ERA/ALICE/EMMA testing thread 2

[seven201]

Link to the old thread
https://www.mumsnet.com/Talk/infertility/4187520-era-testing-after-multiple-implantation-failures-anyone-had-it-done?msgid=110302437&utmsource=mentions&utmmmedium=email&utmcampaign=2020-10-19&utmmterm=You+have+been+mentioned+in+a+post&rei=438192#110302437

Welcome to the new thread. Anyone welcome.

Thinking of you today @Dochas121 ❤️

I'm sorry about your friends @whatcangowrong x

@Dochas121 good luck today xxx

@whatcangowrong sorry about your friends. It's never nice when these things happen but maybe they were trying to be sensitive if they thought you couldn't come anyway? I used to live far from most of my friends and often felt left out so in the end I asked them to invite me even if I probably couldn't come! It felt better and sometimes I could make it happen too x

Love to everyone else. Sorry I'm a bit quiet. Things busy here but thinking of you all xxx

@whatcangowrong

Sorry about your friends - have to admit similar happened to me during all this and I'm not sure our friendships will ever truly recover x

@whatcangowrong

Hey everyone.

@Gardenlady543 sounds like viagra is not the dream, sorry for you. Not too much longer to go and then onwards to transfer. Glad to hear you're able to rest and take things easy. My work is so full on at the moment, it doesn't help if I'm feeling crap but equally I don't get a chance to wallow in misery which is probably good.

@VenusStarr hope that you're sleeping better and not feeling too anxious. Have you had a second hcg draw?

@Dochas121 are you still on track for transferring this week?

I'm feeling fine. Weirdly detached and not upset, probably shows how over it I am! I am now back to weird optimism that my next transfer might work even though all my failures this year would suggest it won't. Will be a double, I don't think there's much risk of twins somehow!!

Had a basic high swab done last week just coz gynae said would I like to, which said no nasties and normal lactobillus now, but I wonder if the canesflor is just sitting there waiting to be swabbed..?

If I don't get anywhere this time I will run into Christmas closures I assume, was it @Janefx40 that that is happening to? Would like to maybe look at switching to Create but wonder if there will be a waiting list. The good thing about my clinic is I can always start when I want. Although I think I'm being told that this next cycle would be too soon after last collection to collect again :( so then with Christmas it'll be late January, ugh. I'm hoping to talk my doctor into doing a collection this next cycle but with much much lower drugs as an experiment to see how I respond, I feel we really need to target quality given these abysmal PGT results and you do read about high doses (450 for me always) don't do the eggs any favours. Any thoughts on this? I've generally been able to run FETs and cycles together pretty much without stopping and I hate feeling like we are not working on anything at any point...

Good morning ladies, hope you don't mind me jumping in. @whatcangowrong I was reading along and wanted to comment about the dose of the FSH medicine.

One of the doctors I am following referred to a study which showed that regardless of age, BMI, ovarian stimulation protocol and infertility diagnosis, the largest number of oocytes retrieved was in the group with FSH doses ranging from 1001 to 2000 IU (the total amount):

link.springer.com/article/10.1007%2Fs10815-021-02179-0

To add to this, in the Netherlands (which by no means is a leader in reproductive treatments but they are strict in adhering to what they think is evidence-based medicine, so not really innovative but still) the highest dose they prescribe is 225 per day.

Just wanted to share.

Ah thanks @TheDutchess3 that will give me a bit of ammo for meeting with doctor. They are convinced it's a numbers game and to get numbers you need drugs. @tiggerwhocamefortea it's also good to know your experiences. When you say poor quality eggs, were you getting blastocysts?

My concern is that I had ovarian surgery for a cyst which resulted in loss of ovarian tissue and so only one of mine actually responds. Wish I had known this was a risk of the procedure at the time. Despite this my AMH was 16 when last measured in the spring and I've collected 8-12 eggs each time which I think is a good result with only one side working. I just wonder if given these limitations there is not much point hammering me with high doses of drugs....

Thanks all for the well wishes! It went fine today. Embryo expanded nicely and looked good apparently. Back from theatre and in the room now having a hot chocolate! Fingers crossed now. Testing in ten days. So I need to find somewhere to do a HCG as I’ve a total aversion to pregnancy tests.

Going to chill in the hotel room for the eve once I get released.

Yay! 🥳 @Dochas121 great news that your little embaby is on board. I feel exactly the same about tests! I've still got some frer upstairs and can't bring myself to do one, so weird, normally I'd need to see the lines but I'm petrified that it's going to disappear, so want to stay in my bubble.
Does your clinic not do beta hcg? X

Well done @Dochas121 🙌. Thinking sticky thoughts on your behalf 🙏

Congrats on being PUPO @Dochas121

I've just had my consultation with Prof Brosens, he said my NK results are normal, he said the first came back as normal which is good and that after a biopsy there is a disruption of the lining so the next is usually low, which is what happened in my case.

I asked about sitagliptin and he said if I'd has recurrent miscarriages then yes but in implantation failure it isn't needed.

I asked if I should worry that my NK cells will be even lower for this transfer he said no.

I told him what's happened with my microflora, he still doesn't seem convinced about it, he said people will low lactobacillus still implant, although I said that my case is clearly unchartered territory, nobody in the medical literature has has 2 x 0.00% lactobacillus results.

I said I'm worried that my ERA receptivity could be related to the poor microflora and I don't want to be doing a transfer when I'm post receptive and he said we're out of time so to come back in at 5:15 to discuss it more!

@whatcangowrong

I was getting 14 eggs a time on short protocol on 225 Bemfola but less than 30% fertilised each time even with ICSI and then no grade 1 on day 3 and then just a couple of average blastocysts each cycle (2 of which I PGS tested and neither normal)

Then when I changed to natural modified IVF fertilisation jumped to 100% and grade 1 on day 3 and top grade blastocysts

Oh @Gardenlady543! How did it go when you saw him a bit later? Good news that he wasn't concerned with your nk cell results, but I guess it also feels like you're no further forward in understanding your implantation difficulties. I hope you're feeling a bit more confident with your upcoming FET?

@Gardenlady543 that sounds like a productive appointment. I totally read it and thought oh god he kicked her out without answering all her questions! I'm glad he let you wait around. I hope he was reassuring later.

@Dochas121 yay! Congratulations for doing that today. I hope you're enjoying your hotel room- I'm jealous! Watch something with Cameron Diaz in or something, perhaps 'the holiday'. Love that film! Sorry, going off tangent and maybe you hate that kind of film!

@Janefx40 hope you're ok.

Waiting for my period still. Have baseline scan booked for Friday but it has to be on cd 2-4 so I think that means I'll have to do a pregnancy test on Thursday am before work if my period hasn't arrived by then. I've been a pretty snappy cow recently, so maybe my period is imminent! Just hope it's before Thursday morning so I can get the ball rolling and not have to re-book everything.

@seven201 period-watching is so frustrating. Hope it turns up (if you can't be pregnant). Second guessing appointments is so hard.

@Dochas121 yay! Congrats. Hope you're feeling good this evening.

@Gardenlady543 so sort of reassuring I one way but still leaving lots of questions unanswered. I hope you got more clarity when you went back. Did you say that Dr was also leaving so was this your last chance to see him?

@VenusStarr how are you feeling?

I'm fine. Also on period watch. I feel like I'm about to come on but only stopped noresthisterone yesterday so should get period Friday. Am now trying to time my cycles to be ready for scan on 30th Dec as not heard back from consultant. I ideally wanted to time this cycle perfectly so that I can have a medication free cycle next month and go into transfer without my body messed up by hormones. But that might be wishful thinking.

Am on a little road trip visiting friends with DD. We're literally touring round all my friends in Derbyshire/Manchester where I used to live. She's waking up at unsociable hours due to bloody clocks changing so better get some sleep while I can!

Xxx

I hope you can get started ASAP @Janefx40 and @seven201

Nope this professor isn't leaving.

So we had a further conversation later on, he is optimistic.

He then sent through a treatment plan which said

• if my next FET doesn't work do another NK biopsy which will act as a scratch.
• take progesterone as recommended by the clinic.
• don't take aspirin
• no need for steroids

I am on aspirin, I’m prescribed it as I have an abnormal PA1 gene and the C4M2 mutation.

The professor has said “Thromboses do not cause implantation failure (a long disregarded misconception) but COX-2 is important for implantation. Hence, there is no indication for aspirin. In pregnancy, aspirin is effective in preventing late adverse obstetrical disorders, like preeclampsia.”

I asked if I should stop the aspirin, he said “my advice is to stop the aspirin, LMWH has a number of actions, independent of its anticoagulant functions, that may potentially be useful. Starting on the day of transfer should suffice.”

I then asked if it’s normal to take just LMWH without aspirin, he said “Heparin enhances the activity of heparin-binding growth factors, a number of which are mediators of implantation. No need to combine it with aspirin.”

So I've stopped the aspirin but will take the heparin.

@Gardenlady543 this is all interesting. Nice that he is optimistic. For what it's worth a doctor I saw in the summer when my usual one was away advised heparin but didn't mention aspirin. I've got homozygous mthfr mutation which was the reason she suggested it.

Sorry @Gardenlady543 what's COX 2??

@whatcangowrong it's an enzyme involved in inflammation, antiinflammatories like ibuprofen inhibit it. But this can cause issues for implantation. I think this is why clinics are strict on not taking ibuprofen around the time of the transfer. Aspirin seems to be used often but it also inhibits COX-2.

🤞 Your period makes an appearance soon @seven201 you definitely ovulated so hopefully you can stick to your original dates (if you're not pregnant from this cycle).

@Janefx40 hope you enjoy your time away, even if your little one is on a different body clock!

@Gardenlady543 I'm glad you managed to get a more in depth discussion with Prof B and it sounds like he is confident. How are you feeling now you've stopped the viagra? Are you due a scan soon?

I'm feeling OK, still very anxious that it's all gone wrong. I've booked in with my clinic counsellor next week. I'm trying to not panic but as each day passes it's getting harder to believe this time will be different. Next week is our danger time and we've never had a good scan, feeling scared.

Awww @VenusStarr try to be calm and trust in the process (and the medication). One day at a time. I thankfully haven't had losses but was so anxious during my early pregnancy anyway so completely get it ❤️. Will it be a 6w scan next week?

Good luck @VenusStarr it’s so nerve wracking. I honestly don’t know how I make it through those stages of pregnancy . Just tackle one day at a time. Remind urself of the positives- ur on immunes, good embryos etc every time u freak. Believe ur time has to come one day and why not now….even after my 6th mc when I was broken beyond words I just knew I had to keep going and one day it would come good because it would just have to. There was no other option for me. (maybe I would need surrogacy or get my Family in a way I didn’t imagine but I would still have my Family was my overwhelming feeling) but it helped me keep going xxx

Thank you @whatcangowrong 🙏 yes my first scan is at 6+2. My 4th pregnancy made it to 6+5 but had no heartbeat (we've never seen one). I'm trying to focus on all the reasons this can go right ❤️

That's really helpful thank you @Cream123 trying to be in the here and now and focus on what's gone well so far. I'm in complete disbelief that I am pregnant again. It's so surreal, what we've been trying to achieve for do long but my brain just won't acknowledge it! I'm writing things down and trying some affirmations like 'today I'm pregnant', 'my body is doing what it can to support my baby' etc.
Hope you're doing OK Cream?

@VenusStarr sounds like a plan to talk through the counsellor but there's no real way to handle it - it's just one of the hardest things to go through. When we were waiting for me to miscarry I had to go in every few days for scans - it was horrendous. The only thing that kept me sane was chatting to a couple of other people at the clinic who had been through something similar

@Gardenlady543 well it sounds like you got a lot of information and it seems positive. Are you feeling like it's answered some questions for you?

@VenusStarr oh I'm feeling loads better without the viagra, thanks! Wow it was horrible! Sorry to hear about your worries, I hope this is your time ❤️

@Janefx40 I'm not sure really whether I feel questions were answered. It's reassuring that he felt the NK results are fine. His opinion was I need to keep doing transfers basically.

I'm now CD7, first scan is on Friday.

@Gardenlady543 hopefully he is right. I do think you have to be in it to win it with this ivf malarkey sometimes, much as it is heartbreaking when it doesn't work and much as we obviously want answers when it doesn't work. Often I think we need to remember that it just doesn't work for no good reason at least 50% of the time 😫

@Gardenlady543 I'm so glad the appointment was so thorough. Do you feel a bit reassured? Yay to stopping the viagra and feeing better.

@VenusStarr good idea to see the counsellor.

So this morning when I went for my morning wee I had some light browny pink discharge and was happy as I assumed that was the start of my period, so on schedule for baseline. Still no period and the plan was to do a pregnancy test in the morning (only for clinic reasons) but I happened upon a cheapie one and just did it and it had a faint line. So then did another wee on a first response and there is a faint line on there too. Holy fuck. I woke my husband up and he is in denial. Worried because of a previous loss and the brown (there is still a bit when I wipe) old blood. I had three bleeds before 12 weeks with my dd and she clung on though. It definitely hasn't sunk in and I just assume it will all go wrong. Trying to focus on the fact that the surgery must have worked, as we've not had a bfp for nearly 4 years.