Frozen embryo transfer or not?

[Nk11]

After a failed fresh transfer in December we have the option to have our one remaining embryo transferred but it is a Day 6 graded 5CB and our fresh 3 day transfer didn’t take at all which was graded the highest quality at the time of transfer. I got my AF like nothing had ever happened just before Xmas…fabulous.

We knew our issue was male factor due to low on all areas but DH recently had an ultrasound that showed a varicocele and 2 cysts. Now thinking we need to have this treated as is now causing DH discomfort but wondering whether we should have the FET or not. Worried it may be poor DNA quality since the fresh one did not work and varicocele can impact DNA frag.

DH has also just started taking Proxeed so we are thinking maybe we will have a better shot if we repair the varicocele and give it a little time but undecided whether to use the frozen embryo or leave it in storage. Kind of feels like we should give it a go and expect it to fail but it’s another £2000 to do this plus the £1000 to pay for the freezing of it. Does anyone have any similar stories or advice on what you would do?

For context I am 30 and have a good egg reserve, only had Bemfola 100 stims so did get 9 eggs but only 2 were progressing at day 3. We can do another cycle after varicocele treatment it is just what to do about this frozen embryo! Would also be nice to hear of anyone going through something similar.

Hello,

Your story is similar to mine on that we have ICSI due to hubby having a severe varicocele. We tried to embolise it but he's in 10% of men whose veins are configured in such a way that surgeon couldn't find it!

So we went to ICSI. I was terrified of embryo drop off rates and DNA fragmentation so hubby stopped having baths, took proxeed, gave up caffeine and alcohol and aimed to ejaculate every other day in the 2-3 months lead up to our first cycle. We ended up with 7 eggs, all of which fertilised and all made it to day 5, when one slowed down and was given an extra day but ultimately wasn't frozen.

Our fresh transfer failed despite being a grade 10, 5AA hatching blastocyst. Our first frozen transfer in October however was successful and I'm currently 12+2 had many scans (anxious IVFer!) and had always been healthy and wriggling around now, fingers crossed remains so!

I think the frozen one took partly because my body wasn't pumped full of meds co pared to a fresh cycle. We didn't have much confidence when our first 5AA fella failed but was so pleasantly surprised to see those two pink lines.

I think you're wise to optimise hubbies sperm for next cycle, it's so important as embryo drop off rates after day 3 are due to male factor. May be worth giving the frozen one a go for now though, you never know!

Have you got a multicycle package or did you pay for one round? I ask as I notice you're paying for the frozen embryo. My clinic also charges around that for frozen so we looked at multicycle plans where you get 2 or 3 rounds and it includes all frozen transfers. It worked out cheaper for us even though we're successful on first round and may not use 2nd, due to paying for the frozen transfers. Not every clinic offers it but worth checking as there are so many hidden costs to IVF aren't there!

Best of wishes for whatever you decide :)

Congratulations so nice to hear that yours worked and with a similar story.
We are with abc ivf. We initially went to Create as that is where DH had an initial semen analysis and had considered the 3 cycle package as it seemed the most economic but we are so new to all of this.

After my baseline scan the nurse was so optimistic that it would be a breeze as I had passed all the tests with flying colours and she said a male factor was the easiest issue to fix. So with that they said to go to the sister company ABC which is nurse led and cheaper. It worked out with ICSI at £3950 but yes we do have to pay for frozen transfers and storage. So if we do need another cycle which we will as even if the frozen works we have no more left, it’s going to be at least another £5k on top of that. With the failed fresh transfer I was pretty gutted as despite having 6 mature eggs all fertilising only 2 were progressing at day 3 so they said I had to have the best one transferred in case none made it to day 5 apparently they like to have at least 4 progressing to wait to Day 5. The Day 3 didn’t even try implanting I don’t think as I started spotting 8 days later and had a full 5 day bleed as normal before my test date.

Honestly part of me thinks if I don’t use the frozen one now when will I and at least I will know then, but the other part of me knows how hurt I will be if it fails despite being pragmatic and having a plan going forwards.

DH ever the optimist thinks taking proxeed and having the varicocele sorted will cure all but I am not so sure. Not had 1 positive in 4 years of trying makes me more sceptical. Unfortunately the nurses at the clinic won’t offer me any advice either as they very much seem to leave it up to me what I want to do. Wondering whether I would be better paying more for a consultant led service as I am starting to think maybe paying less isn’t better especially since I never asked for the cheaper option.

Where did you go for the embolization and was this private or NHS? DH had the scan in December on NHS the GP tried to say wouldn’t normally treat but because of pain would refer to urologist. We’ve asked if we can have a private referral as we would rather get it sorted or try at least so we can move forward with this.

@Imisscoffee2021 sorry forgot to tag not sure if you get a notification otherwise

@Nk11 The NHS won't do much for a varicocele if its not causing pain, or if they do it's a long wait as fertility sadly isn't a priority for them atm.

You'll read alot about varicoceles and how embolization optimised ivf for couples who'd had a less than satisfactory round in the infertility and ivf threads on here. We went to St John's Wood private hospital for the procedure it was about £4k but you can find it cheaper I think, that was just the nearest one to us. Sad it didn't work but had to try that first. Varicocele embolization also takes months to see any results if it is successful and isn't always guaranteed but I've read tons if threads of couples who have had a bad ivf round and then a good one once they dealt with the varicocele.

I'm with Care Fertility Woking and found that you do have to advocate for yourself at times, and push for things a little (like extra progesterone in my case as I bled 7dp5dt on first transfer) and the two multicycle packagecost about £8000, for all transfers I causing any frozen. You also get embryoscope for free so they have a time-lapse and can see the cell division. The meds obviously are on top but if we'd had to do more frozen transfers we would have been bankrupt so it was a good deal for us. Takes the pressure off knowing the frozen ones are there and technically I can transfer for free in future for a sibling if this little guy works out in there :)

Are you in an IVF group on the infertility forum? I joined one as I began my round and it was so helpful to swap stories with other women at other clinics and different protocols, not to mention support is amazing!

Hi ladies. Hope you don’t mind me hijacking your conversation. I just wondered if you had been told that cysts can negatively impact fertility as my OH has them but we have been told that it’s fine. He’s always had them and we do have children already but we’ve struggled to conceive again now for two years and his latest SA was much worse than it’s been historically.

@Anonbaby I couldn’t say for definite as we haven’t seen a urologist yet but I can’t imagine they help as they will cause blood to pool that creates heat in the area. Our GP was of the mindset that if it wasn’t the big C then it was nothing to worry about either but for the discomfort OH is in. They don’t seem interested in the fertility side of things too much. Have you tried Proxeed? My OH has recently started taking it as it is quite recommended to improve sperm quality. I don’t know how they remove cysts whether it is an easy thing but it might be worth enquiring with a private hospital.

@Imisscoffee2021 I’ve read quite a few forums but they were all earlier ones where the ladies had already had treatment I didn’t find any recent that had cases similar to mine on. I just find it so hard that I’ve never had a positive test come back with a clockwork cycle it’s like my body doesn’t want it to happen. That IVF cycle was like my body never even knew anything different. 28 days over and out.

I did start spotting a similar time to what you said but when I asked the clinic about whether my progesterone was perhaps too low they just said my lining was at 10.6mm at transfer so they didn’t think it would have dropped much. I did struggle with thrush bad after the antiobiotics and the progesterone pessaries made this so much worse so they said I could try the injections if I wanted - not sure I like the idea of these I hated the stims 🙄

Cant help but feel rushed into IVF if I’m honest as we only found out my OH had an issue in September where this was recommended and we thought the SA must have been down to the hernia repair he had done as a child as he didn’t know about the varicocele and cysts then. The clinic have said they would recommend we have treatment for that now before doing another cycle but they didn’t say because we think it might help. frustratingly they also said they wouldn’t do anything different on another cycle because I am on this simple pathway they gave me a really low dose of stims which we did get 6 mature eggs from but ultimately we’ve ended up with only one day 6 embryo that is average. I’d hoped we would have at least a few when they said everything was looking great along the way.

No particular advice for you OP but wanted to jump on to say we were me factor and unfortunately had 2 fresh failed cycles (one early miscarriage ) and two frozen failed cycles. Final cycle worked (twins!) despite the embryos not being as good grades as on previous cycles and also slower to become blasts.

@Toastandmarmiteandtea Thank you that does give me hope for our only embryo. The embryologist just said at day 5 it wasn’t big enough to freeze then at day 6 said yes it is a blastocyst now a 5CB and said it was average I thought well that doesn’t sound great! I heard slower blasts could be girls what did you have?

I had a boy and a girl. I think if they get to blastocyst at all, it’s good news. We also had high dna fragmentation but no varicocele or obvious problem. For the final cycle (fresh) we threw everything at it - went on an immunotherapy protocol and added in lots of extras. Also made sure dh was ejac regularly which is meant to help dna fragmentation.

Hi @Nk11

I’m in a similar situation to you now. Had a failed frozen transfer with ABC before Christmas with a day 5 3BB, as my day 5 4BB didn’t survive the thaw. I had to freeze all due to a risk of ohss. Found out Christmas Eve that it failed, in my heart I knew this was the case as I’d had bleeding from 5dpt so suspect my progesterone levels might have been too low.

Now I have 3 ‘average’ frozen embryos left (4BC -day 5, 5CB and 5CC - both day 6). I’ve still not had my follow up appointment and haven’t fully decided on next steps but just wanted to let you know I feel the same in terms of the worry of paying £2000 for another frozen transfer for lower grade embryos.

I have read other posts (including different sites) which confirm that sometimes these embryos do stick so I think my gut feeling would be to give it a go before starting a new fresh cycle just in case your 5CB is the one that will work.

Hope you’re okay! Here if you want to have a chat :) x

@TL037 honestly that it crazy how similar your situation is to mine. I found out 22/12 when the spotting I had been getting turned into full flow and my official test date was 23/12. Even though I knew my outcome would be so close to Christmas when I started it still made it so hard because I genuinely believed it would work.
So on 23/12 ABC called me to ask my test result which I was gutted about and they just said oh sorry someone will call you after Christmas. That was it I felt really let down. I checked their opening hours and saw they were only closed until 27/12 so after this I chased them and chased them 4 emails, 3 phone calls so that I could get a follow up as I needed to know what I could do. I think it’s awful they don’t get you a follow up booked in straight away when they know your result.

Anyway having the follow up they just said it was impossible to know why it didn’t work and when I said why would you do a day 3 transfer when it might have just never developed beyond that point they said it was protocol. I said I’d rather have been told nothing made it to day 5 then have that wait and those pessaries to have nothing at the end of it but they said they couldn’t do that. Everything I asked was met with nothing concrete that I could take any certainty from. I know fertility is a bit grey but I really wanted advice and I still feel like they don’t give me it. I wanted an opinion from them if I should use the frozen embryo since it is average and they just said it’s up to you.

I spoke with them yesterday and I am full of cold currently so I sound awful and she said she didn’t think I was ready to go ahead in my January cycle and to think about what I want to do more which is frustrating now as I have lots of events booked this year that can’t be cancelled like weddings abroad that mean actually if I am having it done it’s either got to be January or after June. So I am thinking to go ahead but I am going to have to go against what they are recommending now.

I am also really sorry to hear yours failed. When the nurse or whoever she was called me to ask my test result she sounded genuinely surprised at my negative and honestly it made me feel like nobody ever got a negative even though I know that’s crazy in that moment I felt like such a failure. It’s good that you had quite a few to freeze though not good about the OHSS curious how that happened as they wouldn’t let me have more than Bemfola 100 dose for fear of that. I just had a good egg reserve but no condition or anything of concern just that they said we stay low and slow and just get what we can. I asked if they would change this if I did another cycle thinking maybe I could end up with more embryos and she said not they would do exactly the same.

When I asked if they would test my progesterone they said that wasn’t part of ABC and I would have to switch to Create if I wanted extra tests doing. Frustrating as I’d initially started with Create asked if I could do the 3 cycle plan and they told me I didn’t need it and I should be fine with one cycle through ABC but seemingly not!

@Nk11 a woman in an IVF group I'm in also enquired as to a mukticycle package with her clinic, was confidently told she wouldn't need it, and had a disappointing first round, I think poor fertilisation rates and then only on blastocyst which sadly didn't implant . She complained and they transferred her to multicycle and included that first round in it. Might be worth taking that further with Create as based on their clinical advice you've not had the round they said you'd have, may he able to get it transferred as a multi?

@Imisscoffee2021 That’s interesting. I don’t have anything in writing though. It was when I went for the baseline scan through Create the nurse said you qualify for ABC which id not even heard of. I didn't ask for a cheap option either I just went with their advice. The nurse said you’ll have no issues you don’t need a 3 cycle when I said that’s what we had been considering. She genuinely gave me that believe it would work as she said my scan was perfect and my bloods came back great. Didn’t seem bothered about the male factor like it was easy to sort. I’m just scared to rock the boat with this clinic I’ve already had to fall out with them over my patient coordinator not coordinating me at all after I made my payment and then with all this over Christmas they were already quite defensive. Is it worth an ask?

@Nk11 sorry to hear that you’ve had to go through this after finding out it had failed. I’ve still heard nothing from them after them learning of the negative test and hoping I will hear from this week as I chased them yesterday. I also contacted them during the 2WW as I felt my progesterone levels were too low because of the bleeding and was also told that it could only be checked if I was with create (and even then it should have been checked on the day of transfer as it would be too late that point).

I was on the lowest dose of bemfola but I still produced too many follicles and at retrieval they got 21 eggs and my oestrogen blood level was too high so they said I had to freeze all due to the risk, despite no symptoms.

I would definitely speak to them about switching to create so you can do the 3 cycle package, it only seems right if that’s how you initially started and then hopefully you can just pay the difference 🤞🏻

@Nk11 ahh this has also happened to me and had a similar issue with my patient coordinator and a misunderstanding re payment which was chased during the TWW!! Can I asked which ABC clinic you’re at?

@Nk11 I'm sorry your first cycle didn't have a good outcome and you weren't well supported over the past weeks by the clinic.

We were "unexplained" but similar in that my cycle was textbook regular and all looked fine but nothing happened in 3 years of trying naturally. My fresh cycle with a perfect top grade blast that everyone was super optimistic about, ended in a very early loss (chemical). I was convinced there was something fundamentally wrong and my body wouldn't support a pregnancy. But I had the FET anyway, with the very mediocre frozen blastocyst, 3 months later despite being so pessimistic I didn't even test at home, just went for the clinic blood test to confirm the expected failure. I just got back from doing the school run with that frostie, who's now 8.

I think we can drive ourselves mad searching for reasons and ways to tip the scales but sometimes it's just a cruel numbers game, and anything that gets to blastocyst represents a good chance.

There's also something to be said for giving your body and mind time to heal from the failed cycle, though waiting feels very hard.

Best wishes and good luck with whatever your gut says is the way forward.

@TL037 That’s terrible definitely chase them they seem so laid back about arranging follow ups but it’s so important. Yes I asked the same about progesterone they said it would have to be with Create because I was concerned why I started spotting but in reality I think it just didn’t take so I think I’ll do the frozen transfer with abc and if it doesn’t work I think it will be an embryo issue. We won’t do another fresh cycle until late summer now because we need to try get the varicocele fixed and hopefully we will have a better outcome. My OH seems to think it will happen naturally if he can sort the varicocele 🙄ever hopeful.

Are you thinking of trying one of your frozens or potentially all of them? Not cheap is it like they make out when you have to pay for each frozen on top of the cycle cost. Did you have any issue with the pessaries? For me they were the worst symptoms wise I was so sore with them.

@TL037 We’re with Leeds

@Cockerdileteeth That’s amazing. I know I have to hear the stories from others because the clinic doesn’t give me much hope. When they call and say your blastocyst is average I want them to say but lots of them work but they don’t say anything. I won’t know unless I give it a chance will I. I just have to b prepared for it not to work! For me the waiting is the hardest part I just want to get on with my life not have it all hanging over me so I’m talking myself more into just getting the frozen done 😅

@Nk11 we have also had icsi (due to low morphology), but I hope this gives you some hope. We have a daughter who we conceived naturally after 5 months, but prior to this we had a fertility check on both of us and my husbands morphology was low then (the same as it actually is now) and we were told that it could happen naturally and it did a month later! When we approached the year mark for baby number 2 we just thought we didn’t want to keep waiting and increasing the age gap between our first and possible second so there is every chance that it could happen naturally, especially once the varicocele is fixed.

I want to see what they say in the follow about the remaining embryos, I really can’t see us paying for 3 further frozen transfers with ABC and especially not when they have told me they are average/ low quality. Will hopefully have the follow up this week or next and will let you know!

I agree about the pessaries, hated the symptoms and to be honest I was just always paranoid that they wouldn’t dissolve properly and then kept wondering if that’s why it hadn’t worked, even though in reality the embryo was probably never going to!

@TL037 That’s really good to hear gives me hope it is possible natural if we just give it time and the varicocele situation may help. My OH is taking Proxeed now so we’re hopeful this will help. Just had a quote on the varicocele embolisation at £7000!! But been told the NHS wait could be pretty lengthy 😣

Ive decided to go ahead with the frozen transfer this next cycle which will be in about 2 weeks and see what happens. At least if it doesn’t work I’ve put that one to bed and can move forward without worrying about what if that one would have worked. I realised I was ok with it when I finally told my sister what I had been up to and managed to talk about it without crying I knew I’d come around to it.

Yes I asked if they could give more progesterone support they said if I went to Create I could have Lubion injections alongside the pessaries but they are about another £1000 for those injections. When I had my natural progesterone levels tested pre treatment they were really high 83nmol where they needed to be above 30 so I’m thinking my progesterone is probably ok and it was an embryo issue so I don’t think I’m going to go down that road.

It would be great to know how you get on with your follow up. Nice to hear from someone with the abc clinic and at a similar point as me. Did you say which clinic you were at?

Lots of luck, Nicole xx

@Nk11 its definitely possible so keep trying - even now we will carry on trying naturally between cycles just in case as you never know!
I can’t believe the quote is that much 😱. Hopefully you can get some more info on how long the nhs wait is while you go ahead with your frozen transfer and then you can decide.

That’s great that you’ve decided to go ahead with the transfer, I do think anything frozen has a chance otherwise I’d like to think they wouldn’t freeze! Like you say at least if it doesn’t work you know you’ve tried it and won’t be left wondering, but I think you have just a good chance as anyone because from what I’ve read the good gradings might not necessarily mean the embryos are genetically normal and vice versa! pleased you have told your sister, it’s great to have someone to confide in apart from you’re OH, we haven’t really told anyone apart from a friend each but that has helped.

Really good to know about the progesterone thank you! I will ask for mine to be checked on the day of my next transfer then and just pay for the blood test separately, as I’m sure they’ll say the same to me as im ABC and not create.

I’ve been told my follow up will be at the end of next week so I’ve gone back and said I would like it to be sooner especially as I found out just before Christmas it failed so it seems like a long wait for a follow up, and also my next cycle should start in around two weeks so would need enough time to decide if to go ahead with another frozen transfer and get they treatment consultation in etc! I’m with the Manchester clinic but sounds like we’re having a very similar journey/ experience anyway!

Thank you, best of luck to you too and definitely hear if you need to rant or anything! Xx

@TL037 Did you manage to get your consultation yet I hope?

We ended up going to Derby Private Health for a consultation re: varicocele and are waiting for embolisation procedure to be booked in now that is private as apparently they wouldn't treat on NHS due to it being below the size threshold of 3.5mm although the doctor we saw in Derby said it was visible through the skin and causing pain so should be treated. They said the NHS wait is about a year and they still might turn it down. The NHS consultant said to just take paracetamol and that in his experience having varicocele surgery doesn't increase any sperm quality at all. Anyway we're getting it done because he doesn't want to be in pain and surely if there's a chance of it helping its worth doing. Its looking at about £3k there. It is almost 2 hours from us but in Manchester it was £8k!

I paid for the frozen embryo transfer just waiting for period to start and prescription so I can pick up meds but that will be looking like early Feb for transfer day. I spoke to the embryologist who gave me reassurance that although the embryo quality wasn't the top grade, it was still good - fair and that to make it to day 6 is good as there are a lot of stages they have to get through between day 3 - 5. Really does annoy me that I had to have the day 3 transfer when they know full well there's a good chance it might not even make it to day 5 never mind implant.

Was quietly hoping that it might have worked naturally this month because OH has been on proxeed but I know you have to give it 6 months to really do anything just wanting that little miracle to happen to me!

The doctor we saw about the varicocele was asking if we have friends who have had ivf but we said we don't know anyone! At 30 now is the time I see everyone my age having babies it seems like I am the only one that is having to have ivf though I know you don't always know.

@Nk11 hi, it’s lovely to hear from you. So pleased that you have made some progress privately and hopefully it won’t take long to the the embolisation procedure to get booked in. Did they say how long the wait would be? I can’t believe it would only be covered on the nhs if a certain size, especially when it’s causing pain 😭. Fingers crossed for you both that you get an appointment through quickly!

How are you feeling about your upcoming transfer? It’s really reassuring that your embryologist has said that about your embryo, I think ours are graded similar? I have a 4BC day 5 and a 5CB day 6 so I’m thinking maybe the day 6 will get used - my pre treatment consultation is tomorrow because of how late my follow up was.

I’m in a very similar situation to you, also waiting around for my cycle to start (I think it will start around this weekend) and then I’ll start medications for my next frozen transfer too. I had to wait until last Friday for my follow up as they didn’t have any sooner😬. They think my last one failed because of the embryo, as opposed to low progesterone, so not planning on changing anything this time round but I will just get the blood test on transfer day to check levels.

I was also the same with hoping it would work naturally this month too, but you just never know it might still! I completely understand, it feels like (especially over Christmas) everyone was either announcing or having babies and it’s so hard to deal with when it looks like it’s happening really easily for everyone else, when I know it might not have been an easy journey for them. I definitely go through waves of positivity/ negativity and just keep trying to think it will happen, it’s just a case of timings 🤞🏻 x

They didn't say how long exactly but when we asked if it would be a few months he said no not as long as that so I'm thinking maybe a few weeks. Then to leave it probably 3-6 months to regenerate and do another analysis. Definitely felt like progress.

I'm feeling a little stressed but trying not to be as I just don't feel I get good communication from ABC/Create. I had my pre-treatment consultation last week and I was considering doing the transfer naturally without meds as my cycles are pretty timely and I think my body works better without meds. They told me that I could but that if my ovulation day turned out to be on a Sunday that they would have to cancel the transfer as they are closed Sundays. So I asked if they could email me over the differences between the two and a few other questions I had which they said they would but I never heard anything further. Anyway with my new cycle due this week I paid the medicated transfer fee on Monday and emailed my patient co-ord to confirm this telling her i'd need the meds asap. No response again so I emailed the main support email and nothing again. Ended up calling today and then got an abrupt email from patient co-ord to which she said she would email me over the prescription and still nothing has come through. Absolutely hate having to chase them all the time and feel like I get no support really unless I pressure them into it. So hopefully I will be able to get the meds so I actually can go ahead. They were trying to talk me into waiting a while for the transfer but I physically can't wait as I have things booked in until June that just mean it wouldn't be possible. Can't believe they didn't fit you in for a consultation until last week when this was pre-Christmas!

Yes my embryo is a 5CB so the same. They said sometimes they can transfer 6AA and they don't work and other times they can transfer embryos that don't look fantastic but they work so not to be worried about it and she said that making it to day 5 is the main part because they have done a lot to get there. I think grade 6 is fully hatched. 5 is hatching, and she said they need to hatch to be able to implant so it is good if that is already happening before transfer.

I will see if I can have a blood test before transfer too will that just be on the day? Did they say that was fine with ABC and do you just pay extra for it?

Did you have any trouble getting the medication as they have just said to go to a pharmacy but said the cost can vary. Silly me thought it would all be covered in the ££££ paying for the transfer.