ERA EMMA ALICE testing thread 9

[Gardenlady543]

@2021ivfagain @Enfys23 @clhiu @CailinInUK @Spin101 @Loz2467 @Mybabydream @Janefx40 @ChickenT2b @kerrym87 @Sar1010 @AM08 @thislittlebird @IVF22 @APSR
@Faithhopelove83 @KLM25 @VenusStarr
@BewilderedBee @Dochas12111 @seven201 @StillWishingHoping

We've maxed out the other one so here's thread 9 😊

@CailinInUK sorry to hear about covid. I had it before an egg collection and it was our worse round. So I would definitely have a 3 month break before a collection if you were aiming for one. However for transfer I would think if you were feeling well it would be ok to go ahead.

I was given antibiotics for SIS! Very annoying they didn’t. Definitely get some asap. They should wipe out any good bacteria but also anything bad so I’d hope if you upped probiotics it might not do too much damage. I don’t remember whether you’ve done an emma/era/Alice before?

@Gardenlady543 myself and DH discussed it and we agree you are right and we should repeat the test to make sure the antibiotics and probiotics have worked. It means realistically delayed transfer till January which we were both upset about ( DH took some convincing). I don’t know why we are both in such a rush but we just want to do it and not be delaying for tests. But as I pointed out to DH we waited April - November sorting out issues before our transfer that worked. So a 3 month delay isn’t too bad. I am just presuming a Christmas transfer won’t work re clinic timings.

I’ve said it before and I’ll say it again. You are wonderful to give up your time to give everyone advice. We would be lost without you! I hope you are feeling well and everything is going well.

@Gardenlady543 @Dochas12111 thank you.
I ended up going to out of hours GP Sun morning at 01:30. My urine sample showed a UTI so GP didn’t think I had a pelvic infection, just UTI, and the timing with SIS was just coincident. I haven’t had a UTI for 20 years and I didn’t have any issues peeing, just fever, chills, aches and pains the day after SIS. I was prescribed cephalexin antibiotic for seven days. I struggled to believe infection wasn’t related to the SIS. GP offered a second opinion so he called hospital gynae Dept who agreed with GP but they offered to see me to do swabs, etc, for reassurance. I didn’t go there yesterday for several reasons - it’s the same ward as where I had my 20 week miscarriage, it was DC’s birthday party yesterday, and I was travelling abroad to work this morning, Monday. GP was fairly confident it was just a UTI. I’m feeling much better today after two days’ antibiotics. WWYD - would you get further checks and push for the relevant pelvic antibiotics or leave it? Though I was adamant about it must be related to the procedure, I’m now coming round to thinking it may be just a UTI. I had similar fever,chills, aches and pains on holiday prior to SIS, which I put down to COVID, but perhaps it was the UTI too.

@Dochas12111 I think you’re doing the right thing by treating your microbiome before transfer and it was a good move of yours to test before transferring. The delays are so hard but you’d probably strongly regret it if the transfer didn’t work as you might wonder if that was the reason. I’m also looking at Jan/Feb for transfer due to COVID and Christmas. Consultant advised against both collection or transfer post COVID, he said 4 to 6 weeks minimum break. I saw a study online that recommended 60 days for FET. I took a Fertilysis menstrual sample just before my SIS (still to post it) but was also thinking of doing EMMA/ALICE/ERA (mod natural) this month. I guess that’ll be scrapped now due to my antibiotics. I want to do modified natural FET instead of medicated but consultant advising against, saying I had implantation on all three medicated FETs with extra day of progesterone as per my original ERA (yes, but only one live birth, one biochemical and one late miscarriage).
What type of transfer do you plan?

@Gardenlady543 yes I echo what @Dochas12111 said. Your support to everyone is tremendous and I’m so happy that your grit and determination is paying off.

@2021ivfagain @ChickenT2b thinking of you both. @ChickenT2b I was about to congratulate you but then read about your chemical. I hope your therapy in Greece is the final puzzle piece.

@CailinInUK thank you. I hope you’re ok, sounds like a stressful time for you too.

@Gardenlady543 i am ok thank you. Back home now but we went back to see the Greek doc on Friday and I asked for a full blood count as I need to monitor my white blood cells on Neupogen. Anyway, my neutrophils came back high and lymphocytes low (or the other way around) and he confirmed that this would indicate failed implantation/chemical pregnancy so I don’t think it was a false positive afterall. This made me feel a bit better somehow. Perhaps because my body is really trying and sperm met egg so soon after my surgery which is promising. I guess I just didn’t have the treatment or meds in time.
After this awful period I’m having, I’ll be on Neupogen from just before ovulation.

Hope you’re doing well and all if good? How many weeks now?

@CailinInUK I’d be happy enough the antibiotics will treat whatever it is - UTI or infection plus if you are doing an emma.Alice etc afterwards it should pick up any residual infection if there is one? Hope you feel better soon.

yes my DH thinks we do too many tests, the last time I did the endometrio the dr commented it was my 3rd one oh wow that’s unusual which has put him off. I did initial one, repeat then test again before this new transfer after pregnancy. I tried to explain to him we are unusual. Most couples don’t take 6 rounds of IVF to get pregnant and I reminded him that our consultant had never seen 0% good bacteria before us so we can’t be benchmarked by what others do.

Fingers crossed we both get a successful transfer after Christmas then! My DD will only be 18 months in January so she is still young too so I guess there is no rush! Before having her we said back to IVF when she’s 6 months old but I wasn’t in the right frame of mind until she was 1 and then we’ve had all these delays!

@Dochas12111 it's always tough around this time with clinic Xmas closures, I just got in a transfer before Xmas last year but with the Xmas gift of a chemical with the tests fading for the first time on Xmas day :(

@CailinInUK I take it they sent the urine off to the lab to assess properly and give you the sensitivities. I would probably follow up with vaginal swabs just to make sure. You should be able to pop to the GP for this, my GP ordered it and just had me do the swabs myself in their bathroom.

@ChickenT2b I think chemicals are a step forward, it is indicating things are at least lining up as they should. What's next for you now then? I'm 28 weeks had a NHS scan this morning which was fine.

@Gardenlady543 Aw wow I’m so happy for you. Does it feel real now?
Our plan is to try naturally for the next few months and if no success then IVF from Feb ish, purely to speed things up if natural takes too long just to end in mc.
But I’m so hopeful after the lap, LIT and with Neupogen that we will have success naturally. I just don’t want to leave any stone unturned and it feels like everyone else in the immunology group on FB is on so many meds so I question if I’m doing enough and if this could even possibly work with ‘just’ LIT and neup. 😕

@ChickenT2b ah thanks, I'm at the point where I think there will likely be a baby. Which was initially hard to believe with my past. I have been lucky that this part has at least gone smoothly.

With the medications, you have to remember most in that group are from the USA and unless they travel to Mexico, they can't have LIT, so most people have to have alternative meds like IvIg instead.

Does anyone have any experience of “early blasts” I’m so worried as I’m finally getting on an immune protocol after my chemical last month and I have left 3 early blasts - day 5. Care rate 2:2. Then a day 6. I’ve used my expanding blasts and blasts. :(

Thanks @Dochas12111 . The antibiotic I’ve been prescribed won’t treat a pelvic infection if I had one, just the uti. I’d need a different antibiotic for that. it’s good you started fairly soon for a sibling as hard to know how long this process takes. I aimed for FET when DC was 18 months as BF for 14 months but it failed the thaw. That was in April 21 :( and it went downhill from there. What type of FET will you do?

@Gardenlady543 good shout to go to GP. I’ll do that when I get back to UK. I do wonder if swabs can diagnose a pelvic infection though…?

@ChickenT2b as heartbreaking as it was, i think you’ve reasons to be optimistic after getting the chemical so soon after your surgery.

@Loz2467 Day 5 22 early blasts are fine. I always had to let my blasts get to full or hatching for biopsy and I’d say roughly 50% of my Day 5 early blasts progressed to full/hatching by Day 6. You’ll probably find that when they thaw, the blast will have progressed before transfer. When are you scheduled for transfer?

@CailinInUK I'm not sure what else they would do other than vaginal swabs. I don't think will be getting a more local sample even at gynae.

@Gardenlady543 I agree. I think that’s all the gynae ward would do too so I’ll go to GP instead. Thanks.

@CailinInUK thank you! I’m just worried I’m wasting more time, emotion and money transferring but I need to use those before I can do another collection and if it gets to that I’ll do testing for sure! I’m on day 5 estrogen today so lining check is Monday 30th so maybe a transfer around the 6th. Just worried after my last chemical thinking I caused it by not taking enough Meds because it wasn’t like a chemical with faint lines so I’m worried implantation took place but just stopped. It’s the furthest I’ve ever got with IVF. I’m adding in an intralipid but just empirically so that’s another thing worrying me. My gosh it’s all such a worry isn’t it. Are you going to delay because of covid? I’m sure I had it 4 weeks ago but I didn’t test.

Hello and sorry for being absent, I've been having a tough time with things not happening for me and a total lack of financial resources to be able to do anything else other than just keep trying.

@ChickenT2b I am really sorry to hear about your chemical it's very upsetting, but it sounds like you have a treatment plan in place so hoping with the impact of that, your sticky one isn't too far away.

@2021ivfagain must have been tough and frustrating to find out about the retained product, have you had the hysteroscopy yet? I hope it went well and your body is soon ready to move forward with the next steps.

@CailinInUK very tricky to know what to do after covid and just another nightmare getting in the way of things for people like us, like we haven't got it hard enough, just when we're finally in the process, something like covid happens and sets things back further. I have also read it can impact both sperm and egg quality and that there may be some merit in waiting up to 3 months. I had a hyfosy procedure last month and was given 3 tablets of Azythromacin to take there and then, but nothing else, odd indeed you weren't offered any antibiotics, but I do thik it's totally possible the UTI might have been picked up during the procedure, I hope you're fully on the mend b now.

@Gardenlady543 very happy for you that things are going well.

An update from me is that after 3 cycles on the superovulation program + Intralipids and Pred without getting pregnant at all, this month I decided to ditch it all, including the intralipids on account of the cost and for the 6th time in my life yesterday I got to see that 2nd line on a PT, which appeared unfortunately way too faint for 12DPO. I re-took a second one thins morning just in case and the line hasn't progressed at all, in fact is slightly fainter so it's another chemical for me I'm afraid. This is a total of 6 losses, 3 chemical in total. I'm stopping cyclogest tonight and taking a final test tomorrow morning just in the absolute miraculous chance something was wrong with the previous 2 tests, but I've resigned to being doomed. I'm devastated by another loss, but also relieved to find out that I can still get pregnant after all, something that after 15 months or either not trying or failing to, had been worrying me a lot. I think this also proves Superovulation doesn't work for me and it's better in my case to let my ovulation happen naturally so that's something I can take off my mind. I think this next month I'll be going back to the pre-conception intralipids as I can't help the nagging feeling that if this loss was due to an immune response, that might have helped, but I got tired of throwing £380 + travel expenses a month at it for it to end up in nothing, plus I heard from plenty of people who fell pregnant whilst on pause and were fine adding them after so I thought why not me maybe for once?

I hope you're all hanging in there and there's some positive progress for you all very soon x

@clhiu I'm sorry to hear about the chemical :( I didn't find the superovulation meds helped me, it kind of just confused my body I think. I would get a lot of follicles following the few days of letrozole then they'd all disappear and if I was lucky one would remain, but then that follicle would have been there without the letrozole and after my body shut down in one cycle, my speiclaist said this just isn't for you and I did mild dose stims instead. What are you thinking for the next steps? What about timed intercourse with immune meds? Could you look at the costs and decide say, I will try this x times?

Thanks @Gardenlady543 I am definitely ditching the superovulation not getting pregnant at all for 3 cycles and then getting pregnant straight away the first month trying without. But yeah basically due to severe financial constraints, but also thinking after this chemical getting pregnant stlil isn’t my hurdle, I’m thinking of going back to pre-conception intralipids, pred and cyclogest with more timed intercourse. Intralipids is barely all I can afford at the moment and even that’s a stretch. I don’t believe I need any kind of stims at although I liked the sound of pushing multiple eggs at the time in the hope of creating at least one normal embryo. I think I’ll just stick with the one a month.
So plan is to book intralipids as soon as AF shows (hopefully a couple of days) and get straight back at it with timed intercourse, that’s the only option I have really x

@clhiu thank you and so sorry to you too. ☹️. Have you done all the testing including immunology?

I’ve just found out I’ve got MTHFR C667T heterozygous. Does anyone else have this and know what I should be taking? I already take methyfolate. What about baby aspirin ?

Thanks

@ChickenT2b yes pretty much everything, I’ve been under the care of Dr Sehata who’s one of the best reproductive immunologists in the country and did a lot of testing. I believe Gorgy does even more, but I can’t afford to do more, especially if it were to turn out I need more expensive treatments like LIT or IVHG. We were never tested for genetic compatibily for exapmple.

I have the MTHFR gene, not sure about that particular variant though and was just told to up my intake of folic acid to 5mg, but I take 1000mcg of methyl-folate instead as it’s easier to absorbed I believe. My acupuncturist mentioned that having that may also impact the absorption of other essential vitamins ad nutrients as well, but haven’t heard that anywhere else

@Gardenlady543 Finished taking clindamycin for 7 days, now down with fungal infection. Have been prescribed fluconazole(1 a week for 4 weeks). Have taken the pessary before for thrush but never this medication. Does this work better? Also have been been told to take balance activ and probiotics to increase my lactobacillus levels.
High v.swab done to check for presence of any bacteria.

@APSR the oral meds for thrush are more effective, but can't be used during pregnancy or close to a transfer. Not heard of a once a week dose, it's usually just 1 x 150mg. It will be fine to do one a week for four weeks as long as you won't be ttc or in a transfer cycle.

Once I’m done with the 4 week course(and provided my swab reports look ok) will be put on the ovary shut down medication for fet.

@Gardenlady543 @CailinInUK @clhiu

Thanks. Sorry for not going on here more often. I’m really struggling. I luckily had a cancellation, however, for the hysteroscopy at my nhs hospital. I had no antibiotics at all and no problems with it. I have a follow-up scan in December so transfer will be in January.

I’m trying to earn more money and work more hours to secure my son’s nursery funding. My MIL is looking after my son while I teach but she doesn’t change nappies or smell poo so I have been getting stressed doing everything between sessions.

Plus I am funding I don’t get to spend much quality time with my husband as he’s working long hours. I’ve been getting really upset as I feel affection is lacking. I know IVF has put a burden on things as well as having to sort out my mum and dad’s care. My husband just gives me a hug before he goes to bed. That’s it lately. I just feel so empty and been staying up late. I had a counselling session today but wish I could have more sessions.

@CailinInUK How is your prep going? I’m sorry to hear about the setbacks.

@clhiu I’m sorry the superovulated cycles did not work. Is that not like what we did for frozen transfer when we took meriofert every other day? It’s good you can get pregnant naturally. I know it’s frustrating though at the same time.

Evening ladies
@2021ivfagain so sorry you’re finding it tough. Sounds like you’ve got a lot on. Take some moments for yourself whenever you can. Our sex life has also suffered a lot going through this but we seem to be on the same page with it so that makes it easier. Affection and love takes many forms and at the moment hugs, kind words and understanding are good enough for us. Strange your MIL doesn’t deal with the nappies or poo?
I hope your review appointment goes well in Dec, no reason why it shouldn’t. We will both be transferring in 2024.

@clhiu sorry your super ovulation didn’t work but you gave it a good shot. I hope you find that golden egg very soon. Seems like your chances will be better trying on your own.

@ChickenT2b I don’t have that MTHFR mutation. I have a different one that is quite common with Northern Europeans. I just take folate in my prenatal multivitamin. You could get your folate level checked if you were concerned.

So I went for swabs at the GP following my concern of infection after fever/chills following SIS. Got diagnosed with urine infection previously but I went for swabs too. They came back clear except the bacterial vaginosis test said ‘clue cells not seen but appearance suggestive of BV’.
GP said they wouldn’t normally treat in these circumstances as I have no other symptoms but given my situation she said she would prescribe me antibiotics if I wanted. I wasn’t sure so we agreed on a re-test in a week or so. I was towards the end of my UTI antibiotics course when I took the swab so I’m not surprised the microscopy looked suspect. I started taking vag probiotics during and after antibiotics but switched to lactic acid last night as pH was a bit high. Unsure which is best or best order … probiotics or lactic acid or alternate.. any ideas?

In terms of my plan, I had my meeting with consultant last week. I’m going to do Emma/Alice/ERA in Nov/Dec. The ERA will be based on a low dose stim FET. 75IU Gonal F per day, trigger and start progesterone two days later with ERA biopsy 7 days after trigger. Not sure what dose trigger I’ll have but I read it shouldn’t be too high. @Gardenlady543 if you can remember your trigger can you let me know?
I suspect my EMMA will show low lactobacillus due to the recent antibiotics. I should get my Fertilysis microbiome results back soon.

I’ll prepare for FET on my January cycle with transfer going into Feb. The wait is a killer. Everyone else will be counting down to Xmas, I’ll be counting down to FET.

@CailinInUK sounds like you've got a good plan, my trigger was gonsai 5000 units.

Thanks @Gardenlady543 . Regarding repopulation of lactobacillus, do you have any thoughts on what regime is best with respect to lactobacillus pessaries (Vagibiom) versus lactic acid (Balance Activ)? I’m unsure which to do first or whether to alternate. My logical brain says it’s good to do the Balance Activ first as that will reduce the pH and hence support growth of lactobacillus?

@CailinInUK vagibiom already has the acid in. I will use other probiotics at the same time as balance activ as all others don't have acid in them. I think it's good to use acid products and probiotics at the same time as the acid environment helps the lactobacillus adhere to the vaginal walls and if the acid environment is not there to begin with due to a poor microbiome then you benefit from artificially creating it.