Hi all, wanted to post this in case it helps anyone.
male factor infertility
Do not and I repeat DO NOT take a semen analysis as a full analysis of your partners fertility if you have sperm issues. It is so important to get a DNA frag test done too. If this test comes back high you need to get referred to a urologist to see if there is something they can do to improve the sperm. Yes you will likely still need to do IVF/ICSI but you have a better chance of it working if you’ve addressed DNA frag issues. Do not be put off by clinics telling you it doesn’t matter. It does!
Our story: did semen analysis. Count of 1mil. Told we would need ICSI. Did a round and all embryos dropped off days 3-5. Asked for a DNA frag test and was told by clinic it doesn’t matter/still need ICSI/ was too new to make a difference. I insisted. DNA frag came back at over 50% damaged. Insisted on postponing next round and getting a urology referral, found a huge hidden variocoele which was embolized. DNA frag dropped to 92%). I clearly wasn’t going to get pregnant doing 5 day transfers with an infected lining (always visually fine on scans).
- Treated it with targeted antibiotics and then vaginal and oral probiotics (canesflor and optibac). Repeat test showed alot of improvement and good levels of good bacteria.
-the ERA also tests progesterone.
Do not allow clinics to fob you off about progesterone . If you bleed early after transfer or have spotting and a failed transfer INSIST on a progesterone blood test. - I bled early after my first transfer. For second I asked for a progesterone test. I was scoffed at and told no one needs more progesterone than what I was on (x2 pessaries, 1 injection into stomach). I bled early again. The ERA showed my progesterone after 6 days of the above was 4!! It needs to be >52 and ideally above 100 for implantation. Again if I hadn’t pushed for the blood test I’d be doing pointless transfers with progesterone far too low. My progesterone was then monitored during the TWW every few days and I was put on progesterone in oil injections and my levels shot up.
- This test also acts as a endometrial scratch
- when I asked about this test re the emma/Alice ( I had already done one ERA) my consultant said he could always treat me without doing it - I.e. give me a course of antibiotics and then probiotics however the reason I went ahead with the test is that some types of bacteria need a targeted antibiotic to get rid of them and you won’t know this without doing the test. However if you are short on funds it could be worth asking for treatment without doing it.
test for natural killer cells
-Again I did this before recommended number of transfers - came back raised and that I needed steroids for transfer.
- immunes is a very complex area with lots of different treatments so definitely do some research into it
- if you feel you might have an immune issue but don’t want to get into testing my consultant did offer me low dose steroids alongside my transfer so you could always ask for this to be included as a precaution if you’ve had failed transfers. Could help but only if you’ve a non severe issue.
thrombophelia tests
-this came back fine but these tests can identify if you’re more at risk of miscarriage due to blood clotting disorder or if you’re unable to absorb folic acid in standard form. Usually done after 3 miscarriages again I got them done before transfer to see if Clexane was needed as I had
a limited number of embryos
Other
- don’t be afraid to move clinics if it’s not working or you don’t feel listened to. I moved from my first clinic when they insisted DNA fragmentation didn’t exist
-I moved from my second clinic when they refused to check my progesterone or change anything from my failed transfer and wanted to repeat the same protocol.
-At my 3rd clinic the consultant listened to me. He suggested we do embryo banking and then do all the tests I wanted pre doing a transfer even though they weren’t actually recommended at the stage we were at. He pro-actively came up with plans when the test results came back bad (re low progesterone and micro biome results)
- don’t be afraid to travel for treatment. We travelled during level 5 lockdown in Ireland (where I’m from) to total lockdown in the UK and it was absolutely fine.
-don’t be afraid to insist on tests or to pursue your gut feeling about things
-Ask the consultant about protocols! My 3rd consultant added in letrozole for the first 5 days of Stims and it did seem to help eggs collected.
-be careful whose advice you take regarding clinic selection. Most people love the clinic that got them pregnant. Some people are trickier cases and in these cases I recommend doing some consultations and asking based on your history what protocol and tests they recommend. I know it’s expensive to do consults but failed rounds are far more expensive. I did several consults before moving to my U.K. clinic and almost tested them on whether it would be their standard protocol or whether they would think outside the box/ suggest something new / flag an issue.
-same goes with additional testing - we spent half the cost of one round on extra testing and our next transfer worked. You can spend so much just doing the same thing over and over.
-additional treatments: I did acupuncture, reflexology, hypnotherapy, fertility Pilates, fertility yoga, fertility mindfulness, lymphatic massage, very fad in the book (pineapple, McDonald’s, plastic free, no makeup etc etc). Enjoyed them all but none made a difference to the outcome of the different rounds/transfers. I wasn’t doing anything for the transfer that worked as it just wasn’t sustainable any more for me having been doing or preparing for IVF from 2018-2021! Do them if you enjoy them. Don’t do them thinking it’ll give you a better outcome or if you don’t enjoy them especially given the extra expense. Don’t put yourself under pressure.
-do your own research / ask questions . There are some knowledgable people on this board who are good at responding. I have been on these boards in various names since I got my IVF referral back in 2018 and so many kind people helped me out
- Go easy on yourself and do what you need to do to improve your mental health. I did not go to baby showers - I just declined the invite and sent a gift when baby was born. Amazon is great for baby gifts - send it on via Amazon and you don’t need to pick things out or go to baby shops. Cut yourself some slack - I hated my friends when they announced pregnancies. I just let myself feel what I felt and I tried not to guilt myself. I figured as long as I wasn’t saying anything to them it wasn’t hurting anyone that I was upset and angry. We are not bad people we’re just going through an extreme trauma. It’s ok to feel whatever you want and make decisions that put you first.
-I did see a fertility nutritionist who helped me lose around 24lbs in 3 months! Mainly weight gain from all the IVF. It was expensive but we’ve kept up some of the eating habits and know now what to do to lose weight while getting right amount of nutrition. Again something to consider if you’ve struggled with ivf weight gain.
Hope some of this might be of use to someone.