To go back to GP for further help, or use last embryo?

[whomoon]

I am nearly 37 and had IVF earlier this year which produced 2 embryos, the first one failed and the second is in the freezer.

We have been TTC for 2.5 years and are unexplained.

It was straightforward to go to GP last August and be referred for fertility tests and the fertility clinic referred us to IVF straightaway.

Before/during IVF we were very much on the journey of having a baby, doing appointments, following all guidance, making sure we make the most of the available NHS funded IVF. But since it failed, we’ve been a bit ‘meh’ with it and have enjoyed having complete time off from thinking about babies, whilst also TTC naturally but no tracking etc.

I thought I’d want to go back to do a frozen embryo transfer with our second and last embryo, but we keep putting it off. Now it’s ‘we’ll do it at the end of the year’. I’m not sure if it’s because we’re enjoying being child free right now, or if it’s the feeling of it actually being our last chance and facing the possibility of this one not working either.

Then I thought, can the GP do anything else for us? DH SA is normal, I’m healthy and all tests are normal. However the only thing I didn’t have was the tube dye test (forgot the name). I also hear about Clomid. Could that help? As far as I know I ovulate as I have all the symptoms, positive ovulation sticks and regular periods.

basically, I’m wondering out loud whether I should have the dye test and ask the GP to refer me back to the fertility clinic to see if there’s anything I can have done on the NHS, before we spend near to £3000 on having this last embryo transferred?

I know time isn’t on my side, which is kind of why I want to hold onto the good embryo until last resort, and try naturally/assisted whilst I’m as ‘young’ as I am.

Would appreciate anyone’s help or thoughts xx

If all your tests are normal, clomid is unlikely to help.
I'm also not sure what support the GP will be willing to provide. They've already funded IVF for you. What would be the point of the dye test? I found in my case they didn't want to do any further tests and just used IVF as the answer for everything. When I questioned why they said it wouldn't change the outcome - IVF would still always be the best option so why waste all that time and NHS money on investigations.
£3000 is very cheap for a FET (ours was almost £9k by the time the cost of drugs was added on) so as long as you have that money available, I'd be trying to use the frozen embryo ASAP so that if it failed there was still time after for another round of IVF.

Have you ever had problems with your lining? If so I would consider the ERA test.

Also did you have your progesterone tested on transfer day? X

If your tubes are blocked then IVF is really your only option. Egg and sperm have to meet somehow.

Do you still want a child?

Personally I’d be using the frozen embryo. My tubes were blocked, and everything else was perfect. Did IVF resulting in one fresh and one frozen embryo. Fresh one didn’t produce a pregnancy. The frozen one did and is now a delightfully grumpy teenager.

If you still want a child and you have an embryo in the freezer definitely go back to the clinic. The first go in ivf is just a standard format that generally works but it isn’t tweaked to you. The second time they tend to have more information about what worked, also your body tends to be more responsive as it understands/recognises the drugs/processes. It’s also worth mentioning that having a FET is so much easier on your body than a cycle where you have to produce, harvest eggs and wait for fertilisation.

Good luck

Definitely transfer that frozen embryo. If that doesn't take then for sure investigate other options with a fertility clinic. But seems strange to do that before using an embryo that you already have.

Thanks everyone for your advice.

To answer some comments, my thoughts with the dye test are checking if they’re all clear because if they’re not, there’s no point TTC naturally. We’re still hopeful we can conceive naturally, hence not going back to the embryo so quickly.

It’s helpful knowing the fertility clinic won’t want to pursue any further tests as I’ve already had IVF on the NHS, that makes sense. That’s why they sent me straight to IVF in the first place I guess!

At first I wanted the FET so if it didn’t work, we could move to a self funded round of IVF as soon as we could, but that’s where we get uncertain. Do we scrape the money together for it? Do we really really want a baby enough to go through that? DH will do whatever I want to do - he’s happy with either outcome although is equally worried about spending so much money.

I’ve had no problems with lining, everything has been great. I don’t think progesterone was tested, however my new protocol for the FET includes a higher dosage as I pushed for it due to spotting at 9dp5dt so worried it may be low. Consultant didn’t seem concerned though?

Thanks for sharing your story.

I do still want a child. It’s the journey of getting to one I’m not sure about.

My first IVF was ‘successful’ according to my consultant. Even though the fresh transfer didn’t work.
Medication was fine and I had 14 eggs with 10 fertilised.

The only unknown is the fact I’ve never been pregnant. So not knowing IF I can get pregnant is the biggest question. Maybe I just can’t get pregnant? Usually stories are about sustaining a pregnancy and assurance to help with that, but I have never got to that point.

I think I’m looking at it from an expense point of view.
If there’s anything that can be done without spending money, then I would want to try that route.
But appreciate I have exhausted that route and it’s inevitable that everything I do now will be paid via private.

My third transfer worked and it was discovered on transfer day via blood test that I was lacking in progesterone so I was given lubion injections. Not saying that's why it worked as I can't possibly know.

I think your original thinking is sensible - that you should do the FET as soon as possible so you've still got time to do another IVF round. It won't mean you have to do another round, so you can still think about that decision when the time comes, but the longer you leave it, the lower your chances of success will be.

Thank you for sharing. I will make a mental note of that, to ask if they can test my progesterone levels on transfer day.
progesterone levels have always been a question mark with me as I have spotted up to 7 days before my period for over a couple of years now.
During my fresh transfer I had hoped I’d get away with no spotting, but even taking 600mg it still happened dead on cue!

Thank you for validating my process of thinking.
This is what it is, even if I’m unsure of wanting to go ahead with another round (if FET fails) I need to give myself the best chance to be able to do it, and be the youngest I can be x

My first two children are from FET, I'd get on with that and save up for another fresh cycle in case you need it, if all your tests are normal ie you're unexplained, IVF is still the best route to a pregnancy for you. I know what you're saying about having all the tests done first, I had the dye test as part of the work up but I was 27 at the time, if I could afford or the GP will agree to refer you it I would probably want to find out if my tubes were patent, it might be the reason you aren't conceiving and the dye flush can sometimes be all it takes to get things moving. I wouldn't wait solely for this on the NHS at the moment though, time would be better spent on IVF

Most people don't get lucky from their first ivf cycle. It took me four rounds to get one that stuck (I became pregnant on my first cycle but miscarried). We were also unexplained with all test results ok.

@whomoon most ladies I know who've gone through IVF are on two 400mg cyclogest a day so 600 is not particularly high.

Of course every case is different but I would push for the blood test to be sure x

I had 3 x 200mg utrogestan , perhaps because tests showed I didn’t need anything stronger at the time?
I will definitely push for the test when I do the FET, and have already got the increased progesterone protocol

This is what I’ve read about the dye test, it sometimes ‘flushes’ out issues and women end up pregnant soon after.
Would they be willing to do that? It was the only last thing mentioned I could have at the time, but I asked to go straight to IVF

@whomoon you can only ask, but it's the timescale that might be the problem, I'd ask and get on the waiting list while you do your FET