2 Chemical pregnancys

[Pink090]

Hi All, I've had 2 chemical pregnancies now, 1 through natural conception and 1 through IVF, clinic says its good news as shows it can implant, but I guess for me, I want to understand what further testing I can do/get to see if there are any issues, I'm looking at Hysteroscopy, or Endometrial scratch before next transfer. Does anyone have any suggestions? as NHS are useless at any advice even. I have Endometriosis aswell but had a laproscopy in Feb 22. This is my last embryo so I want to get it right. thank you for any replies/help x

[WanderingWonder]

Im afraid I don’t have any experience of chemical pregnancies but I’ve had two hysteroscopies, both on the NHS and I would say that’s its best you know what you want them to look for before you do it.

They will take a biopsy from your endometrium if it’s looks abnormal and if you’ve got polyps or fibroids they will remove them if you tell them in advance that’s what you want them to do.

Sorry I couldn’t be more help and wishing you all the best!xxx

[Boo718]

hello, I had 2 chemical pregnancies then I did the era, Alice and Emma tests. They check for bacteria in the womb, infection and optimal transfer timing. It showed I needed an extra 24 hours of progesterone so I did a transfer on day 6 instead of 5 and now have a little girl xxx happy to answer any questions xxx

[Boo718 in reply to Boo718]

Sorry I should say we had to pay private for these tests xxx

[DogMum7 in reply to Boo718]

Hi, I've had two chemicals and my clinic doesn't even test progesterone which is freaking me out. Can I ask when you have the ERA, ALICE and EMMA tests done (eg at any time during cycle) and how much you paid? I really want to push this time as I'm losing my mind xx

[Boo718 in reply to DogMum7]

Hello, it was roughly about £1000 which sounds steep. But what they do is they follow the protocol for a transfer but instead of transferring they take a biopsy and send away for the results. So it was the normal process but a biopsy instead of a transfer. I swear it was the only Change we made after our chemicals xxx the doctors checked my progesterone a number of times and increased it as needed xxx

[Pink090 in reply to Boo718]

Thank you so much, yes same as above when do you have these tests? I am keen to have the tests before transferring again. did u have to push for the progesterone test? I was in 2 pessarys a day and 1 injection x

[Boo718 in reply to Pink090]

Hello. The tests are done as a biopsy on what would be your transfer day. So you follow the normal protocols. Then await the results. I asked for the tests. NHS don’t do it I don’t think. I was on 2 injections a day but the consultant said 2 pessaries is the same as one injection. The bacteria and infection came back fine xxx

[DogMum7 in reply to Boo718]

Spoke to my clinic today and they said as I'm going via NHS I can't even have the tests and pay privately. They're so shocking. Almost can't wait to get this round over with and try somewhere else! Xx

[Boo718 in reply to DogMum7]

Aww that’s so shit 😢 I can’t believe they won’t let you do it xxx

[Pink090 in reply to DogMum7]

I hate that you can't pay privately!they need to revise the system. What test did u ask them for? xx

[Christianbaby]

A hysteroscopy could be a good idea, especially to check for anything that might have developed since your laparoscopy. Some people also look into immune testing (like NK cells) or ERA/EMMA/ALICE tests to check for receptivity and microbiome balance.

Have you spoken to your clinic about progesterone support or blood thinners? Some find that things like aspirin or prednisolone help, especially with endometriosis.

Really hope your next transfer brings you your baby. Sending you strength. xx

[Twiglet2]

I’ve had lots of chemicals but also 2 pregnancies. My clinic didn’t test progestone either but we upped it and added Lubion. I also added clexane to stop blood clotting. I could have tested privately or with tommys for these 2 things but was cheaper and quicker just to add them in. To be honest I still had chemicals and miscarriages it was my clinic and my conclusion that implantation conditions were right but the embryo wasn’t. The exact same set of circumstances brought me my little boy and I’m 36 weeks pregnancy with a sibling so I know it can be frustrating but I do tend to agree with your clinic that it is a positive thing the embryos are implanting as that’s half the battle. You might just need to keep trying to find the right embryo and no amount of testing (except perhaps PGTA) can help with that really but do ask to up your progesterone especially if you’ve had early bleeding etc while still on it xx

[GranolaHippo]

I would test the embryo and/or getting karoryping for yourselves.

I wouldn't bother with ERA, EMMA or ALICE, the evidence that they work isn't there from randomised control trials, as there is no established causation between what they test for and implantation issues, nor is there any evidence to suggest the associated 'treatments' lead to increased rates of ongoing pregnancies (unless a huge randomised control trial has been done in last 2 years...). Of course people fo have ongoing pregnancies after but the data isn't there to say it is from the tests and treatment.

If you want a biopsy, I'd suggest Prof Brosens at Coventry. I didn't find him a very nice person, but the biopsy is linked to MHS backed research and specific treatments. It's important to keep in mimd that you're paying to be part of a study though.

It's also worth getting your TSH levels done and checking for a clotting disorder called antiphospholipid syndrome. Those are the standard nhs blood tests for recurrent loss/implantation failure. They explain things in very few cases, but have very good outcomes as proven treatments. They'll also test for Factor V and another one. Almost no one has the conditions, but again, very well established treatments if you do.

Alternatively, you could see if your clinic will give you all the drugs: doxycycline ahead of your transfer, followed by 3 weeks (minimum) of vaginal probiotics; blood thinners and steroids to support transfer and up your progesterone (pessaries and lubion injections). I see Prof Quenby and this was her protocol. They dont have proven outcomes but can work and don't harm, is her view.

You'd, I think, qualify to see her after 2 chemicals, your GP can refer. Wait time for initial appt is 5ish months.

We've had 12 chemicals, miscarriages and implantation failures (2 of those, rest natural) and 1 ectopic. We have been going through NHS and private testing for 2yrs. So the above is based on that. As aside, we still don't have a reason or treatment... but hopefully you will!xx

[Pink090 in reply to GranolaHippo]

Thank you for this, I had my consultation after the failed and they said pretty much what u have on those tests, but have put me through for karotype and another (which i couldnt get the name of) so awaiting email confirmation. will ask NHS for those bloods again, really is like project managing them to tell them what I want/need 😂. hope u are ok x

[GranolaHippo]

Glad they gave good advice, rather than pushing for maximum spend, I've had both approaches.

Kartorype is really useful ahead of creating any(more) embryos and the results are quite reassuring/helpful. PGTA is useful too (because karyotyping means you don't have something you pass on each time, but doesn't rule out random 'errors' individual embryos).

The biopsy at Warwick (affiliated to NHS but paid for) is useful too, because it links directly to treatment-steroids or stiagliptin, if anything is found. But some clinics will allow you to try steroids anyway, without a test.

Ditto doxycycline (pre-transfer, for endometritis), blood thinners and additional progesterone.

I know it's sort of awful to say, but I really do hope they find something that they can treat. Of course, it can still be random chance/bad luck at this stage, but I always think it is best to get it tested if time and finance allow.xx

[Pink090]

ah ok, they have recommended it for my frozen transfer, do you think they are seeing if there are any abnormalities before having to PGT test that frozen embryo? yes I would rather test and just see... they have also advised a thrombophilia test to check for blood clots, so I am going to see if the NHS will do that.

Did you take DHEA?

do you think i should ask why karotype instead of pgt? x