Thanks ladies. I'm just really sad. It's the second chromosomally normal embryo that hasn't made it and so it's my body that can't look after them. And I don't know how we fix it. We know the uterine environment looked good on a scan but obv something isn't right. Yes I had a bleed before this cycle (which is why we cancelled the hysto and started a treatment cycle), but we don't know why I didn't properly shed the 11mm of lining I grew in my May cycle - why I just got a day of black clots, and although lining thinned, I never got a bleed.
There's other questions which we'll discuss in the follow up. Given I did successfully propagate a pregnancy into crappy lining with no immunes, but didn't into supposedly decent lining with pred / intralipids, question is whether they left me over suppressed. Prof Quenby and Brosens at the Coventry implantation / RM clinic say if uNK cells are on the low end (even if peripheral blood levels are high) that you need some inflammation for successful implantation, and that in some cases pred and intralipids can do more harm than good. I'm not sure that going to their clinic for the endometrial biopsy for uNK cells would add any clarity - from stalking the Quenby threads on FF it seems it could raise more questions than answers. Quite a few women get wildly different levels of uNK cells from one month to the next - which of course doesn't get you any closer to identifying whether pred would or wouldn't be beneficial in a treatment cycle. I'm minded to use my own history as a diagnostic - we know the embryos were both normal, so given I had decent implantation without immunes but didn't with immunes, I think if / when we eventually get to another treatment cycle
Hoping if I’ve stopped the progesterone on Fri I will get some kind of period next week. The hCG was low so there can’t be much to pass, I’d have thought?
Follow up consult is arranged for a week on Friday - hopefully I’ll have had a bleed by then, but if not then we can see what’s going on when he scans me and take it from there. He’s put us in for the last appt of the day so we can take as much time as we need, he said he wanted to meet up so we could review everything step by step, and discuss where we go from here
The broad plan will be another hysteroscopy to check out the uterine environment. We had discussed putting in a copper IUD for 1-2 months to help support the endometrium, but this is TBC, to be discussed when we meet. If I get a bleed then I will restart progynova on day 2, to start to prepare the lining for a hysto & potentially a coil. I’d also taken him some studies about the use of another drug, a vasodilator called pentoxifylline, alongside estrogen therapy in women with very thin endometrium, to prepare the lining for a treatment cycle. So if I get a proper bleed, I’ll start this as well.
If I don’t get a proper bleed that’ll be a pretty important diagnostic tbh (as well as the quality of whatever bleed I do get)
I don’t think I will be able to cycle again for a while, as we really need to work on the endometrium - we can’t keep doing rounds of stims with EC just to put back a frostie, and we need to get me menstruating properly. Ideally if we do the IUD plan I imagine we’d want to have another crack at a dummy medicated FET, to see if I respond better to HRT. We’d also mooted the idea of a Tamoxifen cycle, so that’s on my ever-growing list of questions.
Back onto the bench of boredom I go!!