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 interested to hear you say that about progesterone because everything I have read has suggested there is no such thing as too high. ARGC who have essentially the best success rates tend to keep progesterone over 200 in the week post transfer!! I'm not saying that is necessary but I'm pretty sure it doesn't harm. I took 3xLubion plus 2 cyclogest in my most recent transfer at CRGH but at ARGC I've been on 3 x Lubion plus 4 or sometimes even 6 cyclogest a day. And I don't have a progesterone issue either.

Usually I would start on a lower dose (just cyclogest) and it would be increased a few days after transfer as that is when my levels drop. ARGC test progesterone daily or every other day in the week after transfer. I made CRGH test mine every 4 days and it was dropping a lot. But then as I said I don't know whether this would have mattered to the outcome (all mine were natural cycle transfers by the way or fresh cycles so I also had corpus luteum).

@Janefx40 oh wow! That is very throughout! I should ave asked CRGH to tests me maybe 2 and 4 dpt, but didn’t think about it and they didn’t suggest it. I also had a natural modified so should have corpus luteum. They seemed happy with my level of 143 on transfer day. For reference in my last natural pregnancy I tested after positive pregnancy test at 4 weeks and it was just 106 and they were happy with that too, I was on 2 x 400mg cyclogest only at the time and they didn’t suggest I increase. The pregnancy was lost in the end, but not due to progesterone issues, it was a chromosome abnormality, in fact it was a MMC and I sort of blamed it on the extra progesterone holding it what wasn’t viable that it didn’t just happen naturally. I’m worried now I’d have had a drop as I had horrible migraine all night and still when I woke up this morning so wonder if I should ask for a check tomorrow although it’s £55 quid a pop and cannot really afford all these extra blood tests. No spotting or bleeding whatsoever so far.

@Gardenlady543 Thanks for adding me to the new thread! I’m thinking I need to just go ahead with this transfer as I’ve got 6 embryos and I’ve done all the prostap and meds etc. May aswell try it although I already know the outcome.

Last Oct on a scan when my endometrium was in secretory phase I had two tiny black areas in it. The Dr said it’s likely to be a thicker area as it’s so vascular but now I can’t help but worry. On my hyterscopy back in May last year I had an endometrial fold which he said he corrected but it doesn’t affect fertility and I could have always had it. Im just over thinking everything now and thinking do I want a scan in secretory stage but then how useful actually is that once the progesteone has hit? As the triple layer obviously dispersers and it compacts whereas they only check prior to prog don’t they? So check for thickness and triple layer?

I’ve started my progesteone this morning and it’s the first time having lubion but they haven’t said a time? I did one cyclogest at 6:15am this morning. I’m working all day too! Then another cyclogest at bedtime so I’m unsure where to fit the lubion in?

@Janefx40 I'm flirting between adding in the extra cyclogest to ensure my receptors are saturated for receptivity and then worrying about the physical symptoms I was getting. I guess I'm worried because last time I changed between pio on one day and lubion x2 on the other and now I'm daily pio I'd imagine the level is higher. Also with 3 x more estradiol coming from the corpus luteum I may be naturally producing more Progesteone as well. I guess if you only increased up after transfer day then I could always increase up then, I guess I'd be worried incase I've already lost the chance of receptivity, but I mean I can't imagine I'd have low Progesteone with daily pio, a corpus luteum and then one cyclogest on top. It's so hard to know what to do :(

@Gardenlady543 thank you for adding me to the thread and hope glue doing well ahead of transfer.

@Janefx40 I am at CRGH now and if this cycle doesn’t work I was thinking about ARGC, what are your thoughts on the differences between the clinics? Sorry I guess it might be quite a long answer and ok if you don’t want to / don’t have time to share but I am interested

Ok I just decided to go ahead and put the extra cyclogest in, I guess I'll see what the level is like on Monday.

@Gardenlady543 thanks for tagging me.

@clhiu how are you getting on? When is test day for you? I was obviously pregnant naturally this time but took cyclogest and still had absolutely zero symptoms. Yet I know people who take it every month from ovulation and get terrible side effects 🤷🏻‍♀️

Bleeding has started over here and still a vvfl. @Gardenlady543 could I ask when you did the microbiome testing post chemical, did it detect anything? And is that the only time you’ve done the test?
My fertilysis kit arrives today, bank on hol Mon. Do you this it’s ok to get bloods done Tues for same day pick up?

Also, I really don’t know if I should be telling the clinic that I’ve just had a chemical pregnancy. We are yet to sign the contract (3 cycle refund package) and I am worried they could reject us or something. Or maybe they would take it as a positive sign 🤷🏻‍♀️

xx

@ChickenT2b you need to collect the menstrual sample as soon as you have full flow. I did mine with the bleed from a transfer with a BFN. You don't need to tell your clinic about the chemical, I suspect it won't make any difference to the care they provide. I did 2 x EMMA ALICE and then the menstrual fluid testing which was normal.

I got the update to say our 4AA was euploid, so that’s good, and our 2 x 4BBs were not. Probably not enough embryos to achieve a baby but we have that and the untested 5CC.

@thislittlebird good news you have one euploid although I know the feeling of stress when you only have one shot at a transfer. The odds from my own clinic were that over 91 patients recorded with confirmed euploid embryos in grade 6B-C the clinical pregnancy rate is 35% so I’d imagine with an AA yours are much stronger. Are you planning any further uterine, endometrial and immune testing before proceeding with the next transfer or you’ve pretty much already assessed everything possible?

@ChickenT2b I’m struggling I have to be honest. So much hanging on this working for me as it’s the only shot I get at IVF, I mean have another inconclusive embryo on ice, but it’s the same grade and was biopsised twice so if this one doesn’t stick that other one most certainly won’t either. May aswell save the cost and stress of another transfer and try again naturally although that’s almost guaranteed to just be another miscarriage or worse and I don’t know if I can face that.

All symptoms gone for now except swollen breasts. I called the clinic this am and asked if I could have a progesterone blood test tomorrow and I was worried the headache meant a drop in level and they said it’s highly unlikely it would be that, to just take paracetamol and make sure to drink a lot of water for the headache and let then know if it gets worse or becomes accompanied by dizziness etc…I took paracetamol and it went. I had a tiny bit of nausea first thing this morning, but that’s gone now

@clhiu I understand. I don’t know if a failed transfer this time around would necessarily mean a failed next time with the same grade embryo. I’ve read that many women can take a few rounds to be successful. Fingers crossed for you 🤞🏼🤞🏼
What’s your reason for ivf if you don’t mind me asking? Sounds fairly similar to me in that you can conceive naturally but have had recurrent miscarriages? In my case it’s also taken around 12 months each time just to end in loss. Have you done any immune testing?

@clhiu I just want to say that if your progesterone was too low, CRGH would be worried and bringing you in for monitoring.

I had a friend a CRGH who was young and she had excellent amh, fsh and progesterone levels. She did a natural frozen transfer with trigger and she was given a lot of cyclogest to take every day (3 a day). Her progesterone was high as CRGH like it so and she had 3 successful pregnancies from CRGH.

I also had high progesterone. When my progesterone was lower in a medicated cycle, I was unsuccessful. I had success with really high progesterone. As it was high, I was never monitored for that.

@clhiu If it is less than 100, they will bring you in. That was my experience when I did a medicated cycle in 2019. Regardless of corpus luteum all not they always put emphasis on high progesterone and they do get good results from that point of view.

@ChickenT2b I don’t mind at all. That’s right, our reason to do IVF is so that embryo can be screened for genetic abnormalities. I was able to get pregnant 4 times in 11 months rather easily at least each time dh and I tried properly with regimented timed intercourse, but all 4 pregnancies ended in MC. Because of my age (41.5 at the time of first pregnancy and MC and 42.5 at the time of the last one) as well as no other tests showing signs of concern, it was deemed an egg quality issue and decided all 4 pregnancies were likely lost to chromosomes abnormalities with the embryo. 2 were tested after ERPC and those two were confirmed abnormal further fuelling the theory. Hence why IVF with PGT-A testing, which unfortunately is very very expensive and we absolutely cannot afford even a single round more. We got 5 blasts and 3 tested abnormal, one was actually a complex abnormal! We could afford to transfer that second embryo, but it definitely has a lower chance than the current one in the sense the current is confirmed euploid, but the second one tested inconclusive so it’s as good as not tested or as good as a natural pregnancy. I was given 35% clinical for the euploid and 24% for the inconclusive. Of course miracles happen, but I’d rather trying to get pregnant again for free naturally in that case as the risk of MC is the same.
I had pretty much every single test under the sun done yep, including NKC and thyroid antibodies and have no immune issues. I’m just too old it seems 😞
Mind me asking how many times did you conceive naturally and how many losses did you have? Which tests have you had done so far?

@clhiu I see. A lot riding on this cycle but also a lot of hope given your embryo was tested. The fact you got a euploid and possibly one more sounds like a good sign too should this one not be the one. The wait must be awful though.

We conceived twice naturally in two years. Both ending in miscarriage. First mmc at 13 weeks and the second right now (chemical). In my case, I’m not sure what’s going, probably a mixture. I am 32, DH is 40 and has lots of swimmers but morphology of 2 (not sure what this number means other than normal is 4). I also have severe endometriosis.
I’ve had all the usual blood tests including blood clotting, coeliac, thyroid. No issues.

Since we were due to start ICSI next month which will now be delayed, I’m going to do the RPL and microbiome testing from fertilysis before starting which includes NK cells.

@AM08 the difference between ARGC and CRGH is a long essay! So I'll be brief and you can always PM me if you want to know more.

1. CRGH is more structured and more clinical. You have your own consultant, you go into a medical looking scan room with 2 people in etc

1. ARGC you rarely see the consultant but all decisions are taken by Mr T who heads the clinic and/or Dr Sapna. So all decisions are made by the top people but you don't speak to them much.

1. CRGH is more cautious. ARGC throw the kitchen sink at it. They max everyone out on progesterone, blood thinners etc just in case that is your issue. They don't wait for a failed cycle first. That means you could end up taking lots of meds you don't need but it also means you won't have a failed cycle for a reason that was easily presentable.

1. ARGC do daily monitoring and tailor your stims and meds according to results. This makes it expensive even tho the individual procedures aren't more expensive.

1. ARGC are very big on immunes and don't much care about the cost which is huge although if you don't want to do immunes you obviously don't have to. I did 2 cycles there without immunes. 1 with.

1. ARGC is more personal because you speak to the nurses daily so you do feel that you get more personal input (or at least I did).

1. ARGC aren't that keen on PGT A testing or anything that messes with an embryo. They often do day 2 or 3 transfers which makes sense logically but can be tough psychologically on the patient.

Sorry everyone that got long. Feel free to PM me to ask more if you want x

@Janefx40 that is so informative, thank you so much for sharing the detail as it’s quite hard to gauge from just looking at websites and success rates. So interesting about when ARGC transfer embryos & that they are not into testing!

For now I’m just seeing how this round goes and then trying to scenario plan a bit what I do next. Thanks again and sending you lots of positive energy for your journey 💕💕 will PM you if I have any questions! Thanks again!!

@ChickenT2b I am so sorry to head about your losses, it's so awful is't it. I too had a MMC diagnosed at my 12 weeks scan, had seen a heartbeat twice before at earlier scans and thought this 3rd pregnancy would really be the one, it so so super heartbreaking. I hope your clinic can find the best solution for you and help you get to a way forward.
It may be worth mentioning the chemical as they may be more incline to explore factors that can increase risk of recurrent miscarriage specifically and tailor treatment accordingly. Was our partner tested for DNA fragmentation? Egg quality unfortunately for me is one thing that cannot be tested or fixed, the only way around it is to test fully formed blastocysts and ensure only the normal ones are transferred back.
Of course the NHS consultant advice and approach is 'just keep trying, eventually you'll catch a good egg', like they do not begin to understand the emotional and physical toll each miscarriage takes from you.
What clinic are you planning to go with or are you still deciding?
After my 3rd loss I came across CRGH as they had this consultant who specialises in recurrent loss and ways to try preventing that, because of my history she suggested PGT-A testing straight away, she didn't think immune issues were my problem, but still recommended those checks later on to give myself the best chance.

@Janefx40 very insightful on the differences between the two clinics. For those interested, currently CRGH will test you every other day during a stimulated or medicated cycle, but can ramp it up if they see things developing quicker than expected, for example for my recent natural modified FET they had me going in 3 days in a row for both bloods and a scan and they will adjust medication accordingly. Also in terms of throwing the kitchen sink at it, it might just have been my consultant or maybe my case is a bit desperate, but I feel that's very much what they did with me, both for EC and in terms of through testing before going ahead with FET, but probably because I only have this single euploid to transfer.
So judging from what you have said ARGH, I guess that clinic wouldn't work for me or for anyone who is specifically after genetic testing, I believe CRGH are one of the pioneering clinics in that science and definitely believe in it.

@clhiu I’m really sorry you’re so upset with it all. You do have amh and fsh on your side. You could try fertility acupuncture but that is expensive. Also, you could look into Access Fertility with CRGH. They do not do batching but you can get a 30% at least reduction in costs. Or my friend who was 43 went to a Greek fertility clinic and got pregnant with her own eggs. She had high nk cells and low amh. Her fsh was ok as she had been in dhea for years.

thanks @2021ivfagain , all things to bear in mind I know. I’m trying to take one day at the time and see how this ends then take it from there. What’s the latest with you? Have you decided whether to delay transfer to next month?

@clhiu Well I had my letter today from gynaecologist. He said to take vaginal clindamycin if swab reveals high levels of atopobium vaginae. It feels good having support and being believed. CRGH do not know why I have been delaying my cycle and can’t understand the concern! Apparently, atopobium vaginae can cause all sorts of issues in pregnancy. My gynaecologist also suggested taking a short course of oral clindamycin if I get pregnant to colonise cervix.

At present, I’m in limbo. My symptoms have got worse but they usually do when I’m on norethisterone for longer. I will start oestrogen priming this weekend, do swab, but if symptoms get even worse, I will ask to fast track my treatment of vaginal clindamycin the beginning of next cycle. However, I can’t take vaginal clindamycin and come for scans I don’t think plus I would need time to add in canesbalance and probiotics before transfer. Apparently, it raises ph as well. So I might have to do transfer in June. June will be the latest.

I have been told by a different consultant that I might be able to have extra estradiol if oestrogen is lower, but depends on what my consultant says. I have had to fight for changes such as extra meriofert and extra progesterone. I was only on 225 iu meriofert previously. I still responded well but I think I should have been on 300 every other day. I think my consultant sounds less cautious than yours in wanting to increase your dose when your oestrogen levels are good.

With your levels, you could go to the IVF clinic in Greece and save lots of money. My friend had low amh. She did a mild IVF and had two day 3 embryos transferred. She got pregnant with twins, but lost one. However, she had one that is now nearly 12 months old. She got pregnant at nearly 44.

Good morning.
Anybody on here has an opinion or knowledge about the significance of resting heart rate during the TWW?
I believe it should increase steadily upon successful implantation. Mine kept rising steadily towards ovulation, peaked 4dpo at 74, remained stable till 2dpt, then started dropping by 1 beat per day since, yesterday it dropped by 2 beats and it’s now at 68. Since transfer last Friday I have done hardly any exercises, I usually walk a lot, but haven’t been at all since and I believe that would cause it to increase, not decline. I can’t help reading this as a bad sign, unless it’s possible the enoxaparin slows your HR? I’m on 40mg daily.

I just compared this with my first 3 pregnancies when I also had a FitBit and my RHR kept steadily increasing past ovulation, the opposite is happening this time so I think the transfer is doomed 😞. Would love some reassurance or positive stories if someone is able to provide any at all. Could the IVF meds have something to do with it given I wasn’t on anything at all the first 3 times I got pregnant?

Hi @clhiu I'm afraid I'm no expert on resting heart beats although I have plenty of expertise in 2WW anxiety!

From what I've read, it is the drop in progesterone that can cause the dip in heart rate and your progesterone is at a false level because of the supplementation so whether it drops or not is not likely to be due to the embryo. As I've said before my progesterone dropped a lot in the 2wW and I was pregnant.

Really hope this doesn't mean anything negative for you xxx