Fail after two miscarriages

[MinPinSins]

Hey, I just found out my third fet failed today.

My first was positive, and I got a positive test with
good HCG (99 on 8dp5dt and 400 on 10dp5dt). My second was also positive with good HCG, but I had spontaneous miscarriages at 6 weeks for the first and 6 weeks 3 days for the second. My clinic don't scan until 7 weeks, so I don't know if it was a normally developing embryo, or blighted ovum etc, as it was never seen.

With my fail, I found out on OTD (13dp5dt) through a urine test, so there is a small chance it was a chemical and the HCG had gone back down by the time I tested

All embryos for both the miscarriages and fail were 5AA

For this third, I was on prednisolone and clexane as part of a miscarriage protocol. I also had miscarriage blood tests after the second, and no problems found, bar very low vitamin d. I was on high dose vitamin, d, and tested right before transfer, and that was normal. I also have PCOS, so was on Metformin, although I haven't been tested for insulin resistance.

I have 11 embryos left all from my first collection. They are untested (and I was 29 almost 30 at the time of collection), and I have one 'excellent' left and the rest are 'good' and 'average'.

All the extra tests I could do are quite expensive, so wondered if I could have any suggestions about what to prioritise.

Should I thaw and re-test the embryos? I'm aware that comes with potential risks to the embryos, and I was relatively young when they were made?

Would you recommend a hysteroscopy? I've never had one.

Would you put two back next time, or one? After the fail, my instinct says 2, although I worry I could miscarry both?

Are there any other tests you would recommend? I'm reluctant to do any implantation tests as the first two did implant well with good doubling HCG.

Is there anything else anyone would recommend? Thank you in advance for any suggestions!

Hello. I'm sorry you're going through this, it completely sucks. I've just had my second transfer after the first one failed so I know a bit about how you're feeling.

I think lots of clinics offer very expensive add ons that don't have a huge amount of clinical evidence behind them. Most fertility clinics are for profit, so of course they want you to spend as much money as possible.

Have you had any investigations into your early losses? You may just have been unlucky. And a perfect looking 5AA embryo can still be genetically abnormal.

It's difficult to advise on the genetic testing. You're very young so you should be able to expect your embryos to be much better quality than an older woman's. I've also read conflicting advice about genetic testing. I know that embryos can often develop into healthy babies even after a genetic test says they're abnormal. In my opinion it's just another thing for clinics to encourage desperate people to spend money on. Apparently testing was developed as a way to screen embryos for very specific genetic conditions rather than the 'catch all' testing lots of people use it for now.

Most clinics will be very reluctant to transfer more than one embryo because of the added risks that come with multiple births.

I had a good read of Professor Robert Winston's website the other day: genesisresearchtrust.com/askrobert/
It was actually his lab that developed genetic testing. His Q&A page is quite helpful and you can send him a question. I trust him, more than most fertility 'experts'!

I'm sorry I can't help more, but I really hope you get your BFP soon. It's such a painful path ♥️

Thanks countrypunk. I had miscarriage blood tests, which revealed very low vitamin d, but nothing else. That was resolved and I re-tested before this transfer. No other investigations though!

My lining has got thinner each go (from 10.1 to 8.7 to 8.4) so I don't know if that has had anything to do with the failure.

I'll have a look at the Q&A page, thanks! Best of luck with your transfer!

Hm, from what I've read, anything over 7mm is optimal. So you might just be experiencing normal fluctuations unless your clinic have changed your medication each cycle?

Frustratingly I think for most of us it really is just a numbers game with IVF. I don't know what your issue is but I read a study yesterday that said amongst women with low AMH levels, 84% will go on to conceive naturally within 12 cycles. I'm well beyond that but it still gives me hope that it might happen naturally!

All the best to you ♥️

Thanks, no change to medication, so it probably is nothing.

I'm in a same sex relationship, so that's the reason for IVF, so sadly no chance of natural pregnancy. I also have PCOS and only ovulate a couple of times a year.

I didn't expect this to be so hard!

Ah I see. I hope your clinic are being proactive with you after your losses. I think PCOS can affect egg quality so that could be another factor.

I know, it's horribly hard and a total emotional rollercoaster. There's always another hurdle to jump.