ERA EMMA ALICE testing thread 8

[Gardenlady543]

@2021ivfagain @kerrym87 @Janefx40 @seven201 @thislittlebird @Spin101 @Enfys23
@CailinInUK @BewilderedBee @Loz2467 @Lori2022 @VenusStarr @clhiu @Faithhopelove83 @APSR @ChickenT2b @Mina209 @IVF22 @Lizzybeth1988 @AM08 @Fluffykins33 @Sar1010

Continued in from thread 7 :)

@Gardenlady543 I’m really sorry you’re having this difficult time. All you can do is take one day at a time.

I’ve not had Enterococcus faecalis before but I do get ibs sometimes. I have read it is a form of strep D. Is that right? Should I take antibiotics for it? I’ve emailed my specialist but don’t know how long I will be waiting for an answer. The result is 7.0 out of 20. They class anything above 3.8 as high.

@2021ivfagain yes, the article I shared associates Enterococcus faecalis with AV, alongside GBS and E.Coli. It talks about treatment in the article too.

@Loz2467 lap and hysteroscopy are def a good idea so yep a great starting point.

@CailinInUK that's a great update, a lot can drop off after day 3 so making it to day 4 is fantastic news and I hope they will now continue on to day 5 :)

@2021ivfagain the article @CailinInUK posted looks good, there are a good amount of antibiotics that can be used including doxy in the article, you know I like doxy, but I think you said it might cause you gut issues? maybe that's because of your gut microbiome, I don't know much about microbiomes anywhere aside from gynae. I have heard good things about symprove, have you ever taken that before? it's a probiotic that is supposed to survive the GI tract. I'm not sure about the threshold to treat with antibiotics with these results, has your specialist replied yet?

Another frustrating day for me, I asked to repeat the progesterone in our surrogate with the hcg yesterday and they sent the result today and it was very low and they then told me the doctor decided to stop all medications on Friday without telling me. So I spent all weekend with false hope, when they had already made the decision to terminate the pregnancy which could still have been viable and the decision was made despite a normal scan based on one single blood test result.

@CailinInUK that sounds like good news re your fertilised eggs! Everything crossed for you!

Thank you - I did speak to a few with brown spotting before periods. Some taking cyclogest after O helped and they got pregnant naturally but that didn’t work for me but then another girl had a lap and it took 3 hours to remove all her endo and the only symptom she had was the brown spotting! So I almost feel scared for my lap and wish I’d done it last year rather than putting it off and allowing the clinic to say “ivf can over ride endo”. But I definitely have adeno. So I could just have that but I’m not sure! Because obviously the symptoms are the same xx

@Gardenlady543 that is appalling! Was it one if your embryos as well? Can't believe it, I'd be angry too! One blood test doesn't definitively define the outcome in this kind of situation. Fingers crossed for you x

@kerrym87 it was 2 of our euploid embryos :( , we had done a double transfer and I feel that wasn't taken into account as a vanishing twin was more likely with a double transfer. I have never heard of a clinic stopping treatment so abruptly based on one appointment. I guess I'll know more when I speak to the doctor when they arrange that, it's just awful to know that this decision was made and never communicated.

@Gardenlady543 That is awful. I’m really sorry that the IVF clinic treated you like that. I’m so sorry. You are so strong to go through all of this. You help so many people on this group. You are so kind. I’m hoping for the best for you on Saturday.

I might look into taking doxycycline. Thank you for your kind advice. I do take probiotics for ibs ( Inessa Advanced Daily Complex) and drink kefir so my ibs is much better now. I have taken doxycycline several times for egg retrievals in the past before I realised it started to affect my ibs. Would I become immune to doxycycline? How do you get hold of doxycycline? I’m going to have problems getting a prescription. I don’t know how much I would need and for how long.

@CailinInUK Thanks. I was pleased to get a good lactobacillus result but surprised I still have an issue. Do you have something similar? My nutritionist said it’s also known as strep D, but the information you emailed was helpful. I thought initially I have this issue due to peri menopause, but it seems quite common. However, my nutritionist also said it is connected to urinary tract health and I might have a urinary tract infection, but I have no symptoms. I’ve been advised to take another probiotic for that as well.

Are you planning on taking probiotics and steroids after transfer?

Do you think Good Clean Love probiotics are ok after a transfer? The ingredients seem similar to Flora femme. Also do you have an email address for Spectrum U.K.? I tried contacting them but it was like an online form.

@2021ivfagain doxycycline is actually an antimalarial so quite easy to get hold of www.doctorfox.co.uk/anti-malaria-tablets/doxycycline.html you'd need to see if your specialist recommends treatment first if not, you could do what I did and take 100mg twice a day for three days starting two days before the transfer.

@Gardenlady543 Thank you. My gynaecologist said basically he does not recommend I take antibiotics. I suggested ciprofloxacin as it spares lactobacillus as well, but he said it would treat it and then the strain of infection could get worse in the future. I feel stuck and stressed. My nutritionist who can’t prescribe said it might point to a uti and she said it could be due to my fluctuating hormones. I don’t know what to do. I’ve read it can cause sepsis if it spreads. Feeling quite anxious.

@2021ivfagain book in with your gp and say you think you have a UTI, they will do a dipstick of your urine and if issues in that they will send off the sample for MC+S. Then you'll know if there is a UTI that needs treating. I think if that is normal, then the decision not to treat appears to be appropriate, you were saying you thought your symptoms had improved on probiotics since the swab and you were felling well, so it kind of goes hand in hand with what you thought should happen. You can always add in those 3 days of doxycycline pre transfer like I did.

@2021ivfagain I have 50% lactobacillus and some GBS.

don’t even know if I’ll get to transfer yet so not considering probiotics post transfer or steroids yet. I doubt I’ll use steroids.

I think Good Clean Love says it reduces pH so possibly wouldn’t use post transfer. Again, not given it much thought as it seems way off, if ever.

info@spectrumsupplements.co.uk

I had a Day 5 update. Out of the eight, six have reached blastocysts and two morulas. Sounds great right?! Unfortunately five of six are only early blastocysts so can’t be biopsied yet :(
I know it’s hard to predict but I expect I won’t get more than a couple to reach biopsy stage tomorrow. A bit gutted there were no Day 5 biopsies. Higher rate of aneuploidy in Day 6s and even if any were euploid, lower chance of success.

@CailinInUK this sounds like a good update, I once had 3 embryos in a cycle (1 day 5 and 2 x day 6)- all 3 were euploids. The next cycle I had 3 x day 5... 1 euploid, 1 mosaic and 1 aneuploid. So honestly you really can't call it.

Will the clinic consider a day 7 biopsy of it comes to that, I know it's not great to have a day 7, but there is a chance especially if it's euploid.

Thanks @Gardenlady543 . You’re right, you can’t call it and I’ve had a similar number of euploids on Day 5 as Day 6 but was hoping/expecting a couple of Day 5 biopsies, given the Day 4 update. The older you get the more important Day 5s are and the morphology, as well as euploidy. At my age, chance of any being euploid is very low.

Last time I checked a few years ago, clinic (Care) don’t do culture to Day 7. Not sure about now but doubt that’s changed.

@CailinInUK you could always ask, I find the embryologists so helpful in explaining things and in your case they may consider it.

@Gardenlady543 Thank you for the tip!! I will definately be using Cyclogest PR too now. Though I must admit I am not looking forward to the white gunk this time round but hopefully it will be worth it. I just want to keep using probiotics the whole time though nobody has suggested this... I guess it's just my instinct. But then again I'd hate to mess things up for myself for not following the recomendations.
I actually have a pack of Symprove in the fridge that I panic ordered and will start this tomorrow morn and drink every day until Transfer day (Tuesday 30th)

I was just catching up with all the posts and are you doing surrogate and also yourself at the same time? Or have i misread the scenario. Sorry on the way home from a long of work. Sending love!

@Sar1010 lol I know I'm very confusing! I hadn't told people that I was pursuing surrogacy, but had done some back to back collection cycles at the start of last year, the surrogacy process was very long and complicated and so I kept pursuing my treatment, having immune tests and treatment, having fibroid surgery etc. Our surrogate then got pregnant at the same time as me with perfect betas, whereas mine doubled in the 3 day window rather than the 2 days, but I can see online that the 48 hour doubling is a bit old school and most places say 2-3 days is ok. And I mean how much can you be reassured by betas, every study outcome I saw had positive outcomes with our surrogates numbers and now that pregnancy is over and mine, as far as I'm aware, continues.

Tip for cyclogest, get some lube, I have had some rectal bleeding this cycle. I read the PR route leads to better blood levels and unlike the vaginal route the gunk won't come out on its own, so one less thing to worry about. I try and avoid passing for a couple of hours where possible, but I think 30 mins is usually enough time for absorption.

My vaginal probiotic opinion comes from two places, firstly my friends fertility specialist had her use a daily vaginal probiotic in her FET cycle, so I replicated this, my worry is with the transvaginal scans and I don't know what pH the lube they use is and the embryo catheter can move bacteria into the uterus, it seems a good idea to use the probiotics in the transfer. But like I said I didn't do them the day before and day of transfer, there's no reason for why I did this, I just thought probably best to have a break then. The second source is this research protocol which will put participants on vaginal probiotics in a transfer cycle and continue them twice a week until the 6-9 week ultrasound, I may be going over the board with daily but I figure it's best to be over cautious bmjopen.bmj.com/content/bmjopen/10/10/e035866.full.pdf

@Gardenlady543 I’ll definitely ask. I’m sure you know the Day 7 success rate is really low, but it’s not zero! The staff always get a gentle grilling from me, it’s the trouble with having done a ton of research. I imagine you’re the same.
How are you doing?

I'm doing ok thanks @CailinInUK :) I think today is the day the surrogate had the bleeding and everything went wrong, so it feels like a bit of an achievement to get to this point without bleeding. I just feel there is such a bit appointment to get through on Saturday, maybe the most important of the whole pregnancy, just like that it could all be over and I have no idea how I'd ever move forward having spent years to get this far. I had thought about not having my husband there so I don't have to manage his emotions as well as mine, especially if there is an issue but he has said he wants to be there so the plan is for him to come in. All I can say is thank God for sleeping pills because the only thing getting me through the night is the nytol that is knocking me out.

@Gardenlady543 Thank you. I will consider that. It sounds like a good idea. My head has been in a spin today. I think it’s because it’s been going on too long and I get very little help from the IVF professionals and I don’t have many embryos left.

@CailinInUK I understand. The Flora femme also says it lowers ph which they are supposed to I think. I will be using Flora femme before and after transfer as @Gardenlady543 has recommended. I think I might give the Good Clean Love a try before transfer as well. They have similar ingredients, but unlike Flora femme it has a gelatin capsule which makes it harder to absorb sometimes. I use lakcid intima as well which are good but they say don’t use in pregnancy, so I’ll avoid that one after transfer.

@Gardenlady543 no denying that Saturday’s appointment is huge. You’ve done all you can so hopefully the universe will be kind. It might be good to have your DH there and try not to worry about trying to manage his emotions. Glad you’re sleeping as the steroids wreaked havoc with my sleep. I’ll be thinking of you on Saturday.

I had a Day 6 update. Seven out of eight made it to various stages of blastocyst but just three suitable for biopsy (3 x 5BB). Two were poor quality (5CC and 4CC) and two early blastocysts. These four will be discarded as they’re not suitable to freeze and they don’t do Day 7 culture. I find this hard as although the chances are low for these, it’s not zero. Anyway, reasonably ok with having three make it to biopsy.

Thanks @CailinInUK :) are you the person doing PGT M as well as PGT A? is untested fresh transfers of embryos that can't be biopsied an option in the future at all? Fingers crossed for the results are of the 3 they have biopsied. What's the plan now, are you doing more banking cycle or waiting on the results and assessing from there?

Thanks @Gardenlady543 .
Yes I’m the one doing PGT-M and PGT-A (at 44!) due to genetic condition in DH’s family so untested transfers are not something we’d pursue. It would defy the reason for all this effort over the last seven years. It’s complicated because DH’s status is unknown, we’re doing exclusion testing so not finding out his status (more me pushing this than him) . In hindsight, we would have if we’d known it was going to be this hard to create a ‘risk free’ family. Anyway, we’re in too deep now. We have one PGT-M daughter (age 3) and around seven euploids in freezer that are at risk. I made a euploid two months ago so hoping I can make more and that it wasn’t a fluke as stats at my age are abysmal.

You’ve asked the big question though. If (big if) I was to get a transferable embryo, would I transfer or try to get more… I really don’t know at the moment. My head says to try get two transferable as if I had another late loss I wouldn’t have the time or strength to do more rounds. I’m gearing up for doing another cycle in July. Booked my review appointment for 13th June to discuss. I may not have the PGT-M and PGT-A results by then but wanted to get it in before my next Day 21 (down reg day).

@CailinInUK I can't remember the stats you mentioned before, was it a 1 in 2 risk chance? Are there 7 at risk frozen because you used the "not at risk" ones to have your child previously? If you have got 7 at risk in a row that would seem incredibly unlucky! I feel you on not knowing what to do, I have 6 euploids left albeit in 3 countries and this means a lot of legal paperwork and expensive courier process to move them, the number I have seems a lot but we have no idea what the issue is that have caused us so many problems both in me and two surrogates, it took 9 (7 euploids and 2 untested) to get to the point I'm at and if this pregnancy is successful then I won't be able to make embryos as easily in the future. Me and DH will need to make decisions about surrogacy moving forward and I'm very conscious of not working my way through the embryos we have without fully considering the options.

Oh @Gardenlady543 you’ve literally gone to the ends of the earth to have a family. I believe you will get there and it’ll be worth all the pain you’ve been through.

I banked seven euploids in 2018 over a number of cycles (three, I think, following several all aneuploid cycles due to triggering too early, in my strong opinion) then sent them for PGT-M (more financially favourable that way than to batch euploids then genetic test). Out of the seven, only two passed the 50:50 testing and deemed not at risk, which was unfortunate. The first transfer became my daughter. Had a medical FET and just used cyclogest pessaries. The second embryo didn’t survive the thaw. Since then I’ve done a few cycles and transferred as soon as I got a transferable euploid and not at risk. One 6 week loss in Aug 2021 and a 20 week loss in Nov 22, age 42 and 43 resp. When I got the euploids at those ages I thought they were one-offs, hence didn’t try to bank. And I had success on first go first time round. Now wish I had tried to bank more at the time.