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.

@Rosemarypots Im sorry for what you’re going through. We’re trying the lister for Zymot. Fertilisation wasn’t a problem. All the eggs fertilised in my case. It was the blast quality that was poor. I read that Sperm with dna frag can still fertilise eggs.
Husband has an appointment with urologist tomorrow.

@2021ivfagain thanks for the tip! He’s started taking impyril and Ubiquinol. We made list of treatment options he’ll run them past the urologist tomorrow. We plan to pgta but want to see what combination of treatment will give us the best results:
Zymot, icsi, picsi, imsi, retrieval from testes, leaving a 2 hour gap between ejaculation. I thinks that’s all I know of.

@birdbybird

Hi. My husband also took vitamin c 1000mg, vitamin d 2000iu, Nordic DHA xx 2 a day, l’carnitine, lycopene, 30g wheatgrass, ubiquinol 200mg (but can increase your 400mg), Wellman’s tablet and 600mg alpha lipoic acid.

@birdbybird

My husband was told to ejaculate every two or three days. But I think optimal is every two days.

@birdbybird sorry to hear about you embryo but better to find out rather than do a wasted transfer. What is a zymot chip?

@2021ivfagain I was wondering how you got on. Such a shame they wouldn’t at least let you try an embryo transfer but I’d like to think they are basing the decision on a lot of knowledge and experience. I think that embryo banking ought to be the standard approach for 35 and above knowing now how long cycles can take. My understanding is ERA is only really relevant for recurrent implantation failure so it depends if that’s your issue? I’m not doing ERA as I had one embryo implant and I’m skipping Alice & Emma as antibiotics upset my gut health which I think just causes more inflammation so for me the treatment for any imbalance may cause more problems than it solves. All the endo they found was removed during the op I’m not sure what other treatment there is. I don’t have follow up until 18th Nov.

@Sarahk20000 sorry about your duo stim round but donor eggs sounds like a good plan and as you say it gives you a chance to get yourself feeling healthy etc… whilst you wait

@InvisibleDreamer

Hi. These are my last day 3 embryos. The antibiotic would only be for one day. I’m taking lots of probiotics so I don’t think it would be too bad. The reason why my consultant is advising era is because these are my last ones from my first cycle. He does not even advise PGS testing now as I will probably only get two or three blastocysts.

My gut health has been much better since I have been drinking kefir every day and on prebiotic and two probiotics. I used to get bad ibs.

I only had success when I was 38. I did a fresh transfer of two day 5 blastocysts and one stuck, my 22 month old son. We were dealing with mfi. I had good hormone levels at 38 and even until 40.

I think banking is good if you know you will have lots of blastocysts. Otherwise I believe it’s best to transfer as you go. I wanted to do a fresh transfer but was refused.

I have 7 day 3 embryos left from first cycle last year. The 4 that they thawed produced two day 6 blastocysts: one was 6CC and other 6CB-. The c represents lack of inner cell mass which forms the baby. If I had had 6B-C, they would have done the transfer. It’s ok for placenta to be a c but not the inner cell mass that forms the baby.

@InvisibleDreamer a Zymot chip was suggested to us as a way around sperm fragmentation issues. I have an appointment on Thursday to find out more.

Hi everyone, Good to hear how you're all doing though sorry we aren't all further along.

@Rosemarypots I'm sorry this must be so stressful...but keeping everything crossed the pregnancy will be okay. I had a friend who at her first scan was told there was no heartbeat, and she's now about to give birth, so it can turn around. I really hope it will.

@Sarahk20000 I'm sure that some peace comes from moving on from your own eggs, and I wish you luck. I actually just spoke to the CRGH egg donor person since I started feeling quite hopeless after my last cycle was cancelled, and I liked the sound of their programme. They said the waiting list is 3-6 months which I didn't think was too bad, and with fresh you do have higher success rates. I like the idea of UK donor so it's non-anonymous, but maybe that's the case with ARGC and Cyprus's egg bank.

@2021ivfagain I'm sorry you haven't had more luck so far, but do remember you have those 7 day 3 embryos. It's still a lot of chances. Why don't you just want to thaw them now?

@birdbybird My husband has high DNA frag too, so we had a consultation at the LIster and I was intrigued by the Zymot. But CRGH says it isn't evidence-based. My husband's comet score improved a lot just with lifestyles changes and Impryl. It's worth seeing Dr Ramsay - he also gave my husband antibiotics. Really hoping it makes a difference if I manage to get more eggs. We had perfect fertilization but low quality blasts.

As for me, I was pretty ready to give up on IVF and were just going to go back to trying naturally and hope that if I'm still ovulating there's a chance (oh - my AMH has declined from 12 last summer to 1.5 at last check - disaster). Last month I had only one follicle growing, and we cancelled the cycle. I had recently had covid and a health scare, and my consultant said maybe the stress was a factor (and maybe impacted my AMH? Though who knows). So we're doing one last try with mild stims (which I tried once before and was also cancelled, so I didn't have high hopes). I just had my first scan and had 7 follicles growing in the left ovary (only 2 small ones on my right). I realise that's not amazing but it's actually more than I've ever had on day 6. So who knows, but I was definitely surprised--I'm so used to getting bad news. But maybe removing the pressure from it helped. Still a long road obviously and not hopeful.

@Lola245

Good luck with this round. It sounds hopeful. Also if your ovaries alternate like mine, one ovary might have been leading last month and each cycle varies. You already have good egg quality so that’s what you need to focus on. Your fsh is not too high either. Are you still going to do batching or will you transfer what you have?

I have been advised to do a mock cycle with era, Emma, Alice etc as I only have 7 day 3 embryos left. Of course, I will thaw all of them this time as this is just from one cycle. However, due to male factor, even though 7 day 3 embryos is a good number, I know from past experience that I will likely get 2 or 3 blastocysts maximum. So this will be one or two transfers then that’s it. I’m really hoping it works out but I’m just relying on one cycle. I’m still angry that CRGH didn’t let me do more last year. I’ve spent so much money and time doing this.

@2021ivfagain the ERA sounds sensible given that these are your last embryos. I think if our next couple of transfers don’t work we will have to look at additional things like that as I don’t plan on doing any more egg collections now. We have mfi also, although now OH has stopped smoking, drinking and has lost lots of weight I’m hoping the DNA frag has improved. Really now in theory there should be nothing stopping us getting pregnant but I suspect it still won’t happen naturally, just a gut feeling really.

Yes it’s true what you say about banking part of me thinks I could be pregnant by now if we had transferred as we went although I’d still want to do PGTA to try and avoid another miscarriage.

I agree it was probably for the best they didn’t let you transfer as it sounds like the baby part of the embryo wouldn’t have made it but always disappointing when things like that happen.

@Lola245 fingers crossed for this cycle 🤞

Hi All,
I have just converted from standard IVF to embryo banking as of this week. I had my eggs collected last week and will start Norethisterone on day 14 ready for another collection at the end of November. We are waiting to hear back if they think it’s worth having another consultation with Mr Ramsay as my consultant said the poor fertilisation is due to egg quality and she didn’t think there was anything more we could do (we already take many, many supplements and had things like microbiome and DNA fragmentation checked) other than adding ICSI next time.

Does anyone have any advice for doing back-to-back egg collections? I was quite surprised they were happy to go again so soon and my post-egg-collection diet has been less than ideal!

I should know to never let myself be hopeful... Went back for my day 9 scan today, and the follicles hadn't grown at all. With the mild stims protocol, you take injections every other day so I'm sure that's why they are growing as much. I asked CRGH if I could now take injections every day to try and make the most of these follicles and they said no. I'm sure they have their reasons but I get envious when I hear about how ARGC takes bloods every day and adjusts the meds. CRGH seems very inflexible.

@2021ivfagain yes best to do everything you can to make the most of your last transfers. I'm feeling optimistic for you! You've still got some good chances. BTW I don't know what my real FSH is - it was pretty high a year ago so I'm sure it's higher now. But it's always below 1 after oestrogen priming. I just really want to make it to egg collection this time so we need at least 3 of the follicles to grow. So frustrating as day 6 seemed much more hopeful.

@CharlotteYorkMacDougal I've done back to back - it actually doesn't feel that intense because the norethisterone means your cycle is longer than usual. So it's more like every 5 weeks. When I first did it, I didn't respond nearly as well the second time, but some people seem to respond better the second time. What happened with your standard IVF rounds? (Love your mumsnet name btw)

@CharlotteYorkMacDougal Welcome to the thread. I would say IMSI is better than icsi especially if there is an issue with sperm quality. I had success at 38 when we changed from icsi to IMSI. if I were you, I would do everything to ensure sperm quality is optimal. My husband took all supplements from It Starts with the Egg and I took them as well. Unfortunately, egg quality cannot always be fully improved. However, it might be the protocol. Dhea sometimes can help and ubiquinol. If fsh is an issue, that can be lowered. Good luck

@Lola245

I’m so sorry. How much meriofert do you have left? I opted out of mild stims as I was afraid of not getting many follicles. I only use mild stimulation for FET and last time I had two mature follicles and 2 more getting that way. I was on 225 iu every other day. How many follicles do you have? I think I would take two doses of meriofert and fostimon consecutively to boost chances but that’s me. Please note I’m not advising you to do this.

I take extra zumenon because fsh is really high. The lowest it’s been is 2 with oestrogen priming and that was with dhea and a few extra zumenon tablets. I was desperate to lower it and CRGH did not give me support. I also found norethisterone was better with zumenon as both lower fsh together. Provera doesn’t lower fsh at all.

I’m surprised they won’t let you convert to a full stimulation cycle. Have you spoken with your consultant? I know someone who was 42 and had really low amh and high fsh. She did oestrogen priming and had 3 eggs collected. Out of those she had one day 6 blastocyst which was tested and normal. She had it transferred and became pregnant. It only takes one. You still have lower fsh than me. I had lots of follicles and a good amount of eggs collected but quality is not there anymore for me. You have egg quality in your favour.

Could you convert this to an iui if they don’t let you increase dosage?

@Rosemarypots

Hi. How is it going? Are you getting any support/guidance from CRGH?

I’m waiting for period to start then I’ll start mild stims for FET mock era cycle. I do know that I can only afford this cycle and my transfer. If the biopsy does not work, I won’t be able to do it again. I’m praying they get enough this time. I’m hoping to do a FET transfer in December.

@Lola245 Thank you for the reassurance about doing it back to back! With the round we’ve just done all was going well until six eggs fertilised abnormally (all because more than one sperm was able to enter the egg and fertilise it). The consultant said that you might get the odd one that does that, but six suggests a problem with egg quality and that might be the underlying cause of our infertility (I’m 38 with PCOS and had lost 4st before we started IVF so we thought we had the root causes). When we first started our investigations my husband had variable morphology but very high count (plus high-ish DNA fragmentation that was resolved by antibiotics). His sample was good enough on the day that they said ICSI wasn’t needed (and to be fair it was our preference to only have ICSI if we needed it). We did get a couple of blastocysts for PGT-A but one of them was 3CC which I didn’t think they would test so we might still be lucky but the constant didn’t sound that hopeful. Sorry to hear about the follicles that your clinic are being inflexible with the meds it must be so frustrating.

@2021ivfagain Thank you for all the advice! We believed any issues with the sperm had been sorted through diet, supplements and the course of antibiotics but it’s possible there are still some issues there (my husband thinks the problem is that the sperm is too good 🙄). I will ask the consultant (and possibly Mr Ramsay) about IMSI as I think we need all the help we can get now! We saw Melanie Brown the nutritionist and take everything she advised so we are taking Ubiquinol and I will ask about DHEA but I think (could be wrong!) that they don’t advise it if you have PCOS because of the effect on testosterone. That is interesting you mentioned about the protocol, they have changed the balance but the actual meds are the same (Bemfola/ Menopur) so I will ask about that too, my FSH has always been fine as far as I know but I will have another look at my results printouts! Thank you for all the advice and good luck with your ERA cycle 🤞

@CharlotteYorkMacDougal

I’m sorry you had abnormal fertilisation. Have you got the book It Starts with the egg? It really helped with my husband but I think it helped control blood sugar levels as well. There’s information on what supplements to take. You must avoid dhea if you have pcos. The supplements you need from the book are alpha-lipoic acid 600mg for both you and your husband. You need ubiquinol 200mgx2, vitamin E 200iu every day, 500mgx2 vitamin c (both), vitamin D (I take 3000iu in winter). I also took wheatgrass 30g every day when I was 38 before I had my successful cycle. But you must stop wheatgrass before stims. My husband also took wheatgrass, ubiquinol and DHA Nordic extra.

With PCOS, Rebecca Fett recommends a low carb diet but not to go mad. She advises just one meal eg dinner with no carbs. I did and still do lots of tomato based meals such as stuffed aubergines with turkey mince, passata, onions, garlic, pepper, etc with goats cheese and served with 2-3 additional vegetables. I also ate and still do eat good sources of salmon 2-3 times a week with pesto and 3-4 vegetables but no carbs. I also did bolognese from scratch but with spiralised veg. These can make a difference to blood sugar.

Acupuncture has also helped me. I believe this can affect egg quality to some extent but you have to go weekly.

38 is a good age. I had success then. Also as I said IMSI worked for us and assisted hatching. We did a fresh transfer with no PGS testing.

Another thing I did the long protocol where they downregulate ovaries and turn off hormones but then control everything with stims. I used busereline which you can’t get anymore but there is a replacement. I believe the long protocol can have a positive effect on egg quality.

As you have PCOS, you could try a mild cycle.

Just looking for some reassurance re: ovulation testing. Switched to strips rather than clear blue digital. Had positive yesterday with some EWCM but not managed to DTD yet. Do will still have time? With clear blue seems to suggest you have 48 hours from peak? Negative ovulation strip today. First time I’ve tracked in ages but actually figured may be in with a chance now post lap, probably just setting myself up for disappointment but feel like we should at least try 🤷‍♀️

Hi I had two scans last week. The first one showed a small sac, which was behind for six weeks, and there was an insufficient hCG increase. On Friday a second scan confirmed that this is a failed pregnancy. To be honest it was a relief to have some certainty and stop the meds. I'm going to give it a week or so to see if I have a bleed, and if not I'll need to go to the EPU. I have one embryo left that passed testing, but it's a BC and had to be rebiopsied, so it seems highly unlikely that it will work.

It's a very surreal situation having had four failed transfers of tested embryos yet no fertility issues, as we're doing IVF for genetic reasons and have had a successful natural pregnancy. I almost can't be bothered doing the final transfer - more money and energy on something that will most likely fail. Need to feel my way through the next few weeks, and see if the way forward becomes clearer. We won't do any more retrievals so I think we're getting towards the end now.

@InvisibleDreamer

Not been on the thread much as I’ve been really struggling with IVF process. Feeling emotionally drained and husband is depressed. It’s put a massive strain on our marriage. He said he was never happy about doing IVF again. I feel like I need rebuild my relationship. We’re both struggling. We also have so much to do to care for my mum and dad who are disabled.

I know they’re more expensive but I always found Clearblue ovulation strips easier to follow. I think ewcm is good sign. Usually a peak means you have anything from 24-48 hours before predicted ovulation. It’s always worth a try. It’s never worked for me but you’re younger than me.

@Rosemarypots

Hi. I’m so sorry this has happened. I know I didn’t get to transfer stage but I felt so upset when they discarded my two day 6 blastocysts. I’m feeling emotionally drained and really need to do my transfer in December. However, if my fsh was good, I would wait a few months.

IVF is very consuming. Can you take some time for yourself? It might be best to wait before doing final transfer.

I’ve found counselling is helping a bit but like you these are my last embryos. I’m not doing further egg retrievals, so I know how you feel. It’s a shame you can’t try again naturally for your second but you said there are genetic issues.

Also, someone from another thread had a normal embryo tested twice, like you, and it has implanted. Sometimes the lower grade works.

@Lola245

Hi. Hope you’re doing ok with mild cycle. I think the clinic have been very inflexible.

I went to baseline scan today for era, Emma, Alice and nk cells mock cycle. I was worried as period was lighter but lining was not too thick at 4.6 so ok to start.

@Rosemarypots I'm so sorry about your failed transfer, and after the initial hope. It must be so disappointing and also seem inexplicable. Does your clinic have any thoughts on why this might be happening? I can't remember whether you PGS tested the embryos? Are you able to go back to trying naturally, or is this too risky given your genetic factors? It just shows how hard this process really is, given that you have no fertility issues...

@2021ivfagain I'm really sorry about the toll it's taking on your relationship. I really hope this works out for you, and I bet it will, but if it doesn't, there may be some relief that comes from just putting IVF behind you. After my devestatingly low AMH result, the only comfort I had was to feel like maybe I wouldn't waste more time on IVF and just accept that I'd done everything I can to try to have my own child again.

In terms of my cycle, I have three follicles above 16mm so will surely trigger tonight. It was a long cycle - my egg collection will be day 16. I feel like 3 follicles is almost the worst because it's not a complete disaster so we are going ahead with the egg collection, but obviously ending up with a blastocyst would be incredibly lucky. I'm trying to stay positive though. I think we have to try. And then will have to decide whether we want to try one or two more rounds of egg retrievals, or just give up. But the fact that I had 9 follicles initially this round makes me think maybe it's worth trying a bit longer.

@2021ivfagain IVF is so hard I found my OH would tend to shut down and try to pretend like it wasn’t happening during treatment cycles which was difficult for me as I could hardly pretend it wasn’t happening! I was really worried about our relationship at one point but luckily everything was ok. Is your husband having any counselling or treatment? Caring for your parents as well must be hugely tough, is there any help available to assist you with this?

In the end we DTD twice once the day after peak and then 3 days after (too late??). Am trying to convince myself that I am one of those people who become super fertile after a lap! 😂 I almost feel like if I can just believe it enough maybe it will happen. In reality I think I’m just getting desperate as I’m worried about how long it might be until we get to do another transfer.

@2021ivfagain Thank you for all the advice! We are following a diet and supplement programme from Melanie Brown so I will ask her about the additional supplements you mentioned (we take some but not all of the ones you listed) and look up the book you suggested. I’ve had acupuncture before and it didn’t seem to do anything for me, plus I have my treatment is about 200 miles from home so logistics might be a bit tricky but again it’s probably worth considering!

We found out yesterday that we did get one PGT-A euploid embryo from our first cycle so I’m hoping the next cycle we can get the same again or even slightly more.

Starting to feel really hopeless about everything. Think it’s the SAD kicking in after the clock change and/or just really bad PMT. I’ve tried chasing my gynae to see if the immune tests they want done can be arranged now so I don’t have to wait another 2 weeks until I see my consultant but they have not called me back like they said they would. Just so tired of having to push and be on top of everything and really regretting that I didn’t question it when they said do the lap first and then we will refer for bloods. Just feels like so much time being wasted. Does anyone else feel like you have to push all the time? I never got the referral through from my clinic to see the gynae even though I chased and chased. I was lucky they saw me anyway!

Deep down I feel like we will never have success. Fell asleep after having glass of wine with family lunch and I’m sure I even dreamed that we would never have children. Feels like even my subconscious knows it won’t work. Feeling really hormonal which I was hoping would settle back down after lap as each month it feels like it’s getting worse. Now worrying if period will go back to normal or not. If not I’m at a loss as to what is wrong.

Sorry I only ever seen to come on here to
moan! Just everything is getting to me right now - Christmas Ads on TV & first Xmas coming up with what should have been our 10 month old. I just feel like sometimes the universe is rubbing it in my face. Would really just like to hibernate until winter is over.

@CharlotteYorkMacDougal If you can get 3 or 4 embryos per round I’d say you have a good chance of getting at least 1 of not 2 ‘normals’ per round.

Thank you @InvisibleDreamer we’re still hoping we can get those kind of numbers from our next round 🤞I definitely know what you mean about hibernating for winter! Hope you managed to get your immune tests sorted, having spent far too long today trying to get someone to take responsibility for something as basic as saying what thrush treatment I can have I definitely agree about having to push all the time to get anything sorted 🙄

@InvisibleDreamer

I’m sorry you’re feeling like this. You have some normal PGS tested embryos? I know what it’s like. When I was TTC my first, it was really difficult and we had male factor as well. Are you private or with the NHS? I’m sorry you’re having to chase a lot. I’m used to that too.

@CharlotteYorkMacDougal

I’m sorry to hear you have thrush. When I did my last swab with Invivo, I was showing early signs of having candida which can turn into thrush but didn’t. Fortunately, I was advised to take canesten duo then start more probiotics. I take two boulardii probiotic supplements a day and Nature’s plus ProBio women which has lactobacillus crispatus. I’m also alternating with vaginal pessaries: one night canesflor (lactobacillus plantarum) and other night physioflor (lactobacillus crispatus). Also on an even stricter diet than before: no bread with yeast, obviously no chocolate, no stock with yeast, no cheese and minimal starchy veg. I eat stock free soups with lots of peppers, courgettes, onions, passata etc, almond nut butter (no added ingredients), some full fat milk, oat cakes or rice cakes, eggs, lots of other vegetables, chicken, wild salmon. The only cheese I eat is goats cheese at present. I also eat antifungals which kill yeast but ensure I take them at least two hours apart from probiotics. I have cinnamon, coconut oil, ground ginger, turmeric. Turmeric is only absorbed with fat or black pepper. I use turmeric and black pepper in omelette cooked in coconut oil. I also make avocado smoothies with a tiny bit of coconut oil and fresh blueberries on top. I’m feeling so much better and wanted to give you some ideas.