TTC no.2 after successful IVF for no.1

[Chocoholic85]

Hi,
I’m just after some advice and to see whether anyone is in the same boat!
Just found out that my 3rd FET failed.
We are very lucky to have DD who came from our first fresh transfer. We were also very fortunate to get 5 frozen embryos from that round so have been trying for a sibling. 1st FET was BFN, 2nd was a chemical pregnancy/early miscarriage and 3rd now is failed. Down to the last two and starting to feel the pressure and also wondering why on earth it isn’t working?!
We have unexplained infertility so nothing was ever found with our initial tests and I was 34 when we had out first IVF round so odds were in our favour. I read somewhere that at 34 around 50% of embryos are abnormal so I guess out our 6 maybe the last 3 were all abnormal. I’m also worried something has changed since I had to have a csection for DD. I did have an ultrasound which showed the scar had healed fine and there no niches, I’m wondering if there are adhesions that might not have been seen on the ultrasound though.
Would love to hear any advice for what to do next or from anyone else in a similar position. Thanks x

@Eggling yes I can see how things have been pretty varied. Hope everything is as it should be. Yes, one day at a time!

@KLM25 yayyy glad all is going well for you. I hope you're able to enjoy and relax a bit. Are you getting lots of movements?

@SErunner thank you! I've just started the stimms. I had 5 blasts several years ago (1 baby) and 3 last year (1 unused) so I'm very concerned I'm not going to get much/anything. Hope you're doing okay. Yes, every single ache, pan, twinge is a worry isn't it, especially in those early stages.

@TTC6 thank you. Yes I completely understand what you mean. My little one is nearly 4 as well. And last summer my friend said she was pregnant with no.2 (number 1 was 2 in the autumn as well)and then had her baby at the end of last year. I calculated that she could get pregnant, have a baby in less time it's taken for us trying.

@loulamay wow you have some good numbers. Hope you get a good fert update today.

So I've started the stimms. I have been sweating a lot at night and so frightened my temperature is too high and my few follicles have evaporated. I am on a completely different protocol as with a different clinic so no idea what to expect. I keep thinking that if I get nothing then at least we won't have to waste anymore money and I can work towards closure, however difficult that might be.

@Sofie19 sorry the stims are playing havoc with you. Try not to worry too much, I'd have thought it unlikely they'd drive your temp up so much it would affect things, and the fact you're sweating is good as a cooling mechanism, however horrid it must feel. When is your next scan?

@loulamay how are you doing? Any updates post EC?

I'm feeling a bit better this week, still anxious but more manageable. Looking forward to our scan next week. If that goes well I think I will relax a bit 🤞

@SErunner good luck with your scan.

Nothing major to report on my end just that stims seem to be working and my left ovary is miraculously being the dominant one for a change. I want this week to fly by so that we can get to the real business of whether we can grow any blastocysts the following week. I am feeling like this process has already taken 4 months and I just want to return to normal life soon.

@Sofie19 sorry to hear you’re having rough side affect. What are you taking for stimms? I am on Meriofert and Fostimon. I am sure there are so many others.

Hi @SErunner - all good here thank you. We were staying with my parents so they could look after our daughter while we were away and drove back up through horrendous rain to the Lake District today!

Got the email yesterday that 12 have fertilised, so day 3 update tomorrow!

It seems this is an ectopic so not viable. I'm just beyond broken. I think I'm going to drop off this thread but I wish you all well

I'm so sorry @Eggling. What devastating news for you,m. Of course, do whatever you need to do right now. If you want to come back at any time we'll be here. Thinking of you xx

@Eggling I have no words 😔 I’m so very sorry. Look after yourself and as @SErunner says, we are all here for you if you want to come back at any time. Sending lots of love x

Thanks both, I'm still here. I'm really not sure where to go from here. I'd be really grateful for any advice anybody has.

It seems that this was a chemical pregnancy rather than an ectopic, which is obviously a good thing. We have 4 embryos left, 3 of which we know are euploid.

My consultant said our prognosis is still good. Sometimes these things just happen. He is very clear that he doesn't believe in any of the immunological theories. I was one steroids etc this time and obviously it didn't help so he kind of said well if that was the issue it would have helped and it hasn't.

However, I know people having reproductive immunology treatment and their drs say basically the opposite. I said to DH last night that whilst it could all be bad luck, at some point that surely isn't the most obvious explanation anymore? I have a theory that something in my first pregnancy has triggered a response that has led to the subsequent implantation failures and losses.

It's complicated as all three losses have been different I suppose. O just don't know what to think.

I don't think we can afford tens of thousands of pounds to see dr Shehata or similar. And I know the evidence base is sketchy and don't really want to spend all that money when it could solve nothing. Equally if that is the issue I want to address it.

My brother gets married in Cyprus in July so currently thinking of waiting until after then to try again as I don't want to be early pregnancy over there and risk this happening there. We will have a follow up in a few weeks but when discussing yesterday my consultant suggested maybe down regulating before the transfer and then doing minimal extra medication so not the clexane, steroids etc I've had this time. I'm torn between this and pushing for additional dose of steroids as the woman I know on the immunological protocol said that the 10mg I was on she was advised was far too low.

It's my best friends wedding today so I need to get through that. Then I'm going to call my gp tomorrow or Monday and ask them to refer me to the tommys recurrent miscarriage clinic in Coventry, which I have no idea how long will take. In the meantime will see what our clinic say at follow up.

What do you all think? It's so hard as there's no medical consensus and I just feel completely torn. I want to trust my consultant but I also feel that it just doesn't make sense to have all these issues.

I'm heartbroken we won't bring our baby home this year. Another Christmas to get through. Poor DD, she would be the best big sister. I've let her down so so badly.

Oh @Eggling. You haven't let her down. Not one bit. Look at all you're going through to try and give her a sibling. I can totally understand your despair right now but 4 more embryos is a great place to be and statistically there is a good chance one of them will become a baby for you. I'm glad to hear this wasn't an ectopic due to the resulting treatment for that, but I am sorry it was a chemical.

I personally don't buy into immune treatment either, and the research that exists currently doesn't support it, hence it not being recommended by the HFEA. I think this gives good credibility to your consultant that he isn't pushing it and I would be inclined to trust his opinions - he sounds well informed. RW doesn't advocate immune stuff either unless it is free in the context of a research trial. I think a lot of women are duped into wasting an awful lot of money. Sorry if this sounds strong, obviously just my thoughts and no judgement of anyone who does go down this route - I understand the desperation and if we hadn't had our daughter I can't say I wouldn't be going to the ends of the earth despite my rational brain! I personally do think IVF is mostly a game of luck, waiting until you hit an embryo that is destined to be a baby, which for some takes longer than others, probably for some reasons known and some unknown. Obviously there are some things we can monitor and control (hormone levels, lining thickness etc), but I think so much of fertility is not yet understood and there are probably factors at play that we just don't know about. Sorry if this sounds a bit philosophical - it helped me to feel the outcome was somewhat out of my control, and that I could only do why I could do, but appreciate that might not be what others think and may not help others.

I hope the wedding goes okay today. Take time for yourself if you need to, weddings are so busy no one will notice! I can understand pausing until after your abroad wedding too. It's hard to manage this stuff around so many life events isn't it. Thinking of you lots today xx

@loulamay those are great fertilisation numbers. Hoping your day 3 update went well too?

@Faith2024 I get the frustration. It all just feels so long doesn't it. Never ending waiting. Hang in there x

oh @Eggling I am just so sorry. Welling up reading your post. You have let nobody down at all. You are incredible and you have been through so much this year!

I am thinking of you - really hope you can enjoy the wedding and totally give yourself a break and enjoy your trip to Cyprus before trying again.

I think, like you, I would be questioning everything and I'm the kind of person that always wants an answer to why things are happening. Hopefully the miscarriage clinic and your own clinic can give you some advice.

All ok here @SErunner - 9 embryos still in the running yesterday so we'll see what tomorrow brings!

In other news, DD is on her way home from nursery with suspected chicken pox! Eeeek!

That's great @loulamay. Everything crossed for tomorrows update. Eurgh chicken pox. We've had it, such a pain but our experience wasn't too bad. This stuff really helped, as did soaking oats in tights in her bath water.

https://www.boots.com/poxclin-coolmousse-10076517?cmmmc=bmm-buk-google-ppccPLAsAsHeroCompareare--PMax:+UKKSmartShoppinggBaby&gadsource=1&gbraid=0AAAAADrIajWFU0cI-ySjbX7Cjpu9Zfzu9&gclid=Cj0KCQjwlN6wBhCcARIsAKZvD5jwp1boRKJaOnHdd5aaXIxYTqz1GzY2kL-wwpYnncWEPEGQkx8wpMaAoCyEALw_wcB&gclsrc=aw.ds

@Eggling My heart goes out to you, you haven’t let your daughter down at all, please don’t think that. You’re trying your very utmost. I hope the wedding goes ok today.

I haven’t really got any advice as our bodies and situations are all so different aren’t they, it would be so much easier if it was one size fits all 😏 But I can tell you about my protocols, in the hope it might be helpful rather than confuse you even more. I don’t want to do that.

I do agree with @SErunner about it all being a game of luck to some extent. I really agree that so much is still unknown, and the fact that different doctors don’t even seem to agree on things, seems to demonstrate that. I had that chemical pregnancy and then four failed implantations in a row, before this one worked. Who knows why.

I think that it’s such a positive thing that you know you have at least three euploid embryos. That’s a wonderful position to be in. Plus that’s good news as well that this one wasn’t ectopic, with all the complications that could bring.

I’ll tell you my experience with steroids and Clexane just for your information and in the hope that it doesn’t confuse you any more. I’ve never been tested for immune issues. My original clinic (Gennet in Prague) would prescribe Prednisolone and Clexane empirically just as a matter of course, so being completely clueless on these matters, I just followed their advice and we struck it lucky with our first transfer and had our son.
That was 5mg of Prednisolone raised to 10mg for a week from the day of transfer and then back to 5mg again until 7 weeks. Also a Clexane daily.

I then had 5 more transfers with a similar protocol, the same amount of Pred and Clexane (and obvs progesterone and oestrogen too) which didn’t work (first one chemical). My oestrogen was raised to 8mg rather than 6mg for transfers 3-6, they said because of my age.

By the time of transfer number 7, I was with Institut Marques and I said I wanted to go back to the original protocol which had worked. No change to the Pred or Clexane, but back to 6mg of oestrogen and back to the original timing of the progesterone (ignoring the ERA result which I do feel was a waste of time).
So that one worked, although slightly differently, they raised the Prednisolone to 20mg after the positive pregnancy test until 12 weeks.

Obviously I’m not suggesting that because that worked for me, then that would work for you. I just wanted to make two points -

Firstly, I was never tested for immune issues so I have no idea if steroids and Clexane made any difference or not, but a lot of clinics do seem to prescribe them on a just in case empirical basis. I suppose we’re back to the age old problem of all the doctors disagreeing.

Secondly, after reading a lot on here about steroids more recently, I started to feel slightly nervous about taking them, especially when they rose to 20mg. I hadn’t batted an eyelid the first few times - blissful ignorance maybe!
I started getting concerned about my immune system and catching nursery bugs etc, plus people said they had trouble sleeping. However, I have to say, I didn't experience any problems of that sort and didn’t have any problems weaning off at 12 weeks either, so personally my worries were unfounded.

I’m not sure whether this is helpful or not. I never did a transfer without steroids or Clexane so I have no idea if I needed them or not, but I suppose what I’m trying to say, is that they didn’t do me any harm. I honestly have no idea if they helped or whether it was just a numbers game and a matter of finding the right embryo.

I think that’s a great idea to ask to be referred to the recurrent miscarriage clinic. If you’re thinking of waiting until after July and your brother’s wedding, you never know, it might all fall at the right time 🙏
I don’t know anything about Dr Shehata other than reading about him on here but I’m inclined to agree with you about the money side of things, especially if the suggested medication ended up being the same as you’ve already taken. Maybe there’s more to it than that, I don’t know.

Thinking about you and I know that it won’t help whilst things are so raw, but I really feel that you’re going to get there in the end ❤️ x

@loulamay Just read your update ❤️ That’s fantastic news that there are still 9 embryos going, I’m so pleased, keeping everything crossed.

Not such good news about the chicken pox 🥴 I will say this though - I know there’s never a good time to have it, but you’d be more worried if you'd just had an embryo transfer I’m sure, so maybe it might be good to get it out of the way? Sorry if that’s scraping the bottom of the barrel of looking on the bright side 🤦‍♀️ Hope your daughter’s ok. Bloody nursery bugs x

Yes, could have been much worse timing and we're on holiday next month as well so good to get it out of the way. Currently only small spots so not sure if they will get worse or if you can have a 'mild' case of chickenpox?!

Had a day 5 report today - we have one hatching blastocyst that has been frozen ahead of testing but the others are 1xB (blastocyst), 3xEB (early blastocyst) and 2 compact Morula. I hadn't realised this but apparently, they can only do PGT testing on the hatching ones. Now feeling totally downhearted because if the B and EB don't catch up by tomorrow we only have one we can test. They will freeze those but we have no way to know if they're euploid.

I FRICKING HATE THIS. I also hate that I stupidly got my hopes up again and now it all feels like a potential failure.

@loulamay sorry to hear about your disappointment it’s really hard but see what happens.

@Eggling I think @SErunner and @KLM25 gave sound insight. Having 3 embryos is a really good place and there is a high chance one of them will stick. I don’t have any experience with a transfer yet but I am on low dose of steroids for the two weeks stims for all my 3 cycles. I am not sure if they are behind the insomnia but it’s temporary.

@Eggling oh no!! I'm so sorry. How devastating and disappointing. With regards to any suggestions and things changing since your first arrived, what was your birth like? Is there any chance you could have had an infection and it lead to a less than optimal environment? Have you done the endometritis test?

@Faith2024 I am on those drugs and also one called dexamethasone (or something like that). Finding it difficult to sleep a bit now too. How have your scans been so far?

@loulamay ahh I'm sorry you have had a different outcome for this cycle. That must be really annoying to get a few days 5 blasts previously and not so much today. I hope the others catch up tomorrow for you.

@SErunnerhow are you? Are the days ticking along quickly or slowly for you?

Well I've been stimming for a few days now and some follicles are growing. Moved onto daily scans and bloods now.

@Sofie19 I am on that one, doxycycline (antibiotics for week before EC) and melatonin for the 2 weeks of stims. I know it’s part of CRGH way if you’re late 30s+ and they get bad rep for using all the meds but at the same time I don’t want to do an entire cycle and all that is added differently next time is a few tablets.

I am on day 10 of stims and had the 4th scan this week and going in for another tmwr. Looks like about 6-7 follicles, measuring at 16-14 , also a few smaller ones at 12. I just need to get to Monday/Tuesday when EC will take place. It always takes me ages so they ll probably make me keep going for another day or 2.

I found out I have Thyroid Antibodies during my screenings but it’s borderline and not significant enough for medication. And my thyroid function is also fine but doctor said we will review it at transfer stage so I wondered if that’s why the steroids were recommended. I think some clinics just add them for preventive measures maybe?

@Faith2024 I've been called to go back in tomorrow after my scan/bloods today so we may be there at the same time! 🤣 What is the melatonin you are taking for? I'm not on that. I agree re about taking all the medications. It's really good that your follicles are similar in size, I'm sure that's also meant to be a sign of good quality. Mine are a bit more varied so I guess it makes things a bit trickier for them to work out when I should stop taking the stims.

@Sofie19 it helps with egg quality because it has antioxidant properties and is associated with slightly higher live birth rates but I am not sure how big those studies were. If it helps I will try it. May also help to counteract insomnia but it hasn’t really in my case.

I feel like I live at clinic at this point but I can’t complain because I need all the help I can get and appreciate the close monitoring.

3 sent off for testing so not a total disaster in the end but I was definitely hoping for a couple more. Anyway, as always, this whole sh*tshow is out of my hands so no point crying about it now, just got to see if any of these three are viable. If not I don't think I can do any more retrievals and it's probably onto donor eggs.

@loulamay glad to hear 3 made the cut (literally). The numbers game is rubbish isn't it - it never feels enough. Remind me how long it takes to hear back? Can totally understand your thinking re DE. Have you looked into it much yet?

@Eggling how are you? No need to reply if you don't want to, just know I'm thinking of you.

@Faith2024 @Sofie19 how are you getting on?

The days are crawling by for me. Feeling okay, just very very tired. Scan Thursday, can't think beyond that at the moment.

@SErunner I had my EC today and it was our best cycle ever in terms of numbers, no indication of maturity or fertilisation yet. We got 11 and that’s the same as both cycle 1 and 2 combined. So I am relieved.

We will know later this week about blastocyst s etc.

Hopefully it will all go well for you in Thursday, not long to go now.

@loulamay completely agree with it being out of our control. I think our bodies do the best they can and that is all we can do.
Good you have another option to look into but everything could still work out with your 3.

This is it for us, if it doesn’t work we tried.

thanks guys - what will be will be!

@Faith2024 great news on numbers and hang in there @SErunner !

Can't believe I'm writing this really but we came into A&E on Sunday morning after I started vomiting and having stabbing pains in my abdomen on the left side. Long story short (and not an impressive one thanks to the NHS) but I went into surgery late ast night for ovarian torsion which had obviously been twisting since Sunday and had turned necrotic. Have lost left ovary and tube.

Feeling much less pain today (have never experienced anything like it) but am horribly bruised, swollen and had to have a transfusion because of blood loss.