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 :)

@2021ivfagain I took a lot of flora femme pre and pair transfer. I always do tsh, t3 and t4 but I'm on levothyroxine. Your tsh is a bit low, it's a good idea to test the t3 and t4. Mine is lower than yours but it's because I'm on medication, it can shoot up in pregnancy for people with hypothyroidism so it was better for me to have it lower pre FET.

@Gardenlady543 that’s understandable, hope all goes well tomorrow.

@Sar1010 sorry to hear this. that sounds a sensible plan. Definitely push for checking out the uterus and tubes!

@Mybabydream good luck for the 2WW 🍀

@2021ivfagain sounds like things are moving forward and you’ve got a decent plan.

Just wondering if anyone has anyone taken pred during stims before?

@Enfys23 yes, I take 25mg prednisolone from CD7 of the FET. How are you getting on?

Thanks @Gardenlady543 I’ve finally got my protocol and dates! So I’m down to start pred 10mg on day 6 of FSH injections and then I double the dose from egg collection day. I also have viagra vaginally 25mg QDS this time from start of stims to trigger day (alongside continuing DHEA to trigger). Then starting inhixa 40mg and lubion OD and Cyclogest 400mg BD from egg collection evening. I’m starting norethisterone 20th June for 11 days and egg collection provisionally 17th July. I’m going to have a baseline scan finally and then a day 9 scan (because of way dates fall over weekend). I’m considering booking a scan in between these. I’ve ordered myself some extra monitoring bloods as the clinic aren’t planning on doing any. Not ideal but there we go. Only so much I can fight. Feel better for having a plan and some dates in place.

Good evening ladies, I’m after some advice as always.
Were you ever told to completely avoid running if you’re struggling with fertility and that it rises cortisol levels so badly it has a negative impact on egg quality?
I’m not talking training for a marathon or even half marathon or running professionally. I’m talking jogging 4-6k twice, absolute maximum thrice a week. Mostly in the cardio heart rate zone, but with some intervals in peak.
Just for the record, I stopped it with all my pregnancies and during each IVF cycle, including FET from the start of the stimulations, but when I’m outside of IVF/pregnancy, it is one physical activity I love, it’s good for my body and spirit and if I have to stop that too completely I feel it’s one ask too many, one responsability/reason to blame myself too many. I had my first even acupuncture session this week and I loved it, but she told me to avoid running that it’s ‘really bad’ for fertility.

@Gardenlady543 pleased to read all keeps going well

@2021ivfagain at last they granted you the oestrogen, I know this has been a very long and frustrating journey for you. Do you have a transfer date?

I hope everyone else is doing ok, haven’t caught up with everything yet X

@clhiu I have heard that about running but I ignored it because it's the only form of exercise that I regularly do and I figured it was better to be fitter. Like you I stopped during cycles and didn't run during my FET. I didn't push it either but I think a jog is fine personally.

You always have to balance advice against your lifestyle I think.

Xxx

I think as long as you’re not doing it during treatment and not too intensely + taking in calories to compensate then you have to do what keeps things liveable for you @clhiu Also it depends what issues you’ve had. I’ve been told to lay off anything too high intensity due to thin lining issues and low BMI (which I’ve determinedly got up but it’s hard work and I really physically couldn’t eat more calories - yet still eat healthily - to make sure I got enough calories to keep my hypothalamic-ovarian talk happy) and given we’re not really having many breaks between treatment cycles, then I’d be nervous to now.

@Enfys23 yes this plan is good :) my clinic mentioned starting on the lower dose and increasing up close to transfer, but Dr Gorgy likes people on the higher dose from the start so I did that, I have seen people in the immune group doing what you are doing now. I arranged a scan on day 6 if stims, can you arrange one then and if it shows a lot happening you can tell your clinic to bring the CD9 earlier, I only needed 8 days of stims before triggering in my first collection.

@clhiu I can't see any issue with you running inbetween treatment. I think it would be a good thing to do.

It was my birthday yesterday and I had a few treats. I did have some red wine but haven’t been drinking for months and will not have anymore. Actually, I didn’t sleep very well because of it.

@Gardenlady543 I’m starting vaginal clindamycin this evening but after taking lots of probiotics and with oestrogen now rising I feel like my symptoms have disappeared. Problem is I suppose it could come back just before transfer. I think it’s linked to oestrogen because when oestrogen is low I find it hard to lower vaginal ph. When you took vaginal clindamycin, did you continue taking it when you had your period? I’m worried as I know I need canesbalance in and probiotics straight after treatment but they won’t work so well if I’m on my period. Could I time it that I’m on vaginal clindamycin during period? Problem is with 0% lactobacillus I’m at risk of infections. Plus period raises my ph ridiculously high now things burn.

@2021ivfagain I am sure it will say in the info that comes with the drug whether to use on your period. I probably would avoid this if possible.

@clhiu I’m in oestrogen priming so I will start stimming on cd3. This will be about 21st June. So transfer will probably be early July but it all depends on how I respond this time. I worry that I might not have many follicles left now. I’ve been taking 2mg x3 zumenon tablets a day for oestrogen priming.

With regards to running, I stopped all high impact exercise like aerobics when I started TTC. I was worried it might affect things. I think if you are used to running, it’s fine. If you were doing stims, they say to avoid it.

@Enfys23 I’m sorry about your delays. I hope everything works to thicken lining, but I find meriofert works well. My lining gets thick when my fsh is good. I’m hoping with the extra changes your cycle should go well. The extra scans are a good idea.

@Gardenlady543 I’m really worried about vaginal clindamycin. How long did it take to lower your ph? Will a raised ph put me at risk of getting it again before transfer? As I am peri menopausal, my ph sits higher naturally. I’ve looked at canesbalance and it says you can take them during periods because my concern is when I stop canesbalance during period ph gets even higher and I get burning. I’m wondering whether I could take 3 canesbalance a day to bring ph down after antibiotic treatment? I wish I could take canesbalance after transfer but the IVF consultant has discouraged it, but with no lactic acid after ovulation, my ph will be really high again. When my oestrogen was higher, things were so much higher. Oral hrt works to a point, but won’t kick in until I’ve been on it for about a week after transfer. Even when I use vagibiom on its own my ph lowers very slightly but not as dramatic as canesbalance. Vagibiom would be a better option to use after transfer, but I’m starting to get scared. Did your friend stop with vagibiom at all before or after transfer?

@2021ivfagain can you use a menstrual cup? Menstrual blood is alkali so it's normal for the pH to go up, and I don't think it's good to interfere with that.

The person I know didn't stop vagibiom for transfer, they did it every day.

I didn't measure my pH on clindamycin.

I think you're just going to have to optimise things for your transfer with the estradiol helping the hormonal side of things

@Gardenlady543 I’ve never used menstrual cups. I use sanitary towels but will need to use unscented. The issue is vaginal clindamycin will raise ph and that is what my gynaecologist told me.

When you used vaginal clindamycin and you stopped, did you wait for period then do acid treatment with probiotics?

I’m also thinking if I’m wiping out lactobacillus, should I stop my vaginal probiotics at all? I was going to stop on day of day before and day of transfer.

I’m aiming to use Flora femme after transfer, but if I struggle to use it I might just use Vagibiom. I was just worried as they say to avoid canesbalance after transfer, but I suppose it does not have the exact same ingredients?

@2021ivfagain if I take antibiotics I take the vaginal probiotics right after, if my period comes I just stop on those days and start again after. I would try to time it so my period doesn't come while on them though. If you used a menstrual cup you would catch the high pH fluid before it hits the walls of the vagina, so might have more chance keeping the pH low after.

@Gardenlady543 Thank you for your advice. I started vaginal clindamycin and I can feel it working already! All my blood test results have been done by my surgery. They all seem low.
Tsh 0.80miu/L.
Free t4: 12.8pmol/L.
Free t3: 3.5pmol/L.

@2021ivfagain what are the normal ranges, all labs are different.

@Gardenlady543 fingers cautiously crossed for you. Haven't been up to date on here so missed a few bits.
Sent all notes from nhs clinic to Dr gorgys today, looking at trying to book nurse consult and ema/Alice, unfortunately all my ideal time slots seem to be when we prebooked holidays and someone's wedding as was waiting for cycle to settle after last failed cycle 🙄
just got clinic letter from nhs hospital and for the first time in 3 years this has never been mentioned at all not even at the final appointment the letter pertains too....apparently I have reduced ovarian reserve!!! Don't know if this is a mix up or they never bloody told me but I would have asked different questions and whether a different protocol might have been better. If it is correct I am so pissed off, if not still pissed off as quality of letter as to what's actually been discussed is poor each time. Anyone else got this and what did they do differently as a result? We've always collected 14 eggs but only 40-50% fertilise. He never even mentioned in clinic letter he'd suggested sperm donor.....

@kerrym87 with a reduced ovarian reserve you wouldn't get 14 eggs. I have a high antral follicle count and I get 10-12! I would question what they mean by that. It will be good if you can slot in the biopsy soon, so that you can move forward with any treatment. When is your Dr gorgy appointment?

@Gardenlady543 well, we booked an appointment with Dr gorgy, there was a cockspur and we ended up with Dr chawla instead. Got a bit overwhelmed, spoke to nurses, was told to ring to book ema/Alice with them, rang them and they said I'm trying to book it in too early and it should have been booked with admin team. I've just sent notes from previous clinic today. Dr gorgy had suggested when we go for tests they give us plan for ivf, drugs etc but that feels very last minute without further consultations but we had booked Dr gorgy, nice as Dr chawla was and still paid for it. How does it normally work as we've been in nhs land over 2 years and can't get head around what's going to happen as it depends on what the think from notes baseline investigations and outcome of ema/Alice 🤔

@kerrym87 I mean era Emma Alice any clinic can do, so really you want to know if you need immune treatment as that's Dr Gorgys expertise. Are they trying to get you to do Ivf there, it will be really expensive I expect. I would do the Ivf at a standard clinic and do add ons with Dr Gorgy, my clinic are happy with some of his plan but won't prescribe certain things which I get him to prescribe. Now in pregnancy my clinic have discharged me and I'll stay under Dr Gorgy. What other tests have they suggested?

They're trying to get me to do treatment with them but it's actually similar costs. There's only one place up here doing ema/Alice but he doesnt seem to cover a huge amount and not sure we want to start with one clinic and then they wont work with Dr gorgy. The one up here uses lwc and the one up here has a notnsuch a good reputation for not scanning when they should or interpreting scans/bloods very well. someone ive been speaking too had 3 embryo transfers despite not being told her lining was really too thin and they all failed. We just don't know whether to have main stuff with them as they are happy for us to have most scans and bloods during treatment up here, just ec and transfer down there. Costs are pretty similar

Hi ladies, I’ve been absent for a while since my cancelled FET. @Gardenlady543 I’m so pleased to hear your recent scans went well!

I hope the rest of you are doing ok and managing to look after yourselves during your IVF journeys x

At which stage have people decided to see Gorgy or Shehata? I’m wondering whether I should see one of them to rule out immune issues even though I’ve had just the one FET. Can thin lining be caused by immune issues?

@Mybabydream for my transfer, my first embryo expanded 50% so they thawed another embryo and transferred that one at 70% expansion. My embryos haven’t been tested though. It sounds like they knew what they were talking about. I hope you’re doing ok and keeping busy

@Spin101 do you mean they waited for the 50% embryo to expand further to 70% and then they transferred it? Any success? Tks