IVF/ICSI/FET - any more for any more... MORE!

(253 Posts)
jumpingjackhash Mon 23-Jul-12 17:16:41

A thread for anyone going through fertility treatment, about to start or with a success story to share. Welcome one and all!

So our last IVF/ICSI/FET support, wallow, celebratory and whatever else thread got full, so let's pick up where we left off!

Carebear, great news on your EC on Sat!

I've got over my strop now blush and have re-rearranged my work schedule so all set once they confirm the date tomorrow!

<desperately hopes the thread regulars finds this>

CareBear1 Thu 26-Jul-12 17:58:59

Jumping thats great news well done! That is a great haul, fingers crossed your dna is getting busy as we type. Hope you sleep ok waiting fo tomorrow's news. Love the embarrassing stories!

ZB singing with torch sounds v.cool what a great memory to have. When is test day again, next week? Hope good things are happening inside!

Cookie, good to start talking to clinic, makes it seem less scary.

AFM scan went well again, taking trigger injection tonight and EC on sat.

zeebee1 Thu 26-Jul-12 18:24:26

Great news care so pleased its on saturday.. So a drug free day tomorrow! What will you do with yourself?? wink

jumpingjackhash Thu 26-Jul-12 18:50:27

I LOVE it Zeebee! glad it's not just me amusing the staff at Guys! How cringeworthy is the reading material! DH gets all flustered when I mention it! I do think it's a little ironic that they provide 'quality' fodder such as Viva Beaver hmm but won't let a wife (ahem) lend a hand! wink

How exciting to sing with the torch! A great story to tell your kid/s! It feels like a good sign!

Great news about your EC Care, let us know how you get on!

CookieRookie Thu 26-Jul-12 20:31:38

Jumping and ZB your stories made me laugh so hard I could barely answer dh when he asked me why I was laughing grin

Delighted the EC went so well jumping. Hope your ladies and your DH's boys are having a wild party as we chat and that you are feeling better soon. Thanks for my badge <<twirls so it can shimmer in the light>>

Dh will be mortified when he has to go through that too. It has to be difficult for the dp's to 'produce' in such a clinical setting knowing someones waiting for the eh...final product blush.

Couldn't get the Zita West book today but have it ordered. Ready for a night in front of the television after a tough day entertaining four children.

Working all weekend so may not be back until Monday. Good luck on Saturday Care, hope it all goes well.

CookieRookie Thu 26-Jul-12 23:38:42

I need to run something by you all.

I started a thread before coming here asking opinions on DET V SET as it was suggested by my doctor at the clinic during our initial consultation that we opt for DET. All the research pointed to SET so I started the thread and most people agreed that on our first cycle SET was probably the way to go. We had decided on SET given our circumstances and providing nothing else arose that would point to DET being the safer option.

Anyway that thread ended but some others have posted on it so I was back on it tonight and it's just reminded me of the conversation I had with the nurse on the phone yesterday.

(C&P from other thread)I asked why we were being recommended for DET before any tests were actually done? Was there something they had gathered from my medical history or current circumstances that meant I was more suitable for DET? Her answer was that that is just their policy. I hadn't even thought about that until now hmm I said I was concerned about the complications of a multiple pregnancy and she said I "wasn't guaranteed twins with DET".

I wasn't querying if I'd be guaranteed twins. Is that an odd answer? I took it as they are the experts and forgot about it but whilst they are a highly recommended clinic I know that is not the recommended policy.

Bloody hell, I'm flapping again. It's nearly midnight and I'm sure you're all tucked up in bed. I'm off to bed too. Goodnight everybody.

KnackeredCow Fri 27-Jul-12 08:09:49

Hi Cookie

I would say you don't really need any tests to decide whether you should go for a single or a double transfer. It should depend on number, quality and how many days old your embryos. And of course how many failed IVF cycles you've had in the past. Even on cycle three my clinic asked me if I was "sure" I wanted both back bacause I did get pregnant on my first cycle and then miscarried, and my two (at time of transfer) blastocysts were such good quality.

Follow this link and look through the slides. Towards the end there's an algorithm for woman under 37 on their first attempt: http://www.oneatatime.org.uk/images/5_Sue_Avery.pdf.

At the end of the day you have to make a decision you're comfortable with. Is the risk of twins acceptable to you? Is the risk of a subsequent cancelled FET due to a failed thaw acceptable? What is your clinic's thaw failure rate like?

Clinics tend to be highly recommended if they get good success rates. I'm dubious about this - they often self select easy patients and automatically follow DET protocols in self interest. The private nature of IVF makes it competitive.

The technology is pretty standard, and I don't for one minute believe that one clinic is doing things very differently from another. If there really was a magic formula to significantly improve chances it would not be long before they were all doing it and it would be Nobel prize stuff!

KnackeredCow Fri 27-Jul-12 08:16:59

Sorry - did link from my phone so you can't click through. If you copy and paste it into your web browser it should work.

KnackeredCow Fri 27-Jul-12 11:11:02

try clicking this instead - page number 23

jumpingjackhash Fri 27-Jul-12 11:13:56

Hi Cookie, I think the general consensus is SET is preferable, if everything suggests there's no reason an embryo shouldn't take. However DET can be recommended if circumstances are not so 'perfect', e.g. the woman is older, there are a couple of embryos that 'look worth a shot'.

I'm being very generalistic and not particularly 'scientific' here, btw! I know that Guys will always prefer SET if the conditions are favourable, but Knackered has a point in that live birth success rates are important for clinic selection, so its inevitable it will play a part at some point.

On our first round the consultant recommended we transfer 2 embies, one was our 'best' one, the other 'second best and worth a go' hmm - we ended-up freezing a third on day 6, which was unexpected!

So, I had a call from the clinic this morning - out of our 12 eggs, 11 were mature enough, all were' ICSI'd and 6 fertilised! We're provisionally booked in for transfer on Sunday morning, depending on how they get on.

Of course, that means we'll be having the SET / DET conversation over the next couple of days too. Christ! I think we'll probably go for DET unless they strongly recommend against it.

KnackeredCow Fri 27-Jul-12 11:38:08

Jumping that's fantastic news! Fingers crossed for you.

Cookie Jumping really makes a good point about embryo quality. When the clinic phoned on the morning of my transfer, one embryo was graded excellent, and the other "good" at that point. It was my third cycle so because of my failure rate, and the fact they thought the "good" one only had about a 30-40% chance of implanting they agreed putting two back was sensible. It so happened that the "good" one really came on in the hours between the morning phone call and transfer (and was re-graded) and that's why we had the discussion again immediately before transfer. However, because of my history, I was happy to accept the risk of twins.

The link I've posted also includes the grading scheme for blastocysts (my clinic uses numbers now, but that's so they can be entered into a database), so I shall convert to letters.

For me:

Cycle 1
eSET of 4Ab - implanted but v. early m/c

FET
4Ab/a - failed thaw

Cycle 2
2 x 2Bb transferred - completely failed (beta was 1 so no attempted implantation - I assume that the blastocysts stopped developing within a day or so of transfer).

Cycle 3
1 x 5Aa and 1 x 4Aa transferred - pregnant with twins

So I am definitely an example of where embryo quality has been the leading predictive factor of success.

The embryologist told me that at my clinic they see a 70% pregnancy rate with the transfer of 1 x Aa blastocyst. It's 30-40% with a blastocyst graded Bb. Having two transferred does increase your chance of pregnancy, but it does NOT double. It increases it by about 10%. However the probability of twins is significantly increased. However, this is very dependent on the quality of the blastocysts. Your far more likely to end up with twins with the transfer of 2 x Aa blastocysts than with 1 x Aa and 1 x Bb.

jumpingjackhash Fri 27-Jul-12 11:42:49

I'm ashamed to say I've never really grasped the grading - but I don't think Guys have explained it to me particularly well either! With our first icsi we were shown images of our 5 embies on day 3 - one was described as 'beautiful and the best', one 'worth a shot' the others 'let's see but don't get your hopes up they'll improve any more'. Scientific, eh?!

This time I'm going to ask more about their grading!

<feels woefully uninformed about this bit>

KnackeredCow Fri 27-Jul-12 12:05:48

I had to ask and really push to get the information. Mine were initially described in the sort of terms yours were. The link I've attached to the presentation is really informative.

They assume no knowledge. It was only when I told them I had a degree in Zoology and as part of that had studied some basic embryology (ten years ago, very out of date and I couldn't actually remember much!) at university that they changed the level at which they spoke to me - and the principal embryologist began to deal with me.

CareBear1 Fri 27-Jul-12 19:43:57

That's great news Jumping!

zeebee1 Sat 28-Jul-12 12:10:26

jumping fantastic news - so happy you got so many embies.... Fingers crossed for some more good news tomorrow too...

SET vs DET we've never been undecided there due to my ripe age of almost 40 and that we know 2 lots of friends with IVF twins and we love them & we are so prepared for the hard work that would be ahead of us with 2! Bring it/them on!

Waves to all - nothing much to report - just playing the waiting game & debating if it would be ok to cycle up to see some of the road cycling today...

jumpingjackhash Sat 28-Jul-12 13:23:56

Ladies, how did you feel physically after collection? Aside from feeling a bit 'bruised' down below and some cramping, did you have any tummy ache? I recall last time feeling quite sore and bloated for 2/3 days, but maybe my memory is fading, as now, a few days later I'm still feeling quite bloated and have stomache ache (also not been able to 'go to the loo' since the day before EC, sorry if tmi! I'm putting this down to codeine I was given?). Is this quite normal? Slightly concerned about transfer tomorrow!

zeebee1 Sat 28-Jul-12 13:42:17

hmm jumping I didn't have that much pain after transfer this time, I felt delicate around that area and also my right hand side still felt sort of 'heavy' IUKWIM... But actual tum pain, not really... It might be the old presseries that are making you feel a bit bloaty and also I find that make me quite constipated blush too.... Also I found I was really stressed about ET this time as it just feels less exciting and a bit more disparate this time around... You might just have butterflies about tomorrow? Do you ever do meditation or anything? Sometimes that can help before ET... Get your zita disk out maybe
Hope that helps a bit?

zeebee1 Sat 28-Jul-12 13:43:00

Sorry I meant I didn't have much pain after COllection!

jumpingjackhash Sat 28-Jul-12 14:08:48

Hi Zeebee, thanks - It's a weird feeling, at first I wondered if I'd maybe strained my stomache when I was vomiting, but that would have gone now. I do have a bit of wind still blush so wonder if it's linked to that and the constipation blush. God this makes you feel so attractive and sexy, doesn't it?!

Good idea for the Zita CD, will plug myself into my ipod and try to relax!

You OK? When do you test?

jumpingjackhash Sat 28-Jul-12 15:14:36

OK, think you're right about the pessaries Zeebee, according to Dr Mumsnet and Dr Google (& various other sources) it's likely that the Cyclogest is causing the bloating, cramps (likely to be wind-related) and constipation. Bugger. Off to the supermarket to get some prune juice and lactulose (in case the prune juice doesn't work).

God I hope it works this time!

CareBear1 Sat 28-Jul-12 16:20:11

Hi Jumping, i think that's quite normal - to be sore for a few days. the pessaries make me bloated and give me wind too, though not so bad using front door rather than back door ! Have you tried a hot water bottle on your stomach (only before transfer), or drinking hot water? Wonder how your 6 are getting on - what time do you get the call tomorrow? Defo agree with ZB get Zita on, she'll keep you calm!

Had EC this morning, went fine. Got 8 eggs, which am pleased with - i'd seen 7 on the scans which were all a reasonable size, and we got 9 a year ago with last ivf so that's fine. Wait to hear tomorrow, and relax on the sofa this afternoon!

zeebee1 Sat 28-Jul-12 16:44:13

Care - fab news on your EC... Here's to a good night for them to get jiggy with your DH's little fellas!
Zx

jumpingjackhash Sat 28-Jul-12 16:52:28

Brilliant Care! hoping they do the bizzo with your DH's swimmers! Good luck for the call from the clinic tomorrow! How are you feeling now? Hope you have your feet up?!

I've just been out and bought prune juice (to drink warmed-up), cans of prunes and a box of Fybogel! I'm going to see how they go tonight and speak to the doc when we go for ET tomorrow (or if they call to postpone it tomorrow). Really hoping this little lot will help!

My brain is addled at the moment though, i was booked in for a Thai foot massage today and totally forgot - i'm mortified and will call later to pay for my missed appointment blush.

KnackeredCow Sat 28-Jul-12 18:34:02

Jumping Did you have your EC under general or conscious sedation. The reason I ask is was it traumatic, and I'll guess you'll only know that if it was under conscious sedation.

My last one was under conscious sedation, and due to my adhesions and left salpingectomy, my left ovary is really difficult to reach. The Registrar had to get the Consultant to take over after half an hour. I was in a phenomenal amount of pain for a few days afterwards because to manually manipulate and position the ovary so they could access it, I had one of the nurses pushing down on my abodmen with pretty much her full body weight. It was horrific.

Sorry will finish post later - DH grumpy with me for being on MN

KnackeredCow Sat 28-Jul-12 18:59:57

Sorry - had to do something. DH was rightly grumpy although feeling guilty now as I did tell him I was feeling really nauseous and was then spectacularly sick grin. I should imagine that will get me out of doing things when he insists in future.

Anyway, Jumping is it possible you've had quite a traumatic EC any that's causing the pain and discomfort? My EC was pretty horrific to be honest, and I was conscious for the full 50 minutes I was in there. I have never experienced pain like it. And the discomfort afterwards was getting similar to after my laparoscopy.

By the way, I was constipated too, and it took 7 hours before I could wee again after EC because my abdomen was so sore and bruised.

Care Excellent result! Hope you have lots of embryos tomorrow!

jumpingjackhash Sat 28-Jul-12 20:15:09

Ooh you poor thing Knackered! I was knocked out and only in there for about 10 minutes so I don't think it was particularly troublesome. Will ask when we're there tomorrow.

I'm certain it's bad constipation and progesterone bloat, I'm drinking at least 3l of water a day and peeing for TeamGB, but as for anything else, it's been days! <wails>. In the last 4 hours I've had a fybogel, 1/2 can of prunes, cup of warm prune juice, asparagus and a bowl of bran flakes... Nada, nil, not a twinge of a movement. Thoroughly fed up now! [bloated grump emoticon]

Sorry, tmi and rant rolled into 1!

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