Infertility and Endometrium / Lining Issues

[funkymonk]

Please join here if you are experiencing infertility as a likely result of lining issues... Support and chat needed...

[GlummyMummy]

Aw thanks LH, that's kind of you. I'm doing ok actually, been bleeding since Saturday but it's not been too bad and as I bled early last time too I was kind of expecting it. Though I have to say the positive test did get my hopes up a bit which has made things worse. Busy with my toddler just now though so not had much time to wallow. She's dropping her nap just now so pretty knackered!!

How are things with you? When I read your questions a few posts ago I remember thinking "I could have written that!!"

[LHReturns]

Again so sorry to hear that. I can only imagine that seeing a positive test, and then so quickly it going wrong, is a real punch in the face.

I am still planning to start my first ever fresh cycle ASAP.

Yesterday I went to drop in clinic at Lister for Clamydia and Thyroid Function blood test updates (these are compulsory at regular intervals there).

And also was due a smear - so done today.

Will see my consultant next Tuesday, and if all is looking good, then aiming to start stims when next period starts which should be over Bank Holiday weekend.

I expect to be on a short antagonist protocol again of very high Gonal F plus Cetrotide. At least this means the cycle happens fast.

Trying to keep my cool but it really matters now, and the more I think about it I struggle to imagine all the stars aligning EVER to make this happen.

My GP lectured me today to stop banging on about my advancing AGE. Apparently I mention my AGE whenever I discuss IVF which is not helpful.

One question for you all: if I was lucky enough to have more than one half decent embryo during this cycle would you automatically put two back? It seems at 40 (yes my AGE again!), putting two back is the norm.

Anyone know any success rates for IVF at MY AGE with one or two embryos - or is this a no brainer, should always be two?

[LHReturns]

Glummy if this is a grossly insensitive question at this stage, do just ignore. But I wondered if you have had any thoughts about a break now, or any other next steps?

Thinking of you.

[PotatoesPastaAndBread]

Sorry to hear your news glummy.

I've got a scan on Friday, my first lining investigation. Never had a problem before. We'll see if I do now. Don't understand the new lingo on linings, need to swot up!

[GlummyMummy]

thanks for your kind messages folks. Not sure what next steps will be. We have two embryos frozen but no idea how it all works with frozen transfers as never been lucky enough to have any to freeze before. Would ideally like to start asap but really would be good to do some investigations into my lining first as I really believe that is the issue, though clinic say it's fine.

[bananafish81]

Glummy I’m so sorry to hear about your BFN - big hugs.Hope you are being kind to yourself and can plan something nice to look forward to

FET wise, I’ve only had one (fresh) transfer, but as we expected the cycle to fail from the outset, the plan was that as soon as I got my period after stopping meds after the BFN, that we’d start me on oestrogen for a medicated FET (as long as my ovaries were recovered and the lining had shed properly). However every clinic is different and many will recommend a resting cycle. Your suggestion of looking further into your lining before putting anything else back makes a lot of sense and I would do the same. Can you ask for a SIS (saline ultrasound) to get a better look at the uterine cavity? If this is normal then hopefully this would give you and the clinic reassurance that all is structurally OK. On the flip side it would indicate if there were anything untoward, that would warrant further investigation (eg any hint of adhesions that should be diagnosed and treated by a hysteroscopy)

Potatoes good luck for your scan tomorrow! Lining wise sadly there are a few old hands at the old thin lining game here, so we’ll help in any way we can. Hope all goes well xx

LH great news about getting going so quickly. I would definitely put back 2 in your case. The eSET guidance really only applies to day-3 embryos, and for blasts it’s generally recommended that you only put back 1 if you’re under 37. Over 40 I believe you could put back 3 embryos legally. If I had wanted to have 2 blasts put back I would have had to sign a waiver saying I was doing so against medical advice - but only because I was under 37, it was my first transfer, and I had several good quality embryos. My Dr said with my existing health issues from a spinal injury, twins were to be avoided at all costs. We did however agree that we would absolutely transfer two day 3-ers, as the risks of twins were much lower.

Have attached ssome HFEA data on single vs double embryo transfer, for both day 3 (cleaved) and day 5 (blastocyst) transfers, by age group - may provide some useful guidance?

AFM, I may be starting a treatment cycle….this weekend!!

I got a period of sorts, I’m going in for bloods first thing tomorrow, and if hormone levels are looking OK, Dr says he would be happy to start stims

He thinks the Neupogen wash may well have made the difference as he saw the quality of the lining was much improved 48h post-wash - so thinks this could be why I’m having fresh red bleeding (albeit very very light) rather than the vile black gunge I’ve been having. Will report back - trying not to get my hopes up, but would be absolutely over the frigging moon if we could cancel the hysto and 2 months of an IUD, and crack on with a treatment cycle sooner rather than later

Please, please, please let this not get my hopes up unnecessarily and please let us get the green light!

Eeek!

[LHReturns]

Whoo hoo hoo hoo Banana!!!! In a low key, not too many hopes up way of course..

Very excited about your bleeding, and all fingers crossed that you can can start now. You 'bloody' well deserve it, and all fingers crossed that you return home with a stack of needles and giant sharps box.

Selfishly I would love to be doing this alongside you at similar time.

Like me this will be a short protocol, going straight to Gonal F?

Thank you for encouragement re double embryos. Long way to go to get to that stage but if by some miracle I get more than one, I will transfer two.

[GlummyMummy]

Banana, thanks for kind words and advice, and very pleased to hear you've had a bleed finally! Have to say my failure period has been very strange, not as heavy as I was expecting which makes me wonder if my lining had got even thinner. Keen to get going quickly to make use of the endo scratch I had in June, but guess they will want me to have a break for a month or so.

[LHReturns]

Glummy still thinking about you and would LOVE you to be back in the saddle with this lining question under control ASAP.

[bananafish81]

We have lift off!!

Dr was practically giddy that I'd had some red bleeding - he thinks the G-CSF wash must have made a difference, as the appearance was so much better in 48h.

Hormones are looking great - everything is nice and low so I've definitely had a proper period

I'm starting stims tomorrow morning! Short protocol as per the three prev cycles (I can't believe I'm doing my 4th IVF cycle in 11 months. And we're not even using the bloody eggs!!) - mild dose of Gonal-F now I'm PCOS again (starting dose 150iu), first scan on Thu, when we will probably add in the Cetrotide

Vaginal viagra pessaries are on order - they're so expensive, my vag is getting the gold star treatment

And we will definitely be repeating the G-CSF wash again - one on day of trigger and one on day of EC

We can add in progynova once we've started the Cetrotide if needed, Dr wants to get my natural oestrogen going first, but we can start it in about a week's time if we need to give the lining some more oomph

Hysteroscopy is CANCELLED, hurrah!

[PotatoesPastaAndBread]

Hey banana , that's great news. Of course epically ironic that after years of wishing you wouldn't get a period, you are glad to have one. But aside from that, brilliant news. And well done you for doing your research and getting that wash dune!

[LHReturns]

Go Banana, go Banana, go Banana, go Banana!!

Will write more tomorrow but so very thrilled for you, and so very confident that between you and your lovely consultant you WILL work this out!!!

I am now desperate to join you and start my own stims within about ten days if all goes to plan.

[LHReturns]

Hello all...I dont want this thread to die so I am posting here.

I saw my consultant at Lister this week - we are good to go once my period starts (assuming good Day 2-4 first scan).

Stocked up with Gonal F and Cetrotide - quick question: last time I did not keep these in fridge as only requires under 25 degrees. As it is currently very hot in London I have put all drugs in fridge. Was that correct thing to do and should they now stay there until use?

Second question - anyone ever tried subcutaneous injectable progesterone rather than pessaries? Prolutex it is called. I don't mean intramuscular (Gestone), I mean self-administered under the skin. Just a question - I'm not actually planning to use it as yet.

How are the stims going Banana?

Can't wait for my period to start and get this show on the road.

[bananafish81]

Great news LH! I remember my consultant saying before my first cycle that although the directions were Gonal-F in the fridge, Cetrotide not (this was in Sept last year), if it was easier, it didn’t matter if I bunged them all in the fridge. I keep the Gonal-F and the Ovitrelle in the fridge and the Cetrotide in a cool dark cupboard

Great news about the Prolutex! It’s also known by a different brand called Lubion - the plan would be for me to be on this after EC. My Dr prescribes it instead of the evil Gestone bum jabs as he says it’s more patient friendly

Hoping your period rocks up promptly and you can get cracking!

All OK here - first scan tomorrow so major scanxiety. Was waiting till I had some news to post - I’ve just been stabbing away with nothing much to report, I hope something is going on in there

There's also nothing like keeping things interesting. Apparently I am the first case my Dr has EVER had where we are doing a full fresh stimulated cycle with egg retrieval but NOT making any embryos, as a means of preparing the womb for a frozen transfer

The clinic are scratching their heads about what consents I need to sign as apparently this is a first for them too (I’m with an independent consultant who works with CARE London for EC/ET, so the cycle admin has to go through them).

Well I'm certainly keeping them on their toes…

[LHReturns]

Thinking SO MUCH of you today at your first scan Banana!! Wishing for a perfectly developing bouncing marshmellow lining on its way.

I want to ask for all your lovely eggs but feel that could be inappropriate ('lighthearted').

[GlummyMummy]

LH- I'm an expert on Gonal F and fridges after my fiasco last month which resulted in me having to buy a whole new batch after leaving it out fridge!!!!

Manufacturers say it's continuity of temperature which is important so if your clinic had them in the fridge they have to remain there till you use them. I wasn't aware of this and clinic didn't tell me to refrigerate. Costly mistake for me!

[bananafish81]

Thanks LH - seriously I really hate that I can't be an egg donor, I would love to help another couple. Especially given this time last year I had FSH of nearly 18 and AMH of 1.5 and an antral follicle count of 5, and assumed that donor eggs was a likely end point. Couldn't have predicted how things would have panned out...

My consultant completely got that I really really don't want the eggs to be just discarded - he understood immediately that it emotionally it would help me to think I wasn't going through stims and egg retrieval for nothing, that they were just going in the bin: psychologically it really makes a difference to me to think that they're going to be doing some good.

Glummy argh how frustrating about the Gonal-F - gutted!!! How are you doing?

[LHReturns]

Thank you for all the advice. Glummy, horrible story!!! I have Gonal F and Cetrotide in fridge and will leave them there until injection.

As I live very near the Lister I buy injections in stages when I am there for scans - saves me buying more than I end up needing (last time I triggered after just 7 days of stims due to my short cycle!). So I don't have my trigger needle at home yet.

Banana I can only imagine what it must feel like knowing your beautiful eggs aren't required this time around. Obviously you now make gorgeous ones, and anyone would be lucky to use them and have a mini-Banana-genius!

Waiting to hear about your scan and lining progress....

[bananafish81]

Ah that's handy to be so close LH! I've heard the Lister pharmacy puts a whacking great markup on their drugs, but equally buying meds you don't need is also v expensive

Wish I'd bloody found out earlier that my local high St independent chemist could get me my drugs for loads cheaper! I went in to fill a prescription for progynova, and he saw my consultant's letterhead and asked if I was doing IVF, because he could get the IVF meds from his supplier at a pretty hefty discount. A 900iu Gonal-F pen from Healthcare@Home was £350 on my last cycles, they've recently put their prices up. He's ordered me them in for £275! My consultant said he's pissed off with H@H as when he ran the NHS unit at Barts they paid loads less, and so he's negotiating directly with Serono to get the Gonal-F, Cetrotide and Ovitrelle directly.

Mind you any savings get wiped out by the fortune I'm spending on vaginal viagra. Hope these pessaries come wrapped in a velvet presentation box

If I make it to transfer then it's daily Lubion, Clexane and Cyclogest (prednisolone and aspirin are cheap as chips). If I got pregnant then they're through the whole first trimester. Plus we'll have to see how things go as we may need to take a punt on whether we think the lining is on track, because intralipids should be 7-10 days prior to ET.

Nothing like being a human chemistry set??!!

[LHReturns]

If we are unsuccessful this time I will definitely move to getting my drugs from my friendly local pharmacy - I'm sure the Lister do bump up prices. It's all such a Fxxking hassle - I need a full time IVF assistant.

Banana, you are a walking scientific experiment and I LOVE IT.

[GlummyMummy]

Yeah, so frustrating about the wasted Gonal F! Sure they would have been okay to use but at the time I didn't want to take any chances!! I'm doing ok thanks, not got my review appointment til mid Sept so all quiet here on the IVF front. Been eating like a pig though!! Pessaries gave me upset tummy for a while after stopping them, so glad to be rid of that now!! TMI, sorry!

[LHReturns]

Glummy, there is very clearly NO TMI here. I plan to share a LOT of detail about the colour and consistency of my period next week in relation to the lining that my cans reveal...

Banana, how was your scan today?

[bananafish81]

Definitely no such thing as TMI!

Glummy I think post BFN you are definitely entitled to eat (and drink!) what the hell you like!

LH awaiting updates with bated breath -and I’m not even joking!

My Dr was practically giddy about my period - I sat down and he was like ‘right, tell me EVERYTHING about your bleed, walk me through it’

Scan went well, long way to go but things are looking on track. 6.3mm after 6 days of stims - he said he'd want anything above 5.5mm at this stage, and it's looking like it's thickening, so he was very very pleased with progress and is v happy with the appearance.

My follies were about 13mm so nothing has gone racing off and about to pop - we didn’t actually count them all, just took some measurements of the larger ones. He said if we were doing IVF he’d up my stims to 225iu to get more eggs to maturity, but as things were he wanted to keep things as they were.

He said that when things don't go to plan it makes him really anxious, and that an endometrium that doesn't thicken makes him really really anxious. So he said he was so so happy I'd had a proper period and things seemed to be progressing nicely

I asked him if he’d ever had a case like mine where he’s done a full fresh round just to do a FET and he said no, I’m the first one - he said he’d done ovulation induction (like we tried last month) but never to a full retrieval. So they’re going to work out the consents thing and how the hell they do it!!

He wants to scan me and do a Neupogen wash on Sat morning - thinks we should be aiming for EC Wed/Thu/Fri next week (I’m guessing Fri). My viagra pessaries should be in by tomorrow too, so I can start those hopefully. I asked him if he thinks we will make it to transfer, he said there's nothing that concerns him (yet). He said we can always add in Progynova on Sat if needed, as I’ve now started Cetrotide tonight

So will see about booking my intralipids for Tues, and just keep everything crossed that we do get where we need to be!!

[LHReturns]

Banana I am as engaged in your story as I am in my own.

How many days after EC would they expect to transfer one of your shiny perfect embryos? Is there an optimal day as far as linings are concerned which will dictate this?

Will you thaw and transfer just one of your embryos or more?

Low priority question: does viagra (oral or otherwise) have any interesting side effects? Libido etc?

[bananafish81]

Thanks LH 😘

Timing wise, it's all exactly as per a fresh cycle, it's just we are putting back a frostie instead of one that's been freshly prepared

So whereas with a medicated FET you decide when you're going to do a transfer depending on how your lining goes, with this, it's dictated by EC timings. It's the lining thickness and appearance on the day of trigger that really matters. To some degree we will decide when to trigger depending on the lining, as we can let the bigger ones get a bit overripe - we're not trying to optimise the follicles to get the eggs perfectly cooked, so we can play with the timings a little bit. But we can't just let them keep going - if the lining isn't where it needs to be at some point we still have to trigger. Really desperately hoping it doesn't come to that

Our embryos are frozen blasts, so transfer has to be 5 days post EC (ie a week after trigger). So if we trigger on Weds, for EC on Fri, if transfer goes ahead then ET would be the following Weds.

Feel like I'm tempting fate and jinxing things by having intralipids on Tuesday, and getting the Lubion ordered in. But have to take the risk!! Where's that bloody crystal ball?!

Started viagra pessaries today, having a neupogen wash tomorrow - and if needed we can add in oestrogen tablets tomorrow as well. Just hoping we see some movement and it doesn't conk out!!