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.

@2021ivfagain thank you. I am still avoiding covid, albeit have taken myself out of isolation. It’s day 10 for my husband and I am hoping he isn’t infectious anymore. He is still a light positive on the LFT. These LFTs are reminding me too much of pregnancy tests lol I just can’t face being stuck in the bedroom any longer!
I really have everything crossed they find some good quality blastocysts in the lot you have. Good luck for the egg collection.
@IUV1980 your protocol sounds similar to mine. Albeit I am having lubion and cyclogest not the the crinone. And have some Inhixia blood thinners and steroids for immune issues. I am also having the neupogen. You are ahead of me so will need to tell me what it involves please! I have never had that before either.
i have my endometrial scratch on Tuesday. Fingers crossed I continue to avoid covid and get to it. Albeit am not looking forward it!

@Sarahk20000 well done for avoiding Covid! I forgot that I've got the dreaded blood thinners too. And I will let you know what the infusion involves! If this FET doesn't work, I think I will also be told to take steroids for any subsequent transfer, so may ask how you've found them at a later stage.

Have a great bank holiday weekend everyone!

@IUV1980

I remember the inhixa injections: I had them for all of my transfers when TTC my first. The worst for me was the lentogest as the needle is really thick! Is a natural or medicated transfer? Good luck with the preparation stage.

@Sarahk20000

Thanks. I had to stim an extra day but I trigger tonight and my retrieval is on Monday.

I’m pleased you’re avoiding covid. It’s so stressful but you seem to be doing well. I didn’t like the endometrial scratch either! Good luck

@Sarahk20000

By the way, my husband had nearly 14 days of positive lateral flow tests before a negative. When he gets two negative tests, he is clear of it. It’s strange as my tests were negative for a shorter time period but I had more symptoms!

@2021ivfagain good luck for Monday. So nerve wracking. Hope the extra day helps 😊 btw did you ever self administer the lentogest? On the chance that this FET leads to pregnancy I will need to take it 3 days a week when my husband is abroad for his sisters wedding for 10 days.

how strange on the covid! 14 days! Looks like it will take as long for my husband. Though the line seems to be fading now. St Thomas Hospital let him come back to work so must think he isn’t infectious now 🤞

@IUV1980 thank you. Hopefully you won’t need more transfers and this will be the one for now.

@Sarahk20000

Hi. The rules have changed for covid. I read that even with light lateral flow tests it is still positive, so you might still need to self-isolate in the house at present.

I did a fresh transfer last time for my son, but had to start taking lentogest after retrieval and 3 times a week for 12 weeks. My husband administered it. I’m sure you could do it. I found it difficult and had to ice up for it as it really hurt.

@Sarahk20000 I have self-administered lentogest in the past. And will probably need to do that this time as my partner will be working away for the next few months. It's actually fine, the hardest thing is that it's a tricky angle to stab your own arse!

@Sarahk20000 Have you used lentogest before? I found a routine that makes it pain free for me, let me know if helpful to share?

@2021ivfagain @IUV1980 thanks both. Yes @IUV1980 i have used it quite a few times for two transfers and two ERA etc rounds. It’s not the most pleasant but feels bearable overall. It’s the self administering part I have never done. I am glad you can manage it! Can see it would be tricky to reach lol I will see if the FET works first and then pay attention to how I may do it!

@2021ivfagain good luck for tomorrow! 🤞

@IUV1980

Thank you so much. I’m a bit nervous about tomorrow’s fertilisation results.

How are you getting on? When is your next appointment?

@2021ivfagain Really hope they all fertilise for you!
I have a 'day 14' scan on Wednesday morning, all being well, I guess I'll have the transfer next week. Though I've had so many set backs and false starts, I'm taking nothing for granted!

How did the egg collection go @2021ivfagain? Fingers crossed for excellent fertilization!

And I'll be taking lentogest for this FET too @Sarahk20000 This is my first transfer, I didn't realise there are even more meds than for stims! It makes me worry that we're going through such a big effort for relatively low chances with these embryos... but we are going ahead nonetheless.

Has anyone taken or know anything about Imrpyl? I've ordered it mainly for my DH to take for his sperm frag issues, but the website claims it helps increase AMH naturally too: www.fertilityfamily.co.uk/blog/how-to-increase-amh-levels-naturally/#:~:text=Supplements%20for%20low%20AMH%2D%20How%20Impryl%20can%20help&text=The%20nutrients%20in%20Impryl%20are,needed%20to%20create%20a%20baby.

It recommends that you don't take Coq10 alongside it though so I'd be concerned about giving up those, and know not to believe everything on a product website. Anyway, curious if anyone nows anything about it both for men (DNA frag) and women. @Dochas12111 thought I'd ask you as you know so much about DNA frag! Thanks.

Lastly on the topic of GPS, this is an interesting, slightly troubling recent article in the New york Times: www.nytimes.com/2022/04/20/health/pgta-ivf-pregnancy-test.html

@IUV1980 @Lola245 @Sarahk20000

Hi. This has been disappointing. I had 9 eggs retrieved from 15 follicles. 7 were mature. Out of those 7 only 2 have fertilised normally. Last year my egg quality was excellent, but now it’s declining. My afc is the same and is high for my age but my fsh is getting higher and likely the problem for my egg quality now. My husband’s morphology has also gone down to 1% but we did IMSI and out of what they selected it was top grade sperm. Obviously natural conception is not likely.

I really hope those two fertilised eggs survive and can be frozen at day 3. I also feel that when I stim an extra day my egg quality goes down. In fact, I already had 3 above the mature line, two on the line, one below the line and 4 smaller ones growing before I took the extra injections.

My first cycle I did not stim for an extra day and had just two above the line but ended up with better quality eggs. I still had 9 eggs retrieved, 8 mature and 7 fertilised then. My fsh was lower but afc was still 15 last November.

@2021ivfagain am sorry to hear of the low fertilisation, feels like my last one where I went from 17 eggs to one fertilising. I do sometimes think their protocols etc impact along with our own FSh levels etc. because it’s odd to get such differences from one to the next. I really hope the 2 make it all the way! 🤞
@Lola245 yes there are a lot of meds for FET too albeit luckily they don’t set in until the lining scan with progesterone. Hope things work out despite the low odds. You just never know in the world of IVF, good odds don’t seem to materialise so no reason why it can’t be the reverse.

I had my endometrial scratch this morning. Can’t say it was the most pleasant. I found the speculum more painful than the scratch/biopsy itself. The lady who carried it out was amazing though. I need to find her name so can make sure I have her for the neupogen infusion, as others make the speculum much more painful. She was great at distracting and kept the bed at an angle that seemed to really help. Definitely made it the least painful she could. Onwards…hope the next few weeks go by quickly.

Hi all, sorry not to have checked in recently.

@Sarahk20000 and @Lola245 really hoping you get success from your transfers. Sarah, so glad you avoided covid and that you got through the scratch.

I hear you both re all the transfer meds! My next transfer (hoping we get that far) will be natural or natural modified - simply because after three PGS normal fails (with ERA etc) we need to try something different. But the decision to change approach is obviously not based on anything scientific.

@2021ivfagain I'm sorry this cycle has been disappointing. You probably saw that my second batching cycle played out in a similar way. Really hope your two make it to day three. It's so hard to pinpoint the cause of a poor round. I had so many theories about why mine might have happened, but ultimately I'll never know.

I'm about to start meds for my third batching round. Not feeling that good about it. I was hopeful for the first round, which went well, second I was keeping my fingers crossed that the luck would continue, and then it was such a disappointment - the embryology updates felt like death by 1000 cuts. This third round is more about head down and getting through it.

I'm now planning on doing four batching rounds, given our odds are so tricky with doing both the PGS and PGD. This will be the last time we try - I'm not planning to do any more retrievals after this set of them. The PGD is too expensive to justify paying for on a round by round basis. So it feels like we need to plan for a fourth round so I can feel I really took it as far as I reasonably could.

@Sarahk20000 hello! Just had the Neupogen infusion. It was fine. It's basically a small amount of fluid that they put into your uterus to absorb. So a familiar process: speculum to open up cervix, small tube inserted into uterus, abdominal scan to check tube is in the right place and then they slowly release the fluid over a minute. I didn't feel anything - it's a small amount of fluid (unlike a 3D scan which I've had before and I very much did feel!). In short, nothing to worry about!

@Rosemarypots thanks for your wishes for the transfer round. I can relate to the PGS failures, it’s harder to know what to do when that happens.
Good you are giving yourself the best chance with 4 rounds.
@2021ivfagain i hope your two fertilised eggs are holding on.
@IUV1980 thank you so very much for sharing. It sounds better than I thought. Did they leave you lay down for a while after it? And did you need a full bladder? I find speculums very painful and difficult so am anxious but so good to know it doesn’t last long! Btw do you know if it can be a few days before progesterone starts? I am trying to time my transfer a bit on a certain day which may see me start progesterone a few days later than normao. Good luck with your progesterone and upcoming transfer. Not long now 😊

@Sarahk20000 yes, full bladder required. And they left me tilted backwards for about 5mins after the procedure. There's no getting away from speculum... but honestly it's only a few minutes. In terms of progesterone, I started today, so for me they booked the neupogen on day one of progesterone. My transfer is booked for
next Tuesday.

@IUV1980 @Sarahk20000 and @Lola245

Good luck with your transfers. Are you doing natural FET transfers or are your hormones turned off as in medicated cycle to control progesterone?

I had my day 3 update and I found out that whilst others fertilised only 2 fertilised normally. However, those two were rated top quality at 9 cell with hardly any fragmentation. Both have been frozen now, so I now have 9 day 3 embryos frozen (7 from first cycle and 2 from third). I’m doing my last batching cycle back to back.

My consultant was pleased with how I responded last time, but just worried about egg quality. I’m on melatonin next time during stimming phase. Did anyone take melatonin before stimming phase? Did anyone feel very drowsy during the day with taking melatonin?

@2021ivfagain I'm so happy for you that both embryos grew well and are top grade. And nine is a great number. I hope you feel encouraged!

Not sure what a natural FET protocol is: I'm on a shed load of drugs so guessing medicated?!

I took melatonin when stimming. Took it at bedtime and didn't feel sleepy during the day at all.

@IUV1980 thanks you, very helpful to know all this.
@2021ivfagain great that both were 9 cells and 9 day 3s is a good number to add to, so fingers crossed for the next stages. I have never had melatonin. I like your consultant tries different things.
I am not on a natural FET as having progynova, cetrotide to start with.

@2021ivfagain that's great the two from this round are top grade, and you have 9 day 3 embryos! We'd probably be in a better position if I'd been patient and we did more stimming cycles to get more day 3 embryos, but with 9 so far you'll be in a good place. What made you decide to do one more cycle, rather than just move forward with those?

I'm doing a medicated cycle too. Cetrotide and progynova, then all the luteal phase meds starting hopefully next Friday if all is well. All the faff with the frozen cycle does make a fresh cycle seem more appealing, I must say...

Do any of you ever question whether just quick fresh cycles could actually be better than the very slow process of embryo banking and PGS testing? I suppose in my situation I just find it frustrating that we could have done our embryo transfer back in February, since both our embryos are from my first cycle, and would know the outcome back then (even if it's negative, as it probably will be).

@Lola245

Thank you. Honestly, this whole process is so difficult. Sometimes a break is good. I couldn’t have done a cycle straight after my second that failed. The last few days waiting for the lab updates were difficult.

I’m still 40 until June so wanted to do three cycles. My consultant recommended two but I felt three was better. However, I can’t believe that my egg quality has gone downhill so much. I used to have at least 80% fertilisation every cycle. I’m hoping that the next cycle goes ok.

You had a good number of day 3 embryos from two cycles. Was it 5? Your egg quality is really good. Do you know the cells of your day 3 embryos?

When you did estrogen priming, how many days did you take progynova?

I found fresh transfers easier. If I had been 39 years old, I would have taken a chance and had a fresh transfer. When I had my fresh transfer at 38, I was very nervous until I had my nipt test at 12 weeks. I suppose it gives some reassurance but also it saves time. Egg quality can worsen so quickly.

I’m really hoping you get your positive result. They are already blastocysts so it’s higher than transferring two at day 3. When I did my fresh transfer at 38, I was advised to eat lots of protein. I also made sure I had a walk every day. When is your transfer?

@Sarahk20000 and @IUV1980

Thank you for your messages. It’s been a difficult few days.

That’s good news about the melatonin. I have to start on day 1 next cycle. Did you start before?

@IUV1980 From the two cycles you did at CRGH last year, do you mind me asking how many day 3 embryos you had and the cell number?