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 :)

@Enfys23 my clinic only do a 8 week scan and the midwife said the NHS scan will be week 12-14, they haven't told me a date yet. Dr Gorgy advised that I should have a scan at 6.5 and 10 weeks. So I arranged private ones with ultrasound direct at 6.5, 8.5 and 9.5 and had the clinic scan between the first and second. I have booked another scan on Sunday.

@Gardenlady543 really pleased to hear your scan went well. I clicked on the link 😍❤️

@Gardenlady543 That’s good you have private scans organised. I had more scans due to my age and found it reassuring.

I’m not having a good day. Since I’ve stopped vaginal clindamycin my ph has been raised. I have to use two canesbalance a day and two probiotics, but last night’s Flora Femme did not dissolve properly. I’m considering taking oral clindamycin for 5 days from cd1-cd5 at the start of my treatment cycle. I’ve taken oral metronidazole in my treatment cycle before. My consultant just told me to stop 5 days before. I’ve never taken oral clindamycin before.

I asked my gynaecologist for his advice and he said I could take oral clindamycin to extend the course but he doesn’t know much about IVF. I’m struggling as I need to do my transfer but my microbiome feels worse due to stress, fsh levels, lack of oestrogen.

Also waiting for period which is always a concern nowadays. I have taken hrt for longer this time as I had to extend norethisterone. Can extra hrt delay period further? Also I had hardly any cervical mucus. Is it possible I didn’t ovulate? Will norethisterone overcome low progesterone? I’ve been in tears today as I don’t know what to do for the best. I wish I was not 42.

@Gardenlady543 to stop antibiotics 5 days before transfer.

@2021ivfagain you'd have to ask your clinic if they're happy for you to take it in the cycle.

For Pregnancy it says
Manufacturer advises not known to be harmful in the second and third trimesters; use with caution in the first trimester—limited data.

I've not heard of clindamycin being used routinely in cycles just doxycycline.

@Gardenlady543 I’ve used oral metronidazole in my transfer cycle and my consultant said as long as I stop 5 days before transfer that would be fine.

Problem is my consultant is absent. But if I’ve used oral metronidazole before near the end of my treatment cycle and this would be at the very beginning, would it be very different?

@Gardenlady543 I would be using it from cd1 -5 which is weeks before transfer. Last time my transfer was cd20 or cd21.

@2021ivfagain metronidazole is used a lot in pregnancy though, I think clindamycin is used less.

@Gardenlady543 Oral metronidazole will not do anything for me anymore unless I take a long dose which I cannot in the treatment cycle. I only want a 5 day course of it but metronidazole would do nothing for me. At least I felt better this time with vaginal clindamycin but didn’t take it for long enough. I think it was a bad infection and I’ve been getting recurring BV for a year now.

@2021ivfagain you'll have to see if your clinic are ok with you taking it, can you ask them?

@Gardenlady543 I have emailed but my consultant is absent at present! The Secretary takes days to respond.

Hi all @Gardenlady543
hope everyone is ok?
question: is anyone familiar with day5 embryo grading system 1.2- 2.2 3 … i found online the one which is more like 4AA , 2BB .. but nothing about the first..

@Mybabydream yes 1 is A, 2 is B and 3 is C. It's the same system, just numbers rather than letters. My UK clinic use numbers, all other places I went to use letters.

@Gardenlady543 so a good harching blastocyst 1.1 , is it then bad? Doe sit then stand for 1A?

@Mybabydream

So I've put some numbers on this image and then an image to show the quality of different grades.

A hatching 1,1 is a 5AA, so very good quality blast.

@Gardenlady543 thanks a lot youre amazing !❤

That sounds a good plan @Gardenlady543

I started norethisterone today. Feeling positive though nervous about this upcoming cycle. I found out my repeat cardiolipin antibody (Antiphospholipid) tests show it’s still raised (and in fact higher than in March) so confirming I definitely have this circulating (rather than just a fluke one off high), but trying to be positive the enoxaparin/inhixa higher dose will help with this.
I went for a walk and made a yummy dinner of salmon and red lentil pasta with fresh pesto. So am feeling good about myself today, though I’m sure the norethisterone side effects will kick in soon!!

My clinic also use numbers @Mybabydream and that looks great blastocyst.

@2021ivfagain I hope you get answer from clinic soon. Is there a reason that you wouldn’t just do a further course to extend the vaginal clindamycin rather than switch to oral? Vaginal clindamycin is used in pregnancy for BV.

@Enfys23 Sorry you’re results first thyroid is it that are higher? I hope you’re ok with norethisterone. I’m on it constantly but it does raise ph. However, you’re not on it as much and your hormones are better than mine.

Problem is vaginal clindamycin cannot be used when having scans. I need oral clindamycin and then I will still use canesbalance and probiotics in the evening with NAC to break down biofilm. Problem is oestrogen helps treatment success. This month my cervical mucus has been bad as they wouldn’t let me use vagifem in oestrogen priming phase. It helps to restore things. Problem is I need cervical mucus for probiotics to work. I was in tears today and really exhausted with it all. My IVF consultant is absent and the gynaecologist does not know a lot about IVF! I feel like I’m learning a lot, but it’s too late. I’m also worried that due to lack of cervical mucus I might not have ovulated which might mean I might not have a proper period. That scares me. I really need to do a natural FET and running out of time as it’s taken this long for my consultant to realise my protocol has to be changed to more progesterone, meriofert and oral estradiol in luteal phase for transfer. It’s so frustrating.

Good morning all.

@Enfys23 really glad you finally get to start your next cycle, I have everything crossed for you that this is the right one and hopefully the high antibodies can be dealt with. Will you be on any other immune suppressants like steroids or intralipids?

@2021ivfagain I’m really sorry to hear your consultant and secretary have gone awall, stupid question probably, but have you already tried messaging on the patient portal? I find often I get quicker answers on there than email, even though mostly still not quick enough! I must say the communication experience I’m having at CRP is way way better and more personable.

I had my follow up consultation and the results did show both count and toxicity above the normal levels so the the prescribed course of treatment is intralipids and prednisolone, for now alongside natural cycle as we cannot afford any more IVF and based on my latest hormones levels there’s no reason to believe I shouldn’t still be able to conceive naturally. We’re aware of the risk of creating aneuploidy at my age and with pur history remains high therefore I’m fully prepared for more MC before we finally hopefully catch the one good egg. He was very dismissive of PGTA testing and doing IVF at my age. I also asked to be given Letrozole just in case I need an extra boost as I don’t want to waste a single month failing to get pregnant in the first place, but also my CRGH consultant told me it can be given as mild option to overcome MC caused by abnormal embryo in the sense that by creating potentially 2-3 embryos at one time instead of just one, there’s a slightly higher chance one of them is going to be euploid. So from my next cycle in a couple of weeks I will start trying with Letrozole and timed intercourse.

@Gardenlady543 Professor Shehata made two separate plans, one for natural cycles and one for FET. He included enoxaparin for FET, but not for natural. As both CRGH and the NHS were keen on me using it in a natural cycle as well as IVF (despite no evidence of blood clotting disorder for me) I questioned why and he told me there’s no evidence it actually makes a difference and was very dismissive when I asked why for FET, but not for natural. I know you described evidence in support of it previously and I have an NHS prescription for it, do you think I should still use it even if he advised not to and won’t himself prescribe it? I’m on daily baby aspirin which in itself also serves as a blood thinner as you know.

@clhiu I’m sorry about your results but it seems you have a plan. Did you look into Access Fertility? It does include frozen transfers and you can PGS. You just can’t batch. I know this as I started with CRGH in 2019 and I read up on all their documents for Access Fertility. I also considered it when I was 40.

The Secretary is not missing. He responds in his own time. It’s the consultant who is absent at present. I’m on cd1 today so should be having a scan on Friday.

@clhiu so I just started on aspirin yesterday, Dr Gorgy told me that this can be started once a pregnancy is established. It's best to hold off on it before though as it can affect implantation. Heparin helps with this though. I personally would do the heparin in the natural cycle. My friend who has unsuccessful IVF was told there was no hope and then got pregnant naturally 2 weeks later, she got put on heparin straight away.

@Enfys23 that's great that you've been able to get going.

I’m so sorry I don’t get to keep up with the thread! I’m hoping to be able to now I’m on sick leave for the next 10/12 days.

I had my lap and dye and hyterscopy yesterday. I was waiting for my surgery till 5pm so I was headachy and starving by this point! I got discharged 1am this morning. Been so sick and shoulder pain so far: apparently tubes open and no endo and “normal appearance of endometrium”. Which means all my spotting and clots etc is symptoms of my adeno. So maybe it’s worse than the clinic are making out. They are saying my brown spotting is hormonal which I do agree with but it’s the adeno causing the imbalance because of the higher estrogen.

I didn’t really get chance to talk to the dr afterwards as it was so late and I didn’t wake up for ages. I wanted to ask about the focal adenomyoma. He just basically said all looked okay, no endo and no blocked tubes but I’m assuming there will be images and a full report to send to my IVF clinic. Just not sure how long that will take.

@Enfys23 can i just ask about your NK cells - my dr has tried to say I don’t need anything because I’ve had a birth. But things change? Just like the clotting! X

Hi @Loz2467 really glad you got the surgery over and done with. It's all bitter sweet, I remember having my hysteroscopy for suspected Ashermans and hoping they would find a easily treated issue that explained things, but they didn't really find much aside from some adhesions in my cervix. How are you feeling about everything? I didn't get much in the way of a report after having surgery. You should enquire with the secretary if they can write a report for your clinic. What are the options now, did you join any of the adenomyosis fb groups? It would be good for you to find out from others what the options might be.

@Gardenlady543 that’s exactly how I feel! I was hoping something more was going to be found or he would shed more light about the area near my lining! I did join the adenomyosis group - thank you! Many people have had success once adding blood thinners, steroids and using letrzole too. I’m trying to think of the best way of approaching my Dr re the letztole and her having no experience of using it with down regulation. There are tons of research papers but I also don’t want to annoy people! I just feel drained and not even sure what to do from here.

@Loz2467 just try and get the details of the protocols that have worked in similar cases and tell your specialist you want to try it. I had to do medicated cycles for so long and they didn't work for me, I said after the first one I wanted to do a modified natural it was only after the 4th transfer that they agreed to change, and that's when I implanted with the chemical and then it became clear that regime wasn't right and I needed low dose stims. You just have to keep pushing.