Embryo Banking Support Thread / PGS wait

[ForeverAintEnough]

Hi all, I’ve just name changed but I’ve been on here loads and chatting to many of you under different user names ( irrational fear of being outed!). I wondered if there was interest in a ‘no transfer happening’ group? So those doing embryo banking or PGS or whatever.

I’ve just done one round of embryo banking and found the normal threads difficult with discussion of hoping for a Christmas pregnancies etc.

We are unfortunately taking the long way round with 3 rounds and no transfer. It looks like my first transfer might not be until June 2021.

If anyone wants to jump on feel free!

About us: Me 34, DH 36, TTC 3 years. Both male and female issues. x3 rounds of IVF all failed. Moved clinic to Lister for 3 rounds of embryo banking and PGS. One round of embryo banking just finished with x3 blasts sent off for PGS testing.

@2021ivfagain I'm sorry you're worried. In my experience periods can get delayed for various reasons but it doesn't mean there is much wrong. For me it has just meant that I've ovulated a little later or my luteal phase has slightly extended but the egg and cycle etc are all fine. Delays are hard but don't necessarily mean anything serious. Your body is just taking slightly longer to click back into rhythm.

Did you see a urologist about the DNA fragmentation? Did they recommend IMSI?

@Sarahk20000 my Era, Emma, Alice biospies acted as a scratch and I barely felt it.

@2021ivfagain I tnimk if you get your CRP tested and it is within normal range you should be fine to go ahead as it’ll show your body isn’t inflammed. Could be worth your DH getting the test too - or would he have time to do a SA & DNA frag to check how the sperm is before you start? If anything is high or off normal it would be worth discussing what to do with your consultant.

@Dochas12111

Thanks for your messages. My consultant did say covid could affect sperm and egg quality, but it’s not been happening in the clinic. Also, I was told my age would affect egg quality to a greater extent than covid.

I’ve been advised not to delay. Also my husband has IMSI to rule out dna fragmentation so our consultant does not advise another analysis done. The only issue is his good morphology might go back to what it was before at 2%.

I will get blood tests done but age is not on my side. Also I have ibs flare ups. Does that affect crp levels?

Hi all, given you're all so knowledgeable I wonder if any of you can advise. I'm a long time CRGH patient (three unsuccessful rounds), and have recently done my first batching round of three. I've been taking DHEA since November, and monitoring my testosterone levels via home blood tests. My most recent dose has been 75mg over two days, so half the 'official' dose CRGH recommends.

To my horror, my most recent blood test has come back showing my testosterone level as 6 pmol/l. To put this into context, I would be banned from competing at the Olympics against other women with this level. Normal levels for women are meant to be between 0.3 and 2.1 pmol/l. I'm very concerned I might have damaged my eggs, although I've had no physical side effects. I've now stopped taking DHEA and will retest in s fortnight.

Can anybody please advise? I've set this out in an email for my consultant, but she's not been in touch yet, and I suspect she'll make a point of having no view on it given CRGH refuses to monitor testosterone

@Lola245

Hi Lola,

I am just catching up on this thread, I used to message a lot more before. I am at CRGH too. I have a low AMH of 3.25pmol/l. I just turned 33. At baseline I usually have 3-4 follicles.

I am accumulating oocytes whilst waiting for my husband's sperm DNA fragmentation to improve.

I am starting the mild protocol this month too on my Dr's suggestion, I am with Dr Duran.

@Rosemarypots

In terms of DHEA I would get advice from your Dr. However there is some information on the internet from Dr Geoffrey Sher, he talks about DHEA and it's impact on different ovaries.

Do you have a low amh or follicle count?

@Ivfhoper

Hi. Hope your last cycle went well.

Are you able to do IMSI as from what I know that eliminates dna fragmentation issues?

My husband had poor morphology before and we did icsi for one cycle at 38 but it was unsuccessful. Then we’ve been doing IMSI ever since and had success at 38 with my son.

Also my husband is taking wheatgrass as it’s good for sperm quality. He’s taking a lot of supplements. I hope your husband’s dna fragmentation improves.

@2021ivfagain

My last cycle was not good, I ovulated prior to the egg collection.

Please tell me a bot more about your cycles when you were 38 and your husband's sperm fragmentation.

My husband is seeing a Urologist and Andrologist and they have said that IMSI/PIMSI does not cancel out the DNA fragmentation so it is better to improve the fragmentation AND use those techniques. So we are waiting for this reason. Dr Duran at CRGH said the same thing.

@Ivfhoper

Hi. I’m sorry your cycle was not successful but at least you know it’s something which can be resolved. Did you not have cetrotide?

When I was 38, my amh and fsh were really good, but my husband had poor morphology for quite a while. The first cycle I had 3 blastocysts but nothing implanted; we did icsi. Second cycle we did IMSI just in case there was an issue with dna fragmentation as well. We were told IMSI is better. My husband’s morphology improved: he was on a lot of supplements and did some acupuncture. The second cycle worked with a fresh transfer. My son is now 15 months old.

At 33 egg quality will be great. I was told at 38 that 50% would be normal, but your quality would be much better.

Could you try a cycle with IMSI? I can send you a list of all the supplements my husband takes if that’s helpful. Let me know.

I’m keeping my fingers crossed for your next cycle.

@Ivfhoper

Hi. I also meant to say that I’m really sorry it happened. I know that they do frequent blood tests to check levels. Have they suggested how they will prevent it next time?

I know that I take norethisterone which makes ovaries quiet and I’m wondering if you could have something similar. Or could they do more blood tests?

@Rosemarypots I'm sorry to hear this and that must be alarming. Are you sure you can trust home tests? Where do you get them? It really annoys me that CRGH won't test testorone/DHEA-s after you start taking DHEA, and seem annoyed when you ask the question even though everything I've read (including It Starts with an Egg) says you should. They just gave me another bottle of DHEA and it specifically says 'test your levels after a few weeks' so I was just thinking I'd demand to be tested actually. We're paying for the blood tests so why not do it?

I'm about to start cycle 3 of 3 rounds of embryo batching, though they've found two 'hemorraghic follicles' so are testing my hormone levels, and I find out if I can go ahead this afternoon. Last month I also had hemorraghic cysts following my egg collection and I wonder if that's why my 2nd cycle was much worse. Has anyone else had this?

@Ivfhoper My husband had bad sperm DNA fragmentation too, so we're doing IMSI. I've been hopeful IMSI has done the trick since we've had good fertilisation/embryo rates from the (few) eggs we've gotten, but since it's CRGH they are frozen at day 3 so don't actually know how we're doing in terms of blasts. Which, after two cycles, I'm starting to feel quite frustrated by...

What's your husband doing to improve? Mine has just cut out caffeine, almost all alcohol and taking supplements. But it's only been a couple months.

Hi ladies, I’m the original thread creator here so I keep an eye out. Just to say re:

Dhea: anything over 2 testosterone wise is meant to damage egg quality so I wouldn’t do a round with high testosterone and it is so important to monitor it with regularly blood tests (every 4 weeks)

DNA frag: ICSI/IMSI do not ‘fix’ DNA frag. You need to try get it as low as possible. It’s so important to see a urologist to rule out infection or varicoele or something that can reduce it. Then use IMSI alongside that. Supplements wise should be on high dose omega 3’s, high dose ubiquinol along with a multivitamin one such as proceive max.

Unfortunately @Lola245 until we got frag down all our embryos disintegrated between days 4-5 and were ok on Day 3.

@Lola245 I was asked today if I have a cyst. One huge follicle on only day 4 of low dose stims. Waiting to hear this evening what the plan is & whether cycle will be cancelled. I think I may need longer break between cycles, it’s only been 4 weeks this time. I am also on cycle 3. Starting to wonder if I’m just too old / whether my body can cope with so much ivf.

Update on the DHEA - I tested my testosterone again five days following the high result, using a different blood service that took a proper draw, and the result came back as 1.7 pmol/l, which is within normal limits. The first lab believes the course of norothisterone could have skewed the result upwards. On balance I've decided to go ahead with the next cycle, as the spike seems most likely to have been short lived, given all the reference points I have. Also, given the number of months it takes for egg follicle development, I'm not convinced that delaying by one cycle will make a great deal of difference.

@Dochas12111 Well we're just starting our 3rd cycle so I appreciate the advice but it's pretty dispiriting to hear that... I'm 40 and my FSH has increased dramatically this year so I don't have the time to wait. My understanding is that DNA frag can take 3 months at least to start to help. And anyway we've done these 2 rounds already. It makes me really worried that none of our day 3 embryos from these 3 rounds will make it... And I'm worried enough about my side of the equation given my age. We do have a 2 year old, conceived naturally, so trying to be hopeful that we've made it happen once.

@Rosemarypots that's a relief, and good luck with your cycle! I spoke to the nurse at CRGH today and she said I could just request a testosterone and dhea-s test at my next visit to the clinic.

Hi All

After a bit of collective advice. Cycle cancelled today due to one dominant follicule. Could this not be converted into timed inter course / IUI? Wasn’t advised to presumably because clinic knows we are egg banking and PGTA testing but thinking as last cycle didn’t go well either perhaps it’s worth a shot? My estrogen levels seem to be messing up our cycles so not feeling hopeful for future rounds.

Been told to stop all stims but take ovitrelle on day 10 but not been told why. Should we DTD day 11 & 12 and hope for the best? Also can someone tell me about estrogen priming? I’ve seen it mentioned online but don’t know anything about it, don’t know if I should be annoyed clinic haven’t offered it?

@InvisibleDreamer sorry about your cycle. I did a small amount of estrogen priming because I had a couple of dominant follicles that ruined my cycle. The next two involved estrogen priming. It was designed to downregulate slightly to get more even growth. I did get more even growth but the bad round was the only one I've ever had like that anyway so hard to know if it was just an anomaly.
Yes I think DTD days 11 and 12.

@Lola245 don't be dispirited. I was also told that IMSI can't help with DNA fragmentation because the only way to know if a sperm has DNA damage is to kill it! BUT when you first posted about it I did a google and there is a study that showed IMSI improved live birth rates in couples where the men had high DNA frag. So I suspect the truth is somewhere in between - maybe you can't identify DNA sperm frag through IMSI for certain but the best looking sperm are still the most likely to be healthy! Either way, you only need one good sperm so you always have a chance.

As for being 40...yes it's not young but you're not at the end of the line yet (says the 44 year old who got 2 euploid embryos). There is always hope. But sometimes that's the hard bit xxx

@Lola245

Hi. I just wanted to wish you luck for your third cycle. I know it’s difficult to see positives sometimes but with IMSI they do pick the best sperm so it does increase your chances. Also, the fact you conceived naturally in the past is a good sign.

I’ve started norethisterone as I’m gearing up for my next cycle. I’m having blood tests done but like you I don’t want to delay things.

@Janefx40 and @SarahK20000

How are you getting on? Hope you’re both doing well.

@Janefx40 and @2021ivfagain thank you for the supportive words and encouragement. We've actually just decided to cancel this mild stimulation cycle as it seems I wasn't responding. Confusingly the first scan there were a few medium follicles but then at the second scan they only found 8 very small 6mm follicles and my oestrogen hadn't gone up enough so CRGH suggested we cancel.

We're now going to test the five day 3 embryos we have and see whether we might have a normal embryo in there. So at the end of this month we should know if we have a normal, and then would probably go straight to FET. And if not, we'll have to do more rounds I guess though I'm worried I seem to be getting worse with each cycle.

I feel so anxious about culturing them to blastocyst in the next few days, and then sending them off for PGS testing. I'm praying we end up with a few blasts. Since I'm unsure what to do about PGS if we only end up with one or two blasts. Would it be worth it? It's CRGH's view that it's always worth it since better not to waste time/money on a FET if the embryo isn't viable. But then I come back to the fact that PGS itself is controversial, and is there any chance that a viable embryo would be screened out. Have any of you done PGS for only a few embryos?

Also my dhea-s and testosterone both came back high - 20 for dhea-s and 1.8 for testosterone. So I hope that hasn't been the cause of my worsening cycles... My Dr agreed I should stop taking it for now since clearly it hasn't been helping. With the first cycle I'd only taken it for 6 weeks, whereas now it's been almost 4 months.

How's everyone else doing?

@InvisibleDreamer I meant to say, sorry about your cancelled cycle - it is really disappointing isn't it? THough better not to pay for a disappointing cycle and give your body a break. Did your clinic say you could try naturally after your cancelled cycle? I've just asked about this myself but have a feeling they'll say no.

And on oestrogen priming - I think clinics suggest it for patients with high FSH and low AMH, as it helps lower FSH before the cycle and leads to even growth as @2021ivfagain said. So maybe depends if you have either. Which clinic are you at?

@Lola245 sorry to hear your news. It must feel disappointing. Yes I remember the biopsy anxiety.

I'm not an expert but I think the embryos that sometimes correct are mosaic and you can still choose to transfer them if you want to with counselling.

I think whether you test or not depends on your age and whether you are planning more collections. I was 43/44 at egg collections so we knew that most if not all of my embryos would be abnormal. We also didn't want this process to drag on (hmmmm that didn't work!!!) so we didn't want to risk unnecessary failures or miscarriages which cause more delays (as well as being upsetting).

If you are younger (even slightly younger because 44 really is the very tail end) then you could take a chance that some are normal. However if you are planning to do more collections afterwards then you may not want to risk failed transfers that would delay future collections while the clock ticks.

Those were the things I took into consideration and decided it was worth testing.

We had 4 blastocysts tested x

@Lola245 just to add as you will know from this thread, euploid embryos doesn't mean you won't have failed transfers either of course. I've had one anyway!

@Janefx40 From what @Lola245 says I’m not sure the oestrogen priming would be suitable for me. My FSH either doesn’t change or do what they expect when my oestrogen goes high (I’m not sure exactly). I think my AMH is considered normal although I was never told the level & I don’t think it’s been checked in 2 years. I’m sure I ovulated before day 11 but we did manage to DTD once beforehand. I’ve since been told I have a cyst which is releasing oestrogen so not sure I would have released any viable eggs anyway :(.

@Lola245 Yes it is disheartening when cycles are cancelled I am also finding each cycle just seems to get worse atm. I have to say I am glad to have a bit of break now though. We are with Create in Birmingham. They didn’t say whether we could try naturally or not between cycles but we are trying anyway. We have 4 embryos banked but I would like to get more. We have to bank now as if we have failed FETs or more miscarriages it could then be too late for another egg collection, so this is worth considering. It’s virtually impossible to disregard a viable embryo unless the lab makes some kind of error. The only ones that can correct are mosaic embryos where there is half an added or missing chromosome rather than a full one.

@Janefx40 thank you for the support, I always really appreciate your perspective. We're only looking to have one kid, so I think if it turns out we are lucky enough to have a viable embryo, we'd go for a FET rather than more rounds. My doctor seemed to agree that given that I had an okay round followed by two bad rounds, that it's best to let them grow to day 5 now and PGS test any that remain. But it does mean we could end up having to spend £3500 to test just one or two blasts, which seems crazy. But on the other hand paying for more rounds if we are lucky enough to have a good one (fingers crossed) seems hard to justify. Of the four blasts you had tested, you got three normals right? I'm just really keeping everything crossed that we get a good blast rate from our 5 day 3 embryos...

And remind me, what's the next step for you? Do you want to do more rounds before another transfer?

@InvisibleDreamer It sounds like we might be in a similiar situation - I also feel like the rounds are getting worse and worse and it terrifies me that this is just age. My Dr wants me to test my AMH again since it was 12 last summer but he clearly thinks it's probably gotten lower given my results. So I'm dreading that test. So you're at Create - are you doing natural/mild IVF or normal stimulation? How did you know you ovulated by day 11?

Hi everyone…. I hope you don’t mind me jumping on and resurrecting a pretty old thread 🙏🏼

I was hoping to find anyone in a vaguely similar situation to help ease my mind 😵‍💫🫣

im 42, no previous kids, 1 MC last year naturally conceived. Unexplained infertility at that point after 2 years TTC. Now at 3 years and AMH has dropped a lot since MC to 0.5.

I’m with a clinic in Spain - did a short protocol cycle, ovaries kicked in super quick and a day 4 scan (early because of weekend) showed 3 measurable and 1 small follicle in left ovary, 1 measurable and 1 small in right (odd because naturally right ovary is very dominant!!)
I started on Orgalutran immediately as 1 had reached 15mm.
12 follicles on day 7 scan.
went to trigger on day 9, retrieval day 11.
all screwed up because I ovulated early!! 😩

the clinic were happy to go straight into a 2nd stims cycle so I took progesterone pessaries for 5 days after then had a basal scan last Friday.
ovulation was confirmed. Right ovary quiet. Left ovary had follicles still recovering with blood in them (they had found 2 left to drain but got nothing)
I started stims on cycle day 2 on Tuesday and gad another day 4 scan this morning (early again due to timings!!)
today they’ve found nothing on the left ovary except the old follicles that are smaller but still recovering. And 4 on the right at 10, 7, <6, <6

so now I’m freaking out!!
will the left stay dormant or kick in??
is this cycle a waste of time??
my right didn’t do much last time - can it be better this time??
the clinic are happy to go ahead still but im
anxious 😵‍💫😵‍💫😵‍💫😵‍💫

Has anyone got any insights?? 🙏🏼❤️