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 really hope you’re able so that you can relax and enjoy your pregnancy, if that’s even possible for those of us who have had a tough journey.

I’m on a medicated cycle 8mg Progynova a day and 50mcg patches twice a week. I’ve got a scan tomorrow. The only change with this cycle is the patches were added from day one rather than two weeks in. I want to be hopeful but i don’t know if the patches are going to make much of difference

@Gardenlady543 Did you have an infection before transfer or did you take doxycycline to prevent infections? I did think of taking Flora femme on the morning of transfer and need to double check, but my consultant said avoid on transfer day. I am
going to take vagibiom and Flora Femme day before and day after but spaced out, but still worried about whole day without a probiotic. Sorry if repeating myself but did the person you know even take vagibiom on transfer day? I would like to take Flora Femme in the morning of transfer. I will need to ask that question again. Is it bad that I have to stop the canesbalance soon? I want to take 2 probiotics a day before and after transfer. Is that too much? One Flora femme in morning and vagibiom at night or vice Versa.

I hope they help @Spin101 some people do weekly well with patches. What cd will you be for the scan tomorrow?

@2021ivfagain no infection that I was aware of, I did 5 days of metronidazole in the cycle off just in case. The doxy was prophylactic. I would take flora femme that night, if you do it in the morning it will be all gunky for the transfer. The person I knew took vagibiom EVERY day of the FET from after the bleed stopped until the first scan.

@Gardenlady543 since my cancelled FET cycle in may, I’ve had two bleeds so am not really sure what cycle day I’m on as I don’t bleed otherwise. I went in for a scan two weeks ago and they checked my ovaries were not active and then got me to start. I’m on day 14 of the medicated cycle today. Should they be checking my estrogen levels? They didn’t do that last time

@Spin101 my clinic have been pretty variable in medicated cycles, some times they checked it and other times they didn't, the only real reason to do it is if the lining isn't responding to see if there is room to increase the dosage of estradiol. I think in a lot of medicated cycles there will be no bloods, in modified unmedicated and unmedicated cycles it's pretty useful to predict ovulation.

@Gardenlady543 do you mind if I ask when to take the doxy? I’ve seen it in many protocols too but I can’t remember when.

Do I need to add vaginal probiotics too? And would this be the month before transfer. I reckon my next transfer will only be September time so I don’t want to stray everything too early.

@CailinInUK I’m sorry it’s difficult. I have weekly counselling sessions as there are lots of things going on. It does help. Do you have someone to talk to at the clinic?

@Gardenlady543 Thank you for your advice. I actually spoke with my consultant today briefly which was lucky and asked about taking the vaginal probiotic on the transfer day. He said it needs to be at least 6 hours after transfer. If I am dry, could I use Vagibiom?

Do you know if BV causes vaginal inflammation too as well as bad discharge? I’m on the first day of oral clindamycin so hoping it goes. My lining is already 11mm but out of 9 follicles 3 are larger but still not at 18mm. Do you think I should contact my GP? My consultant thinks I am obsessed with antibiotics and probiotics but I just want to feel well. Do you know how long oral clindamycin takes to work? The vaginal clindamycin seemed to work straight away.

@Spin101 Could you ask for a blood test? I had bloods done today as getting close to trigger.

@Loz2467 I took Doxycycline 100mg twice a day for 3 days from 2 days before transfer. You can get it from here www.doctorfox.co.uk/anti-malaria-tablets/doxycycline.html I took metronidazole for 5 days the cycle before and then followed with 10 days of vaginal probiotics. Then I took the vaginal probiotics daily in the FET.

@2021ivfagain glad you could speak to your doctor and they said you can take it in the evening, it should be fine just do it before bed that night. Hopefully you haven't got a full on infection with everything you've been taking.

@Gardenlady543 thank you so much! So 2 days before transfer and then transfer day? And that’s the 3 days done? If this medicated FET doesn’t work I don’t know if I’d be waiting a while to do a natural medicated is it called? Where I can work with my own estrogen levels rather than adding more? Just pretty gutted my consultant won’t add letrzole. Even if it was just for 5 days through endometrial prep. The dr in London suggested a full month of it then up to date 10 endometrial prep. So frustrating.

@Loz2467 yep that timing is what I did, the cycles are:

Medicated- with artificial estradiol and the ovaries and quiet and won't release a follicle.

Unmedicated/natural- no meds at all, just watch the body for ovulation and transfer when a embryo would get to the uterus after ovulation. I think 6 days after the LH rise.

Unmedicated modified/ natural modified- similar to the one above but with some meds involves, like letrozole or low dose stims, watching for ovulation still. but it can be timed a bit with a trigger. If there is a trigger, transfer is 7 days later.

Letrozole got better outcomes than a natural cycle in this study of IUI patients www.ncbi.nlm.nih.gov/pmc/articles/PMC3131247/

This study looked at the combination of letrozole and low dose stims again in iui https://atm.amegroups.com/article/view/32800/html

Live birth rates were
7.0% natural
9.0% letrozole
14.0% letrozole + menopur

Lining thickness
7.3±1.6 mm letrozole
8.8±2.1 mm letrozole + menopur

Lots of people do better on a modified natural cycle. A lot of clinics don't like them even though they have better success rates as it's harder to predict transfers and more monitoring and bloods are needed. It's the type that worked for me though.

@Gardenlady543 Thank you for your help yesterday. I hope your work is getting better.

I am just wondering when it comes to using vaginal probiotics whether I should still push them in as far as possible. On the packets it says to push them far back, but worried about what to do after transfer.

I’m having another scan today. My oestrogen level is almost double of last time which is odd as my medication is only slightly higher. It’s 933. Is that a good level? I still don’t know why I’m getting dryness and inflammation if my oestrogen is much higher. Lining was at 11mm yesterday so hoping it’s not much thicker!

That's a good level @2021ivfagain . I don't think it matters where you push them, the cervix is there to separate where the embryo is.

I had my scan today and average thickness was 4mm, trilaminar. I know that’s really thin but being on the NHS I don’t think there’s much else they can offer. I’m going in for another scan at the end of the week and I think the recommendation is going to be to transfer. They didn’t do any bloods.

Has anyone had lining as thin as this and been successful in getting it thicker?

@Gardenlady543 you mentioned letrozole and menopur above. Do people tend to take the two at the same time? When I asked my doctor about letrozole a while ago, he mentioned letrozole didn’t do much for me during ovulation stimulation which I tried pre IVF. I feel this is the only thing they might be able to do differently for me at this stage. However I have read that letrozole might thin the lining too.

@Spin101 if you look at those links I think there are lining measurements for the various options and letrozole will have a thicker lining I believe than without it. Now it didn't work for me, because my body was stimulated by it and made several follicles then as soon as I stopped (you only take it for a few days at the start of the cycle) all my follicles disappeared. So the first cycle it was saved by low dose stims although ended in a chemical, the next cycle it couldn't be saved. So the doctor scrapped the letrozole and just had me on Meriofert 75 units a day from cd2. How did your lining respond to stims in the collection cycle? I think I've seen examples of a good outcome with a lining of around 6mm, but not with 4mm. It's hard to know without knowing your estradiol level whether you have enough in your blood stream for the lining to respond over the next few days. Can you use the oral estradiol vaginally, that increased my blood level.

What doses of patches and tablets are you on @Spin101 ? As a reference I was prescribed 6mg oral, 6mg vaginal (same tablets just using them vaginally) and 100mcg patches. If you’re on less than this I wonder if at least scope to increase doses or add in vaginal route?

@Gardenlady543 On 150IU menopur during EC, my lining got to 4mm but was not trilaminar. In my first FET, with 8mg Progynova/day and 50mcg patches added two weeks in, it got to 4.2mm trilaminar and we went ahead with the transfer. In my recent cancelled mild stims (not so mild as I over responded) of 150IU gonal f every other day my lining was 4.3mm and not trilaminar. It seems my lining quality reduces with stimulation.

I will try to get bloods done on Friday so I know for next time.

@Enfys23 I’m on 8mg a day orally and 50mcg patches every 3 days. How often did you change your patches? Can you remind me what your lining was like with those doses?

I did enquire about using Progynova vaginally before i started this cycle and was told they don’t think it makes a difference and that my receptors would be saturated already.

@Gardenlady543 @Enfys23 do you think it’s a good/bad thing to self prescribe half my dosage vaginally? I know I won’t get a higher dose than 8mg on the nhs.

@Gardenlady543 thank you so much for explaining! I’m still finding it hard to understand but I’m getting there! I’ve seen people with endo or adeno not always have success on the FET straight after down Reg but the one after. So for example someone I know (she’s in Aus) had failed FET straight after down Reg then success in her next. So on withdrawal bleed took letrozole for 5 days follow by HCG booster shots and then her immunes and blood thinners and prog as usual. Is this a modified natural? But after down regging I don’t know how everything got started again? The meds? Sorry for so many questions I’m just wanting a back up plan if this doesn’t work but even then I’m worried my Dr won’t agree to it.

@Spin101 if they've told you you can use it vaginally why don't you try one vaginally at night, if you wanted you could do twice a day vaginally. I think it's worth trying.

@Loz2467 that's sounds like a modified natural cycle. I'm not sure how it works with down reg as I thought it turns everything off, so they won't get a bleed, but I've heard of people doing modified natural after down reg so it must be possible.

@Spin101 I've heard of viagra for lining thickness too, on nhs, might be worth looking at in future if needed, fingers crossed.

Anyone on here take supllemrns such as NAC, ALA, vit e, ubiqinol etc? When having ivf I stop taking them after egg collection but have been taking all way through cycle as we've had enough trying naturally so not really doing that for ttc. The NAC does cause digestive issues if I increase dose to recommended quickly, which if I stopped and started each cycle would keep happening. Its not going to cause an issue continuing is it? Will ask clinic when we go to see them in 3 weeks time but wondered if anyone knew in between x

@Gardenlady543 thank you. I tried it last night and this morning. I assume the white pasty residue is normal as with Cyclogest?

@kerrym87 thank you. I’ve asked my doctor a few times about viagra and he doesn’t believe in it. I’ll have to go private to try viagra. Sorry I can’t help as I haven’t been taking NAC. I am taking a high dosage of vitamin e (800 IU) and ubiquinol. I assume we should stop all of these after transfer.

@kerrym87 I’ve used all those supplements you’re talking about. Ubiquinol 200mg x3 times a day is good for egg quality, lining for transfers and also helping to lower fsh, but that’s obviously not an issue for you. I use NAC daily as recommended by my nutritionist: I only take 600mg a day. It is a strong antioxidant and a natural blood thinner. It is supposed to help boost follicles as well during stims, boost egg quality and also help break down biofilms that are formed from bacterial infections. I’m stopping NAC after trigger and should be stopped a 5-7 days before egg collection. I also take alpha lipoic acid even now but will stop before transfer. I used to take NAC on empty stomach but now take with food. I also take NAC when I am about to eat. I take two oral probiotics 20 minutes before eating and then NAC as I’m about to eat. This helps with digestive issues.

@Spin101 Sorry you’re having issues with lining. I think I’m a bit worried about my lining being too thick! Ubiquinol 200mg x3 times a day is good. Are you doing transfer soon?

@kerrym87 NAC can be taken safely throughout pregnancy but just stopped a week before caesarean. If you are on blood thinners, you can’t take NAC. Only 600mg a day is recommended in pregnancy. If you are taking low dose aspirin, you can take NAC throughout as I know someone who did this. You still might need to get advice as every one is different.

@kerrym87 I took coenzyme A/ uniquinol, after embryo creation I reduced to 200mg once a day. I took vitamin e to try and help my lining but it didn't help that much.

@Spin101 I tried to push it as high up as I could but yeah there will be some tablet residue come out, it's smaller than the pessaries so you shouldn't get much, when is the next scan?

Erg I woke up with the worst sore throat today, I hoped it was because I slept with my mouth open all night but it's still bothering me so I'm worried it might be an infection.

@Gardenlady543 I’m sorry you have a sore throat. Could it be a side effect of the steroids? I hope you feel better soon.

I’m having to go for daily scans as they have changed their protocol. I’m finding the antibiotics are raising my ph which is worrying when I have to stop canesbalance soon. Do you think I could use two vagibiom a day to bring ph down faster before transfer or could I continue to use canesbalance for a bit longer?