Infertility investigations/IVF in Scotland - thread 2

[Kitekat81]

A thread for those who are undergoing infertility investigations / IVF in Scotland 🙂

@scirocco keeping everything crossed for you.

@Kamiros my own feeling is to try and get it as low as you can then you won't be forever wondering if it was the TSH. I am non symptomatic but clearly unstable and have since found out several women in family have thyroid issues and we are not a family who have had much success with large families so I do wonder if there is a connection?

@comiston34 You're right I think. Spoke with both clinic and GP. I've been increased to 100 now and have another blood test in 3 weeks. Feels much better.

@Scirocco keeping everything crossed for you! It's such an anxious time 😔 sending big huge massive hugs xx

We attend our GCRM nurse planning appt today with the hope we can start next week as it'll be CD21 next Fri. Feeling strangely anxious even although I know nothing tricky is happening today.

How likely are they to start us so quickly?

I think we are both anxious as we tossed and turned all night. Poor cat was decided to sleep elsewhere due feeling sea sick I think! Lol

@comiston34 I remember getting a shock when I went to them for my planning meeting. I was expecting a couple of months wait and it was less than 2 weeks. After all the waiting it seemed to fly by. Natural to be anxious though. So excited for you.

@Comiston34 sorry I have no experience with GCRM but hopefully you'll get started soon!

Day 9 of stims today. Went in for a scan and bloods this morning. Left ovary is looking good and is doing as it should, the right ovary is slightly behind but I was told it's nothing to worry about. Waiting on a phone call from the clinic for next steps, but I was told it's likely I'll be back in on Sunday for another scan with egg retrieval Tuesday! 🤞🤞

Great news @itsmschanandlerbong

Hi everyone. I'm with GCRM and have noticed quite a bit of difference that they don't seem to do baseline scans to check downregulation or monitoring of progesterone levels during IVF like other English clinics.

Has anyone else been concerned about this with their treatment? My period started 4dp5dt and they didn't seem at all bothered to check progesterone levels for instance, and this was after a super poor EC (I only had 4 eggs, 2 mature despite not having a ferility issue and having an AMH of 18.8 which is normal for age 31).

They didn't offer any answers for what was not a normal IVF cycle response. I don't know if I'm over thinking it, but it bothering me a bit heading into next cycle.

@2mumlife Hi. My first cycle was with GCRM and failed in April. I was 8dp5dt - not as quick as yours but still felt early to me. I'm a bit different in that I have very low amh 0.3. I only got 1 egg but it was a 4aa blast. I was on flare protocol and was given a 2nd Ovitrelle on day of transfer, no pessaries. The whole thing bothered me, especially with having had a mc 6 months before, so I asked about it at my review meeting. I was told that with flare protocol if the progesterone isn't right it's because the follicles developed poorly and the egg wouldn't have been good quality anyway. Part of me thinks I should trust the experts but they've said a few things now that don't sit right with me, progesterone support and checking levels seems pretty common and easy to do so not sure why he's against it. He also told me that elevated TSH following the cycle was nothing to do with the treatment which seems to disagree with everything I've read, albeit I'm not an expert and my reading is limited.

I'm due to start a 2nd cycle with them and its already paid for through access so I'm going ahead. In general I've liked them but yeah things bother me.

What protocol were you on?

Hey, sorry I've not been active - took a break from all social media for a few days.

Now have a 5AB hatching blastocyst on board!

One embryo didn't make it past day 4 but the third is still in with a chance - it's in the morula stage so the clinic want to give it another day to see if it develops to meet their criteria for freezing.

@scirocco Great news- everything crossed for you

Thanks! 💜

Lots of love @Scirocco. Fingers firmly crossed

Thanks @florafoxtrot - it's hard to believe when I think about what's happened so far. 2ww here I come...

Hi @2mumlife - I'm not with GCRM but it sounds like you had a similar response to me on that cycle. It's so upsetting, isn't it, to get unexpectedly low response to treatment and then get so little consideration of it by clinic staff? Thinking of you - I really hope this cycle works out better for you.

Unfortunately the third embryo didn't develop enough to meet their freezing criteria. Now it's all down to this little one inside.

I did, however, finally get some acknowledgment that the protocol wasn't right for me - I'd said this from fairly early on and the clinicians had insisted it was correct, but today someone said that the pre-stimming investigations definitely suggested I should have responded better and that a change in protocol would possibly have been better. They're going to suggest a different protocol if we do another cycle.

@scirocco Just shows you have to trust your gut. Hopefully it won't come to that and this transfer will be successful.

@Kamiros I was on a long protocol (Prostap CD21 with Menapur after bleed). I only stimmed for 7 days, they got me to take my trigger after day 8 scan. I really think they should have left me longer. Really interesting to hear your experience as they said at review that subject to another AMH yes they'd move me to Flare protocol if we needed another EC round (we've paid for 2 full IVF cycles through Access fertility too) with a delayed egg retrieval, so egg pick up 37 hours instead of 36 hours after trigger since so many of mg eggs weren't mature (we got so few eggs at EC partly because they wouldn't come away from follicule wall - they'd expected 7 eggs we got 4). Everything I've read says Flare is really used with low AMH so not sure what to expect as they said more risk of OHSS. My consultant said they'd only do it with me if they retest my AMH to checks it's not too high for moving to Flare. Consultant had said with Flare I'd only have ovitrelle for LP support already. Which other drugs did you take with Flare? It's a 4AA they are putting back this time (my fresh embryo was 5AA). It's the one good thing consultant keeps focussing on that both mature eggs made great little blasts. Are they changing your protocol for your next round? When are you getting started?

@Scirocco Congrats on having a blast on board! Such a shame about not having 1 to freeze. Hopefully this one does it for you and you won't need to think about changes in protocol! Do you mind me asking you your story / experience?

@2mumlife, thanks for thinking of me. I'm happy to share if it might help.

Well, in 7 years of trying, we've only ever had 2 positives so far - one 6 years ago (early miscarriage requiring emergency surgery due to bleeding) and one last year in the second trimester (absolutely the worst experience of my life). We're "unexplained" but I suspect immune issues are involved due to other aspects of my health (eg thyroid autoantibodies). BMI is a bit on the high side (over 25) but not horrendously so - daily exercise (not during this TWW) and mostly healthy diet, no alcohol or cigarettes or anything like that.

This was our first IVF cycle. We'd been due to start last year but the pandemic delayed it, then we conceived naturally and had our second loss, and had to restart waiting...

Before stims, my AFC was 18 and my AMH was 23, so the clinic were really surprised I responded so poorly. They had me on menopur but only for 9 days and kept saying the response was poor so I might not have anything to transfer (fortunately one embryo made it!).

We're hoping this transfer works...

@2mumlife So I had one injection of prostap for down reg on cd4 then I had 10 days of Ovaleap, quite a high dose. They're going to do exactly the same again as actually it all worked as well as expected. I got 2 follicles, a third was almost big enough but didn't develop right after trigger, one follicle was empty which is apparently normal. I'm on cd2 and supposed to be calling tomorrow to arrange getting started at the end of this cycle but I'm going to delay a month. My TSH is still higher than I want it to be and I didn't ovulate this month either. I want a little longer for things to settle, I'm hoping they're going to be okay with that.

@Scirocco I'm so sorry for your loses, what an awful experience you've had both times. Was having a good back and saw you used ICSI and didn't have a great fertilisation rate. I saw someone posting recently who had no eggs fertilised by ICSI - would be absolutely devastating after all that work with stims. Just makes me grateful for even low numbers of day 5 blasts. You do sound very similar with AMH score and lower number of days stimming. It was weird as it wasn't until after the EC anyone started referring to me as being a low responder (in fact the nurse who called me after scan to tell me to trigger said I was "on the fast train"). I very much seemed to have 2 lead follicules that they went with, with lots of smaller ones. I see other clinics making decisions to let some go overmature to let others catch up that I do wonder if we'd have had a better outcome of they'd left it a bit longer. Fingers crossed for you that this one sticks and stays for you, it sounds like you so deserve this after all you've been through.

@kamiros Interesting it's still prostap they give you. I took a long time for bleed to come on prostap last time and they'd said then they thought I must have had a bigger flare. I'd wondered before if that was what caused me to have a couple of lead follicules and such a short stim period. Not tried ovaleap yet - we have 4 medicated donor sperm IUI attempts with Letrozole, gonal-F and ovitrelle before moving to IVF. Different cocktail again for FET cycle at the moment (Fyremedal and estrogen just now, getting Lubion injections and Utrogestan suppositories for progesterone support later). Is your TSH something you've had tested at GP? It's not something they've ever tested me for. I'm sure you'll be able to take a month off, they've always been good when we've taken breaks.

@2mumlife They tested it when I first went to GP about a year after we started trying. It was really high and they put me on meds, tested 3 months later said it was fine and to keep taking them. When I had my mc it was very high and the doctor at the hospital said it may have caused it (but they don't know). Increased meds and it went right down, this was 4 months before 1st cycle and nobody said to test again, I just thought it would be ok. Tested right after failed transfer and it was high again. It may not be related but it can be and I want to get it really well controlled before I go again. It can have a real effect on things.

@Scirocco it's so difficult, you put your trust in the clinic thinking they know what's best. Hopefully it won't have to come to another cycle 🤞🏻🤞🏻

@2mumlife I'm the same age as you with a similar AMH (18.3) at GRI and I am on a short protocol, no prostrap, just straight to stimming. It's strange how different clinics would do a different method with pretty much the same case.

I had an appointment this morning for a scan and bloods. When I went in the nurse said I didn't need a scan because I'm ready, but took some bloods and a covid test. Got a call this afternoon to say I was good to take my last evening injection at 9pm and booster at 10pm, with egg collection scheduled for Tuesday morning, it feels so surreal to finally get to this point!

Fingers crossed, @itsmschanandlerbong!! I'm starting stims tomorrow am (menopur 150 for a couple of days and then add fyremadel) after taking norethisterone for 8 days and resting for 5, myperiod came yesterday as expected(well, heavily spotting but on track for me). Saying that I am nervous is an understatement!

@Kamiros That's really interesting. Its not something that I've ever been tested for and I've had 5 unsuccessful attempts so far (all BFNs). I feel soemtimes things might get missed as we went to clinic as my female partner obviously doesn't produce sperm! We did have a HyCoSy done before starting treatment but that was it really, as I guess they weren't really looking for underlying issues.

@itsmschanandlerbong It is interesting to see different approaches! Good luck with EC!

@GemmTryTTC Exciting to be starting stims!

I'm enjoying next couple of injection free days as I'm done fyremadel and just on the estrogen pills until lining scan on Thursday. I've never bothered paying attention to my lining thickness in previous scans as I've always been so focussed on follicules, but clinic have never suggested its been a proiblem, so I'm just hoping I have a good lining

@2mumlife I was always aware it might be an issue as I struggle with my weight and energy levels - always worth a check though, only a blood test.

@itsmschanandlerbong Good luck, hope it goes well.

@GemmTryTTC So exciting. It sounds crazy but I enjoyed doing the injections, finally felt like I was doing something.

I called yesterday and arranged to start on day 19 of next cycle so I'm about 9 weeks away now.