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 hope you are well and the situation at home with parents is all ok. Hope you are also managing to switch off a bit with a slight gap this month. I am ok. I am going once a week for 40 minutes. But about 25/30 with the pins actually in. Feel like I should have done twice a week but am comfortable with my acupuncturist and she is only in the clinic one day a week. I had a session today, I still can’t get past it’s relaxing impact. People at work are even noticing that I am different and a bit calmer this cycle. I had my lining scan today. It was ok at 8.8mm (which was good for me as normally on 7.2mm throughout all the previous cycles around this stage so maybe the acupuncture, vitamin e or foods I am eating may have made a slight difference). I now have an IVIG drip and neupogen infusion on Friday and then transfer next Wednesday (am trying to do acupuncture before and after it if I can). Really hoping can quickly get to it so don’t have to worry about covid and delays atleast. And will try and enjoy the bit between the transfer and pregnant test!

@Sarahk20000

Hi. Yes it’s been difficult as my Dad’s still in hospital. He’s been admitted to hospital 3 times in two months.

You seem to be doing really well. I really admire your positivity.

I’m trying to not stress as I don’t want to undo the acupuncture. It is relaxing and my acupuncturist focuses on energy points. I feel pulsing in my head.

I wish I wasn’t delaying my next cycle as I was looking forward to completing the batching. It’s starting to get to me. Also, I’m feeling really fed up quite a bit and worry about my hormone levels getting worse. I have to do my next cycle next month. I wish I was younger and had more time.

I’m pleased to start norethisterone next week. I’m really hoping my last cycle will be ok.

I’ve also started introducing vitamin e to my long list of supplements! I already have vitamin e in pregnacare but I have 200iu vitamin e every other day. I tried taking 200iu every day and had a bad stomach. I also eat a lot of food with vitamin e like nuts and seeds and avocados. I’m also still on wheatgrass which contains vitamin e. I eat Brazil nuts to keep thyroid under control. What else have you been taking for the FET? Did your consultant ever talk to you about a natural FET or a natural modified FET? I know medicated cycles tend to be more successful and reliable.

Is your transfer next week?

@2021ivfagain oh no your dad’s situation sounds difficult. Hope you manage to cope ok. Yes the feeling of time getting away and it being too late is a real issue in this. Fingers crossed you get to your next and final round quickly and it’s a good one.

My supplement list is very long too and I am not sure any of it besides the basic pregnacare conception that I take that is really needed. But my nutritionist has put me on loads of microbione related stuff as tests showed I didn’t have good stuff, plus vitamin e, folic acid, NaC, COq10 and vitamin D. For food I do the same as you mainly proteins and veg (though struggle with eating vegetables). Oats and flaxseed. Nuts avocados, Brazil nuts etc. Have also been making beetroot juice with lemon, mint and kale. Have also started with some pomegranate. My husband is killing me with the curries and rice I make for him tempting me lol I can’t believe I have spent 2 years without eating sugar and white type carbs etc. i have only lost 10kg and still remain on the cusp of obese BMI but still atleast feel better in myself. I have been managing 6000 steps a day. Am thinking how much walking is ok in 2ww. Maybe I will take it fully easy for 4/5 days after the FET. I can feel I am in rebel mode, I want to go watch top gun lol, am very tempted by the taste of London festival as it’s near me at Regent’s Park soon, and I have already booked afternoon teas! Think all the time of being careful is getting to me but I need to be careful as I will be on steroids etc even if not pregnant.
yes the transfer is scheduled for next Wednesday. I need to sort the flat out and clean etc a bit to be organised so I can feel relaxed. I start leave from work on Friday for 2 weeks so am relieved about that.
no my consultant never even mentioned more natural options. She strikes me as being a fan of more medicated protocols.

@2021ivfagain sounds like we are in a similar situation in terms of waiting to do our last batching rounds. If AF behaves herself I will be due to start next round around the 18th June. Am definitely feeling the time pressure too. Having your dad being very unwell must be very upsetting I’m sorry you are having to deal with that as well. In terms of supplements I only take pregnecare, omega 3 & coenzyme Q10 but I am also trying to eat a higher protein diet with nuts & avocados etc…I always have treats though when I’m doing stims just to get through it!

@Sarahk20000

That sounds like you are doing really well. I understand you want some normality and treats to look forward to. I miss going out for meals and going to cafes. I had to cancel my eye test today as I was worried about covid and can’t afford to cancel this next cycle. The supplements are good but NAC is specifically for egg quality I think. How much vitamin e do you take? I can only stomach 200iu every other day as well as lots of vitamin e from food.

The beetroot juice sounds amazing. The only thing I would advise it perhaps avoid mint closer to transfer. My acupuncturist told me mint cools the uterus so hot food and hot/ warm drinks are better. Mint has a cooling effect apparently. I try to drink hot or warm water every day and measure 1.5 -2 litres.

The afternoon teas sound amazing. Treats are good during transfer. Do you drink decaf or ordinary tea? When I did my fresh transfer 2 years ago, I drank a cup of ordinary tea everyday, nettle tea and decaf tea as well as lots of hot/warm water. I also had two squares of dark chocolate every day too. When I took my test, I went off tea and nettle tea completely!

Another important thing is for my transfer that worked I moved around quite a bit, but not too much. My kitchen tap stopped working so to get a drink or do the dishes I had to keep filling the kettle up upstairs in the bathroom! It involved frequently walking up and down the stairs. I also went on a gentle walk each day and sat out in the sun playing board games from time to time. A walk every day is good.

@InvisibleDreamer

Hi. Thanks for your message. I hope my cyst has disappeared by then and that yours has disappeared too! I take norethisterone which controls when I have my period. I start it on 2nd of June, so my cycle day 1 should be 17th June.

I have to be careful about sugary food as I take buserelin during stims and it can affect blood sugar levels and cause really bad headaches.😩I make sure I have a treat on retrieval day.

As for protein, I have nuts and seeds with every meal or at least two. For lunch I often make broccoli soup with hazelnuts and chickpea burgers or an omelette. I always make an avocado and lime smoothie but serve it warm never cold. Sometimes if I’m short on time I have cauliflower, spinach and scrambled egg with one slice of whole meal toast followed by an avocado warm smoothie! Evenings I have either salmon with pesto and 4 types of vegetables, spaghetti bolognese with spiralised veg, ratatouille with lentils, chicken and extra veg, chilli with cauliflower rice or healthy chicken jelfrezi with cauliflower rice. I also do stuffed aubergines with lots of veg.

I understand you are feeling anxious. I was the same when TTC my first. I feel like it now as well. I understand but you are younger. Even at 38 or 39 you are in a good position especially with good fsh. You have a good chance.

Whooo hoo some good news for once…cyst has gone & lining now looks normal again! Will keep an eye on it during next round but fingers crossed 🤞 it’s not now an issue. I guess this means there’s no scarring so very relieved.

@InvisibleDreamer

Good news about lining and that cyst has gone. I expect you’re relieved and happy you can start next month.

@InvisibleDreamergreat news on the cyst and lining. Fingers crossed for the next round.

@2021ivfagain
i had the IVIG drip yesterday. Took 2 1/2 hours but I used the time to spend on my iPhone surfing stuff and clearing out old pictures. The only uncomfortable part was the constant blood pressure monitoring otherwise it was strangely relaxing to be stuck in one place not being able to do much. After that I had the neupogen infusion and @IUV1980 you were right it was a non event. The doctor used the smallest speculum and it was over in what felt like seconds. It was much much easier than the scratch. The hard part was that they were running 40 minutes late and I was bursting to urinate. In the end I had to go twice to relieve myself a bit but was all quite stressful! Sorry TMI lol
@2021ivfagain i have 300gm of vitamin E. I don’t feel it as such, why couldn’t you have much? Yes I am keeping with egg quality supplements too incase I need to switch to a collection cycle though I think I am so drained with it all that a donor cycle is feeling more tempting now to have a better chance of success as at nearly 42 and my husband 52 we aren’t getting younger and I am not sure after 9 constant cycles over a year and a half in some form I don’t have much energy left now. I know donor isn’t guaranteed success either but takes age pressure away a bit atleast. I don’t know what crgh egg bank waiting lists are like though. I would like to pursue somewhere like Spain to match my looks more but I know my husband doesn’t want to go abroad. My mixed race background though makes it easier as Asian donors are almost impossible to get, as what’s important would be a healthy happy child rather than the genetic make up. But this is all for another day. I am channeling my acupuncturist’s advice to feel positive about the upcoming cycle. You are right about the cooling foods I think i should switch to more cooked betroots etc. the walking also seems a good suggestion. I didn’t know whether to really cut exercise down for a day or two after the transfer but I suppose circulation is good. I am drinking one cup of caffeinated tea a day otherwise I have decaf if i fancy any additional drinks. I now have a covid test on Monday and Wednesday transfer so just want to fast forward. Have some liver and kidney function tests following IVIG too, some of the potential side effects did scare me a bit. The progesterone and blood thinning injections are taking some getting used to again, think the 3 month break really made me forget about them! I am calm and relatively ok still thanks to meditation and acupuncture, hope it continues and it isn’t the calm before the crash. I will spend the next few days sorting flat and cooking etc so it’s all nice for the pregnancy test wait and I can take it easy for a bit.

@Sarahk20000

I’ve never had IVIG drip. What is this for? Are you still having a trigger injection as part of your protocol? It all sounds very complex. You are doing incredibly well. I hated the endometrial scratch when I had it for a frozen transfer.

I have ibs which is aggravated a lot by the antibiotics we take for each cycle. I found out that when I was taking 134mg (200iu) of vitamin e each day I was having painful stomach cramps and felt unwell. When I changed to 134mg (200iu) every other day of vitamin e my symptoms improved dramatically. However, I do eat a lot of vitamin e in my diet already. I eat a whole avocado every day and nuts and seeds. I also have a lot of fresh salmon every week.

I understand with the egg quality. I personally would try another cycle with your own eggs first if you even have to. If I’d had more blastocysts per cycle, I would have chanced a fresh transfer with assisted hatching. I spoke to a woman today with high fsh who is 42 years old (nearly 43) and pregnant with IVF. She was about to give up. She had to do estrogen priming. She also did lots of acupuncture. It is not impossible as I think your hormone levels should still be good. However, you might need a protocol which concentrates on egg quality such as melatonin.

You might be lucky this time. You never know. This could be the golden embryo that sticks.

Anyway it sounds like you are doing really well. I admire your strength and positivity. As for exercise, a walk each day is a good thing for blood flow.

Where do you buy the beetroot? Did you say you use fresh? I want to make some beetroot soup! It sounds like a good idea.

I’m getting nervous about my next cycle, but I can’t delay any further. The acupuncture does help my mood slightly. I’m being very careful not to go out. It’ll be nice to have a meal out or go to a cafe and do normal things after this next cycle.

@2021ivfagain tell me about it when it comes to cafes etc. I think a meal even going around London doing normal stuff would feel like a holiday right now! Yes I will think about the fresh cycle as reserves and hormone levels may still be good. I buy betroot from Ocado and use their whole food organic one. I am not a fan of this, the pomegranate or Brazil nuts but am having it anyway. Yes the IVIG is for immunes. I have high NK killer cells etc so am on steroids and IVIG for that. Was on intralipids before but consultant is trying IVIG this time incase it was a factor in the miscarriage and this can help more. It’s antibodies from blood donors I think to repress the immune system, which may be attacking the embryo mistaking it for a foreign body. Apparently can help. Let’s see. It’s £1890 a go and I would need it every 4 weeks so really adding to the already extortionate amounts I seem to have already spent. But if it helps then definitely worth a try.
i don’t need a trigger injection. It’s basically progynova (estradoil) to start to thicken lining, cetrotide to stop natural ovulation, then progresterone for 5 days (I am having injections, pessaries and tablets for this - my daily schedule is ridiculous). The blood thinning, steroid and IVIG are the add ons. It’s the kitchen sink medicated FET protocol I think. With the scratch and neupogen and antibiotics pre cycle I don’t think much is left that she could add. It’s the day 6 blastocyst quality of B- that is most probably the tricky bit in the mix as no idea if it will be good enough to implant and even if it does then good enough to go onto live birth. But it’s a euploid so as you say you never know. Chance is the biggest factor in ivf for me.
hope your cycle comes round quickly so you can get to your euploid blastocysts and transfer.

@2021ivfagain

What clinic are you at and who is your consultant? Thanks

@IVFPrayingForBioChild

Hi. I go to CRGH.

@Sarahk20000

Hi. I’m starting to panic about PGS testing and the freezing and thawing process.

When your blastocysts were PGS tested, were they hatched or hatching? Does the 6 grading mean hatched or hatching? Thanks

Hi @2021ivfagain, Dr Aimee recently did a podcast (20 May) with Dr Geoffrey Sher, where they actually talked about why freezing at day three and then growing to blast, testing and refreezing is a good way of doing it. I found it reassuring and a better explanation of this approach than CRGH has given me. I think CRGH should publish some FAQs!

@2021ivfagain i wouldn’t be too nervous about it if I were you. There is something almost comforting in the combined numbers! Atleast it’d more than 1 cycle’s worth to take through to blastocyst. Fingers crossed you get a good number over to euploid. I found the PGS test wait really hard! I think it’s fully hatched, the pictures of the ones they have transferred so far show it as having hatched. It always niggles at me whether that’s good for implantation or not but they do it for all PGS testing and I trust them as a clinic. I had my covid test today, a pain in the middle of all this but I suppose I feel happier knowing people in theatre are tested. I have my transfer under sedation. I was wondering is the timing of acupuncture before and after transfer important. Mine aren’t going to be exactly before and after with a few hours in between due to timing between clinics, appointments and the sedation aspects.

And all mine survived the thaw despite many not being euploid. 12 got through thaw and 7 made it to blastocysts with only 2 reaching the stage they wanted on day 5 (this was also a nerve wracking).

@Sarahk20000 and@Rosemarypots

Thank you both for your messages. I suppose the waiting to start this next round is making more anxious. I hope the cyst has gone. I start norethisterone in a few days so hoping the cyst will not affect my period. I’ll be pleased to start and get the batching done.

I know the covid tests are a pain but it is reassuring that they are doing the testing. @Sarahk20000 Good luck with your transfer on Wednesday. I think you did really well: 7 blastocysts is a good number. Did you get day 5 blastocysts from one cycle? Did you get any low mosaics?

I can imagine it’s been nerve wracking for you. Good luck for Wednesday. I’ve never had transfer under sedation before. That sounds a good idea: I always struggle with the transfer as it really hurts, but I think it’s because of the shape of my cervix!

As for acupuncture, I was once told to avoid acupuncture the day of transfer. So I did acupuncture the weeks leading up to transfer, the day before and the day after.

@Sarahk20000 that's a great conversion rate from day three to blastocyst!

@2021ivfagain i didn’t get any mosaics. Just abnormal or normal. And the euploids I think were from 2 cycles but could have just been one. I don’t actually know as they seemed to join all the day 3s into one batch. But the quality in one cycle was much better (no idea why) and the rest seemed relatively rubbish. @Rosemarypots The conversion was good and the 3/7 euploid was relatively good for my age too but doesn’t seem to be going well in converting to feasible pregnancies, now that I am on the last one😞

@2021ivfagain thanks for the good wishes. Need to get a bit more relaxed, the cleaning and preparing isn’t helping lol I had heard the acupuncture before and after transfer can help success rates but who knows!

I understand @Sarahk20000 - I try not to think too much about my three failed euploid transfers. I'm going for a natural / natural modified transfer next time, if we get anything suitable following testing. I've just finished norothisterone ahead of starting my fourth and final retrieval - meds arrive tomorrow.

Sending you so much luck and good wishes for your transfer - I so hope this is the one.

@Rosemarypots good luck with your final egg collection. Wow you have resilience to have gone through the transfers and then more egg collections. And yours is a healthy attitude to not dwell on previous cycles. Is the natural modified to try something different? Is it to help implantation?

thank you so much for your kind wishes for my FET. I finally completed all my chores and am looking forward to getting tomorrow out of the way and resting for a week 😊

Thanks @Sarahk20000. We did our three NHS rounds (also with CRGH), which resulted in our three failed transfers, and then we decided to give it one last shot with the batching approach. As you know, it's not generally possible to batch with the NHS, so I feel glad we are able to take this approach, even though the costs are eye-watering.

If I get the go ahead at the baseline scan this week then I'll have done four egg collections in 14 weeks, which is a bit mad. This one will definitely be my last one. My meds order was cheaper this time, as I've only ordered just enough for the cycle plus one day's contingency, and I'm sadly quite looking forward to stopping some of the vitamins! As is my DH.

I'm moving to a natural or natural modified protocol as I conceived my older child quickly and naturally, and I feel like it might help me to replicate a more natural approach. I've always struggled to get my progesterone levels up with CRGH's medicated approach, and I've done ERA, a hysteroscopy and immunes. So this is basically the last thing left, with an hCG wash this time.

Will be thinking of you tomorrow. And a week's rest sounds very welcome!

@Sarahk20000

It sounds like you’re really prepared. I think having the transfer under sedation is a good thing. I’ve always struggled with transfers.

@Rosemarypots

I had problems with the medicated FET cycle in 2019, but my two blastocysts were not PGS tested and we have also mfi, which in some ways, was worse at that point. However, I believe from my research if you do have problems responding to the progesterone medication, as I did, a modified FET natural is good, but also a mild stimulated FET is very good as it emulates the fresh transfer. I’ve just found this out today. Most people do respond well to medicated FET, but I didn’t.