Hi everyone, and thanks for being so supportive on this group. You all are amazing I must say. I just need advice on what to do at the moment because I am on cross roads regarding this Ivf journey. I am 41 with PCOS.
I have had 2 unsuccessful FET , the first one ended up with MMC at 8w5days, the second failed to implant both were High graded PGTA tested . Had a meeting with my clinic and they said it is embrayo quality failure. Just confused because why is it embrayo quality even when it is has been tested?
Now, I have 2 PGTA tested low level Mosaic embryos , and 5 day6 blastocyst embryos untested. My clinic suggested of transferring first, the 2 low level Mosaic embryos at once to give it a chance.
I am scared of transferring Mosaic embryo and how many of you have succeeded with Mosaic embryo. I don't actually know all these grading and what to believe anymore since the 2 quality once still did not end in pregnancy. Everything seams to be a game of trials really.
Please, I need advice if I should go ahead to transfer them, or to test the remaining 5 . What protocols do you recommend because, I have tried both medicated and natural protocols but all failed. I have done thyroid test and it came back normal.
My clinic said they will be using medicated FET this time 800mg cyclogest, 25mg Lubion and 75mg Asprin. Please I need advice because I don't know what to believe really .
What are the success stories at 41 with PCOS because I am emotionally drained at this point.
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Yketha
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Regarding the mosaic embryos, you can join the My Beautiful Mosaic Embryo group on FB. They have loads of info/experience and you can search by chromosome affected if you know.
hi lovely, so sorry you’ve had two failed PGT transfers.
Yes low level mosaics have good success rates, my son was a low level mosaic after two failed PGT-a euploid transfers.
If your mosaics were high graded (5AA etc) and PGT-A normal then it’s unlikely to be a quality issue but not impossible. At this point I would be looking at doing various tests to see why they didn’t implant or miscarried as you may need some immune testing and drugs etc
I wouldn’t go straight to doing a transfer with your mosaics without first looking more into why the first two didn’t work as at this stage it’s likely something else is going on.
But when you do get round to doing a transfer with the mosaics then rest assured low level mosaics have similar chances to euploid embryos.
Hope that helps! I just wrote a long post about what we did on someone else’s question about what to do after two failed PGT transfers so I’m happy to send you that too if that’s helpful.
Thank you, lovely. I’m so glad to hear that you had a son from your own experience, as it gives me hope to stay positive.
I would appreciate it if you could share the reply you gave to someone else. You are definitely right that there might be another issue, as it doesn't make sense to blame everything on the embryo when the embryologist confirmed that the embryos were of high quality.
Agree with Wishinandahopin something else may be happening (implantation issue?) or there is some misunderstanding. It's true not all PGT-A embryos are high quality - PGT-A only *screens* for chromosomal abnormalities not the quality of the embryos. Also it does not consider genes which issues there (Brca and other genetic issues) can cause implantation or embryo development issues.
It's woth having a face-to-face with your RE doc to hear it again and ask more about say the quality of your tested embryos that didn't work and you remaining ones.
Separately, PCOS is considered by itself to impact the quality of embryos (any age) - this may be what they are saying without saying it. Were you on Coq10 for your cycles? Being on it well before your cycles is thought to support the mitochondrial integrity of the eggs that they believe is impacted by PCOS and age...
I have 2 perfectly normal cuties from low-level mosaics (details in my profile). A genetic counselor told me not to try either. Just saying as you need to ultimately get info and go with your own advice.
Thank you so much for your explanations Jumpppy. I know that my age and PCOS are factors , but my clinic not providing any other things that could also be a factor , then saying that those my 2 Euploid embrayo are of high quality is actually a conflict and confusing as well. I have booked appointment with the embrayologist to get lots of clarification because, if the embrayo are not viable, there is no need wanting me to keep transferring, wasting my money and time without exploring more options and tests.
No, I was not on Coq10 during my cycle but was on so many other supplements including Inofolic alpha and metformin.
Congratulations on your 2 perfect cuties that you got from the Mosaic, this is so amazing to here 🥰. This gives me hope , and there could be a hope for me along the line xx.
hi lovely- this is the reply that I sent someone else. Some of it may not be relevant for you but I’ll paste the whole thing. I will add they told me it was likely an underlying embryo cause that my first one failed but there was likely more to it than that:
“Here are the stats: the chance of the first PGT-a tested embryo not taking is 30%, the chance of the second not taking if the first does is 12%. So you are now in the 12% of people that 2 in a row don’t take (as I was).
At this point you could just be really unlucky and it would likely work the third time if so. (Only 5% 3rd PGT-a transfers fail to implant after the first two haven’t) But I think a lot of factors can help decide your decision going forward:
How many PGT-A tested embryos do you have left? If you have over 2-3 more then you could do another transfer and see (like your husband is saying).
It also depends on whether you want the chance at a sibling or not down the line? We wanted enough embryos that we would be able to try for a sibling down the line (that is if we were lucky enough to even have one) and that meant making the embryos then as I was already almost 37 at that point.
So if you have only 1-2 embryos left and you want a chance at a sibling down the line and you’re over 35 say, then you may want to do another egg collection first. We did this as we only had mosaic embryos left from the first round. That said for us our second egg collection was not as successful and didn’t yield any euploid embryos.
Then you have to think that you guys are now on the wrong side of the statistics- the 12% that the second PGT transfer didn’t work for. Which means the studies that say ‘for most people…’ don’t necessarily apply to you. So for example if ERA has been shown to not make a difference in 85% of cases (I don’t know the statistics on this I’m using as an example) then you’ve a higher chance now of being in that 15% that it could work for.
What we did was this:
We did the era/emma/alice - they were all fine and I actually feel they were a waste of time and money but I know some people have sworn by them but at least we didn’t have that as a ‘what if’.
I had an hysteroscopy- I would say if you’ve not had one of these it’s probably a good idea. This can tell a lot of things, they found that my uterus was a bit narrow due to extra fibrous tissue and they could widen it during the procedure. They weren’t sure this was why it wasn’t working but it could have been a factor.
We had some immune testing done, the one that flagged up for me was KIR/HLA-C2 compatibility testing. My clinic felt this was the immune testing with the most evidence behind it (they didn’t agree with NK cell testing etc). I was found to have an incompatible KIR to my husband’s HLA-C and so was seen by a reproductive immunologist and prescribed a specific drug to help that from transfer up till 9 weeks. (I was also then given steroids, clexane, aspirin but it sounds like you’re already on that)
Lastly, having done two medicated FETs I wanted to do a more natural FET the next time, I couldn’t do fully natural due to v irregular cycles, so I did a stimulated FET, prepared for it as if for an egg collection (though milder drugs so as only to create one leading follicle) and then had a trigger injection and progesterone. I found my body did better working alongside my natural cycle.
All this to say our third transfer worked, and it was a mosaic embryo as we had no PGT-A ones left. I will never know exactly what caused it to work that time and not the others- could have been a mix of a few things etc.
Anyway I really hope this helps give some hope as I know how awful it feels to have those two unsuccessful PGT transfers.”
Sending lots of luck! Happy to help with anything!
Thank you so much lovely for sending this. It will help me to explore better. You mention something that rang a bell to me about immune testing. Where did you do the immune testing ? Is it with your clinic or you went somewhere else? This could be applicable to me because my husband has HLA B27 in his gene which might be a compatibility issue.
So is the reproductive immunologist from a private as well?
I am much interested with the immune testing to atleast rule out compatibility issue because my clinic is not mentioning any form of test and it seam as if most options have not be explored before going for another transfer xx
We’ve got a complex low level mosaic embryo frozen. The consultant wasn’t too thrilled about it but our genetic councillor was really positive.
The group on facebook is called My Perfect Mosaic Embryo. It’s very american but there are some really good stats and really positive stories. If you haven’t already spoken to a genetic councillor I really recommend doing so xx
I would also look into some other tests before transfer. Grading is irrelevant but if euploid embryos are failing I would want to know if there was anything else going on with the environment xx
Thank you very much for taking the time to reply to me; it really means a lot right now. I will look into the group and also explore the tests before next transfer. I find it unconvincing to attribute everything solely to embryo quality without considering other possible factors.
I absolutely agree xx We’ve transferred 11 untested embryos so far and I refuse to believe every single one was abnormal. I’ve been pregnant 3 times so I can get pregnant it’s just getting them to stick!
I had a hysteroscopy and biopsies at christmas along with peripheral NK cell testing. I had a septate which was corrected and I will now do an immune protocol before my next FET! Maybe a hysteroscopy is something you could look into?
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