ERA EMMA ALICE testing thread 7

[VenusStarr]

Hi all. We're on our 7th thread! Really hoping for some more positive news in the coming months.

@CailinInUK Sorry I sent the wrong message! I’m really sorry. I think my head is full of preparing for my next transfer which my consultant is not very optimistic about. I’m sorry you did not get the result you wanted but you did get a normal so you still have a good chance especially the fact that your egg quality is good and your ovarian reserve is good for your age. I’m wishing you all the best for your May cycle. Are you doing long protocol again? One thing I would say is to take the probiotics as you go especially if you’re taking antibiotics now.

@clhiu Over 12mm is thick. I usually get to that stage on trigger day. What cycle day are you on? I just had a negative email from my consultant so not feeling great about my transfer.

@Gardenlady543 Do you usually do a final swab before transfer? I have looked into fertilysis but they are expensive. I do have a spare test with Invivo but I would have to do it a week after taking antibiotics. Definitely taking Flora femme after antibiotics with canesbalance and doing another probiotic each morning. I just want to know if my atopobium vaginae levels have dropped. I did contact Fertylisis via email and they advised me to do the full microbiome assessment, but it’s so expensive. I asked about the basic. They said it still picks up atopobium vaginae, but the full assessment would pick up if there is a more serious infection going on. My head is spinning at times. I like Invivo but my nutritionist can no longer help me and my consultant doesn’t trust their results. I trust them.

I have been referred to a gynaecologist in Plymouth but my first appointment could be in 4 weeks. I’m conscious that time is ticking.

Not feeling very confident. I asked my consultant about taking dhea in my transfer cycle to increase oestrogen, but he doesn’t think it will make much difference in my case. He did, however, advise me I could restart vaginal probiotics 4-5 days after transfer. I’m taking metronidazole at present and taking probiotics, but after I finish I’ll be taking vaginal probiotics morning and evening.

I feel as though this is wearing me down. My embryos are so precious, but I suppose I have to take a chance. I did feel that with higher oestrogen at the start of my period this month my symptoms are not quite as bad and I had more cervical mucous when I finished oestrogen priming. The issue is after transfer my fsh will rise without the estradiol support. Will the extra progesterone make oestrogen lower? I did feel when I was gearing up for transfer and then tapering off lubion my progesterone getting higher and high fsh symptoms returning. My consultant has not discussed this with me.

Sorry for lengthy message.

@2021ivfagain I don't do swabs at all, I think they would just freak me out. I am going to use 3 days of dozy before the transfer this time and daily vaginal probiotics. I think if I were you I'd take some antibiotics right before transfer as well as the vaginal probiotics similar to what I'm doing stopping just before and starting after transfer. I'm not sure about the hormones but post menopausal women do medicated FET so it can't matter that much. You are doing modified natural are you?

I started spotting today so that's 2 days earlier than expected. I called up to hopefully book in a baseline scan, waiting on a call back now. Getting pain on the left hope a cyst hasn't formed there as there was a 8mm follicle.

@CailinInUK I think it's because it's a proper private hospital maybe? And not just a clinic? Maybe!

So the PGT-M is looking for a specific thing, is that right? That's such a shame that you got the euploid but it didn't pass the next test. Hopefully next time. We're doing PGT-A this time, all being well.

@Gardenlady543 omg, they haven't even given you a biscuit? I was given that with the NHS, maybe a tea too but I was dozy from the sedation so can't really recall. Can't believe @VenusStarr also didn't get a biscuit!

@Faithhopelove83 glad to hear your scan went well!

@clhiu I always have good lining, no idea why, wish an embryo would like to settle in there!

@Gardenlady543 fingers crossed you can get a baseline scan done!

@2021ivfagain I did the expensive fertilysis one, the costs are annoying but it did get my consultant here to pay some attention to that stuff.

Ok so I had a call at 9am on the dot. 10 were mature from the 14 collected and 9 fertilised normally, which is great because our "best" (unsuccessful) round was round 1 when we got 15 eggs, 12 mature, and 9 fertilised normally so to get fewer eggs and fewer mature but still 9 fertilised and in the running today is really good. I'm a little nervous because it feels like we'll end up with nothing because we're doing PGT-A of the excess, but at least we'll get to transfer one if it makes it to day 5/6.

Because DH has all these clumpy sperm, I'm really hoping that the solution he has to provide the sample into and the IMSI will have helped get some decent ones. She said they're good DNA wise (from the frag tests) but they just can't swim, they're immobilised by the antibodies. I can't say my hopes are high at this stage, it is what it is now. Just a shame it took 4 years to learn why his sperm didn't swim.

@kerrym87 I can't remember your last update (think it's on another page), but fingers crossed you're ok post transfer. How's the pred?

Good news @thislittlebird keeping everything crossed those 9 continue to grow well. Do you get a day 3 update?

I'm sorry you're feeling worn down @2021ivfagain I hope you can get some clear guidance from your clinic.

Good news @Gardenlady543 hope af gets in full flow soon 🙏 hopefully no cysts (or any other setbacks now!)

Your lining is thick @clhiu is there any reason they've not already moved onto the next stage? I remember my first FET and once I got to over 8mm they planned progesterone and transfer.

My temps are creeping up, started pred today as per the plan. I'm supposed ro start cyclogest too but was going to hold off a day or so, as not sure I've ovulated but I'm doubting myself now... 😒 I've not missed this anxiety over decision making!

@thislittlebird that great news! Fingers crossed for some good embryos. I'm just waiting for is which is 19th......its harder to be positive with my history and how I'm home alone as hubby back at work and I get easily worn out means it's harder to keep distracted. Pred is OK, slight increase in appetite with lack of activity and not able to do yoga means I'm getting a little doughy 😅 my uniform dresses may not fit when I got back to work. Getting awful bloating by bed time....waist goes up by 1.5 inches but back down by morning.

@2021ivfagain I think progesterone does reduce oestrogen but also fsh as it wouldn't make sense to have body trying to stimulate when preparing for possible implantation etc. I have been given oestradiol alongside my progesterone each time to maintain lining (although enver had a thickness or maintenance issue with lining....with failed transfer I didn't bleed until meds stoppped)

@VenusStarr I think it's fine to hold of on Progesteone if you're not sure as my understanding is the level is to maintain pregnancy rather than for receptivity, best to be sure you have ovulated as your body will start releasing Progesteone from that.

@thislittlebird these are good numbers :)

Baseline scan is booked in tomorrow morning, I may actually be doing some form of treatment and have updates soon rather than sitting on the bench!

@thislittlebird 9 fertilised is good, especially if this is the first time you get to do something different to deal with the sperm issues by adding IMSI.
I'm painfully aware good lining doesn't equal successful implantation by any stretch, but at least is one less thing that could be going wrong and I don't have to worry about.

@2021ivfagain yesterday was cycle day 9, day 7 of alternate stims. I don't recall specific lining thickness for each scan when I did the ERA mock cycle in February, but it was definitely above 12mm at the post-trigger scan, in fact, unless this sounds completely insane, I'm pretty sure it was above 14mm.

@VenusStarr they are not triggering me yet as LH hasn't surged yet as per monitoring bloods and the dominant follicle wasn't quite ready to pop yesterday, I believe the biggest was either 15 or 16. My guess is that I'm responding slightly slower than I did during the ERA cycle. What happened then is that after my day 9 scan I was asked to go take the Meriofert injection again that night as normal, but to back again the following day for another scan and bloods and that's when I was told to trigger, on day 10. On day 9 last time I also saw an LH surge with a home test, which I still haven't had this morning, but based on lining and follicle size I'm expecting they may have me triggering either tomorrow after the scan and bloods or go back again the following day and have me trigger then so 1-2 days later than last time. I'll just have to see what happens tomorrow. Also because the ERA test found my endometrium to be receptive, they are following the same protocol as much as possible, although I believe that's more to do with the number of days post-ovulation than the follicular phase.

@Gardenlady543 that would be very unlucky and a real pain if there was another cyst and if the previous one hasn't gone away, I hope not, but in case, will you be planning to give your consultant an earful? I really hope it's not the case and it's just cramps.

@clhiu yeah I do hope the IMSI will help, but where they don’t move I’m worried it won’t make a great deal of difference but we will see. So far the same as our first ICSI round.

For me the good lining thing is frustrating because we haven’t had success, but it’s definitely nice not to have to worry about that as well.

@VenusStarr yeah, we get a day 3 update but that didn’t mean much last time because it all went to hell between day 3 and 5 🙃. They’ve booked me in for an early transfer on Monday because we’re hoping to PGT-A test any extras.

I’ve also started Cyclogest today. Almost relaxed into med free life too long for a minute there, starting more injections tonight.

@kerrym87 I really hope we get some, the PGT-A is already likely to wipe what we get out but it is what it is now. It’s incredibly hard to be positive when we’ve been through all this shit. I kinda hate pred! I started it today myself but not for ivf, for asthma. The sedation seems to cause me to develop a bromchospasm so I’ll take it for a few days leading up to (possible) transfer.

@Gardenlady543 remind me, is it a FET or new cycle you’re hoping for?

@thislittlebird I'll be doing a modified natural FET- if baseline scan is ok then Meriofert 75 units a day and then potentially fyremadel and definitely a gonsai trigger. I will be on a full immune protocol with intralipids, the specialists wants 2 scans showing progression before we do them since the last FET was abandoned. Prednisolone 25mg and Inhixa 40mg from CD7. Progesteone will be cyclogest 400mg twice a day and PIO daily.

@clhiu the specialist just says my body does unpredictable things :( , I do feel it's the fyremadel being added too early that caused the abandoned cycle though. I guess also letrozole is not for me though and I'm keen to see how I do without it and with low dose stims instead. So happy to get to try this type of cycle. If I am given the all clear to start!

Just after some thyroid advice... my bloods are back and tsh is raised 3.36 😫 feel like this cycle is already a bust... I'm on 50mcg of levothyroxine. I did run out of tablets while we were abroad due to the delays, so maybe missed around 5 days, no more than a week though. Is this really bad?? 😢

@VenusStarr your TSH needs to be under 2.5 but ideally lower, missing those 5 doses isn't great but the half life of levothyroxine is quite long so you should have still had a good amount in your system. I would suggest you up the dose. I increased my dosage recently because of a TSH of 1.85 my endocrinologists wants it under 1.5 and wants me to increase up my dose automatically with any positive pregnancy test as this sends TSH up. Get on the phone to your GP and get an increase in dose I'd suggest. I know you had no choice as you were stuck abroad due to the shit situation you were in, but next time always make sure you take a good supply when you go away as you really do need a consistent daily dosage. I always take first thing in the morning with a sip of water, then I have nothing to eat or drink for 1 hour, I don't take any medications or calcium for 4 hours after. Ideally you need to avoid caffeine close to the dosage as well.

@thislittlebird yes I totally get the frustration when everything seems to be completely fine on paper and then things don't work out 😔, literally what is the point. I know what my odds are so probably my lining being good or anything else will mean nothing in the end

@Gardenlady543 I hear you, basically impossible to predict how it's going to go which is true for most people and IVF cycles, but it sounds like in your case you have even more wild cards than most in your bunch.

I wonder if someone with expertise or experience can advise on taking Omeprazole during luteal phase + 2WW + possible first trimester.
Getting a bit frustrated with my clinic as they're not very responsive to this issue since they prescribed 150mg Aspirin and 40mg heparin injections a day. My stomach lining has always been very sensitive to anti-inflammatories and painkillers like aspirin to the point that after just a few days, say if I'm treating a cold, I get severe indigestion pains and heartburn. I know blood thinners have similar effects.
With my last natural pregnancy I was prescribed half that dose of aspirin and heparin from a positive pregnancy test as they are found to help prevent miscarriage in some patient. After barely two weeks of taking them I started getting very bad pains that were keeping me awake at night as soon as the pregnancy terminated I was able to stop and the pains went. I'm really worried that doubling the dose will have an even more dreadful effect so I asked my consultant whether it would be ok to take 10-20mg of omeprazole daily as I know that to help with such symptoms and it's one kind of gastro-protector that is allowed during pregnancy so I didn't think it would do much harm. The first - very unhelpful - response (via my consultant secretary) was to just 'remove the aspirin from my treatment plan', something I don't really want to do as it was recommended both by my private and the NHS consultant and there seems to be a decent level of agreement that helps both with implantation and preventing miscarriage. So I got back to her and said that wasn't really answering my question and Ideally I wanted to be able to take it but needed to know if Omeprazole was ok and the response I had to that today was that I shouldn't take that, but use Gaviscon instead. I have to say gaviscon does absolutely nothing for me both for heartburn and indigestion pains, whilst Omeprazole does. Anybody has any idea why I should not be taking it, how it might interfere with implantation or other medications and why to my consultant would it be preferable to forego the aspirin altogether than taking it with that?

Thank you @Gardenlady543 I had taken my last sleeve on holiday as was running out anyway. Frustrating. I've only got 50mcg tablets. I just hope it's been caught early enough to not impact negatively on this cycle.
I keep mine by the bed too and take it as soon as my alarm goes off so it is usually an hour before eating.

@clhiu omeprazole is part of my protocol. Starting the day I take prednisolone from. I'm on aspirin as well daily, but only do the omeprazole after ovulation/ 5 days before a transfer. So I don't think it's an issue. Could your GP prescribe it?

🤞 you get a fresh and some embryos to test @thislittlebird

@VenusStarr sorry to hear your thyroid are causing havoc now, I hope it can be fixed quickly by increasing the meds dosage and you don't have to cancel the cycle, it's all so down to the wire for everyone every time 😫.
Thanks for the advice on omeprazole, I really don't understand why my consultant would be so against it. Indeed I already have enough left form a previous GP prescription to take me through the 2WW (I would also only start if after ovulation, when I'm advised to start taking the aspirin and blood thinners) and have a GP called scheduled in 2 week's time to order more if needed. So getting the prescription isn't the issue, but I'm concerned as to why my consultant would say not to take it as I'm now worried it may impair my chances. @Gardenlady543 I hope you don'd mind me taking advantage of your expertise, but do you know any valid reasons for me not taking it and do you feel in balance would be better not to take the aspirin at all than take it with it?

@clhiu omeprazole is fine, I'm already on it and will remain on it if we get bfp. If in doubt there's an online resource called BUMPS which tells you what is advised or not. It's also about benefit of meds outweighing risks for example, mental health meds x

@clhiu might just be because they're clueless from that side if medication. I find gavscon dual action best, plus eating little regular meals, with dairy, sleeping a little propped up and not going to bed on an empty or full stomach. I have reflux and hernia as it is you see. Might be worth trying a reduced fat, fizzy drink and caffeine diet too if not already doing x

@clhiu Sorry it’s causing stress. Just had my nurse consultation so aiming to transfer to start in May. I find things stressful too with them.

Could I just check are you taking steroids as well as aspirin? I need to decide if I want to take steroids.

Thank you @kerrym87, that's very helpful of you. I will try with the gaviscon at first and follow all the above advice. If it doesn't work I think I'll start the omeprazole and ignore the consultant advice on that 🙂

@2021ivfagain I do find it quite tricky to get straight answers fro them at times, many times I had to go back and forth between the nurses and secretary several times because the point of my question was being missed, I was wondering if it was just my consultant, but seems it's not and I am sorry to hear you are facing this continued stress, but times 10.
No steroids for me as my NKC and thyroid anti-bodies are normal. I just have to add 3 doses of intralipids as one particular NKC value was slightly higher than what my consultant deemed optimal for implantation (according to certain studies) albeit within the normal range.
Were you prescribed steroids due to confirmed immune issues or other reasons?

@clhiu

Aspirin:
Prof Brosens said: Thromboses do not cause implantation failure (a long disregarded misconception) but COX-2 (aspirin blocks this) is important for implantation. Hence, there is no indication for low dose aspirin. In pregnancy, low dose aspirin is effective in preventing late adverse obstetrical disorders, like preeclampsia.

Heparin has a number of actions, independent of its anticoagulant functions, that may potentially be useful. Heparin enhances the activity of heparin-binding growth factors, a number of which are mediators of implantation.

So I take Inhixa 40mg from CD7 and no aspirin.

Re stomach protection:
I’m not an expert in what is and isn’t safe in pregnancy. But sounds like you have already done some research there. Stomach protection is pretty common in protocols so not sure of their reasoning.

Esomeprazole is over the counter and is pretty similar if you did have issues sourcing.

Another option to consider is Famotidine, it may be harder to get hold of, but is often recommended in USA for the at home immune protocol.

@VenusStarr Have you had your vitamin d levels checked? I was told that can affect thyroid levels. I am on a high dose of vitamin D, 3000iu a day split up throughout the day. I hope you sort out the issue but you could safely take up to 2000iu vitamin d a day if you’re not doing so. I’ve been told that by my clinic but obviously if your levels are really high then you would need to check.

@Gardenlady543 I hope everything goes ok for your next appointment. When is it? I’m doing the same protocol as you so natural modified FET with stims. I’m just on higher dose stims than you. I don’t really wanted to do medicated as I had lining problems when I used that protocol. I just know of people in America who have done natural FET and have had oestrogen and progesterone support but I think I’ll just ask for estradiol to be measured.

@kerrym87 I’m not having estradiol support after natural modified FET transfer. They are more focused on lining which usually gets to about 12mm with stims. I have had estradiol support when I did a fresh transfer but this is a natural modified frozen transfer cycle.

@clhiu I find the clinic to be very cautious and perhaps they worry that it is too much medication to take. It’s like my consultant wants me to stop my additional vitamin c before transfer, stop vitamin e and cut down on vitamin d before transfer.

Thank you @2021ivfagain I'm on 2000iu vitamin D as I was found to be low. Have been on that dose for a long time.
I was thinking the stress of dh's health probably hasn't helped, plus missing a few days, plus I saw something about estrogen levels and once you have progesterone the tsh balances out (not explaining well but am in a Reproductive Immunology Facebook group and saw it there today). So hoping it might be a combination of all that.
Have sent an email with my results and the recommendation from the clinic (75mcg for 6 weeks then retest). So hopefully that'll be signed off. I only have 50mcg tablets and they said not to double up.

Good luck tomorrow @Gardenlady543 for your scan.

Thank you @clhiu we've done timed intercourse this cycle, with a trigger. It was all going so well. I should've expected a spanner in the mix 😒 I triggered on Tuesday, so hoping I have ovulated now (am super bloated today). Just worried the thyroid level will impact implantation/pregnancy, if we get that far.

@2021ivfagain baseline scan is tomorrow morning to see if I can start. I think usually don't start estradiol until after ovulation to let the body do it's thing up until ovulation.

@VenusStarr I was on 100mcg and then reduced down to 75mcg but recently changed to 75mcg 5 days a week and 100mcg 2 days a week with a plan to go to 100mcg daily if I have a positive pregnancy test. I think 25mcg adjustments are sensible.