Pre IVF advice

[Egghatcher]

Hi,
We had our tests/ consultation last month and have been advised to go ahead with ICSI. We have decided to wait a few months to start and I was wondering if anyone could advise on how to use this time productively. I need to lose weight so that’s got to be a focus. What about supplements or specific foods that might help?
I’m going to get the GP to test my thyroid too.
Any advice would be most welcome.
Thanks in advance.

@Egghatcher I hear the book it starts with an egg gives some good advice.

This is what I do:

Supplements
Prenatal vitamin (I take one with methylfolate rather than folate, I didn’t realise that a lot of women have a mutation affecting their folic acid metabolism)
Coenzyme Q10 Holland and barett 200mg
Vitamin D and
Vitamin B complex (I’m vegan)
Vitamin E 800mg
Omega

I recently started taking l-arginine but that’s because there’s some indication that it helps with lining.

Diet wise I’m vegan and eat a Whole Foods plant based diet, if you’re interested in this diet then have a look at Dr Michael Gregor, he advises about a daily dozen- foods that you make sure you eat every day. If weight loss is what you’re planning then I’d advise a lifestyle change rather than a crash diet.

I don’t drink any caffeine or alcohol.

To try to improve my endometrial thickness I added in pomegranate juice, beetroot juice, Brazil nuts, a daily smoothie with spirulina and spinach. And it made no difference, but you know it’s healthy.

@Gardenlady543,

Thanks so much for your reply, it was really useful.
I’m currently taking the Zita West prenatal supplement as is DP so need to check out what it actually contains

I’m so scared about my mental state but I’m not really sure there’s much I can do for that other than feel as prepared as possible!

Thanks again.

@Egghatcher I think all prenatal meds will probably be quite similar, I just changed to naturelo prenatal recently when I found out I had the folic acid mutation and I was told to take methylfolate 5mg as well. I mean I could have stuck with one with folic acid in it and supplemented with the methylfolate, but it seemed more logical to change.

Sorry to hear you’re worried. If you have an underlying mental health condition then I would say, do what you can to be in the best place possible before the treatment starts. Your clinic should have access to a fertility counsellor, I spoke with one recently and she gave me some techniques to help. I would recommend you make plans to have ongoing support during the treatment if you’re worried about your mental health: so either with the clinic’s counsellor or with another counsellor.

@Gardenlady543 that’s good advice, thank you.
I think we get 2 sessions included in the package so perhaps seeing someone before it starts is a good idea.

I lost a baby last year and am suffering from secondary infertility. It’s been a hell of a year but I’m hoping I’m strong enough to peruse this route. My age is a big factor for sure, otherwise I’d definitely have given myself more time.

Have you had many cycles (if you don’t mind me asking)?

Oh bless you @Egghatcher I’m sorry to hear about your loss how old are you if you don’t mind me asking? I’m 35, me and DH tried for 12 months and never got a BFP I had a fresh cycle in November, we did really well and got 9 blasts, but both the fresh and frozen transfers were unsuccessful, I had the embryos PGT-A tested and 83% were euploid, so we’re working on the issue being implantation failure at the moment, I’m having investigations.

I went into IVF thinking this will be the thing that works, and it’s a rollercoaster, there are real lows, so I can’t emphasize enough the importance of setting up appropriate support.

@Gardenlady543 I’m 38.

Great advice about support, and something I will seriously put into place before we progress.

I’m sorry to hear your transfers were unsuccessful. The consultant recommended we have the PGT-A testing due to my age also. There’s mixed feedback on doing it on your first cycle though. It’s a bit of a minefield with so many decisions to make too.

Thanks for taking the time to reply, it’s been really helpful.

@Egghatcher I mentioned PGT-A before I started and then after the first unsuccessful cycle but my specialist said it wasn’t really necessary. I then insisted on it after the second cycle. I find the cycles difficult both physically and emotionally and would rather know that an embryo that has a chance of working is put back.

There are negatives, it’s an extra thaw, my best embryo didn’t survive the thaw. There’s a chance embryos can be damaged in the process and some come back as mosaic (a mix of euploid and aneuploid) and sometimes you get an inconclusive result. I heard a specialist on a podcast day if your under 40 and have more than 5 embryos then you may want to consider it. Essentially it can reduce the time to pregnancy but doesn’t increase the chance of success.

Ugh! There’s so much to think about. Do they tell you what chance each embryo has after the PGT-A?

A big part of me is petrified about even pursuing this route but on the other hand, I feel like I need to take some charge of it all.

Where are you up to with everything? I’m so sorry that you’ve had such a tough time.

Oh bless you @Egghatcher you’re so sweet I’m having a mock cycle with an ERA at the moment, I’ve just had recurrent implantation blood tests. All this stuff is usually considered after about 3-4 unsuccessful cycles but I got a lot of high quality embryos and high rates of euploid embryos so we brought the tests forward as it makes no sense as to why I’ve never been pregnant.

You can always test frozen embryos in the future, you don’t have to decide straight away.

As for the chance of success: my embryos were in an embryoscope (incubator with a microscope) they were monitored and each one was given a score for the chance of success. Although a good score doesn’t mean it’s a euploid embryo, and the only aneuploid embryo I had had a 10/10 score!

Having your embryos PGT-A tested will tell you if they’re euploid (normal), aneuploid (have 1 too many/too little chromosomes- they will either fail to implant, miscarry or result in a condition like Downs Syndrome), mosaic (could work or not work), or inconclusive (no additional information).

So the only real use is to help pick the best one for a transfer. If you ended up with 6 embryos, around 50% will be aneuploid. So the PGT-A may help pick out those ones that won’t work, helping reduce the time to success, but the UK tends to do a trial and error approach and since most aneuploid won’t work anyway, PGT-A is often not recommended.

@Gardenlady543 That’s good that they’ve brought the tests forwards. I think the not knowing/ wondering makes it all worse. How did you find your previous cycles?

I think I’ll probably go ahead with the PGT-A testing. I still don’t feel like I know enough about the whole IVF process though. We had an hours phone consultation and I felt like my mind was blown. The consultant recommended a multicycle package and I didn’t even realise that it included frozen egg transfers so I thought it was literally two shots at it.

*Previous transfers.
I don’t even know the correct lingo!

Is that what you’ve gone with @Egghatcher I’m on a package too with access fertility, 2 fresh cycles and unlimited FETs until I either run out of eggs or have a live birth. It has helped with the costs, while I’ve paid a lot more for these extra tests, I don’t need to worry about paying for the cycles.

The cycles really are fine, I got some pressure as my ovaries got bigger in the fresh cycle but that’s because I have a high AFC most people don’t get that, the meds were fine I didn’t get symptoms from them. In the frozen cycle the estradiol they use for the medicated cycle makes me nauseated but again lots of people don’t get that.

You could mention that you’re interested in PGT-A and decide depending on the number of embryos you get, my specialist does a freeze all and then you have to wait for the results before a transfer so it could delay things if your specialist does the same. If you say got one or two embryos then you’re probably better just doing the transfers. In my case I got 9 so it would be sensible to consider PGT-A to help with selection with that many.

Yeah, that’s what we’ve decided on @Gardenlady543. It will hopefully help us budget somewhat although I can still see how things will spiral. Luckily we’d been saving to get married so that’s now become the ivf fund.

I think we’re going to start our first cycle in June/July. We’ve just hit our 12th cycle of TTC so the specialist was keen we get cracking and not wait too long. We got pregnant on our first month with our baby who died. None of it makes much sense to me really, but I definitely think being miserable and riddled with grief can’t help. Hoping by June/ July I’ll be feeling stronger and better prepared.

When will you get your test results from the ERA?

Oh bless you @Egghatcher what happened with your first pregnancy if you don’t mind me asking? It must have been so awful and I’m sorry to hear that things are still tough. Knowing you can get pregnant is a good sign. Grieving is very difficult and it’s difficult to balance out giving yourself enough time and the biological clock.

Our IVF fund is our upgrade to a better house fund lol. I guess weddings and moving houses can wait for now. I think becoming a mother trumps these things.

I had another scan today, I’m at 7.9mm they want me over 9mm before I start on progesterone which I’ll take for 5 days then I’ll have the endometrial biopsy and then it’s a wait of 2-4 weeks. So a little while to go still. And then that’s it for tests and hopefully I can plan for a cycle starting mid-May.

@Gardenlady543, yep, bigger houses/ getting married can go on the back burner for now. Plenty of time for all that! Haha.

Fingers crossed you can plan for a May cycle. Everything seems to take such a long time doesn’t it?

I got pregnant really easily (and had the shock of my life) but even from the offset things weren't ‘normal’. I had lots of early bleeding and numerous scans which showed he was fine. I had horrendous hyperemesis and anxiety but by 17 weeks id started to get my head around the fact it was going to be ok. I had a routine midwife appointment and she couldn’t find his heartbeat. She wasn’t overly concerned because I was only 17 weeks but because I was clearly anxious she sent me to the hospital for a reassurance scan. And he had died. It was literally the worst moment of my life. The post mortem showed he had the cord wrapped around his neck several times which is so uncommon at that gestation. He was perfect, just really small. He died just as lockdown 1 hit so it’s been a really tough year but in many ways I’ve had to face exactly how I’m feeling because there’s been no other distractions. I’m very blessed to have another child from a previous relationship, he certainly kept me going through some bleak days but he’s a teenager now so needs his mum much less these days.

Oh @Egghatcher I’m sorry what a horrible experience, I hope you’ve had some support since counselling etc. I really hope things work out for you with IVF

Thank you @Gardenlady543. Counselling has definitely helped.

I really hope things work out for you too. This is a tough old road for sure. Thank you for your advice, it’s so useful to ‘speak’ to others going through a similar thing.

@Egghatcher I was a newbie to all this just a few months ago, I got so much from being on these forums at the start and still do now. Even though I’m only 2 cycles in, I feel like an expert now! So just come back and ask me anything if you think of anything, I’ll try my best to answer! Also when you do your cycle, join the thread on here for those having a cycle at the same time. They are usually called IVF June etc.

@Gardenlady543 thank you so much, that’s really kind. And I will most definitely join the thread when I start my cycle.