IVF/ICSI/FET May 2023

[Sj2505]

Hi, I don't think there's a thread for May, not that I could find anyway.

I've just started Norethisterone to bring on AF ready for my FET. I had my ICSI cycle in Feb but was high risk for OHSS, so after retrieving 24 eggs, this clinic decided to freeze all.
Luckily, because I ended up very unwell with OHSS for around 6 weeks and ended up in hospital for a little while!

But I've recovered and soooo ready for my embabies! We're aiming for transfer week commencing 22nd May unless AF comes earlier than planned then it might be the week before. It's likely as I'm on CD46 with all the signs of imminent AF 🤞🏼

If anyone else is cycling in May please feel free to share the journey ✨

@kingster1, no problem, and I hope your scan goes ok tomorrow 🙂

Hi @LittleWeed82 👋 that all sounds very positive and a good number of follicles. After all, it only takes one (or so I have been told anyway!). Interesting about blood work tests... I only had a blood test on day 5 scan and will have them on any subsequent scans. I didn't have one on the first scan though. Something for me to bear in mind for any future cycles...!

I think it depends on your clinic as to when they do bloods. I'll have to have a blood test every day and they will adjust my meds accordingly. But if it helps even a tiny bit I'll do it!

I'm coming close to starting stims, hopefully this day next week all going welll with scan. My mind is starting to go into overdrive a bit now.
This will be my 5th ivf cycle.
Just wondering for anyone who had egg quality issues, how did your doctor know? Is it in the blood results or from embryologist looking at the eggs after collection? I've never been told I have bad egg quality but last round in March dr collected 5 eggs( only one mature) 2 more eggs matured in the lab and all fertilised. 2 arrested after the 3rd day and we had one embryo left for testing, which tested abnormal.
So now I'm thinking I must have poor egg quality, what would ye think? I've been taking all the vitamins from ISWTE book every day since November 2022, I'm turning 37 next month

@hereshoping123 good luck with your next cycle.
I have egg quality issues likely due to my endometriosis. Also my consultant thinks the last two times, the reason for little/no mature eggs, was due to the trigger. He thinks last time that the follicles hadn't matured or released the eggs so they stuck to inside wall of follicle. Hence the reason only 2 mature eggs collected and rest of follicles were empty.
This time im having a double trigger and waiting 40 hours before egg collection. Not sure if it will work but consultant seems to think that has been my issue.
I'd talk to your consultant re their plan to get more mature and quality eggs. That's their job and each time they do a cycle, they learn how to tweak it. Hopefully next cycle with be the one.
Did you have Icsi last time?
Could it be a sperm issue as well as the eggs?
I always have a list of qs for my consultant, he sees me coming with my little book of qs!!

Hi folks, I want to get some idea about the standard of communication with IVF clinics during the EC-ET journey.

1. Do you usually get to speak to a clinician about the results of embryo cultivation after Day 5/6 of EC? We asked for a quick debrief to help us understand the outcome, what went well and what we can improve etc as well as the next steps e.g. to proceed to ET or do EC again.

The coordinator point blank replied that it's unnecessary before the results of PGT-A, which we don't agree. Not sure this is just with Czech clinics in general (@kingster1 any ideas?) or with this particular one.

1. Is it normal that coordinators handle sensitive information such as the final number of embryos in emails??? They were also filtering and answering health related questions like what constitutes as CD1 because my period bleeding was slightly different from the usual one.

Sorry @kingster1 er1 my question was for @Infertilitylife rtilitylife !

Thanks @kingster1 for your reply. Do u mind me asking what your double trigger is? Hopefully a double trigger does the trick for you 🤞 I actually requested a change in trigger after march's disaster egg collection, so he has prescribed me 2 X gonsai. Previous trigger has always been ovidrelle. this is my second cycle with Dr Danek in Prague, I do feel that he triggered me too early in March and at my last follicle tracking scan he didn't measure all the follicles maybe only one or two, but I thought maybe he's so used to looking at follicles every day that he knew the sizes!! During all my tests the only thing that was off has been testosterone levels, which was low and I'm on DHEA now. Other than that my cycles are normal. We have used ICSI for all 5 cycles due to motility issues however in March my partners sample was excellent after also taking the supplements from ISWTE book! We will get DNA frag test on my partner in 2 weeks!
I probably need to go in with a list of questions the same as you do. I have always just trusted the consultants plan and went with it

@hereshoping123 I had a double trigger. It was Ovitrelle and Buserelin.

@hereshoping123 we do have to trust the consultants. But also helps me understand why they choose XYZ and ruled out other options.
I havnt had info on my trigger yet, will get that tomorrow. But I know its going to be 2 triggers.
I asked the consultant why he thought my egg quality was down and what else can be done.
Also i asked about Maturing eggs in the lab, but mine were not even suitable for that last two times. Good your team did that for you last time.
Sounds like you have done everything you can do to improve egg and sperm quality.
My gynaecologist in Ireland suggested intralipid infusion also, before and after transfer but my ivf clinic not keen on that option this time as iv only had one failed transfer.
@Infertilitylife that is strange. Maybe it was a misunderstanding over email. She probably means that they feel they can't comment until the tests come back. Maybe reply back to say you would like a quick phone call with consultant if that would help. And that you know another consultation will be needed once results back but would like a phonecall as you have questions.

Also I have discussed things like when to start meds, when my bleed started and how heavy it was etc over email. I got my protocol and asked questions about it over email. But anything more sensitive usually phonecall. They advised me over email that cycle day one is when flow is heavy. If this is after 4pm, cycle day one begins the next day. Even if bleeding is light, only count as day 1 when continuous flow before 4pm.
I hvnt got as far as having embryos, but in our paperwork they have told us that discussions re embryos will be a phonecall by embryologist.
Good luck x

@LittleWeed82 I hope your first injections go well today. 8 follicles is really good :)

@Caubabatko After egg collection, my doctor came in and told me how it went. The following day I told how many of those were mature and how many had been fertilised. Then on day 5 I was told how many made it to blastocyst and were able to be frozen. The updates on day 1 and day 5 were both done via email from our co-ordinator. I had no contact with the doctor apart from on scan day, egg retrieval and transfer. Every other thing was done via the coordinator.
I would definitely push for more information, it is your body and your eggs/sperm etc they cannot refuse. That is one thing I made sure to do, I pushed my opinions/views as much as I could.
My coordinator was good but again you need to stand up for what you want. I was told my lining was too thick (15mm) but I pushed for the transfer as I knew that it would decrease with the progesterone. And on day of transfer it was 10mm which is perfect. However, the coordinator had emailed me when I sent scan results showing it was 15mm and simply said endo is too high we must wait for next cycle. And I emailed back saying no, I’ve done research and want to go ahead as planned and did not want to wait, which has turned out to be a good thing. I know that any medical questions/decisions are made by the doctor but are just communicated through the coordinator.

@Sunflower360 @kingster1 good luck for your scans today!

@LittleWeed82 welcome! You can definitely still be optimistic at 41. Hope the first injections went well.

@Infertilitylife how's your tests coming along? Hope you're feeling ok, and they're getting darker for you!

@TheBirdintheCave good luck for your update today!

@hereshoping123 sorry to hear you've been through so much. I have everything crossed for this round for you.

@Caubabatko I've had all my contact via phone, unless I've emailed them for something, but I don't have a coordinator, we just have to speak directly with the nurses. But all my embryo updates were over the phone with the embryologist.

I'm now on my third day of Oestrogen. I haven't had any side effects and the spotting has completely stopped now thankfully.
I'm going to be using a hot water bottle to try to thicken up my lining ahead of the scan next week.
Any other line thickening tips & tricks??

@Sj2505 This is from day 5 to day 7 so does look to be progressing.

I’m happy your spotting as stopped. Fingers crossed your lining gets to where it should be x

@Infertilitylife thanks for the story and encouragement! Yeah we are phoning them to follow up. Really interesting to know how 15mm becomes 10mm. Were you on progesterone pessaries? Was it a fresh transfer or a separate transfer cycle?

@Sj2505 I hear lots of people get to speak to the embryologist directly, my clinic has unsympathetic "middlemen" who get in the way.

@Caubabatko yeah progesterone pessaries. I had 2 tablets, 3 times a day. This was a frozen transfer that I had.

Thanks @Sj2505 Unfortunately scan did not go great. 1 follicle is growing well. Anything else (if there was anything else) is doing nothing. So I'm at a cross roads - do I carry on with this cycle with 1 egg (pointless in my mind) or cancel and revisit at a later date with a natural modified or mild IVF cycle. I have DOR, so high stimulation was never going to mix well with me in my opinion but the consultant advised that as a short protocol, suppose it's a starting point. When I had my first scan before starting stims, they said they could see 4 follicles, and somehow, after stims, it has gone down, which is making me wonder whether that protocol just does not work for me. I'm waiting on a call from them this afternoon, but I would imagine it may be game over for this cycle.

@Sunflower360 I am so sorry it wasn’t better news for you. Sending a big hug. It’s such a cruel process. I hope the doctors have some good suggestions for moving forwards if they do cancel. ❤️

@Sunflower360 really sorry to hear your disappointment. My last cycle I did not respond well, I was on the short protocol. I hate down regulation but this seemed to work better for me ie the longer protocol.
Hope you get a positive phonecall later today with a plan. X
@Sj2505 good luck with your next stage of thickening. I have no tips, my lining always seems ready, it's my ovaries that let me down. Good luck with your next scan. X

Thank you @kingster1 @FlapJackered will see what is said and take it from there

@Sunflower360 I’m so sorry the news wasn’t what you wanted. I hope you are ok.

@Infertilitylife oh wow 🤩 congratulations! That is looking amazing now. How are you feeling?

@Caubabatko that's a shame. I guess so many different clinics have very different ways of working.

@Sunflower360 I'm sorry to hear that. I guess it's good to have one that is responding as it should, but collection etc is a lot to go through. I'm sure they will have some good advice when they call.

@FlapJackered how are stims going?

@kingster1 thank you!

@kingster1 how is your stimulation going? What meds are you on, if you don't mind me asking!
We ended up with 2 frozen out of 9. We want to do another EC, but this time in another CZ clinic, as the mandatory STD test appears to be only valid within CZ and we speak their language. We are interested in your experience with yours in Olomouc, is it IVF Clinic?

@Sj2505 good luck with the thickening! I hope the techniques work. 🤞

Just had my day 5 scan and not great news. There’s lots of random fluid in my uterus and ovaries aren’t responding much to the stims yet. So they are going to see what’s happening on Monday but may have to do a freeze all… that’s if I get any embryos! Why is it never straight forward!

@FlapJackered @Sunflower360 Ah nuts :( I'm sorry it wasn't great news for either of you.

Thanks @TheBirdintheCave @FlapJackered sorry to hear that. Could they see follicles? Perhaps they will increase stims for you?

@FlapJackered im sorry to hear this. Hopefully things will turn around by Monday. I had some fluid too, but seemed to have disappeared. Wasn't lots but some they said.

@Caubabatko 2 frozen embryos still a good backup. We have never had any embryos to freeze. Got pregnant last year with our one and only embryo. Ended in miscarriage however.
I had scan today which is my day 11 of stimulation. I have 7 follicles, 6 of them around 17mm. None on my right, but I prefer that my body focuses on the left as last 2 cycles, left didn't do well anyway. Estimating 6 eggs if we are lucky.
Iv been on Decapatyl for down regulation. And added in Gonal F 300 for stimulation. Monday is my egg collection. Ovitrelle twice, 6pm and 7pm as trigger tmro.
Long protocol suits me best.
I would highly recommend IVF clinic Olomouc. 2 hrs train from Prague, or we flew into Brno from Stansted. Bus from brno is an hour to olomouc, very easy. Flights everyday from Stansted with Ryanair, very cheap also.
Dr Machac is very friendly, listens and great consultant. He came from a big clinic and set up this one I believe. Iv also met his other consultants last cycle and they were all excellent also. They have a lot of patients from abroad, from all over the world, iv had no issue with communication. Dr Machac and Iveta speak English. One Dr I met didn't, but Iveta translated and was no issue.
This is our 2nd cycle with him. Last one was the short protocol which only ended with 2 immature eggs. Iveta is my coordinator and she is ace. Would highly recommend. Prices also very good, on their webpage. We are staying in hotel Flora, tram right outside and 3 stops from clinic.
Ask me any qs you might want to know. There is a Facebook group for patients going here also if you request to join.
Where have you had your treatment if you don't mind me asking, is it Prague?