Embryo batching with PGS testing

[2021ivfagain]

Hello. I thought I’d start a new thread. It seems like the old one has been closed.

It’s been really good to share advice and experiences when going through the ups and downs of embryo batching.

@Janefx40
@Lola245
@Sarahk20000
@Ivfhoper
@Dochas12111
@Rosemarypots
@InvisibleDreamer
@tulipsandsnow

If I’ve missed anyone, please let me know.

Hi @2021ivfagain how are you getting on? I hope you’ve fully recovered from covid.

I’m glad there is a new thread as I wanted to post on the old one but it was full to apologise to @Lola245 for my previous post. I didn’t realise you were as far along with the batching when I mentioned the DNA frag. I am sure some of the embryos will make it - ours didn’t but then we had very high frag of over 50%. I just get frustrated when I see clinics not treating it properly as we spent over 12,000 before we got it sorted and I’d hate anyone else to go through the same so I always mention it as we were also initially told ICSI/IMSI was enough. I understand when time is not on your side though there is only so much you can do. Wishing you lots of luck with the progression to blast and hope you get a good few to test!

Hi all. I'm approaching egg collection for batching round two. Disappointingly, it hasn't gone as smoothly as the first round, and my stims are being extended by a day. I've heard lots of people say their second round was better than the first, so I was hoping I'd be the same.

We have 11 day three embryos frozen from the first round from 15 eggs, and this time I think I'll be very lucky to get 12 eggs, looking at my graph. I know it probably sounds like I'm doing well, but we're doing PGD as well as PGS, so on average only 25% of any blasts we make will be suitable for transfer.

I'm wondering whether I should have a longer break between rounds two and three (I went straight into NET for two weeks following the first collection, and then started stims on next bleed), but I also just want to get it all over with. I'm using a lot of energy in planning my life around cycles, and the thought of prolonging this is very daunting.

I tested my testosterone again this week, and it's within normal range, so I'm hoping my high reading was a short lived blip caused by the interaction of the NET and DHEA ahead of starting stims.

@Dochas12111
Hi yes thanks. Also we had blood tests and my crp was 0.7 and my husband’s was 0.6. My vitamin D was 108 and iron was 55. All results were in normal range so I have to proceed this cycle due to age. I’ll be 41 in June so time is not on my side. I’m hoping that being triple jabbed helped me. Thanks for your advice.

@Lola245
I’m sorry your last cycle was cancelled but it’s good you had embryos from the first two cycles. When I started thinking about embryo batching, I read a review where a 42 year old woman from CRGH had 5 day 3 embryos from two cycles and ended up with a normal embryo which stuck. I know it does not always happen, but a little hope can be a good thing.

As for mild/natural IVF, it can work. However, I would ask if there are other protocols available to you if you even need to do more cycles. You might already have your good embryo.

Good luck

@2021ivfagain that’s great you got the bloods done. CRP that low indicates no inflammation in the body so sounds like a full recovery. Nice to have the peace of mind to proceed. Wishing you the very best of luck with it.

@Lola245 I think we are standard IVF although I only have a low dose of drugs as I respond excessively to most drugs. I forget what the difference between standard and mild is? I’m usually on a 150 dose of stims which was being dropped to 112.5 this time to begin with until my Cycle ended up being cancelled.

@Lola245

You should have an email which will take you to this new thread.

@2021ivfagain thanks for starting the new thread.

@Rosemarypots sorry this round is disappointing. It's so hard to know if taking a break would help. There is so much variability between cycles anyway. Let us know how you get on

Xxx

Thanks @Janefx40. It's so hard to know what to do for the best. My consultant said she wouldn't advocate back to back retrievals if she thought the outcomes from it were suboptimal, but at an individual level surely it's harder to say. Ideally I want to plough on and get the retrievals over and done with, but would reconsider if it seems like it's really not a good idea. I need to see how many day three embryos I get, I think, but the timings for making decisions don't really align as for back to back you start NET the day after retrieval. But then hopefully egg numbers will give an initial steer.

How are you getting on with your immune investigations?

@Rosemarypots yes it's hard to know - some clinics require a full months break between cycles, and others like CRGH do it back-to-back. I've done it back-to-back the last 3 cycles, and the 2nd and 3rd were much worse than the first, so it makes me wonder if possibly my body needed a break. With both of the subsequent cycles I had cysts/hemorraghing follicles. I think it sounds like you're doing really well though. And isn't it always the case that basically only 30% of blasts are normal and suitable to transfer?

I can't remember if I mentioned in the last thread that my doctor has now told me to stop taking DHEA since my last results were 1.8 for testosterone and 20 for dhea-s! I think the fact that CRGH recommends 75mg per day is just too much (at least according to the It Starts with an Egg author). I wonder if it might be the cause of my dismal cycles 2 and 3. But maybe I'm just hoping for a cause other than advancing age... I think after a brief pause I'll start just taking one DHEA tablet a day and hope that's the right balance. Just thought I'd mention since we've debated the merits of DHEA on this thread!

@Dochas12111 thank you for writing, and no reason to apologise of course. I believe my husband's is quite high in terms of DNA frag (I forget the percentage), though he's made radical changes in the past three months. And given that we've gotten pregnant naturally and quickly three times (2 of those miscarriages), it makes me think his sperm can't be that bad. I forget your backstory - did you have miscarriages and that's how you discovered the DNA frag issue? Anyway, based on your advice I'm going to suggest he makes an appointment with Dr Ramsay if we have a disappointing blastocyst rate. Our embryos are being grown to day 5 this week...

@Lola245 we saw Mr Ramsay. He's very lovely and helpful. Interestingly my age was a factor (I was 43 then). He said that younger women's eggs can correct a lot of sperm damage but at 43 my eggs wouldn't do that so it was more significant.

@Rosemarypots what is NET?

Thank you @Lola245. I'm in my 30s, so roughly 50% of my embryos will hopefully be chromosomally normal and then on average 50% of those will be unaffected by the genetic condition we're trying not to pass on. But because of having two variables it's possible to be very unlucky - the chromosomally normal embryos we produce could all be the ones affected by the genetic condition, and vice versa. We just have to hope for some luck. I've had three failed rounds before the batching, and we did get three good embryos, but sadly none of them stuck. Also, our three day conversion to blastocyst rate hasn't been that amazing compared to some others - I think around 40%.

I'd been taking 75mg of DHEA over two days (alternating two tablets per day with one), and then about three weeks ago reduced to 25mg each day. I agree that CRGH's dosage seems likely to be too high for most women.

Will be thinking of you this week as your embryos develop. Fingers crossed you get some good blasts x

@Janefx40 NET is just shorthand for norothisterone.

@2021ivfagain thanks so much for creating this new thread.

Sorry to hear of people’s cancelled cycles. I really hope you all find the embryos that work for you.

Sorry I have been quiet, I have been trying to take a complete break from thinking about ivf for a while. After the miscarriage was worried about my mental health. I have been doing acupuncture which is definitely helping my well being. And also been using excuses to walk to coffee places to force myself out of the flat. I live in central London so plenty places around so it’s been good to do that around working at home and getting 30-40 minutes of walking in a few days a week. I stopped going into the office as covid was spreading so fast (my boss seems to be turning a blind eye to me doing this, which is very helpful). My nutritionist advised a check on things like vaginal infections and Candida etc and everything seems elevated or a distinct lack of good stuff. Am having antibiotics already as advised by my consultant, will try some probiotics etc. am hoping it gets better as it could be linked with miscarriages. I have an endometrial scratch on 3 May and my next cycle should start soon after coming off Northisterone on 6 May. Am quite nervous about this round with our last day 6 euploid. Let’s see how it goes! Not sure I am ready to face it all again.

@2021ivfagain thank you for starting a new thread.

I had my 7th egg collection last week, we got two more mature eggs, these have been frozen.

I am preparing for the next cycle now, currently on Norethisterone and will also be oestrogen priming.

@Ivfhoper that’s good news on your egg collection. Have you had many breaks between rounds? I am waiting to do my fourth collection (on hold for 2 months due to covid & a cyst) which will be my third this year & we are considering doing another one or two after that. I feel like I’ve had enough already though!

@InvisibleDreamer

I have had 7 egg retrievals in 8 months. Sep 21 - Apr 21. I could not have egg retrieval in December because CRGH would not allow me to cycle.

I have a low amh so I really cannot afford to wait. If I had the choice I would pace myself. I am hoping that my age [32] will help me.

@Lola245
Hi. I was told by an embryologist that at 40 years old about 30% would make it to blastocyst stage. When I was 38, it tended to be between 40-50% made it to blastocyst stage. However, I’ve known people older than me who have had more blastocysts.

However, your fertilisation rate is good from first two cycles. I’m sorry you’ve had cysts.

@Ivfhoper
It sounds like you’re doing well to keep having eggs to freeze. I admire that you keep going and have so many retrievals. I’m starting to panic about my next two.

@Sarahk20000

Hi. I understand how you feel. I miss acupuncture, but I’m almost self-isolating since covid as I’m scared to get it again and delay my retrievals.

I’m starting to lose hope as I’m dreading the next retrieval. I might have to go back to acupuncture. I’m doing estrogen priming this cycle and stopped norethisterone yesterday at day 25, so should be starting soon!

I’ve also been making myself busy with working from home, looking after my son and cooking a lot of healthy meals. I stopped my dark chocolate, I was having a banana with avocado in a smoothie but stopped that now as worried about bananas. My diet is very good though: I make broccoli soup, chickpea burgers with tahini and sunflower seeds, I have chai seeds with porridge and blueberries. I’ve been eating avocados. I’m still eating low carb bolognese, ratatouille, stuffed aubergines, salmon and all with a range of vegetables.

As it’s getting closer to the stimming phase, I’m starting to panic. My diet has never been as good, but I think my age is the problem. I don’t think I could face another bad cycle.

I’m really sorry. I think what you’re doing is good. Working from home is good. Acupuncture is excellent. I do recommend taking a strong probiotic alongside your antibiotics: I take Probiotic Complex by Bettervits. I don’t know if you can still take it in pregnancy, but you could take it for a month now. It works quickly.

Good luck to you all. Xx

@2021ivfagain I can totally understand your covid position, the threat of delay constantly acts as a worry. I am so nervous all the time, despite now literally moving into self isolation I can’t avoid my husband and as he is a doctor he is seeing so many patients face to face. Fingers crossed we manage to stay away from covid. Your diet sounds excellent. I am not doing as well as you as keep struggling to get many veggies in! Good advice on the probiotic, my nutritionist has recommend some. I also understand the feeling of not wanting to face another bad cycle, fingers crossed this one is a good one for you, best of luck with it 😊
@Ivfhoper your resilience is great to get through that many retrievals in a row. And yes with your age can be hopeful for some good ones in there. @InvisibleDreamer multiple rounds really tests a person. I am not surprised you already feel like you have had enough.
What an experience ivf can be, let’s hope it’s worthwhile for everyone.

Hi all. @Lola245 I've been thinking of you - hope you've had some good news with growing to blast.

@Ivfhoper I'm impressed with your stamina doing so many rounds. Have you found the output so far to be consistent across rounds?

@Sarahk20000 totally understandable that you've needed a break. Sometimes you need to feel separate from the IVF for a bit.

I've had my three day update today from batching round two. It's been a disappointment. 10 eggs all mature, 5 fertilised and only 2 day three embryos frozen. Embryologists have no answers as to why it's panned out like this - eggs looked good and apparently the sperm sample was fine, although I'm concerned that my DH had a bad cold for weeks (not covid). Our first batching round last month gave us 15 eggs, 14 mature, 12 fertilised and 11 day 3 embryos.

I felt this second round wasn't going well throughout stims, but I was ignored - no consultant would speak to me. I'm not saying they should have cancelled the cycle, but the lack of interest and engagement from the clinic (CRGH) has compounded my distress. I'm wondering whether I should try Lister instead, but it would be a big deal to move at this point. I have my consultant follow up next week, but I can't imagine it will give me any answers. Rather fed up, as you can probably tell!

@Rosemarypots

Hi. I’m sorry you had a disappointing second round. As you know, my first round was really good, but my second was awful. In fact, I had nothing to freeze from my second round.

I’m sorry your husband had a bad cold. Did he have a temperature at all?

When I was in my 30s, I avoided back to back retrievals as I was with Access Fertility at that point and it was not allowed. I’m wondering if a short break might be better for you as you are younger. My reason for trying to do back to back or close together cycles is age.

I must admit that is not good you could not speak to your consultant. I had to as I was so upset, but had to pay for an extra consultation. It is difficult to speak to consultants. It’s much easier speaking to nurses.

When I did IVF for my son (first child), CRGH were amazing. I could not fault them.

I hope you have a good third cycle. Could you ask if a break is worthwhile? I know mentally I was not in a good place after my second round and felt quite depressed.

Hi @2021ivfagain, thanks for your message. Yes, my husband had a fever but it was only for one day, and the research I read online suggested that fevers that last for three days or more are most closely associated with a negative impact on sperm health. It's always a little bit of a gamble about whether to go for it each cycle or wait for the "perfect" conditions. I'm also terrified of either of us catching covid, so each month we don't have it feels like a win.

I'm frustrated with the clinic because there's no other service I pay for where I'd face so much disengagement having paid so much. For example, there's no way my financial advisor would treat me like this. You'd get more input and support choosing a bloody TV in John Lewis. I find the nurses to be generally kind and pleasant, but they aren't empowered to give their own view - they're more like healthcare assistants.

I've thought about delaying for a cycle, but my consultant via the nurse has told me to stay on norothisterone and she'll speak to me next week. I'm keen to crack on as I have an older child and already the age gap is a lot bigger than I wanted. The clinic insists that the outcomes of doing back to back are the same as when leaving gaps, but you do wonder.

@2021ivfagain which clinic are you with now?

@Rosemarypots
I’m also with CRGH.

Hope you have a good cycle next month. I know about the fear of covid.

I’ve woken up a bit worried this morning as I’ve eaten grapefruits (not many) and just found out they can interact with progynova but was not warned about it. I hope I’ve not messed up my cycle.

Anyway, I know how it feels wanting a sibling for your child. My son is 16 months old. I’m worried that time is running out for me.

Hello!

I’m 41, a CRGH patient and about to embark on a FET cycle so thought maybe I should join you guys. I’ve been on this ivf treadmill for a while and it’s quite lonely 😞

I batched over last summer which was successful. In total I ended up with 8 euploid embryos. I had an FET in November which resulted in a chemical pregnancy. In January and February I had further tests (Endo Quartet) and in March I had a hysteroscopy. Thankfully the test results were largely normal. I was due to have an FET in April but caught Covid on day three of my cycle so it was cancelled.

Today is my last day of norethisterone before what I hope will be my next FET cycle, but I keep developing ovarian cysts which have postponed my various treatments to date. So between the tests, the cysts, and covid even beginning another FET cycle will feel like a major achievement for me. I’m not holding my breath as there always seems to be something

Good luck with all of your cycles! I will follow your posts with interest.

@IUV1980

I’m sorry this has been a lonely journey. I know how that feels.

I think I’ve messed up my next cycle. I’ve been doing estrogen priming this cycle as I had a lead follicle last time which messed up my stims. I stupidly ate 2 or 3 grapefruits over a week when taking progynova and now it could have messed things up! I don’t know what to do. I’m starting to lose hope. First covid delayed this cycle and now I might have affected this cycle due to not reading the instructions carefully! Apparently, grapefruits can increase or decrease absorption of progynova. The problem is due to age my consultant won’t want me delaying any further. My consultant has already said this.

Plus my husband is getting fed up with the IVF. He told me today that he did not really want to go through IVF again with all the stress we have looking after my mum and dad who have carers due to health issues. My Dad has been in hospital twice since Christmas due to his massive stroke nearly two years ago.

I feel so stupid. The nurse called me today and said don’t worry, don’t eat anymore and I can start norethisterone again when I get my period or go ahead with the cycle and have a blood test at baseline scan. I never had this many setbacks last time I was doing IVF for my first child. My husband said he’s worried about the pressure of it all and is happy with one child as it’s hard work. Sorry but feeling very fed up. I even had two small squares of organic 85% dark chocolate but my diet has been excellent.