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.

@Sarahk20000 I’m sorry your family situation is so difficult. I get on with my husbands family but if they just decided to move in for months on end I couldn’t cope!

@2021ivfagain I don’t know from our reports which embryos became blastocysts however I’m sure your clinic could write a more detailed report if requested. I also don’t how many cells our blastocysts have we will just transfer the better graded ones first assuming we get some normals after PGTA.

@Lola245 I also saw recently someone on a Facebook IVF group who had 7 blastocysts from one round all abnormal starting to panic now that we won’t get any normals either.

@2021ivfagain I’m not sure when we will transfer as we are doing the PGTA. If we don’t have any/many normals we may do another collection round. I’d really love this to be our last collection but I’m not counting on it.

@Dochas12111 and @InvisibleDreamer thanks for your kind words, I just need to feel stronger in myself so others don’t bother me. @InvisibleDreamer you seem to be accepting the reality of needing more rounds to find PGS normals, hopefully you will get enough from the batching you have done so far. Sorry to ask but I think you also had failure with PGS normals before, if that is right, did CRGH not push you down donor eggs? Were they ok with more batching? Are you younger than I am? Reason I ask is I wonder if my consultant will give me the option of more batching.

@Sarahk20000 We had one failed FET and the second ended in mmc. We were quite naive during our first round and the clinic were confident one round would work so we didn’t do batching or PGTA. It’s hard not knowing why we lost the baby. I’m worried it’s to do with my immune system as I have long standing health issues & had some results prior to transfer that suggest that I may have an autoimmune condition. Our clinic haven’t pushed us to donor eggs yet I guess it will depend on the PGTA results. I’m now 39 I think my egg quality is ok but not great, I usually have 3 or 4 eggs that don’t fertilise and tend to lose at least 1 before day 3. Unfortunately OH has moderate DNA frag as well so between us things are not that great. We are with Create in the midlands.

Oh yes sorry I forgot you are at a different clinic. I had a miscarriage with a PGS tested embryo, no idea why that happens. Have your clinic done the NK cells etc tests? Plus ERA/EMMA/Alice? Worth doing it not already. 39 I think is still at a slightly younger end so if you are producing viable embryos they won’t push you down the DE route. Fingers crossed your rounds get good results.

Did anyone see there was a big article in the Sunday Times last weekend about IVF? It mentioned the astronomical costs, and the high failure rates. It mentioned a hedge funder who started a company called Gaia, where basically you don't pay past an initial amount if you don't end up having a live birth. And if you do, you pay the cost back over five years. gaiafamily.com/mumsnet

They've been advertised to me on Mumsnet. Has anyone looked into it? I'm skeptical but curious.

Also I've had some brown spotting today, I'm on day 19 after my failed transfer cycle. Have you guys ever had random spotting the month after a failed transfer?

Can I ask whether anyone has any thoughts on i). back-to-back cycles and/or ii). oestrogen priming? I need to make a decision on both of these in the next few days.

I gather oestrogen priming is generally used for DOR and poor responders, neither of which is me (my issue is all aneuploid embryos so far despite a good number of blastocysts). My eggs tend to grow in batches though and I potentially missed out on three last month due to this.

@TwinkleInMyEye123 I'd think you'd be fine with back to back cycles if you have good ovarian reserve. I did it last time and the second cycle was much worse, so I'm hoping that was because my body hadn't recovered, and therefore next time I'm taking a month off in between. Clinics seem to be mixed on whether they advocate taking a month off in between or not.

No advice on oestrogen priming - it was recommended to me because I have low-ish AMH. Have you tried taking DHEA?

Maybe try a different protocol? Cetrotide for example can impact egg quality. You could try flare? How many embryos were aneuploid?

@Lola245

What do you have instead of Cetrotide?

I've converted to natural modified so it won't be an issue now, but 20 of my embryos died and I was on Cetrotide.
This is very annoying why do they use it?!

@Lola245 I saw that article and looked up Gaia. They have a tool where you enter all your details (number of previous rounds, age, BMI, etc.) and they then provide you with a percentage chance of success for X number of rounds. I think my stats are fairly normal for my age, and was surprised by how many rounds the tool thought I needed for an 80% chance of success. I then got an email later to tell me I wouldn’t be eligible for the plan because I didn’t meet the threshold percentage. Having fiddled around with the tool with different ages and AMHs, etc. I think their requirements are quite strict and that they might be looking for young candidates (<early 30s). Definitely worth a go!

@TwinkleInMyEye123 Oestrogen priming seems popular in US clinics to promote even follicle growth, and seems to have success. I have same thing with a couple of follicles zipping ahead and my last cycle was cancelled because of it. I don’t know that I have low AMH, as had it tested at the end of my stims which have since found out is meant to make it dip significantly. Im having a flare type protocol with Buserilin for my next cycle to promote more even growth.

Sorry to gatecrash thread!

@Sarahk20000 I haven’t done the NK tests but I will be on pred anyway prior to transfer for other reasons so not sure if there would be a benefit. For me I don’t feel like there is enough reason for doing the ERA etc.. as was able to get pregnant on 2nd transfer last time. I may consider it later on if we don’t have any success.

@Lola245 ive seen the ads but not looked into it I think you don’t pay for unsuccessful rounds or pay a reduced rate but then if you had success after 3 or 4 you would have to pay for them all?

Sorry 18 of 20 died - I'm superstitious at the moment so I need to correct this.

@Lola245 sorry to hear you didn’t have great results from back-to-back cycles. This is what I’m nervous of. However I work in education so next month would be an ideal time for me to go again. My consultant is fine with this provided my ovaries appeared recovered at the baseline scan. I guess if it looks like a duff cycle I can always cancel (it wouldn’t be the first time I’ve done that alas).

We had 5 blastocysts from 19 eggs, all aneuploid. My best friend had much lower numbers but is pregnant now. Just goes to show I guess that it really isn’t a numbers game…

@IVFPrayingForBioChild that’s just awful. I’m so sorry. At what stage did they all die? I have had Fyremadel before rather than Cetrotide but don’t suppose that’s any help? It’s less itchy. Otherwise long protocol with no need for an antagonist? Those are probably both really obvious suggestions you and your doctors have already considered.

@Mouseorchestra7 AMH dips significantly when tested right after stims? Really? Why did nobody tell me this?! This might explain why I went from 16 to 10 between September and January but then had an AFC of 19 last month without retesting.

@IVFPrayingForBioChild drop off on embryos is actually very normal. Has your consultant flagged this as an issue to you?

for me out of 6 rounds of IVF we created 37 embryos and only 6 made it to blastocyst.

i was told that from any round of IVF the goal was to get one embryo and hopefully a spare. Not that all embryos would make it to blast. It does happen but it’s rare..

@Dochas12111

Thanks for sharing your experience.
I learnt about the drop off rate on these boards and independent research.
The clinic didn't prepare me for it.
It's silly but in my heart I think they were my babies.

@TwinkleInMyEye123 Yes, there are a few scientific studies to support it, as well as anecdotes (example: pubmed.ncbi.nlm.nih.gov/20729237/). It nosedives, and then climbs back up gradually after HCG.

Thanks @Mouseorchestra7 , that’s really helpful. My AMH was last tested in January less than two weeks after stopping stims for an abandoned cycle. I wonder how much that affected it.

@Lola245 I contacted Gaia and they said my 86 percent chance with donor eggs wasn’t even meeting their threshold. I wonder who does lol but they can offer 0 percent financing. i don’t get random spotting but my period lasts forever (14 days plus) after a transfer and has brown spotting towards the end.

I had my my consultant CRGH appointment today. And she said my case was baffling to them due to the failures with 3 normal embryos. It was just very hard to know what could be causing the failures especially as we got past implantation once. She said they will have a case review in the clinic on it. But I should also seek a second opinion outside CRGH. She said we had two options most probably surrogacy or donor eggs. She recommended 3 batching cycles again and freezing any resulting embryos. But transferring donor egg embryos in a FET. If that also doesn’t work out a few times, then using my own egg embryos in a surrogate. Whilst this all seems sensible I don’t think I have any more energy for batching and am overwhelmed with a surrogate option as worry they are legal mother etc. Am debating whether to pursue this option or trying a fresh transfer with ARGC and then reverting to CRGH donor eggs if that doesn’t work. I am so confused as money, time and energy are all depleted now.

@Sarahk20000

Your story is especially hard to read - everything is fine until implantation, all those tests!

You seem to have a lot of additional stress - in-laws, any way to cut them out, they must be affecting your physical being through your mental being.

Have you a quote from ARCG?
I tried Gaia as well, not in the hopes of them paying upfront, at 42 years old that isn't happening but for the 0% financing option.
£7,700 they quoted for ARCG, for 1 cycle.
I don't know how they can know the cost for certain.
I picked ARCG as that will be my last resort - I'm so put off by the way they are but if CREATE doesn't work out the will be it.
How can you go about surrogacy in this country?
Does the clinic help you find someone?
Thanks

@Sarahk20000

Hi. I’m sorry that the consultation was not as you had hoped. I really think ARGC might be your best option. In my experience, when they say they will do a case review nothing much happens.

Do you still have endometriosis? I don’t think they have looked into this enough. Did you have an ERA? Frozen transfers are very difficult to get right irrespective of anything else.

If you did stay with CRGH, are you 100% happy with your consultant’s support? I know you don’t want to have a different consultant, but Dr Seshadri is head of clinical research. She’s also very approachable and has lots of positive reviews.

The other option is Access Fertility but there is no batching allowed. You just pay upfront, do a cycle and the cost includes unlimited transfers. You pay for two cycles which includes all monitoring. You could do a fresh transfer and then anything else you get you could PGS test.

Thanks @2021ivfagain and @IVFPrayingForBioChild . Yes it’s really confusing. I am thinking ARGC if they take me and then trying with them and if it doesn’t work come back to donor eggs in CRGh. I think surrogacy is difficult in this country and the legal basis makes me very nervous. I did have ERA testing done. I have mild infection and silent endo. Let’s see. And to top it all I tested positive for covid today. I think I have been out and about too much!

@Sarahk20000

Hi. I’m really sorry you’ve got covid on top of everything! You need to take some time for yourself to rest and get better.

I think ARGC is going to be good. If you have to go back to CRGH, I would definitely see the consultant I recommended. I’m sorry you’re having a difficult time. ARGC treat women in their 40s a lot and your levels are good so that should not be a problem.

I understand about the surrogacy issue. That sounds difficult.

Is your ARGC appointment next month or the end of this month?

@2021ivfagain ARGC is 20 July but is reliant on CRGH passing my files onto me. They have said they have a month so can’t guarantee it until 22 July! Annoying, as I am sure it’s easy enough for them to transfer over. It’s confusing for me because if I did want to take the CRGH offer of batching every day is crucial and I could potentially start my Northisterone next week. My consultant said to ignore the 28 day rule following covid. But I just don’t know if I want to do any more batching with crgh but am worried if my FSH isn’t good and ARGC doesn’t let me cycle I will have wasted time. Am just so confused. I will be receiving a contract from crgh and payment etc in next few weeks so need to decide what I am doing atleast in the short term. the only sure part is I want to get into CRGH donor list incase my own eggs don’t work out soon.

btw has anyone had DHEA. I remember some chat on this forum on it I think. My consultant has recommended it and given me a prescription. Where do I buy it from?

@2021ivfagain how is your dummy run etc going? What dates are you now working to?

@Sarahk20000

Hi. CRGH are dragging their feet. You’ve got time to decide which option to take.

I took dhea and felt ill with it. It didn’t help me at all. It was my worst cycle. Nothing fertilised but it can work for some women. It might be worth starting on a low dose like 25mg once a day. I also had cetrotide which affected egg quality as well. I would ask about melatonin as that can affect egg quality. Wheatgrass is good for bringing down fsh if not too high. It tastes awful but I take 15-30g a day 30 minutes before evening meal. I also take 200mg ubiquinol x3 so 600mg a day. It might be worth getting vitamin d checked: I take 3000iu plus 800iu from pregnacare.