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Infertility

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ERA EMMA ALICE testing thread 8

1000 replies

Gardenlady543 · 25/04/2023 18:23

@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 :)

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18
Mybabydream · 21/06/2023 17:52

Hi all @Gardenlady543
hope ur all well!
so after my BFN this fet , i discovered that the embryo transferred was a borderline Hatching blastocyst 2.2-3 when frozen while apparently i still have a HB 1.1 in storage
I feel failed , as if i was set for a failed cycle although ive been at this clinic for 4yrs now !!
Aren't they supposed to transfer the best quality embryo first given both were euploid?
what are ur experiences ?

Enfys23 · 21/06/2023 18:08

@clhiu I’m glad you have a plan to move forward. It doesn’t make sense to me to suggest enoxaparin in one type of cycle but not another! I’d be asking for it regardless. Yes I’ll be on prednisolone from quite early during stims this time.

@Loz2467 glad you’ve had it done finally. that’s a good suggestion to find some protocols to share with your consultant. It’s your care, your body and you know your case better than anyone else so it’s okay to do this.
I’ve not had NK cell testing done. My consultant was happy to prescribe the steroids and heparin based on my history with endo and autoimmune conditions, and the most recent results with the thrombophilia antibodies means they’ve been happy to up the dose of the enoxaparin. If we get eggs/embryos (so nervous about this) this time and go to transfer and it doesn’t work. I think I will move to embryo banking for a while and then try transfers with Lupron suppression prior for the endo. I’ve not had any suppression before transfer before. I worry my endo is getting worse and worse with all this oestrogen fuel. But so far it’s been bad idea to suppress me as I already have poor response to stims and low ovarian reserve and we’ve not wanted to make situation worse while still needing to create embryos.

Hope everyone else doing okay. Thanks for your kind wishes.

Enfys23 · 21/06/2023 18:09

@Mybabydream cross posted sorry. That seems unusual without discussion with you. Was there a lining thickness issue or anything like that?

Gardenlady543 · 21/06/2023 18:23

@Mybabydream are you with Care and were your embryos in the embryoscope, as they prioritise based on the embryoscope score. This is why my recent transfer was a 1,1 despite being my last but one embryo left(it was 8/10 on the embryoscope score so lower grades went before it as they had higher embryoscope scores.)

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Mybabydream · 21/06/2023 18:35

@Enfys23 No no issue at all , my only issue was emma alice which was sorted

Mybabydream · 21/06/2023 18:35

@Gardenlady543 i am with Care but never told anything about embryoscope

Mybabydream · 21/06/2023 18:38

@Gardenlady543 is embryoscope relevant if embryos are pgt a tested ?

Gardenlady543 · 21/06/2023 18:40

@Mybabydream the embryoscope score is like grading it is a selection tool. I had my embryos tested after 2 transfers of the 7 tested, 1 didn't survive the thaw and I had 6 left, 5 were euploid. So it's the embryoscope they used to select the order from best to worst.

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Gardenlady543 · 21/06/2023 18:45

@Mybabydream are you on a package like access fertility etc or the care multi cycle package, because embryoscope is included with that if you're not in a package you have to pay extra. It's called care maps.

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Enfys23 · 21/06/2023 19:20

Gardenlady543 · 21/06/2023 18:23

@Mybabydream are you with Care and were your embryos in the embryoscope, as they prioritise based on the embryoscope score. This is why my recent transfer was a 1,1 despite being my last but one embryo left(it was 8/10 on the embryoscope score so lower grades went before it as they had higher embryoscope scores.)

That makes most sense.

ChickenT2b · 21/06/2023 21:21

Hi all, hope everyone’s doing ok.
@Gardenlady543 good to see another positive scan for you 😌 I hope things are also going better work wise?

Today was my last day of 2w of metronidazole following the fertilysis results and I also did 7 days of clinamycin. I did a couple of canesten but didn’t get on well with them. I’ve been taking canesbalance nightly. And I think I’m supposed to now start the balance activ? My question is what about the canesbalance? Do I leave it until I finish balance activ or alternate? Or one AM and one PM 🤷🏻‍♀️

Also, where does everyone buy Flora Femme? I can’t seem to find it online except from the US website but it doesn’t work for me. I was thinking of doing one more week of canesbalance probiotics and then one a week plus a week of flora femme when I can get my hands on it. Then ramp up the flora femme when we eventually do ivf.

I’ve been taking oral optibac for months but obviously it hasn’t done much since my levels came back so low. Just not sure if I should even bother continuing with it 🤷🏻‍♀️ maybe it helped a bit but not enough without vaginal probiotics 🤷🏻‍♀️

Thanks all x

clhiu · 21/06/2023 22:14

@2021ivfagain it may sound weird to say, but I don't really mind the diagnosis of high NKC (mind I don't know if likely to cause other problems later in life) as at least there seems to be a clear issue that should be treatable rather than just the standard 'unexplained' or your eggs are just too old kind of thing, especially since the IVF transfer that ended in a chemical was a tested euploid embryo. I just wish the CRGH tests spotted that and put me on Pred, it might still not have worked, but it sounds like a potentially key issue was missed. Not looking forward to the steroids that's for sure, especially if I have to keep going for a few months before being successful, but I have to give it a go.
Honestly when I say we have no more money for IVF, I really do mean none, even if the packages are convenient and do save some money, it's still way more than what we have. I don't want to go into explaining my current financial circumstances, but we genuinely cannot afford it at all so I'll just have to take my chances with the risk of just creating lots more aneuploidy and more MC, but it's a risk I have to take and the best I can do at this stage. It will of course depend on the type of miscarriages, if they were just chemical pregnancies then I think I could easily take another half dozen, no problem, it may sound cynical to speak in these terms, but when the only option you have is to keep going, you're going to see the outcomes that cause the least physical distress as desirable ones in balance.
Good luck with the baseline on Friday, it's finally happening and I hope it's the right one for you although I appreciate you still have significant concerns with the microbiome, I hope they don't interfere after all.

@Gardenlady543 yes I am tempted to do the enoxaparin anyway, especially since I have a 3 months supply on the NHS. Having said that, I did that in my 4th natural pregnancy and for the IVF transfer and both pregnancies still failed so I don't think I'd be one of those cases for who it makes a difference, given also I was cleared of any blood clotting issues.
With the baby aspirin is just 75mg and I'm advised to take that on an ongoing basis, form the day of my first appointment last month (for the FET I was prescribed 150mg, which the consultant then removed from my plan so I didn't take it, also because of what you explained about how it affects implantation). I've come across studies showing that for women with a history of recurrent miscarriage (aka myself) it seems to reduce the risk of further MCs if taken for at least 6 weeks before conception. The clinic specifically told me to take in in aid of egg quality. I think may be something to do with reducing inflammation, which in turn should have a positive impact on egg quality. I could potentially stop from ovulation through to the 2 weeks wait as at this point the egg will have been used, to minimise any possible impact on implantation. I was also prescribed baby aspirin after ovulation with my last natural pregnancy and I wouldn't say that impaired implantation in my case as I had a BFP and positive viability scan at 6.3 weeks, before the baby stopped growing at 7 due to a confirmed trisomy 15. I think I'll continue the aspirin and maybe start the enoxaparin after ovulation, when would you recommend starting it please?

Gardenlady543 · 22/06/2023 06:22

@ChickenT2b canebalance and balance activ do the same thing so one or the other is fine for the first 7 days of probiotics. I have ordered flora femme from the brands website I don't think you can get it from anywhere else.

@clhiu my clinic used to have my start clexane the day of transfer but Dr Gorgy had me start it CD7 I think to help with the lining. If you implant while taking aspirin you can start it earlier, I was a implantation failure patient so they didn't want to add anything that would make it more difficult.

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Enfys23 · 22/06/2023 11:40

Feeling quite down today as found out my repeat AMH after 10 weeks on DHEA has fallen from 5.8pmol/l (back in April) to 2.56pmol/l now. Feels completely pointless that I’ve put myself through weeks of DHEA side effects. Not sure if it’s just natural variability in the AMH readings but doesn’t give me much hope for the upcoming stim/EC.

Janefx40 · 22/06/2023 22:15

@Enfys23 I'm sorry you're feeling disheartened. DHEA is meant to increase your free testosterone and DHEA levels which have an impact on egg quality. AMH is a measure of your egg reserves which doesn't really go upwards on treatment. Personally I don't think AMH is that useful a measure. Follicle count is far more relevant in my view.

Love and best wishes to everyone on this thread. I do still follow and think of everyone xxx

Enfys23 · 22/06/2023 22:26

Thank you @Janefx40🧡 my consultant seems to put a lot of store in it so wanted to repeat it. I’m going to have to just put it out of my mind and remain positive ahead of baseline scan and hopefully the day 9 scan on stims etc. Good news is my testosterone is in the upper side of normal range now on DHEA 50mg. I’ll stay on this dose now.

clhiu · 23/06/2023 06:22

@Enfys23 I’m sorry to hear you’re going into EC with this added worry, I find AMH quite a confusing parameter, for example I’m still not clear whether it can sometimes go back up, but as @Janefx40 I honestly think AFC is more important. Speaking from experience as well, quality over quantity any day and If DHEA improves egg quality that is what you really need to be successful. I’ll be thinking of you in this next cycle x

Enfys23 · 23/06/2023 08:24

Thank you @clhiu really hope AFC is ok on baseline scan. AFC seemed to be only 2 on the scan in April. Problem for me is quality doesn’t appear to have been the main issue (of the few eggs we’ve got all have fertilised and made it to good quality day 5 blasts) though of course we don’t know about aneuploidy (they’ve maintained I’m too young for PGT-A, though my age is creeping up now as this journey takes longer and longer). So the main goal of the DHEA was to try and increase my AFC. But I’m really just going to try and focus on all the good things I’m doing and hope for the best. There’s really nothing in my power I can do to change that situation and stressing about it is hardly going to help is it.
I've had a few pregnancy announcements happen at work and a new baby arrived etc so that always just makes things tough and is triggering. I feel lucky I’ve found all of you who will understand.

Gardenlady543 · 23/06/2023 08:35

@Enfys23 if you want Pgt a then you should be allowed it. I was persuaded away from it and ended up needing to thaw my embryos for biopsy which put them at risk. I'm glad I did the testing as the cycles are so hard I wanted to know I wasn't putting an aneuploid embryo back. In my case the rates of euploidy really helped my case and it became clear my issue was implantation failure and not an embryo issue.

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Mybabydream · 23/06/2023 09:48

@Gardenlady543 @Enfys23 hope ur well! So it seems my 1.1 hb was kept till the end as they prioritise day 5 embryos as this was a day 6 embryo

@Gardenlady543 i took aspirin also in my first pregnancy throughout almost the last weeks but also started after confirmation of pregnancy

@Enfys23 hope all goes well, fingers crossed for you

@Loz2467 would be great to hear on Nk cells if irs not applicable if u had previous births before? I will also ask my consultant next week as i thought it could be good to investigate too

Gardenlady543 · 23/06/2023 09:59

@Mybabydream ah that makes sense, are these euploid embryos as well? I think it's good you have a high graded embryo still to use.

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Mybabydream · 23/06/2023 10:31

@Gardenlady543 yes i only have 1 euploid left z the rest were no results after pga testing or mosaic

Gardenlady543 · 23/06/2023 10:34

@Mybabydream as far as I'm away euploid with a good grading has a similar success rate regardless of day 5 or day 6. This is a good article about the overall changes for different grading: natalist.com/blogs/learn/guide-to-ivf-embryo-grading

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Mybabydream · 23/06/2023 10:40

@Gardenlady543 hope so! I think i will try one last FET and then im done, im exhausted from all perspectives!

clhiu · 23/06/2023 16:12

@Enfys23 I hear you, I didn’t realise DHEA could also improve AFC, in which case I hoped it served its purpose 🤞. Good luck with the baseline scan.

Does anybody know why they give you a trigger injection with letrolzole/superovulation? Or is it just certain clinics? Is your body less likely to have an LH surge and ovulate naturally when stimulated with extra FSH? Or is it just to better control and time intercourse?

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