol/L. The cycle didn't work. But at least the info gained can be useful for planning next FET.

Some studies suggest 70-100nmol/L are optimal and the Rescue Protocol (adding injections from the transfer day to raise P4 level) does not always work. (see Mumusoglu et al, Frontiers in Endocrinology, 2021 12:688237)

Good luck!