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

I think I agree with you @SErunner it’s just hard when you are told of these tests as ‘options’ and there is pressure as we have 2 euploid embryos so it’s almost implied we would want to do everything to make sure nothing is missed but that also sounds equally unhelpful!

Our main issue was declining AMH and egg quality due to natural ageing.

I already ruled out ERA, NK test, and Hysteroscopy. I did the dummy transfer and saline 3ds scan to make sure no scarring from previous C-section, that’s the only one that made sense to me. The doctor said the scan was all clear and they couldn’t see any abnormalities. So now I am just going back and forth on this EMMA & ALICE test in case there is some chronic inflammation or something. I am just not convinced but also don’t want to waste a good embryo.

@Faith2024 with the Emma/Alice one of them is the microbiome and the treatment is probiotics I think. Are you able to take the probiotics as if you had the biome issue without getting tested or is it not that simple? We are getting the endometritis one but have been on the NHS waitlist for a while for it rather than going through the clinic/paying. I know exactly what you mean re. wasting a good embryo. I don't know what we will do when we have to decide about the add ones either.

@Edf tentative congratulations!

@SErunner Hope you’re feeling ok after Friday. I’m glad this sunshine is helping. Hopefully the waiting was the worst bit and you feel like you can start to move forward now. A horrible experience to have to go through.

@edf I’m whispering congratulations to you ❤️ That’s lovely news but I clearly remember how nerve wracking this first part is. Hope the days pass quickly and you’re feeling ok.

@Sofie19 I’m really sorry the results weren’t what you’d hoped for or expected. The disappointment is so tough. Hope that the NHS appt comes through quickly for you or they’ve at least given you some idea of a timescale.

@Faith2024 I know how hard it is when they suggest all these tests and it’s impossible to know whether they’re a waste of time and money 😏 My clinic were really pushing for me to have a hysteroscopy before this latest transfer to see if my c section scar was causing any issues. I was actually planning to have it, if this latest transfer had been unsuccessful.
I had the Emma and Alice tests last summer together with the ERA as the endome-trio. I’ve probably said this before but I think I’m proof of the inaccuracy of the ERA as it said I needed an extra day of progesterone - I tried that and I had an unsuccessful transfer. Went back to my original progesterone timing - successful implantation.
When it comes to the Emma and Alice, they both came back clear for me, so I suppose the best I can say is that the biopsy put my mind at rest and ruled those issues out as potential problems. I think there’s some other cheaper test you can do by sending a sample off to Greece? Fertilysis or something? There’s a thread on here Emma/Era/Alice with pages and pages where you could find out the info.
I know it’s an impossible decision. We only really decided to go for the testing as I went to see Adrian Lower in London and I was expecting to find out I needed to pay thousands to have my c section scar repaired, so in a weird way, we felt like we had saved some money when he said that was fine, and he would only suggest the Emma/Era/Alice 🤦‍♀️ Good luck with whatever you decide anyway x

@Sofie19 thanks. I think I just need to do it with my own clinic if I am going to do it. I want to do transfer asap and if it doesn’t work move on to next one. I have been doing this since January and I just want to close this chapter of my life.

@KLM25 thanks for that insight. I saw that thread and got overwhelmed. I think I just need to reconcile the part of me that thinks this is unnecessary with the part that sees this as maybe potentially preventative, if at all.

@edf tentative congratulations! Keeping everything crossed for you and I hope you feel able to celebrate a bit soon. I know how scary it is.

@SErunner I hope you're doing ok, I've been thinking of you

@Faith2024 you sound similar to me, I've also been wondering if scarring from my c-section is the cause. I do have a teeny tiny niche but I'm assured that won't be the problem, I haven't had a hysteroscopy because the drs have said there isn't an indication it's needed and it might cause more harm. We talked about the ERA and ALICE tests this time but I already take probiotics and my consultant thought it would probably be a waste of money. It's so hard to know what to do though isn't it, and you feel under so much pressure to get it all right.

@KLM25 hope you're well! Really useful to hear your experience with the ERA. We are going to try adding an extra day of progesterone this transfer as my consultant says that's what basically all of the tests say so why waste money on the test. It does feel like a lot of it is guesswork tbh which is a bit galling when you're paying ££££

Im on a bit of a downer today. I’ve actually been feeling ok but realised this morning that that was because I’d convinced myself I’d somehow got pregnant this month and then tested this morning and obviously I’m not. I’ve had the symptoms I get when I’m pregnant (my boobs change, all veiny and huge nipples) which I’ve never had any other time so I was stupidly expecting a miracle but two negative tests this morning which has really upset me because now I feel like my body has tricked me.
I’m also now a bit stressed at the clinic but basically we had our follow up with the dr on 1 May and went through a plan and he said he’d give me a call after the conference to let me know if anything changed. I said in that appointment that I needed another prescription of hydroxychloriquine as I wanted to stay on it (I carried on taking it after the last loss) as it is part of the recurrent miscarriage panel at St Mary’s which is the nhs hospital to be on it for two months before transfer. He said he’d talk to my patient coordinator and sort this out. We didn’t hear anything so chased this up and the coordinator said she’d sort it but I still haven’t had it through. So I’ve now not been on the hydroxychloriquine for almost two weeks. And I’ve been calm about it because I thought I was pregnant but now I know I’m not I’m freaking out it that it’s going to mess it up next time. I know our dr will say it won’t make a difference but I’m just upset that this one little thing can’t be sorted and it’s affecting my trust in the clinic. I’m also confused as to why we now have to wait for the 28th as my impression was the dr was literally going to phone me and let me know if anything had changed. I don’t know why we need a full consultation when we’ve basically already had one.

I’ve emailed this morning about the prescription and said I’m disappointed and I’m going to ring the clinic later and see if I can speak to one of the nurses just to explain why I’m confused about what’s going on.

I'm also anticipating a pregnancy announcement from the friend whose wedding I was at the day after I found out about the loss last month and that's stressing me out, plus my brothers wedding in July and anticipating another announcement soon after. I'm gutted because of all had gone to plan and our first transfer for a sibling way back on July 2022 had worked we'd be taking a 3 year old and 15 month old to this wedding, and I'm not even pregnant with our second child yet.

@Eggling thanks, otd was yest and all was ok so far

im sorry your having a bad time of it- body playing tricks on you is just the worst and there is nothing worse than thinking it’s worked only to have those horrible blank tests stare back at you! Imagining what could and should have been is so heartbreaking, I know exactly how you feel- virtual hug!

it’s so bad the clinic have let you down in such a way- it’s like they don’t appreciate they are dealing with people pushed to their limits and can feel very vulnerable- I really hope you get the answers you need and the prescription asap!!

Hi @Eggling 👋 I'm so sorry your body is messing you around in that way, that must so frustrating and upsetting. Also frustrating re the mess ups with your prescriptions. I hope they can get that sorted for you so it's a weight off your mind at least. I also think we have some pregnancy announcements coming up soon which I'm dreading. They're just awful to deal with aren't they. I also think about timeframes a lot and what would/could have happened. I find this occupied my thoughts some days more than others. It's very hard seeing most people around you sail through these parts of life, and whilst I'm sure you have lovely people around you, they just don't get it if they haven't been through it I don't think.

@Faith2024 it's so hard to know where to draw the line with the add ons isn't it. Part of the problem with the Emma/Alice I think is that there isn't good evidence the microbiome even has an impact ie plenty of women who would test as 'poor' get pregnant naturally anyway. That said, I can totally understand the feeling of wanting to do it for a sense of completeness. I think it's such a personal decision. Hope you can work out a plan soon and move forwards.

I'm doing okay post surgery - relieved that aspect is over and being back at work is good to keep me occupied. I still feel quite up and down emotionally, but nowhere near as distressed as I was initially and I think some of this is just hormones fluctuating still. We have decided we are definitely not doing any more IVF and it feels good to draw a line under it. We are going to continue trying naturally though but with a hard end point that if nothing has happened by the time our daughter starts school I'm going to go back on contraception and we're going to move on as a family of 3. I think I'm happy with this - it feels hard facing another year of uncertainty, but I don't feel ready to stop trying naturally yet. I suspect I might come to a natural end with trying naturally before next year, but we will see. Hopefully this is a good compromise!

@Eggling sorry to hear that, negative results can really get you down. You still have your FET so hang in there. The clinic shouldn’t be causing so much unnecessary stress. Sometimes escalating and speaking to someone on top of emailing might be needed. As for me, last week’s scan showed no scarring and no abnormalities so that is one hurdle out of the way.

Thanks for everyone’s supportive words. I got in touch with my doctor and asked outright if she would recommend it for me and she has said yes she would. That has made my decision easier even if I personally feel it’s unnecessary. I don’t want to look back and wonder, I need to have the feeling that I have done everything I could. But no more tests after this fingers crossed.

@Sofie19 I am not bothered so much about the micobiome rather if there is bacteria which is damaging or inflammation etc. anything I need to take antibiotics for before transfer.

@SErunner I am really glad that is now behind you at least physically and that you have plans for your future. There is something liberating about never having to go though this process again, even though my journey hasn’t been that long it puts my mind at ease. My personal cut off point for trying was till the end of the year. For me it’s just about getting older. Regardless of the outcome the dream of motherhood has already been fulfilled and alongside the pain there is yet so much joy in life to be experienced.

Thanks everyone. We got the prescription sorted and I spoke to the consultant last night and I think we are ok to start the FET cycle on this bleed which I'm anticipating will be soon as had some brown spotting this morning. I'm still feeling rubbish tbh, feeling really negative about this next cycle and can't see how it will work. It just seems so unlikely to have 4 positive test after FET in a row (notwithstanding the last three have all ended shortly after). I'm really struggling to do anything, concentrate at work, sleep well etc at the moment but there's nothing I can do about it. Fortunately wfh today and yesterday because I've basically been in tears the whole time so lots of having my camera off and being on mute!

@Faith2024 and @SErunner I think it sounds really sensible to have a cut off point to move on. I'm not there yet and honestly don't know if I'll ever be able to let go but I think it is so brave and definitely right to take into account the impact on your existing child and family. I feel a lot of guilt for the impact this has in my daughter - she was asking me again this morning why I'm sad and gave me a cuddle. I'm really worried about what this will do to her in the long term.

@Faith2024 I'm really glad your doctor has helped. Sometimes having someone else make the decision for you is really useful! Totally understand the need for no regrets.

@Eggling very much understand where you're coming from re probabilities, but glad you can start soon and previous outcomes really do have no bearing on this one (totally get that's hard to believe though). Glad you've been able to WFH, hopefully that takes a little pressure off. I am also struggling to concentrate, not sleeping etc. I do empathise. Work is not getting much of me at the moment!

Re the end point - all I can say is the feeling of wanting to stop IVF just crept up on me (even before this miscarriage). Before I'd have always been so 'on it' in terms of booking and paying for next appts but I found I was dragging my heels, finding reasons not to. We had lots of conversations and I thought about it a lot, played out the different scenarios/outcomes in my head, and over the last 6 months it just feels like I have come to a natural end point. It's not that I don't want another baby, I do, but not enough to want to continue the disruption IVF puts on our life. We have so much good, I don't want to miss it all being consumed by something that might never happen, and I can see us being happy as a family of 3. There are lots of upsides!! I'm sure it's different for everyone, but if you'd told me I'd be here a year ago I wouldn't have believed you. Hope this doesn't cause upset, just thought I'd share in case it's useful.

Ps I can't remember exactly how old your daughter is, but I am certain this won't have any long lasting impact on her. Talking about it in a measured way sounds sensible, but they are incredibly resilient and don't necessarily read/interpret/feel everything in the way we do.

@Eggling I echo what @SErunner has said, every transfer is a new chance regardless of what has happened before. Also, I am sure you are doing your best for your daughter.

As for coming to a decision to end trying/treatment everyone gets there in their own time and based on their own circumstances, if that is something they even wish to do. But now is time for another chance so one thing at a time. Looking at each step at a time is something that has really helped me from getting lost in my own head.

Hi everyone - sorry I've been quiet, am totally behind on where you all are but have been thinking of you.

We've had our consultation with the London Egg Bank and are moving forward with choosing a donor! Feeling more hopeful than I have in a while, and relieved that I won't have to do any more egg collections.

I think it was on this thread that someone managed to get their GP to run a set of blood tests for them, was it you @SErunner ? They want us both to have a test for infectious screening like HIV etc, sadly they won't accept the results from our Czech clinic, but the admin girl I spoke to first said our GRP might do it for free...

@loulamay if you ask your clinic for a print out of the tests and then show the print out to your gp they might be able to do some - I needed some stuff like hiv, hepatitis, chymadia etc for IVF as my previous ones were out of date. The gp did the majority of them for free which was helpful during a costly process. Good luck!

@loulamay so sorry for the lack of response. Yes it was me. My GO ran a full blood screen for me last year just to check everything that could be checked. Definitely no harm asking, hopefully they will be agreeable. That's very exciting about starting the donor process. How are you and your partner both feeling? What are your steps for choosing a donor?

Great - definitely going to give it a try! We are on holiday for two weeks which is much needed but will organise for when we get back!

We have gone through the London Egg Bank for a few reasons - they have a clinic quite near us so that's handy, they have eggs already frozen and ready to go and the donors in the UK are non-anonymous, meaning any children we have can find out more about them at age 18.

We created a shortlist from the profiles and then sent them photos of me and they came back saying one was a great match facially so we went with that one!

How is everyone getting on?

We are back from a lovely holiday in Greece and I'm feeling excited about our next steps. If all goes to plan I think we will be doing an embryo transfer in mid July.

Wanted to ask what things, other than your protocol meds, do any of you do to prepare for transfer? I am on my usual Vit D, Vit C, B vitamins, Omega, Prenatal, and have just ordered some women's probiotics (never had microbiome test but just throwing this in there in case). Also trying to do the usual of less caffeine and alcohol. Also, I don't want to go crazy because I'm never sure how much of this really plays a part and it can make it all feel more stressful when you're trying to achieve the opposite!

@loulamay great you’re feeling so positive and that you have a plan. I am on all those things except the omega which I was thinking of adding. Probiotics cannot harm and I was recommended to take them up to transfer.

My FET was scheduled for June but the EMMA & Alice test results showed slightly elevated levels of one of the bacteria (11%) , most likely caused by antibiotics use ironically so I am on a course of antibiotics and starting probiotics after that until transfer. The recommendation is to repeat the test but I am reluctant to do so as I think the antibiotics will do the job,’it will delay me and it’s yet another invasive test. Also my doctor thinks the results we not worrying at all in comparison to what she sees.

My transfer is likely to be around 20-24th July and I really just can’t wait to get to that point.

@loulamay Hey! Your plan sounds quite exciting! Yay for things going ahead.

Just pregnacare, omega 3 vit d and was thinking of the probiotics. I also take levothyroxine.

@Faith2024 I wondered how things were going for you. Which probiotics are you taking? I finally had my follow up (couldn't face it before) and the Dr seemed pretty confident the reasons for all my previous failures/miscarriages was due to chromosome issues due to my PGTA results being far lower than what's expected for my age. He didn't seem overly convinced for me to do the other tests but I am still mulling them over. I compare to how he was with our first consultation and basically said w needed PGTA and I guess he was right. But I am wondering if taking some probiotics anyway would negate the need for the biome test. My transfer won't be for quite some time. I'm getting an NHS hysteroscopy which I'm expecting to be clear and going on holiday in august so unlikely to be before then!

Nice to hear from you @loulamay - glad you had a lovely holiday! And great to have a plan with things happening so soon. Wishing you all the luck in the world with this first try with donor eggs.

@Faith2024 glad to hear you're also heading in a good direction towards transfer. I can see your logic with not repeating the test.

@Sofie19 lovely to have a holiday to look forward to! Hope your hysteroscopy goes well. From what you've said it does sound like there is a quality issue doesn't it. Did he have any other suggestions or just to go ahead with tested embryos?

I generally stuck to caffeine and alcohol free throughout our IVF. Supplements wise I took a supplement from the vegan society as I follow a vegan diet, extra vitamin D and some folic acid as well as ubiquinol. Not convinced on the benefits of any supplements for fertility but vit d is good to take anyway and the ubiquinol made my hair and skin much better so enjoyed the added benefits 😂 all that said - in the run up to the month I conceived naturally for the first time ever I was drinking alcohol from time to time and caffeine 🤷‍♀️

I'm doing okay. Physically all good after the surgery for the miscarriage and emotionally much better. Had a few rough weeks with hormones up and down but doing okay now. Just waiting on my period to start so I can get a sense of where my cycles are at and we're going to continue TTC naturally for now x

Lovely to hear from you @loulamay! Your holiday sounds wonderful, and very much deserved. I think you're right with FET prep that it's a hard balance to try and strike between doing things to help and not stressing yourself out. It sounds like you're doing the best you possibly could be there. I do take a load of supplements including a women's probiotic thing, and haphazardly shove some of the canestan probiotic capsules up there too 😅

@Faith2024 it sounds positive that your dr was reassuring about the results. Totally understand you just wanting to get to transfer!

@Sofie19 I'm glad your follow up provided some sort of answers. Great that you have a holiday to distract you as well.

@SErunner I'm glad things are going ok for you. It's likely to still come in waves I guess, but fantastic that you're looking forward.

I had FET of a 4bb on Monday. I had some fluid on my uterus on a scan last week so was convinced we were going to have to cancel but the fluid had cleared up on Mondays scan. Lining was 9.4 mm. I'm on a higher dose of prednisone this time along with the clexane and lubion. I'm struggling to feel positive about this one tbh, although logically I know I'm only 3dp5dt so wouldn't have any symptoms yet. I have had a tiny bit of brown spotting since transfer which I've never had before (this is transfer 7 in total) which has freaked me out, I think this one was a little rougher than the others so probably just knocked my cervix a bit or something. I am having bloods done to check my oestrogen and progesterone levels on Monday anyway, on transfer day my progesterone levels were apparently really good (130 but I don't know the units so can't really compare to anything!). Oscillating between trying to be hopeful and trying to protect my heart I suppose.

We do seem to be getting close to completion for our house move though, at last!

Lovely to hear everyone is in a good place right now with lots to look forward to and positive steps to take,

@Eggling got everything crossed for you! The dreaded tww! Hopefully your house completion can keep your mind off things,

we had a viability scan last Thursday (from our 4bb coincidently) at 7 weeks and so far so good, back next Thursday to hopefully see a good 9 week scan and graduation from the fertility clinic

Thanks @Edf, I'm not feeling any of my usuals symptoms so not feeling all that positive about this one unfortunately. Great news about your scan - hope you're feeling ok!

@SErunner I'm glad you're feeling much better. The hormones after a MC are so volatile aren't they. I hope your period comes soon for you and you can get back into a regular rhythm. Just reading the rest of your post...of course your body decided to fall pregnant naturally the month you had alcohol and caffeine! Why do our bodies trick us!

@Eggling Ahh I hope the embryo is snuggling in nicely! It's so hard not to analyse all symptoms. Do you know when you are going to test? I mean, I know there's OTD but will you wait? I'm pleased you're getting closer to completion - I hope it goes quickly for you. We have put house on the market for a couple of months but no offers and not too many viewings so we might have to adjust the price.

@Edf I'm glad everything is going okay for you so far.

Well at the follow up the Dr said we basically had 2 options...to go ahead with the tested embryo or do another EC to try and get any more. When we had the first consultation he seemed certain we should do PGTA but he didn't seem fussed on all the other tests even though the clinic offer them. I think I will still have a think but even at the best of times euploid embryos have "only" a 60% chance of working so I'm really unsure.