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 Thanks for the message. I'm sorry to hear about the cancelled round. Whether I PGS test depends on how many blasts we get. As I've got pay the same fee for up to eight, I'm not going to test until/unless I have enough to make it worthwhile.

Re: ARGC. Short answer. I never did a cycle there. I fell pregnant naturally shortly before I was due to do my first IVF cycle. We're pretty sure that my unexplained infertility is caused by a very rare (autoinflammatory) disease, which happens to be somewhat treatable with Humira. It turns out that ARGC are very poor at dealing with women with rare undiagnosed immune diseases and, as such, we've been using Dr Gorgy to do immunes and having our IVF at CRGH.

@Rosemarypots I had four eggs over 13mm. I had two lead follicles that were already 15mm by my first scan, and they apparently suppressed everything else, so I ended up with three giant cysts (4mm, 3.5mm and 2.5mm) by egg collection day and all my other 8-9 follicles stayed small.

Has anyone heard of Low Level Laser Therapy (or Photobiomodulation Therapy) treatment for infertility? I just came across it on an Instagram post, but then doing some research it seems possibly legit (and no side effects or discomfort). You get the treatment during the two weeks leading up to egg collection. But it's 6 sessions for £1200 at this clinic on Harley Street...

www.lasermedicine.co.uk/how-to-improve-egg-quality/

They referenced this study which shows impressive results in women over 35, but it's not an objective study: www.ecronicon.com/ecgy/pdf/ECGY-08-00402.pdf

Curious to hear any thoughts on this! I feel like I'll try anything...

@Lola245 hello I had LLLT. My acupuncturist used it on me. At the time she didn't charge extra - the laser was part of her standard acupuncture session (£80). So if you're interested, it might be worth making an appointment with Eva Stecz at The London Acupuncture Cljnic on wimpole street

Hi everyone. Am here today with a strange request. Can I ask anyone who has spare noresthisterone to PM me? There is a National shortage and I am 7 tablets short. I am prescribed it like most of you at CRGH.

Am going into my final ever transfer round at CRGH and have been using noresthisterone which has been working for me and has stopped me ovulating too early. They are using Provera instead but I don't want to change anything if I can help it for my ever final cycle.

@Londonwriter sorry you've not had a good round. It can be so variable and very hard to know if this is age related, protocol related or just random. For me personally I wanted to get as many eggs as possible rather than do mild and get fewer. I know people think that this can help with egg quality and they may well be right. For me though I felt it was more of a numbers game (but I was 43 so much older than you fertility wise).

@Janefx40

I also would prefer to use norethisterone. I used provera but I did get spotting and then heavier. I much preferred norethisterone. The shortages are terrible: I can’t do my last ever cycle with buserelin as there is a shortage of that.

Provera can be good as it can induce a period which is the same as norethisterone. Are you doing a natural modified FET or medicated? Good luck with everything. I know how difficult IVF is. I’m at the end of the road with it all and just want to transfer now.

I regret not doing a transfer last November when I wanted to do it but consultant discouraged me.

@IUV1980 Interesting - did you think it had an impact on your round? I'll look into her. The science and studies seem pretty sound and it certainly sounds like it can't hurt, it's just the money... I think I might try it - I just really need this next round to be more promising since I'm back to square one.

@Janefx40 Sorry I don't have any norethisterone either. These shortages are crazy. But hopefully provera works just the same for you. I'm praying that provera succeeds in allowing me to have a normal 28 day cycle this month, since I've had two months of short cycles so haven't been able to start IVF again all summer.

@2021ivfagain thanks for responding and for not judging me for my question! I nearly got banned from FB for asking the same thing! It's so frustrating as I am prescribed it but just can't hold of get it!!

Noresthisterone is thought (though unproven) to prevent your body recruiting a follicle too early. I'm not sure if it would be the same with Provera. In one of my natural FET cycles, my follicle charged ahead - it was huge already at baseline and this didn't give my lining long enough to thicken. Noresthisterone possibly helped or maybe it was coincidence. That was why I wanted it.

Yes we are due to start another FET after this cycle. Our first euploid embryo failed. This is our last ever embryo. Our first FET with this one was cancelled due to thin lining (not usually an issue for me). Our second was due to go ahead and then I got Covid. We now have to decide whether to do another natural or switch to medicated. It's just been very hard.

Sorry I haven't had the headspace to share more and interact with this thread. I do follow but sometimes you have to step back a little.

Wishing you all good things x

@Lola245 it's impossible to know whether or not it made any difference… After a very bad round at ARGC, I moved clinics to CRGH. And I did a lot of stuff to try and improve my chances with CRGH: diet changes, lots of supplements, acupuncture (which included cold laser) and of course I was on a totally different drugs protocol at CRGH and we used my partners frozen sperm from when he was 15 yrs younger. I had two good batching rounds that resulted in 4 and 5 blasts respectively at CRGH. And I was v lucky that the majority were also PGS normal. So it was successful for me - but I have no way of knowing which element made the difference. But like you, I just threw everything at it in the hope that something worked. I'm not sure I would have paid £1200 for the laser, but was v happy to have it as bonus during acupuncture. My acupuncturist told me anecdotally that some of her clients do you think it made a difference to their cycles and she has certainly read all the studies, so would be a good person to talk to about it.

@Janefx40

I understand. I was so depressed after my cancelled cycle but have been so stressed.

I wish I could use norethisterone. It always worked well for me. I was told it suppresses ovulation. I think provera lengthens a cycle. For me, it lengthens it to 28 days but it can cause spotting. Have you done an era?

It is such a hard time. I’ve only got one more stimulated cycle left but can’t use flare anymore. I wish I could get hold of more buserelin and norethisterone.

In the medicated cycle, you could take cetrotide to suppress ovulation.

Good luck

@Janefx40

Just a thought for natural cycle. Could you take estrogen and provera just for 5 days to lengthen and suppress cycle for FET?

@Janefx40 I wonder whether that's why I had the huge follicle on my cycle. The first time I used norethisterone. My cycles are extremely regular so I had no idea why I was taking Provera in the first place and my period started about two days after I stopped taking it, so it was a bit pointless anyway!

@Londonwriter I don't think I was that clear - the noresthisterone prevented me from getting a follicle that was large at baseline. Or we think it did (you can never really know since cycles vary).

However during my banking cycles I think it did also help to make sure I started with even follicles. I also had one or two much bigger in my first banking round and I think that impacted on the final outcome of that round.

As I'm doing FET it doesn't really matter for me how big the follicle is at ovulation but it matters that I don't ovulate too quickly so having a large one at baseline isn't great as it shoots off and ovulates too soon - if that makes any sense!

Good news is I rang round a lot of local chemists and found a box!!

@IUV1980 I can relate to the lifestyle changes. I did a lot of changes to diet etc before my banking cycles but have no idea if it helped. I hadn't done much of that when I had my successful round. It's so hard to know x

@Janefx40 Are you based in London? If so could I ask what chemist had norethisterone?? Great you found it!

Not in London I'm afraid. I got it in a chemist in Berkhamsted near where I live. I asked if they had any more but I think they just have a split box of 15 or so left.

I called about 3 or 4 chemist before I found some.

Hi, can you swim whilst trying to TTC or IVF? The water can't cause infections etc can it?
Do you double up on swimming bottoms?
Thanks

@IVFPrayingForBioChild they don't usually recommend swimming after you've had a procedure. So probably not after egg collection or transfer. I'm not sure about during stims. I don't think doubling up swimming bottoms would help much though. Are you going on hols or just fancy a swim?

@Janefx40

Going to see the in laws in Marseille - so needed to get a bit of swimming in, in the UK before showing off there - looks like I need to thoroughly research this too.
Everything has to be researched!

Hey sorry guys been missing the thread as been so busy. Been attending to my mum due to her fractured arm after a fall, work is busy and then trying to sort the monitoring cycle with ARGC. Am feeling a little overwhelmed as just also had some staff complaint against me so that is adding stress (I really hope IVF outcomes aren’t genuinely impacted by stress levels) I really want to take time out of work and do ivf but keep thinking it’s what is paying and my husband won’t play along if he is paying for it all and secondly any career break will impact any potential maternity leave . @Janefx40 best of luck with the FET. It’s really nice to hear from you after all this time, also glad you found some Northisterone. The shortage is worrying. Whilst it’s my most unfavourite meds in terms of side effects I am very reliant on it to get the withdrawal bleed on time; ARGC don’t seem to use it though. The ARGC experience continues to be a good one, the attention to detail is better than my CRGH consultant so far - albeit the old looking waiting room and hand written invoices really takes some getting used to lol but once in touch with people there they all seem so on top of stuff , helpful and kind. Getting consultants to answer questions is not a problem. They let my husband off from his sperm fragmentation test and ultrasound, which was handy. I got him to sort all his bloods and sperm analysis in one day so he needn’t go into clinic again for a while. The sperm analysis was good this time. Strangely two years ago there wasn’t any motility and low count but this time it seems ok. My AMH was 18.5 so it’s come down by 1 in 2 years as it was 19.6 then. The DHEA test came back low so I have to have some twice a day at 25mg. Let’s see how rest of monitoring month goes, am a little worried about prolactin as I always have it high. Still waiting for a period so can start it. Really hoping I manage to do a fresh transfer next cycle in September so can get past the ARGC journey. So rare for success at 42 with one cycle so it feels a bit pointless doing it but I will try my chances. CRGH did offer us 8 donor eggs but it was a Brazilian donor and my husband preferred a Caucasian donor due to my mixed British heritage. Let’s see if they get us another match but some signs of progress there. I was actually wondering if ARGC is a very good experience would I be able to transfer these CRGH eggs over to their clinic.

@Sarahk20000 hello! Glad ARGC is good so far. It's much less professional and clinical but far more supportive. The nurses will give you endless time. And yes there is much greater attention to detail in terms of the treatment than CRGH which is a bit by the numbers. Yes you can transfer embryos to there from another clinic. I have done it before. But wait and see if you like it first.

If you ring enough chemists you will probably find some noresthisterone. I tried smaller ones. Fingers crossed.

Sorry about the complaint at work. It's difficult not to feel stressed but try not to take it too hard. These things happen and it isn't life or death. Sorry about your Mum's arm too. It's all happening at the same time for you.

Xxx

Actually have some good news for once! Out of our 6 embryos 4 are PGS normal. Can’t actually believe it!!! So no more embryo banking. Am really really relieved. Unfortunately can’t do transfer yet as I’m really unwell with a flare up of digestive/intolerance issues & my consultant is concerned about about my possible immune issues so I’m going to make an appointment with an immunologist. There aren’t any reproductive specific ones in our area but hopefully they can still help. I’m just worried that my health may not improve as been this way for a month now.

@Sarahk20000 If you feel you need a break could you schedule some relaxing time on the weekends? Such as a spa day or even just a candle lit bath & a face mask. Could you also take a bit of holiday if you need to during the IVF? Sorry about the complaint people seem to have become a lot less tolerant and pleasant since the pandemic sadly :(.

@InvisibleDreamer wow this is fantastic news. Congratulations. It must be a relief to know you are done banking.

I go to CRP in Epsom. Lots of people travel there from all around the country. The other main specialist is Dr Gorgy in London. Coventry is the other big reproductive immunology centre. Whereabouts are you based?

@Kelb79 this is the current thread. You posted on the old one which is now full so I can't tag you there x

As the name suggests I'm crestfallen.
I need some advice - my consultants have no ideas, nothing.

Cycle 1 - mild IVF - I got a few embroyos - however, only one made it which was frozen at Day 3 - 12 cell - no fragmentation.

Cycle 2 - mild IVF - I got a few embroyos however, only one made it which was frozen at Day 6 - 9 cell - no fragmentation.

Cycle 3 - Narural IVF - no stims except Tamoxifen - 1 egg that matured, fertilised normally - day 3 it is only 5 cells and grade 3 fragmentation.

How can my Narural cycle embroyo with less stims be worse than the medicated cycles?

Partner had no sperm DNA fragmentation.

I was at least hoping for one embryo that would have been a good cell division and no fragmentation.

I can't understand how the day 3 cell division is falling each month as well as the 1 natural cycle being a disaster.

I have no hopes that this will make it to Day 5 and frozen.

Does this mean I need high stimulation?

@Janefx40 thank you. Yes I won’t jump at moving embryos and might split them with both clinics for transfers. Let’s see how I get on with ARGC and let’s see if I even get to an egg collection and transfer. But so far they are feeling more relaxed and supportive.
@InvisibleDreamer What incredible news, so pleased for you. Fingers crossed for when you get to your transfers 😊
@CrestfallenBadEgg How old are you? Is your AMH/Follicle count low? Sometimes a different form of protocol works for people. For example a short protocol didn’t work as well for me and I didn’t get any blastocysts using that. Maybe a change of approach could give you a better outcome but it depends on your basic hormone/egg numbers.