Advise please - What would you do?

[Dobcaty]

Morning ladies, I'm on board a couple of IVF thread but thought might get more advise, so here I am.

Background, I'm 36 (37 in August), DH 52, been together 17 years. He has two children from previous marriage. We started fertility investigation during covid, but we not eligible for NHS so went private. After 3 failed IUIs, we started to do long protocol IVF - ICSI as he has high level of antisperm antibodies (initial investigations didn't flagged this)

first round - 10 fertilised eggs, none of them developed well, 2 transferred on day3, none to freeze, implantation failure.

second round - 11 fertilised egg, 1 transferred at day5, two in the freezer (both of them 4AA), first time in my life BFP, but miscarriage at 4weeks2days.

We had our follow up appointment on Tuesday to talk through for the next steps and were given 2 options:

1. start the FET -long protocol - transfer probably beginning of Aug

2. do some private investigation with blood tests, which result takes 10-12 weeks to come back, and if nothing found we can start the long protocol FET approx mid October, transfer end of Nov. In the meantime I can be referred for recurrent miscarriage clinic (1 implantation failure and 1 miscarriage already classified as recurrent) and do hysteroscopy with NHS - waiting time approx 18 months - or private (cost more or less £2k)
   I've asked her what she would do? She went silent for a minute or so, clearly struggling with her answer, but she said 90% of these tests come back negative, but we need to make the decision.

DH wants to wait and do the tests. I want both now😅. If we do these tests, we could end up to do the FET the same time when is our house moving window(new built) so unlikely I want any more stress added to it, and definitely I don't want xmas time, so thats all will be pushed early next year.

Additional info: in the last 12-14 months I have mid cycle spotting so asked GP to run another blood test with FBC, thyroid, testosterone, LH, FSH and CA125 (my mum had ovarian cancer and I have a small cyst on the left), result should be back by next Wednesday.

I'm gearing up for my af (first since the mc) probably I will have the full flow by Monday and thats when we need to have a decision
What would you do?

Hi

Just saw your message and i feel like i could have written this. I am one year older than you (38) and my OH is 52. He also has children from previous relationship. Have been TTC with 18 months. One BFP at Christmas and had a missed miscarriage at 9weeks. it did take 18 months to get a positive preg test.. I have one son from a previous marriage. Have had all my tests done and everything appears OK. However, after a lot of persuasion DH agreed to have semen analysis. Sperm Igg antibodies are at 100%..
He is very unsure he even wants more children, sometimes he is all for it, other times not. He is sometimes open to further investigation/trying ICSI with his sperm. However, I had planned a sperm donor ICSI before my BFP .
Feel I am at a crossroads. Ideally, would love the child to be his, but worried about the time and health implications the high sperm antibodies may have as well as the chance of have another MC. .
Has anybody been in this situation>> Any Advice>? X

Hi @AgainTTC @Dobcaty no idea if you're still on here but can I ask what you guys ended up deciding in the end? Thanks

@Fariapea yes still here, but lurking just now :)
Ended up to doing the investigation, everything came back normal (very quickly) so we had a FET transfer end of September 2022 (a day later of our house moving) again with long protocol but with different medicine as they were on shortage in the UK that time and had my daughter in June 2023.
Since I am pregnant again (14 weeks) with a very surprise natural conception. (We were planning another FET early next year)
How long have you been TTC? What is your journey so far? Xx

Hey this is amazing news so happy to hear this. Makes me feel happier! So glad things worked out for you. So our story is we've been trying a year no luck. Due to age (36/41) we both had tests recently. Mine seem ok. My DHs are mostly all ok but morphology was 3% and we noticed asas 100%. We spoke to the gp who didn't think the asas meant much and to work on morphology. But after reading online we're both a bit panicked tbh. We're booking in to have initial consults in the next couple of months. I am pretty scared of the thought of having eggs removed so hoping they think we'd be good for iui maybe? Are all your dh SA parameters normal apart from asa if you don't mind me asking? Thx

@Dobcaty hi can I ask what you different in this cycle? I have had a failed fresh and failed FET. What meds were you on with the round you were successful in

@Fariapea

Will you be eligible for IUI/IVF on the NHS?

With what I know now, I wouldn’t go through IUI again, and I have needle phobia. Considering the sperm morphology (4%) and high ASA (95%) we had, our chances of getting pregnant with IUI were roughly the same as with natural conception, since the sperm still needs to swim and break through. In hindsight, I feel we wasted time and money on those cycles, but of course we learnt a lot from them.

As for egg retrieval, it wasn’t as bad as I expected. I was sedated and don’t remember a thing, and I didn’t experience any significant pain, just some discomfort. However, I’ve read stories on MN where not everyone was as fortunate.

With ICSI, ASA isn’t much of an issue since the embryologist selects the best sperm and directly injects it into the egg, improving the chances.

If you choose to go down the IVF/ICSI route and need to go private, I’d recommend looking for a smaller clinic. Our experience with ours was fantastic, and the personal care made a big difference.

Hi. So my gp has referred us but she was really candid and said the wait list for ivf is 2 yrs if need it! She said we may be able to get iui within 2 months but I am not convinced. So we're looking privately now. I am planning on booking a consultation next month. I guess with iui I am just thinking what if it did work and I could avoid the whole egg collection thing. If you don't me asking do you know what your husbands sperm count was? And which clinic did you go to? My dh has started proxeed plus so I am really praying and hoping it may help. Thanks so much for your advice you've been super kind and helpful.

@Sherr33
We switched from Buserelin injections to a nasal spray (I’ll check the brand on my invoice), and I also had an additional progesterone injection, Lubion, alongside Crinone. My other half believes that the waiting period (for the test results) gave my body time to recover and rest from the egg retrieval process, which might have helped as well.

@Dobcaty what were your days like after transfer? I can't be bothered making changes to my diet this time 😩 were you resting or on the move? In terms of supplements were you told its okay to take post transfer. After my frozen transfer I got unwell. My immunity is crap anyway but as soon as I had the transfer I got cold sores and mouth ulcers and I sort of knew that this isn't right. I wasn't able to take any medication for it either 😕 so I'm wondering would it be safe to take vit c and any other immunity boosting vitamins

@Dobcaty sorry to bother again. I wanted to ask when you tried iui did you use clomid or letrozole? Or was it unmedicated? Thanks

@Sherr33 when the successful transfer happened we were in the middle of the house moving, literally got the keys a day before and still needed to empty the previous one, and didn't take time off from work either, so it was busy 2-3 weeks. Which is helped me to not symptom-spotting all the time!
However I did started to rest up after the first positive results as I had on and off spotting and heavy bleeding until the 13weeks mark.

I didn't take anything else just the pregnancy vitamin (supermarket own brand) and made sure I drink plenty of water and eat plenty of fruit/veg.

@Fariapea it was unmedicated in terms of prepping the cycles (I was classified with unexplained infertility, so regular cycles with regular ovulation) had I think 2-3 scans before ovulation, and then got a HCG shot before the IUI (monitoring LH levels with strips)

@Fariapea I would also check if you’re still eligible for NHS-funded IVF after having IUI on the NHS. Some ICBs (previously called CCG) areas only cover one type of treatment, either IUI or IVF, but not both.

So i am definitely ovulating too and have regular cycles. I read that they also medicate ovulating women to make them release more than one egg in the hope that iui works if the males motility/morphology is normal hence we're now working on improving those. They wash the sperm of the antibodies. We're thinking lister or crgh so will see what they say. Can only try I guess. Thanks!

Thanks I will but tbh we're not waiting 2 yrs for nhs ivf-time is not on our side. They've said 6-8 weeks for maaaybe iui but even that I am not sure. So we're going privately now. Thank you so much for your help and good luck with your pregnancy. So so happy it worked out for you in the end xx

Amazing news @Dobcaty we were on some initial IVF threads together and I am also pregnant naturally. How are you feeling? This pregnancy is so different for me than the IVF one x

Did you also have antisperm antibodies as an issue @PMAmostofthetime ? Congrats x

@Fariapea good luck on your journey, and let me know how things are going!

@PMAmostofthetime wow! Congratulations to you too! It feels weird that we have been trying for years and then bumm when you at least expecting, doesn't it? 😀

How far are you along? How old will be your little one when your surprise bean arrives?
I think the biggest differences between this and the previous pregnancy that I am more tired and exhausted this time (bc running after my 16 months DD, working full time and studying to change carrier a little more than I can hold 😂 ) but I am less anxious this time as I know my body can do it.

@Fariapea I was unexplained fertility
DH was Azoospermia however with the right support from the NHS that was reversed and was low motility.

@Dobcaty 23 weeks, DD will be 22 months.
I nap when she naps, when I am not in work.
I am exhausted and in bed as early as I can fit in.

On a positive note one of the Mum's who we go to baby group with has a 19 month gap and said that it's easier when they have arrived. X