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Conception

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IVF/ICSI/FET - any more for any more?

999 replies

jumpingjackhash · 05/01/2012 10:05

Hi all, we're about to start FET following an unsuccessful round of ICSI last year (well, we got the bfp, but then I miscarried shortly after Sad). But... time to get back on the bike and go again...

Anyone else going through this?

OP posts:
KnackeredCow · 21/03/2012 17:14

Afternoon all

Gosh it's been very busy on here over the last week! Apologies again for going AWOL. I managed to contract the vomiting bug that's doing the rounds and have been rather incapacitated since the weekend! Anyway, I'll attempt to catch up!

Josie What devastating news. Absolutely awful Sad. I really hope you are just taking a long time to respond. Why won't they try again? Sorry but I don't know what your reason is for subfertility. Is it possible to try a different protocol or something? Could you get a second opinion?

Your question is spot on about the stims and buserelin working against each other. You need to down reg to stop premature release of any eggs from the follicles. However, in the long protocol (which uses an analogue to shut down the pituitary gland) you down-reg first, I think, then start stimming. In the short (antagonist protocol) you start stimming on day 3 of your cycle and later add in an antagonist drug that binds to the LH stopping the surge (and premature ovulation). Therefore you don't shut down your pituitary gland. The short protocol capitalises on the fact that your normal hormones are still running in the background, so it's possible to mildly stimulate on it or aggressively stimulate. At least I think that's roughly how it works. The short antagonist protocol isn't suitable for all, but a recent Cochrane Review showed it to be as effective as the long protocol in terms of live birth rates, but with a lower risk of cycle cancellation and OHSS. Many clinics avoided it until recently in the false belief that the live-birth rate was lower, which isn't the case. Of course, it's not suitable for all and I am sure your clinician has picked the best protocol for you. But sometimes clinicians get set in their ways. Just saying.

Also, from what I've read on Google,there are two main reasons that clinics haven't adopted the antagonist protocol (although remember that it may not be appropriate for you anyway ? I don't know). First, conservatism of an individual clinic's consultants, and second the hours over which the clinic operates. I believe planning is harder for clinics using the antagonist protocol and so more difficult for a small clinic operating a five-day service to offer it. I was on the short (antagonist) protocol for my first cycle as an NHS patient (with good ovarian reserve). Although I'm now a private patient, I'm still with the same clinic, which is NHS managed. I don't think there's much difference in the cost of the two protocols, it's more down to scheduling rather than NHS vs private (as Jumping said).

Lumili How are you doing? Feeling any better at all, or still low? I'm still very much in the dumps.

We did have our review appointment with the clinic on Thursday. We discussed doing a number of further tests. One of the registrars at the clinic is writing an MD on recurrent implantation failure, so they offer a pretty comprehensive service. However, it takes months to get some of the results back AND they stressed that they probably would find nothing. This would delay us doing another round of IVF until September. Because I got pregnant on the first cycle and then miscarried, they seem to think if we persevere we'll get there. They did say that they would recommend further investigation after a third failed attempt. So, after much thought, we've decided to give it another bash in May / June and then investigate if that fails.

After some thought, DH and I have decided to change strategy next cycle and have what appears to be the best two embryos transferred at day 3, and any left over cultured to day 5. If on day 5 there are some beautiful blastocysts, we'll freeze them and attempt to transfer on a subsequent frozen cycle should the fresh one fail. To date all our embryos have failed at blastocyst stage, and our hope is they might do a little better if popped back inside me earlier. Might not work, but we're desperate! Clinic is being supportive if we want to do this.

CareBear Glad to hear your transfer went well. How's the 2ww progressing? Agonising, isn't it? Wishing you lots of luck.

We've decided not to do egg donation next time, but only because PiL have been superstars. They didn't realise we didn't get NHS funding and have ?lent? money, to pay back when we can afford Hmm which will cover us for another round. I would like to egg share though; it would be great to give another woman the chance of having a baby. I do think I might get timed out though - I'm already 33! DH is considering sperm share too, although is asthmatic so not sure if he'll be rejected?

Karbea Your drug regime sounded really complicated, but 8 eggs is fantastic and 5 fertilising is a superb result. Fingers crossed for you!

Jumping Yes, you definitely have to give it a try. I don't think you can leave the frosty in the freezer. You'd simply think ?what if?. Good luck for your transfer. Has the date been confirmed yet?

Zeebee Sorry to hear your lining isn't progressing so quickly. How frustrating.

Lizzie I'm seeing the counsellor at my clinic and have also found it really useful. It's good to have somewhere to vent and cry. A bit llike this thread, really Grin

Well sorry for mega post. Again. I promise I will attempt shorter but more frequent posts in the future.

to everybody that I haven't namechecked. Sorry - no offence intended.

lizziebennet · 21/03/2012 18:24

This reply has been deleted

Message withdrawn at poster's request.

duggs1976 · 21/03/2012 18:43

jose hope the dr gave you more information this afternoon ?
hope you don't mind if I join you ladies? It would be good to share the journey with you over the coming weeks.

I've been TTC for almost 3 yrs.. 3 miscarraiges over this time. one trisomy 13. Last one in July 2011. Diagnosed with High natural killer cells where my immune system can attack an embryo thinking it is a cancer cell.
I am on steroids from ovulation for this under dr shehata at the miscarriage clinic.. been ttc again since September. 2 natural cycles, 2 super ovulation and 1 IUI. Now this month we will try IVF for the first time with screening CGH to ensure a chromosonally good embryo is transfered. I also have mild PCOS..so on metformin, although cycles regular.

I am currently on cycle day 6 of a short protocol. I had an 8mm lining and 14 antral follicles on right (polycystic ovary) and 7 on left ovary at my baseline scan on day 4. I have another scan on Friday day 8. I am on menopur injections right now.

Sounds like a few of you have a lot of information on IVF to share. I also have the zita west cd's on my iphone. Am having acupuncture too... not really many side effects so far.. am v tired though I guess that is the menopur (is like gonal f) ?

KnackeredCow · 21/03/2012 18:47

Welcome duggs

I think Menopur is a form of FSH, just made in a different way to Gonal F. I was shattered on Gonal F. Think it was a combination of stress and medication.

So sorry to hear about your history of miscarriage Sad

duggs1976 · 21/03/2012 19:31

Thanks knackered do you mind me asking about your experiences so far? Have you have a couple of failed implantations ? Sorry I should look back but on iPhone now.

lumili · 21/03/2012 19:49

Karbea that is great news, congratulations. Do you know when you will be going in for the egg transfer?

Josie I hope the phone call you received at 4pm went ok, my thoughts are with you.

Jumping sounds like you have got Friday planned to the very last detail :) it is good to be organised.

knackered sounds like you have a plan for the way forward, that is great.

Duggs welcome. I am so sorry to hear about your miscarriages, good luck with your IVF for this month.

I hope everyone else that I haven't mentioned is ok and doing well.
x

JosieSmith1 · 21/03/2012 21:51

Hi, just a quick update, I will reply individually tomorrow. Nurse who phoned just said the blood test showed that not a lot was happening and that they'll discuss it tomorrow and ring me in the afternoon. I'm not very hopeful but will let you know tomorrow afternoon what they say

CareBear1 · 21/03/2012 21:54

Hi Duggs, I'm really interested in this Mr S and immune therapy, have u seen him privately and if so how much has everything come to so far if u don't mind me asking?

Afm only 2 more sleeps till test day. Just had some pink spotting which for me often precedes AF. Had acu earlier so praying it was that instead.

CareBear1 · 21/03/2012 21:57

X posts Josie, have everything crossed for u for better news tomorrow

jumpingjackhash · 21/03/2012 22:30

Wow Knackered you're seriously clued up on all this! Thanks for the explanation!

Glad you and DH have a strategy for your next steps, hope this one is lucky and you also get some frosties for brothers/sisters in the future.

Karbea great result on the fertilisation!

Hi there Druggs, sorry you've had such a rough ride. I hope the Menopur doesn't completely knock you for six, I was on Gonal-F and didn't really have any side effects once I got into the swing of it. Keep us posted on your progress!

How are you doing lumili?

Josie, if they're still not saying it's not going to improve then you need to be positive - see what the doc says tomorrow, it might be better news than you think. Sending boosting vibes to your follicles (wherever they're hiding).

Care your 2ww seems to have gone by quickly (IMO at least, probably not for you though?!).

Afm, I seem to be bloating on the oestradiol and Cyclogest, which I think is a reasonably good sign (as in textbook side effects), trying to manage my own expectations for Friday, just in case frosty doesn't thaw well enough and it's all off. I'm managing to sleep ok now though, so feeling quite relaxed and good otherwise.

OP posts:
CareBear1 · 21/03/2012 22:36

Jumping they'll test me 9 days post transfer, so less than 2 weeks

Karbea · 22/03/2012 08:20

Is any one using cyclogest? I seem to be having major painful upset belly about an hr and a half after taking it, I'm going to call the Argc today and ask if I should continue, it is a known side effect :(

Knackered at my clinic as soon as they can see front runners they put them back, the best place for them is back in you, so that sounds like a good strategy.

Josie fingers crossed for later.

Duggs I've been diagnosed with nk cells cd56, which is why I'm on the clexane and dextathingy...

I missed the call from the embryologist so need to wait till nine so I can call them back. But he left a message saying 'two divide good" not sure if this means only two have divided well, or all have divided into two?!?!
I'll either be transferring tomorrow or Sunday, depending on how they are dividing.

zeebee1 · 22/03/2012 08:44

Hi karbea I remember having the most awful pain using cyclogest following EC- was in agony - so the dr told me to put them in my behind instead Blush
I think it's because your front bottomBlush has been through so much trauma during EC that the cyclogest must inflame it a bit. I was able to put them back up the front after ET tho... Good luck!
josie loads of luck for your call later
jumping thinking of you loads for tomrrow - do they call you in the morning to say how the defrost has gone? I too love borough market - always spend too much ££.. Anyway good luck Wink
care wow test day tomorrow! Already! Good luck and good vibes Wink
Waves to everyone else - am on the bus to work and on stupid iPhone so can't scroll down and name check others - happy Thursday all Smile

jumpingjackhash · 22/03/2012 12:15

Karbea I don't recall any stomach pain with the Cyclogest but I did find it hard to sit properly when I started it after the EC - I put this down to my bits taking a bit of a bashing during the EC. I did however feel really heavy in my tummy (and feel like that now I'm on it again with no 'messing around down there', so that must just be the progesterone building up).

Zeebee I'm not sure - I guess they'll call if there's a problem, but chances are we'll be en route then and only find out when we're more or less there. Really starting to worry about this now - hoping with all my energy that frosty is OK and settles in after a straight-forward transfer.

Hope you get a good call later Josie

Care - how come just 9 days? Good luck with the testing! Smile

OP posts:
Stangirl · 22/03/2012 13:37

Hiya

Having had several rounds of IVF (with good and bad outcomes) I found myself drawn to this thread - having been part of them before on both this forum and others.

I was diagnosed with early menopause in 2007 and went down the egg donation route. First cycle I conceived but mc'd at 9weeks. Had a large number of gynae problems to sort and then had another cycle (new donor) about a year later. DET resulted in single pg and my DD in 2010. I had another cycle in 2010 (yet another donor) and DS was born in 2011.

I just wanted to share this to show you that success from quite bleak positions does happen and wish you all the very best.

JosieSmith1 · 22/03/2012 14:33

Well, the nurse just phoned and said that I have to have another scan on Saturday and we'll see from there. So there must be enough going on for them to be willing to continue. They could have said there's nothing more they can do and given up on us, but they haven't. So fingers crossed there's still hope!

jumpingjackhash · 22/03/2012 15:24

Hi Stangirl, it's really good to hear the success stories, so thanks for reminding us that good outcomes are possible!

Hey Josie, that's really positive! Indeed if they'e asking you to go for another scan then they must think it's worth it! Smile I take it you're keeping on with the stims in the meantime?

OP posts:
zeebee1 · 22/03/2012 16:15

thank you stangirl inspiring to read - so happy for you...

josie I'm really glad you are going to have another scan on Saturday - good luck with it Wink

welcome to duggs - sorry to read of your miscarriges - you sound like a very brave person. I need to take a leaf out of your book! Good luck with your scan tomorrow - are you enjoying the accupuncture? I don;t think i could do without it now - I love the way it makes me feel - think it's helped me calm down a bit in life too - which is possibly what is stopping me get PG naturally...

karbea - also meant to say - good luck with the transfer/s - happy divisions!

KnackeredCow · 22/03/2012 16:56

Duggs On my first IVF attempt I had one blastocyst transferred, briefly got pg and then had a very early mcSad. A subsequent FET failed because our blastocyst didn't survive thawing. We've just had a second failed attempt at IVF. This time two blastocysts were transferred, but both failed to implant. That said, neither were as good quality as the blastocysts on our first round. I have tubal infertility on my left side - had a partial saplingectomy when a paratubal cyst was removed. The rest of my pelvis was full of adhesions due to peritonitis as a child. Right ovary was stuck in the wrong place Sad

Care and Jumping big days for you both tomorrow. Will have everything crossed for you. Hope everything goes smoothly and you both get positive outcomes.

Karbea Any news on your embies? Does it look like they will be going back tomorrow or Sunday?

Josie That news must be a relief. I really hope you get a good result on Saturday.

to lumili

Well I'm still signed off sick and feeling really low. Been off since the day we knew it hadn't worked, and then had vomiting bug on top, which didn't help. Haven't left the house since Saturday when I went to see a friend. Dreading going back Monday. I just feel so drained, exhausted, fed up and I can't motivate myself to do anything apart from sleep. Please tell me this will pass. I've just got it into my head that we're never going to have children and my confidence is shattered Sad

duggs1976 · 22/03/2012 18:30

Hi care yes seeing dr s privately. Is not cheap but then none of this is. £300 for initial appointment. He will look at which tests you have had (on nhs presumably) and the one usually missing is nk cells text which is £300. If u have elevated nk cells he will put u on a steroid programme, check out ttc predinsolone threads on here . There r quite a few of us. Any specific questions do ask am happy to share Smile

duggs1976 · 22/03/2012 18:36

knackered sorry to hear your story. It is just so tough going through all this. You have had one implant though so u can get pregnant. Have u considered CGH testing of your embryos to ensure the ones you replace are chromosonally normal? Just a thought. The frustrating thing about ivf failure is u don't really know if the cause is random chromosonal egg issues or uterine receptive issues? Like immunological for example? They say it is like seed and soil and both need to be spot on to work. Remember there is only 25% chance of PG in natural cycle so don't give up. If u Google dr sher CGH you will see some interesting articles and maybe a video too. Is quite fascinating.Smile

KnackeredCow · 22/03/2012 18:46

Hi duggs - yes we discussed the possibility of further testing with the FC after our second failed IVF attempt. However, although they were supportive if we wanted comprehensive testing, they did counsel us that it probably would not show anything and we'd most likely simply been unlucky. A lot of the tests take a while to come back, and so it was looking like September before we could cycle again. After a great deal of thought DH and I have decided to try one more cycle, but if that fails we will have the full litany of tests. In fact, our clinic said they would strongly encourage further investigations if we had a failed third attempt.

On our second attempt our blastos were quite early and so slowing down in development by day 5. I wasn't surprised they didn't implant and just wondered whether they'd have done better had they been transferred prior to day 5. The only reason culture is done to day 5 is to make it more likely the embryologist selects the best embryos, but many embryos just won't make it that far. So next time our strategy is to have two transferred on day 3 and have any others put on ice.

Will get on Google though and track down the information you've recommended, so thanks for sharing. Smile

Karbea · 22/03/2012 21:30

Hello,

Sorry I thought I'd given an update this morning :

1 is 4 cell with no fragmentation.
2 are 3 cell, 2 are 2 cell, with varying levels of fragmentation.

The embryologist thinks we will transfer tomorrow (day3)I guess they just need to see which of the others is the best.

How much does clexane hurt :(

Belly has been better today, hopefully getting used to the cyclgest!

duggs1976 · 22/03/2012 22:24

Any one know where is best to get clexane from ? I went to boots today was £200 for 5 weeks. I guess ontop of the £7k ivf and CGH plus all killer cells treatment it is a piss in the wind so to speak but I wondered if anyone had any tips !

Raspberryjam · 22/03/2012 23:10

Hi everyone,
That's great news Josie that they are going to scan you again and hopefully things will have progressed for you.

V exciting Karbea - thinking of you tomorrow.

Hi duggs1976. We have decided very late on to do chromosomal testing on the polar bodies this time and have just signed consent forms at the clinic in fact! - I'm going for EC tomorrow so v nervous as even if we get embryos with ICSI - might not be any suitable for transfer if they test abnormal. It does add to the cost but we've decided to for it as I'm over 40 and greater number of eggs could be abnormal - but risk is there is nothing suitable to put back - I suppose better to know that ?. I think several clinics offer chromosomal array testing of the polar bodies now, with samples taken to a separate testing lab elsewhere eg Oxford? I think.

Knackered hope you are feeling a bit better soon. Glad you are feeling like trying again though.

Zeebee - I'm loving the acupuncture too - I seem to go into such a deep relaxation and was snoring during last one!

thanks for your story Stangirl and congratulations.

Hi to you lumili- hope you are ok.

Off for some shut eye now, but v sore boobs - ouch!!!!! and nervous!!!eek