Bleeding and periods after unsuccessful IVF attempt

[GlummyMummy]

I have just been through a failed 2nd attempt at IVF, following a successful attempt in 2013 (we have a nearly two year old daughter.)

This time round I had my embryo transfer last Sunday but on Friday night my period started and I've been bleeding very heavily since. We have sadly accepted the fact that it hasn't worked :-( Clinic are still making me test next Sunday and told me to keep up the progesterone gel.

I have to say I was really surprised that my period came while still on the crinone gel, and particularly that it came so soon (6 days after ET) Will need to ask doctors why this might have been, anyone else had a heavy bleed so early in two week wait?

I just wondered if people who've been through this before could tell me how long they bled for and then when their period came the following month? Hard to know how soon things will get back to "normal".

[Everhopeful76]

omg Honeybee. I nearly cycled with Create and was put off by one of the Consultants trying to make me panic buy 3 cycles.
Create do claim and are proud of the fact that they've never had a single case of OHSS, but I actually think that is BS, they were obviously not very cautious in your case .
My Consultant knows the Medical Director there and thinks they are lying in their claim too
Do you get your blood test tomorrow?

[Honeybee79]

I can believe it's technically correct because they will halt it if they think it's dangerous and won't let you have a fresh transfer.

I had the opposite issue - we considered getting the 3 cycle package and were v inclined to as it would take the pressure off a bit, but they advised us to just pay for one cycle . . . Remains to be seen how gold that advice was!

In other respects they have been great - lovely nursing staff in particular and really liked the doc I first saw. She told me I could start ivf straight away or go away and lose weight to give myself the best chance. She was pretty honest and direct but kind at the same time iyswim. Anyway, I lost 3 stone before starting to get down to a bmi of 24.

Where are you?

[Honeybee79]

And I think that they only claim that they have only ever had one patient hospitalised fir ohss - which I can believe. The thing about ohss is that it only happens after they have triggered you. If there is a risk, they will give you a different trigger that enables them to collect the eggs in the usual way without you over stimulating, but the different trigger does not support a fresh transfer. That's what happened with me.

[bananafish81]

There was a thread a little while back all about experience of create

It was quite, shall we say, illuminating

Another MN poster was hyperstimulated and may not have been hospitalised but felt dreadful and had to freeze all

Women on a low AMH thread I'm on over at fertility friends had higher doses of stims on a so called mild cycle than many on 'conventional IVF'

I don't call 300iu mild!!

That was a moderately high stims short protocol cycle. Nothing different at all from a conventional short protocol. They talk as though all IVF involves down regging which is disingenuous

Cycling with them doesn't involve any fewer scans or bloods than on a short protocol anywhere else, the stims aren't necessarily mild, so it's not quite the unique approach they make out vs so called conventional IVF

I can't remember which thread it was on but one poster described the most horrendous experience - she said she had paid up front for ICSI but for some reason they did IVF and she ended up with zero fertilisation. Disgusting

[bananafish81]

glummy 8.9mm is a perfectly respectable lining

It was touch and go whether I'd be able to have a fresh transfer or whether we'd have to freeze all due to my thin lining

My consultant said his absolute minimum was 7mm but he liked 8mm or above

He said if there was any doubt about the endometrium we would freeze all rather than transfer into a suboptimal uterine environment

We didn't know if I would have a transfer until day 4 when I had a lining scan

The oestrogen tablets had worked wonders as my lining had grown 3mm in 4 days, to 8.5mm (and that was under the influence of progesterone when it had already started to compact)

I had a fresh transfer and got my BFP 8dp5dt

At my 7 week scan my consultant was delighted to see that my lining had held up beautifully

Very sadly at my 10w scan we discovered I'd had a MMC

However the lining almost certainly wasn't the problem. It was thick enough to support implantation and propagate a pregnancy

So I wouldn't say 8.9mm was a thin endometrium - certainly most clinics would say that was more than adequate

Have you had the uterine blood flow checked with the doppler? My blood flow was terrific and my problem was oestrogen (it thickened up once I started the HRT tablets at EC). But there's lots that can be done to improve uterine blood flow xx

[Honeybee79]

Well, I have nothing to compare Create to as this is our first cycle. In many respects they have been great, but I do agree that there is nothing mild about mild ivf.

The problem is that there are bad stories about pretty much every clinic out there, at least the odd one or two. I originally went with Create as a friend had a really positive experience there after a truly hideous one at Lister!

If we need to do another cycle (we'll get our blood test results for this transfer tmrw and have another blastocyst on ice too) then we may consider going elsewhere, but we would need to think carefully about it.

[bananafish81]

Absolutely! There are women on the same thread who have amazing experiences - especially with natural modified cycles, which can be absolutely brilliant for low amh-ers. Certainly a good handful of BFPs, especially with the multicycle packages

[Blondeshavemorefun]

Totally agree about different clinics

Friend said lister was amazing and so it should be for their price

Can't believe they charge £200 for a mock embryo transfer

Clinic where I had 1&2 didn't even offer it
3&4 did and was free

I lost faith with clinic 1&2 but friend got preg there so she is happy

[Honeybee79]

Well, have had my blood test and now just waiting to hear! Soooooooo tempted to just do a test.

[bananafish81]

Good luck honey

[Everhopeful76]

A mock embryo transfer? Do they do this to check there is no issue with your cervix before trying for real.. £200 is very steep for a mock smear test type procedure. Yikes.

Best of luck honeybee. I am sorry what I said higher up the thread seemed negative, I just had a bad experience with Create when I first started this whole process. I am at the BCRM (in Bristol) but am a satellite patient of the lead Consultant (who has her private clinic as well as working in NHS). Hence my comments about 1 size fits all, am paying the price tag (mostly because the NHS wouldn't treat me as was single,crap AMH, BMI over what it should have been- athough lost3 stone since that pt and endo) so I suppose I just feel am possibly not getting any better service,but cant fault the staff,they were excellent. Suppose I just felt I d get more support in the 2ww by being offered extra blood tests incase progesterone levels were wrong etc given my unique circumstances.If it fails,I guess I can consider another clinic. Don't live in Bristol anymore, so would be looking in the Midlands or London. Create offer a fertility MOT at satellite clinic in Bristol, that's why I was aware of them in the first place

However as Banana (Hi Banana) articulates the interesting USP they have, in terms of mild cycles for low AMH'ers. There is indeed nothing mild about them from other posters, but they were going to give me the stimulated cycle of 150iu gonal-f, on a natural stimulated cycle but they were definitely quite aggressive with trying to get me to buy 3 cycles, saying I had an 8.5% success rate with one . Given my lowish response to 450 iu stimms recently, I don't think I would have got very far at all,so think I made the right choice...time will tell. Even with the high dose, my body naturally selected 1 follicle, with 2 trailing behind and the others were either too small or had been infected by tiny endo cysts on the left ovary. This produced my 2 eggs, 2 embryos and now I wait a few more days on the result. I was on long protocol which I was worried about, although not in terms of lining (had 11.5mm 2 days before EC altho admittedly was worried as they didn't recheck) Hard to get everything right I guess, because everyone's body response is different

[bananafish81]

Everhopeful I'm a low AMH-er who did really well on high stims, but a LOT of women on my low AMH/high FSH cycle buddies board on Fertility Friends do much much better on mild or natural modified

The thinking is that if you're only going to get a couple of eggs with max stims, you may well get better results and better quality (especially, I am told, amongst older women with more fragile eggs) with a light tap rather than a sledgehammer

I found it counterintuitive that surely if you don't respond to a megaphone, you're not going to respond to a whisper? But many many women do, and seem to get better quality that way

As I say, I personally did very well on high stims, despite my low AMH and high FSH (although I am a bit of a freak as the embryologists all asked if my AMH could have been a lab error, as women with almost undetectable AMH of 1.5 are not supposed to get 17 eggs)

However I planned to try natural or mild if I didn't get anywhere with high stims - as you're by definition getting fewer eggs you in theory need more cycles, but that's the case if you're only going to get a few eggs anyway. I personally would have tried a single cycle to see how I got on before trying a multi cycle package, if I'd ended up going down the mild/natural route

[Honeybee79]

What is a mock embryo transfer?!

That's fine everhopeful, it's the name of the game, so many mixed reviews of so many different clinics! Had my blood test at Create this morning and now waiting for the call later today . . . . . God, it's bloody stressful, isn't it?! Really well done on your weight loss - I also lost 3 stone and so glad that I did it before embarking on this IVF rollercoaster.

I can see the rationale for natural ivf for low amh . . . . and I thought I got the rationale for mild ivf for women like me with PCOS . . . until it all went a bit tits up and I couldn't have a fresh transfer!

Banana - it does sound to me like there might have been a lab error if you got 17 eggs! I got 17 eggs and have PCOS and was overstimulated!!

[bananafish81]

Honey a mock transfer is exactly what it sounds like - it's a practice run so the Dr can basically familiarise themselves with your cervix and uterine shape so the actual transfer goes smoothly and they can site the catheter correctly

My consultant didn't do them as tbh he said if you were experienced enough you should be able to work it out on the day!

My AMH was tested three times in three different months, and came back as 1.5 each time

Different labs too - so unlikely to have been a lab error!

I also had FSH of 17.6 in July, although it bounced down to 9.5 the following month - you're only considered as good as your worst FSH so I was essentially in borderline premature ovarian failure

Ironically when I was 28, in 2010, I was diagnosed as having PCOS - with an antral follicle count of 42

Then 5 years later, in 2015 at the age of 33, we discovered the PCOS had gone with all my eggs. My FSH and AMH were horrendous, and my AFC was just 5

Before my second cycle, I had an antral follicle count of 10 at baseline, but managed to get 17 eggs - all mature

I am convinced the DHEA made a difference, as the quality was remarkably different too

I am having a genetic test on Sat to see if the reason my PCOS transitioned into a state of severely diminished ovarian reserve is to do with a particular genetic marker, as I'm interested to know WHY my eggs (seemed to have) all disappeared

I also find it fascinating how a mild short protocol can be beneficial to both very high responders (PCOS) and very poor responders (low AMH)!

[Everhopeful76]

Banana - All makes sense to me, it remains to be seen if the sledgehammer approach has worked- will know v v soon. My AMH was 1.2 when I first had the test done, but at that point so many follicles were obscured by endo. Create couldn't be certain but felt I had just 2 follicles on both sides. Then on later scans, with a different Consultant and my NHS endo gynaecologist (and following a lap also) they were showing 1 or 2 more follicles overall, without any stimulating drugs- have no idea why that was but seemed positive,until I started to get dermoid cysts on right obscuring them again. So my ovaries... nightmare, my womb has always shown up as more hospitable. So now am this far, am just hoping, hoping and hoping some more.

However what was interesting was that despite all the supplements I took for almost 4 months......CoQ10, DHEA, vitamin D, pre pregnancy multi vit, extra folic acid (had dire reserves of vit d beforehand) and had acupuncture (which was having weekly whilst I was having treatment) I still had a clear lead follicle right from the off- around 20mm at EC. I just had it stuck in my head that that was the one, so even tho they said we might not get a single egg, my hopes were pinned on this one and then I got 2. The others were obviously never going to win the race, and have been worried that the menopur did cause these mini endometrial cysts I suddenly developed.

So if I need another shot, I might try the natural modified route (what other clinics beside Create offer this - anyone know!?) but would probably get my AMH re done first, and let my thoughts flow about donor embryos or eggs also. I can really only afford this a couple more times at most.

I guess I should stay positive on this attempt first as still in game, but so hard.

[bananafish81]

I'm pretty sure that CRGH do natural modified

I think Lister may do

Even the mighty ARGC do natural cycle if they won't let you cycle with them because of high FSH

Might be worth asking about estrogen priming to prevent early recruitment of a lead follicle, to artificially suppress any FSH rising in the luteal phase of the preceding cycle?

Of course I hope this one is the golden egg and you won't need to do this!

[bananafish81]

Oh and a LOT of women on FF go abroad for natural or mild cycle as it's sooo much cheaper, even with flights

Reprofit and Gennet in Czech Republic, and Serum in Greece are both v popular on FF

[Blondeshavemorefun]

Yes a mock is to check they can get the catheter up you easily and no problems in inserting spectulam (sp) and opening cervix etc

Basically like a smear

As I said clinic where I had 1&2 didn't do it

Clinic 3&4 discussed it on the phone and said would be done at 1st consultation to make sure all was ok

I thought it was a good idea tbh. I have quite a narrow odd shaped cervix due to scarring from biopsys from cancerous cells - smears are always uncomfortable but ok iyswim - tho they didn't know this

Thinking back 1&2 ec was soooooooo painful - I was screaming and DF in room next door was thinking what the hell was happening :( I had max amount of drugs :(

3 ok and 4 was fet

I think as they checked me first on no 3 they knew how my cervix was shaped so that there no was pain at ec and they got more eggs 11 and 9 fertilized and 7 got to day 5

Yes if they are good at their jobs then they should be able to insert it right - but all cervixs are different and with what is at stake I think all clinics should do a mock transfer at consultation so no hidden surprises

As I said mine was free but lister charge £200

Any one else have a mock transfer? I might start a new post to enquire

[Honeybee79]

Thanks. Waiting.

I know a couple of people who had really positive experiences at Serum and yes, much cheaper.

[Honeybee79]

OMFG the clinic just called - my blood test came back positive. Am shaking!

[Blondeshavemorefun]

Amazing news

Manu congrats :)

[Honeybee79]

Thanks. Am in shock. Utterly in shock. Just hope it sticks.

[bananafish81]

Amazing news honey!!

[Honeybee79]

Thanks Banana. I don't know what to do with myself!! Keep pacing round the room and then starting blankly back at my work!

[Everhopeful76]

Congratulations honeybee, great news!!
Thank you banana-
I ve already contacted the serum clinic and they ve responded. Your not wrong about costs, 2 cycles for price of 1 comparing to my current clinic. Back up plan potentially in place.
I may go to crgh open evening to get a feel also if need to. I know the Czech Republic clinics wouldn't treat me because of lack of partner. Cool, feel a bit happier.
It's weird that my body knows what's happened to embryo before my mind but am standing firm and not testing x