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.

@Lola245

Hi. I’m sorry you’re getting delays. I had never had spotting before but I did this time. It did improve but it can happen when fsh is high or you don’t ovulate.

My stress levels have been through the roof. I think I had a month when I didn’t ovulate.

Fsh was high. I did estrogen priming but it was compromised by caprylic acid and I think heat which spoilt my medication. I’m not doing well. I’m only allowed one more cycle of stimulation. I’m repeating it next month. If it’s not in range, my cycle will be cancelled. The only chance them will be the 9 day 3 embryos.

I’ve been an emotional mess and so devastated. It’s a double blow: the thought that I might not have another child and my high fsh. It started getting high in January. It can accelerate so fast.

@Sarahk20000

Good luck with everything. I understand your lack of motivation. I think part of me just wants to live again but I understand how you feel. It’s so hard once you get to 40 and above.

I know a friend of mine was lucky at 43 nearly 44 and she was struggling when I got pregnant and now she’s doing better than I am. She’s nearly 45.

@Janefx40 so very nice to hear from you. Hope you are well. Yes it will be a different experience from CRGH, let’s see!

@Lola245 Sorry you are facing potentially more delay. I am waiting for my period post the withdrawal bleed after FET. My withdrawal bleed lasted 3 weeks but I am getting period like symptoms at the moment so maybe it will come again in my usual 32 day cycle.

@2021ivfagain sorry you are feeling so devastated. This is all very difficult. You may want to consider speaking to a counsellor. I keep debating it myself too.

The ARGC consultation was quite interesting. Sapna did seem to have read all the notes from CRGH, which was very impressive as she only got it an hour before the meeting!! She seemed very on top of detail, more than my CRGH consultant ever has. They have said they will put me through their monitoring cycle, albeit she doesn’t think I will need the hysteroscopy again. So let’s see what that brings. Her initial view was that because we are still producing PGS normal embryos and that my AMH was good, I should still try with my own eggs. She said we had the option of banking 2 cycles or one fresh transfer. I said to try something different I would prefer a fresh one, though I feel very nervous about blastocysts with chromosome abnormalities. She said at my age we could put 3 in if we ever got 3 blastocysts. She was concerned that I may need Humera for a while so maybe the banking may be better whilst waiting for that to work. She also said my husband and I should both try and reduce our BMI. She also recommended PICSI rather than IMSI this time. She said they do short protocols and talked about the intense daily monitoring. I live 1 mile away from the clinic and work is near too so am hoping I can manage. My problem more (if we get the go ahead and hormones still ok in monitoring) is my husband. He was livid after the meeting and said we are just throwing more money at low success options, so I am really worried about his constant irritation and anger at the money we are draining and the intensive appointment schedules etc. i am really pushing him but it feels very difficult as he is completely against it. My mum has just had a fall last wee and a few fractures etc so I am having to attend to her (and she is very frail as age is hitting in) and my job in September October when new government comes in will be very crazy so I am just feeling a bit overwhelmed overall.

Sorry I should have said with anyone with ARGC experience, if you can please give me any tips on best managing cycles with them I would be really grateful.

Btw the one thing that also concerned my husband was that Dr Sapna was mentioning the cancer and other risks of multiple cycles and how I was on the wrong side of it. That spooked me a bit. CRGH have never directly said this.

@Sarahk20000

If I can give you one piece of advice, go with argc and do a fresh transfer. Avoid PGS and batching. If I could go back in time last year when my levels were good, I would’ve just done a fresh transfer.

Please don’t delay. You have a good chance. Fresh is best.

This has confused me
I was told that frozen is better.
What are other posters experiences on this?
Thanks

@IVFPrayingForBioChild

The uterus is more receptive with a fresh transfer so implantation rate is higher. Also repeated batching is stressful.

ARCG - how does it work with them
Do they expect you to be in their clinic everyday from opening to closing times for the duration of the protocol? Say 2 weeks?

If you WFH was it possible to tether your phone to your mobile and just work in their waiting room minus any meetings?

Or, can you rent a desk nearby and they give you some notice if only an hour to say they need you to come in for xyz tests?

Thanks

@2021ivfagain What is caprylic acid? I'm sorry you are having such a hard time of it all. The endlessness of batching is really hard. But 9 day 3 embryos sounds like a lot to me! It will take me ages to get that many I'm sure. Why not just develop those to blastocyst now? (Sorry if you've explained this already - and I'm sure you just want to make sure you have enough.)

@Sarahk20000 what do you mean about cancer? As in a risk from IVF cycles?

In terms of fresh vs frozen: i have to say after this experience, of it taking several months for my cycle to return to normal, makes me not want to have another transfer until I feel we have a better quality embryo, so maybe it will make me re-think PGS testing. I just can't help but think if back in April we hadn't gone for a transfer with two low-quality embryos, but instead did some more rounds, we'd be in a better place now. Instead we had to wait 7 weeks to transfer two low-quality embryos that had a low chance anyway, and now it's been over two months of my cycle being out of whack. At least this period feels 'normal', like a full period, but it came on day 21. I've always had 28 day cycles. So this transfer has been more like a four-five month process...

@IVFPrayingForBioChild i haven’t got experience of ARGC yet but am assuming it will be very fully on. A friend of mine said she had to go everyday at a point in the egg collection round at 0730 but was only called back in afternoon twice. But others on the board may have more experience. On frozen vs fresh I don’t know if one is superior over another. My experience of batching, like others on this board, is just it seems to take a longer time to get to the same result as a few fresh rounds.

@2021ivfagain yes I think that is what I am going to do. I have tried batching and it hasn’t served me as well.

@Lola245 yes the egg collection rounds and risk of cancer. The consultant said at 5 rounds now I would be on wrong side of how many I should be doing. I have heard of people having a lot of rounds so don’t know how much a risk is really is but the mention threw me a bit.

my husband is being so difficult. aRGC has asked for a testis ultrasound, dna fragmentation and sperm analysis. He is refusing to do anything except the analysis. I have had to write back to Dr Sapna asking if we can do away with the others and can she just assume fragmentation. She won’t be impressed. She asked my husband to have Impryl and we have it in house and he won’t touch it. So I think I am literally on this journey alone and he is going to make it much harder. Let’s see what the consultant says.

@IVFPrayingForBioChild with ARGC in week 1 you do bloods every morning. The blood clinic opens at 7:30 but you don't have to go that early. Then on some days they will also ask you to go for an early scan. If you go early you can be done by 8:30/9am. They call you in the afternoon to tell you what drugs to take that day.

In week 2 you do the same but need to be within 30 mins of the clinic until they call you with results (around lunchtime usually) as they may call you back in for more bloods. To be honest that only happened to me once.

So it's actually ok and because of their early morning bloods easier to fit around work than other clinics in my experience.

Sorry to just pop up to talk about ARGC but nothing else going on in my depressing story! In summary endless cancellations.

@Sarahk20000 I'm so sorry about your husband, that must be so frustrating. Given that the majority of IVF stress falls on the woman getting treatment, it is annoying how difficult partners seem to find it. Taking Impryl is the easiest thing in the world though, and couldn't the semen analysis and dna frag be the same test? Do you think he doesn't want to do it since he's worried he might be causing the problem? What would he prefer you guys do now instead of trying another round with your own eggs? I'm really sorry - not what you need!

Could I ask what your recent AMH is? Just curious what ARGC considered good.

In terms of fresh vs frozen I was given the impression that there is little difference in success although the IVF calculator by Uni of Aberdeen gives much higher success rates if you put in you have had a fresh transfer previously so I don’t know what that means.

In hindsight we would all have done things differently if we knew our choices weren’t going to work but the opposite choice may not have worked either! It’s just a total gamble isn’t it.

Our PGTA results have come back really quick so booked in end of next week to find out the results. Realistically we will be lucky to get one or two ‘normal’ embryos but I just feel like that’s not enough to get to live birth. Any subsequent pregnancy will really be a test to see if I have significant immune issues. I will be on steroids again but not convinced this will be enough to prevent another miscarriage, that is if we even get that far.

@2021ivfagain I’m sorry your cycle is being delayed 9 day 3 embryos is a good number though.

@Sarahk20000 I’m sorry you husband is not being supportive perhaps he is finding the idea of more treatment hard? The expense and commitment is daunting especially when there are no guarantees. The DNA frag & Sperm Analysis just require one sample so at least you can get those done.

@InvisibleDreamer @Lola245 The fragmentation test is not in the clinic, she has referred us. So that’s why two samples. The ultrasound he just doesn’t want to have. I said I had to go through all sorts of invasive procedures. A few seconds of someone putting an ultrasound on his testicles is surely
not the end of the world but he has categorically refused 😞 and i really hope the clinic let us bring a sperm sample from home for tests and egg collection as he won’t proceed if they don’t as well. Yes Impryl is not hard to have and he eats others meds like his diabetes ones which sit next to it 🤔 I think he may be bothered about results but he is more bothered about inconvenience. He says he doesn’t strongly want children and as I am dragging him on this journey he wants least impact. Good luck with your results @InvisibleDreamer.

@Lola245 i haven’t had my AMH done again. Will go into a monitoring cycle now
with ARGC where they check everything is ok. AMH was 20 two years ago, let’s see what it is now. But need all my hormone results to be ok before they will confirm treatment.

@Sarahk20000 sorry about your husband. It's hard when they disengage but not unusual. Mine can be the same. I'm sorry things have been so tough since we last spoke.

@Sarahk20000 I agree with @Janefx40 my OH tries to pretend that it’s not happening. He won’t even join me on zoom appointments with our consultant. It’s his way of coping but I feel it’s unfair as I then have to deal with everything. I don’t think it’s mentally healthy either so not sure it will do him any favours in the long run. I think with it being male factor issues for us he would prefer to live in denial. I think women are just better at dealing with emotions and have more emotional resilience.

@Janefx40 @InvisibleDreamer thank you, I think you are right. For us we needed IVF to start with due to male factor too. No motility and a low count. Oh well let’s see if he comes round. Hope dr Sapna indulges him so I can have a peaceful life. I am waiting for my period now so I can start the monitoring cycle. A new clinic will take some getting used to. Have taken them up on offer for complimentary session to talk about intro next steps on Monday.

Btw would you write to the CRGH consultant to tell them what I am doing. I feel I should as I didn’t sign contract for the 2 batching rounds albeit did sign up for donor eggs.

Sorry to gatecrash this thread it seems like the only active one with multiple users that have had experience.

I need to make an urgent decision by tomorrow morning whether I should cancel my egg collection or not.

I'm with Create and purely on Tamoxifen.
Started period last Saturday day 1.
Started Tamoxifen day 4, twice a day, 20mg tablet each. 40mg total a day.
I've got one follicle about 13-14mm and a few smaller ones.

The clinic are pressuring me to cancel as it hasn't reached 17mm. And it was 13mm on Friday and 13-14mm on Saturday.
They are saying it is slow growing so I should cancel and it won't make a good embryo.

Is this true slow growers make bad embryos?

I don't mind there is only one main follicle as I have had bad egg equality and wanted to stay away from daily injections which I feel didn't work for me anyway.

I don't want any 'what-If's' - this 13mm on Saturday could still be a good embryo.

Any experience of this situation?
Thanks

@IVFOneOffPoster Different circumstances but I have a toddler right here from a very unlikely seeming cycle which came close to being cancelled.

Other than money, what is there to lose?

@TwinkleInMyEye123 sorry you're going through this stress. I don't know anything about cycling with tamoxifen or mild IVF. You're only Day 9 today so 13-14mm would normally be fine but it could be different expectations on tamoxifen, I don't know. Can you ask to do a couple more days of scans before you decide?

@IVFOneOffPoster sorry tagged wrong person!

@IVFOneOffPoster Why not wait a few more days to see if it catches up, especially if you're only on one drug? You can still cancel up to day 12, or whenever you take the trigger shot. I'm not familiar with tamoxifen. I had one round cancelled which was mild IVF - not enough follicles and they weren't really growing. i was happy to cancel since then we didn't have to pay for the round, only the drugs (which was quite alot though!) Is yours a natural or mild cycle? Have you ever done a normal stimulation treatment before?

Hello everyone,

Just joining the thread for some advice and support as several of you seem to be at CRGH and doing embryo batching. I'm 42 and have a two-year-old DS from a freeze-all PGS cycle at CRGH, and a five-year-old DS who was naturally conceived following immune treatment at ARGC.

I've just finished a second freeze-all cycle at CRGH and it was completely different from the first one. First time around (at 39), I got 12 eggs, 7 mature, 7 blasts, 6 suitable for freezing and 1 PGS normal. This time I got 10 follicles, but only 3 eggs, 3 mature, 2 blasts on Day 6, but only 1 suitable for freezing.

My consultant has apparently changed my protocol for another cycle to something a bit like mild IVF with the aim of getting more eggs/blasts. Just wondered if anyone had experience with this? We are going to go to a CREATE seminar, as well, as I don't know whether to change clinic.

Hi @Londonwriter, I'm sorry to hear about your second cycle. Do you know how many of your ten follicles this time were 13mm and over on trigger day? Generally, only those sized follicles contain mature eggs.

One of the many tricky things about IVF is the cycle to cycle variation. So in my first batching round, I had eleven day three embryos to freeze from 14 mature eggs. In my second batching round, one month later, I had two day threes from ten mature eggs. If my first batching round has been the one that gave me two day threes, I'd have been really upset and convinced my fertility had fallen off a cliff.

You did incredibly well in your first round to get six freezable blasts from seven fertilised eggs - the average is more like 40-50%. But then your euploid rate was lower than might have been expected (although great that your one seems to have worked!).

As you'll know, sadly age-related decline does tend to accelerate from 40, so some of the difference in your two rounds might be due to time passing.

I don't have personal experience of mild IVF, but I know it can be a good option for some women looking to improve outcomes.

@Londonwriter Not to be discouraging, but I did a round of mild IVF at CRGH and it had to be cancelled since I didn't respond well at all. I'm 40, have a 2.5 year old naturally conceived, but we've had to do IVF to try to have a second. I had one okay round at CRGH (6 eggs, 4 day 3s, 2 low-grade blasts) and one bad round (only 2 eggs, 1 day 3, no blasts), so after the bad round they suggested mild IVF, and it had to be cancelled. But some people have better results that way so it seems worth trying, and if you cancel then obviously you don't pay for the round. Are you going to PGS test this time? And why out of interest did you switch from ARGC to CRGH, given that you had good luck there?