Is it time for DE?

[bluebird3]

Hi everyone,

I've had 3 failed ivf with my own eggs. I'm 31, a bit overweight but bmi is 29. I don't drink much, don't smoke, get plenty of sleep, etc.

I had a mc with cycle 2 and a chemical with cycle 3. I always get 10-12 eggs, have a 90% fertilisation rate. By day 3 usually only 2-3 are left in the running. I usually 1 good blast to implant and maybe 1 other that's ok.

At my review appointment today I was told that I'm consistently having poor quality embryos and the recommendation is donor eggs.

Does this seem like the right advice? I am trying to get my head around this as I wasn't expecting to be told donor eggs being young(ish).

Anyone?

Hi Bluebird3,

I have had IVF using first my own eggs then when that had failed twice donor eggs.
My reasons for failure were attributed completely to my age (wrong side of 40!) as I have a child conceived naturally when time was on my side.
Finally on my 7th IVF (2 with own eggs, 5 with donor) I am pregnant .... with twins!!!
2 for the price of 7 we say!
Do you have any children at all?
Over the last week or so i have felt my babies fluttering away in my tummy and honestly just as exciting as being pregnant naturally the first time around.
My husband and I are just looking as these babies as being full siblings to our child and honestly I can’t imagine being anymore excited if it werw my eggs.

I am just SO happy to be having another baby .... plus one!
Can I ask are you having your treatment in UK or abroad?

Thanks for replying shaun. I don't have any children yet. We originally had ICSI due to low sperm count so it's been a bit of a shock that they now think it might be the eggs. It's nice to hear how you feel about your pregnancy and twins. Congratulations!

I'm currently using a UK clinic but if we do go for donor eggs will likely go abroad as I don't want the wait times. Where did you have treatment?

Hi Bluebird3,

Our original treatments (x2) were private here in UK using own eggs. I felt so disillusioned that our IVF clinic was based a hard sell of add ons and on hindsight unlikely to have succeeded.
When it was suggested that DEs would be better option, rather than go on a long waiting list in UK (expensive and we didn’t like the notion that eggs aren’t anonymous) we began researching abroad and eventually settled on Reprofit in Czech Republic.
There was literally no waiting list and overall treatment cost a fraction on that quoted in UK.
We incorporated our treatment with family holiday and I can’t praise professionalism of clinic enough as well as ultra high tech.
Yes, it has taken a few attempts to get where we are at the moment but it all seems worth it now!
I am pretty sure our final treatment worked as for the first time I tried a natural cycle which sort of makes sense now as I have always had a very regular cycle.
Hope this helps!

I can recommend IVI Alicante. Our donor egg baby is running around at nursery right now!

Can I suggest getting a second opinion at another clinic? We had two goes at ivf and my eggs were the issue similar to you we were advised to look at donor eggs decided to try another clinic for one last attempt. We asked for a consult pre starting ivf to go over what they felt were the issues they agreed re my eggs but changed the drugs regime and added in DHEA. This was in Jan 17 I was due to start the ivf with the clinic in the March and found out I was pregnant naturally at the start of March- I strongly believe it was the change in meds particularly the DHEA. Good luck

Thanks for the suggestions everyone. I'm just shattered and really low about everything. I just want a baby and can't get over how easy it is for most people.

Part of me wants to go straight for DE as I just want to get going, but the sensible part of me is saying I need a break, to wait for the test results, get a second opinion, etc. All of this takes time and it's likely I won't get started again either way until at least August. The waiting is killing me. And the stress of knowing even with de it might not work. I don't know how to keep going.

Aww Blue it's really hard especially when everyone else is popping out babies like peas! Maybe take a break and get a second opinion but dont rule put a donor egg. I do know how you get. Our first round failed and I couldn't wait for the next round

Hi @bluebird3 how are you getting on? I've been reading your thread with interest.

We just failed our first ICSI. It was done for MFI but I have low ovarian reserve too. We got 14 fertilised embryos but only two poor quality blasts at the end. The consultant has said there is a fundamental problem with either the egg or sperm quality (DH and I are both 31 fit and well. Don't smoke normal bmi etc etc)

Our consultant has sent DH sperm for dna fragmentation analysis as if this is high surgically retrieving the sperm directly from the testes helps. If it's not high he says our chances are only 5% per cycle and he was hinting at donor conception..... have you have high sperm DNA fragmentation checked for?

Best wishes

Hi hoping. Sorry about your cycle. It's really shit isn't it? Are you NHS or private? We are paying privately but still going to our NHS clinic. Our consultant said they no longer do dna fragmentation tests as there is no real evidence as to what the results mean either way. I don't know if I agree with that as I know plenty of clinics do have it done. It's so hard to know what to do when you get conflicting advice!

We've been told to have the following tests: thyroid (me) , blood clotting thrombophilia (me), karyotyping (both). My gp rang and said my thyroid was borderline and to go back for another in 3 months. I haven't had the results of the other 2 but we have an appointment in April with the consultant to look at the results.

Depending on the results we might move clinics and they might recommend dna frag/immune testing so we will see. In the mean time I have read 'it starts with the egg' and I'm trying to follow the advice in it, mainly following a Mediterranean diet. My dsil is training to be a gynae and she said med die this being pushed as really good for fertility.

What are your plans?

Hi @bluebird3,

Sounds like we're in similar (depressing) boats! I've just failed first nhs cycle so moving onto private - we're trying to get the access fertility 3 cycle refund programme but waiting to hear back. Interestingly consultant says thy look at age, AMH, number of eggs retrieved and reason for IVF but not embryo quality so financially it makes most sense!

I've been looking at papers on dna fragmentation and in the last couple of years there's been some promising results (albeit small trials) so I feel confident that surgical retrieval will help (but we need to know if DH has high fragmentation first - results in a couple of weeks!) it feels a bit like we're resting all our hopes on this though. My only other hope is that they massively over stimulated me - my pre IVF AFC was 9 but I had 32 follicles and 20 eggs retrieved so this might have effected quality. Like you lots of our embryo misbehaved before day 3 (cleavage straight from 1 to 3 cells) - unfortunately I've read that's more likely to be an egg quality issue so the dna fragmentation test won't make any difference to that anyway!

I also have an under active thyroid - interestingly GPs are really bad at managing this in fertility - your TSH level needs to be below 2.5 otherwise your chance of miscarrying is higher. The range for a non pregnant person is 0.3-4.9 so my GP often tells me my level is normal when it isn't. It has to be less than 2.5 - so if I were you you need to be started on thyroxine ASAP (I'm assuming if level is borderline it's about 5?). I don't mean to put the wind up you but I get so frustrated with thyroid in pregnancy being mismanaged by GP - speak to your fertility doctor if needed but do follow it up as it will impact on things...

Finally I've been contemplating the it begins with an egg book - I'm a scientist though and only like to do things with evidence so I'm a bit worried it'll be hocus pocus! How are you finding it?

Xx

We do seem to be in similar situations!

I am really annoyed about this whole thyroid thing. When they first tested me 2 years ago one month I was 3.7 and the next month I was 2.3. At the time I was told this was fine despite family history of thyroid issues. Then at our most recent wtf appointment the consultant asked if I'd been put on thyroxin to bring it down, which I hadn't. So my thyroid is obviously fluctuating a lot and nobody thought to test again in the last two years throughout 3 cycles of ivf. Then this most recent one they didn't tell me the actual number just 'borderline.' I called in on Friday to ask for a printout of the results and they said they would have to ask the GP and to come back Monday so that's where I'm at. Our next appointment with the fertility consultant is the 2nd of April so hopefully will get put on thyroxin by then.

I do think I have a hormone problem as I have strange periods. Most months I have Bleeding for 2-5 days before period properly starts and can vary from sticky brown sludge to bright red spotting. So most months periods effectively end up being anywhere 7-12 days. Also 2 years ago my day 21 tests showed I likely wasn't ovulating every month. Nobody has wanted to treat any of this as when they saw dh's low count (8 mil) they just went straight to ivf. I'm really upset that I've potentially put my body through 3 cycles that maybe were always doomed bc my hormones are out of whack resulting in bad egg quality. We also had he cleavage 1 to 3 thing which we were told was 'totally abnormal...freakish.' That was fun.

As far as the book... I don't know if I believe it all but figured it can't hurt. So I'm taking ubiquinol, cut out plastics in the kitchen with bpa, changed personal care products to phthalate free and am trying the Med diet, although not super strictly.

It all feels very overwhelming. I think I'm going to go to the Fertility show in Manchester in a couple of weeks to get some other opinions.

Xx

Hi @bluebird3 , I'm not surprised your frustrated by the thyroid thing / I'd find out your levels if I were you and go from there. If it's borderline at 5ish I think you need thyroxine but if by borderline they meant borderline for TTC (so about 2.5) I don't know. The only other thing is whether you've had your thyroid antibodies checked (called TPO) as the guidelines are if you have antibodies and borderline you should just be treated anyway. Hope that makes sense.

I wouldn't think a borderline thyroid result would impact on your period much? My consultant asked about my periods and my ovulation and then said "to be honest it doesn't matter as you need ICSI and we'll control the rest".

Let me know how you get on with the Manchester show (and in general)

Best of luck xx

Hi hoping. I'm really confused now. I've picked up my results and on 14/2 TSH was 5.2 (normal range for my clinic is .27-4.2). They redid it on 9/3 and TSH was 2.8. How can it fluctuate this much in 3 weeks?

They also checked thyroid antibodies and they were normal. Blood clotting results are normal.

I've been reading up on hypothyroid symptoms and the ones that fit are tiredness, trouble concentrating, depression and feeling cold all the time. I just thought I was depressed due to infertility but now wondering if it's this?

Well 2.8 is still higher than the recommended guidelines when trying to conceive and you obviously have tendencies towards hypothyroidism and a family history so I would probably press to start taking 25mcg of levothyroxine. Gp might be a bit uncomfortable with this if so they should get advice form endocrinologist or a fertility doctor? You could email call your clinic and ask their advice?

I get mine checked every 6-8 weeks now on treatment as trying to conceive - I probably could leave it longer but it's such an easy thing to manage and I'm not letting this be the reason ivf doesn't work!

Thanks for the advice! I've booked a gp appointment so I'll see what they say.

Has anyone talked about trying donor sperm? If you know that there are problems with the sperm (you started treatment because of low spent count), it doesn’t make sense to me to blame the IVF failure on your egg quality without any other evidence (would be different if you were 40+, but you’re young!) Also it would be a lot cheaper and potentially simpler.

I’m not suggesting you should do this, but I think it’s too early to be thinking of donor eggs. If your TSH has been 5.2 in one measurement recently then you probably have hypothyroidism and it certainly is not optimal for conceiving. When was the test done? TSH is highest first thing. I would get it tested again early in the morning and before you even run more complicated tests try a couple of months of levothyroxine. Also, yes, as you know, you’re significantly overweight, and I think it would be worth trying to get your own body as healthy as possible before giving up on it. (The thyroid issues could be making weight loss very difficult right now, so please address that first.)

Hi 'hops'. I had the same question about donor sperm. The fertility consultant said that as dh's motility and morphology look good the ICSI should have bypassed the sperm count issue which is why they are leaning to donor eggs. But they did admit there is no way to really know if it is the eggs or sperm.

Both my recent TSH tests were done first thing around 8am. I've booked in to see the GP and am hoping to get on thyroxin ASAP.

My weight has been a real struggle. I have been exercising a couple of times a week and walk my dog daily. I've been cooking really healthy and my dh has lost weight but nothing seems to shift on me. That being said I haven't completely cut out treats so I know there is more I could do. Hopefully if I get my thyroid sorted that will help with the weight. I don't think it's a magic cure but even if it meant I had more energy to exercise that would be good. Currently I fall asleep around 8pm as I'm absolutely shattered just from going to work. I just thought I was depressed.

I agree it's too early to jump to donor eggs just yet. My current plan is to 1. Sort my thyroid, 2. Lose weight, 3. Eat a med diet and then probably try again with my eggs later this year. If it's made no difference whatsoever then I will reconsider.

Let us know how you get on @bluebird3 ! We've had husbands dna sperm fragmentation back and it's moderately high - they said if it was high they would do surgical sperm retrieval as this may lead to better quality embryos. Not got follow up for 2 weeks now though to find out if that's the plan.

I feel tired when my TSH goes above 3! Have to start napping and weight goes up. I'd press to your gp your symptoms- good luck x

I'll be interested in what they say about your dna frag results as well hoping.

I can't get in to the gp until the 28th so hopefully they will put me on thyroxin then.

I hate all the waiting for appointments! I'm impatient to get going with things.

Go doesn't really have to see you in person - I mean examining you won't help? You could ask for a telephone consult with the duty doctor (that's how my surgery works). It's so frustrating when waiting and seems to add on months overall!!!!

GP**

My GP office is really small and don't offer phone appointments. I'm going to have to wait but I have kept checking the online booking system in case a cancellation comes up.

Just an update. After 3 weeks of faffing my GP has finally given me thyroxin on the advice of the fertility clinic. My last three tests have been 5.2, 2.8, 4.2. So the consultant ob said I am borderline between m sub clinical or overt hypothyroidism.

Once it's controlled under 2.5 for 12 weeks then I can have another cycle with my eggs. How are you getting on hoping?

Hi @bluebird3 , glad to hear you're now on treatment and hopefully it will help a bit!

We saw consultant a couple of weeks ago. Basically said he thinks there might be a bit of an egg and sperm quality issue but most likely sperm as most died off after day 3 which is when the sperm kicks in.

So has told me to take supplements to help with quality and husband having surgical retrieval of sperm to minimise dna fragmentation (which came back moderately high)

Start injections a week today at a lower dose of menopur - they don't want to risk OHSS as I'm unlikely to have anything good enough to freeze so they need to go back in this cycle and they suggest putting two in!

I'll let you know how I get on? X