My husband and I are just about to start our second round of IVF. I’m 37 with low AMH (8) but our main issue is sperm-related (we need ICSI). Earlier this year our first fresh cycle gave us two apparently good quality embryos but the first (fresh) transfer I miscarried at 9 weeks and the second (FET) was BFN. After the heartbreaking miscarriage our clinic tested me for the full range of possible causes for miscarriage because all had looked well at our 7 weeks scan. The tests didn’t show any reason for the miscarriage. It’s devastating to think neither of our good day 5 blastocysts worked and we’re now back at the start of the IVF process.
I’m feeling nervous as we approach our next attempt which we are absolutely desperate to work after such a difficult time. I have many anxieties running through my head day and night which I really hope the mumsnet infertility hive mind can help me with! I’ll try to phrase my worries as questions:
i. Our consultant has suggested we consider PGT-A for our next round. I’ve done a lot of research and think I understand the pros and cons of PGT-A. I’m not sure whether we’re ideal candidates but I suppose the consultant is suggesting it due to me being 37 and both our embryos from our last cycle having failed in one way or another. However, as our last cycle only led to two day 5 blastocysts (from 10 eggs collected), I’m worried sick about PGT-A leading to us having nothing to transfer! The miscarriage was traumatic but I’m still leaning toward preferring to give embryos a chance rather than having nothing to transfer at all. I’d appreciate any views / experiences / opinions on PGT-A or no PGT-A …?
ii. The consultant has suggested raising my stimulation drugs to the highest dose. I like the idea of hopefully getting more eggs but could a high dose of stims compromise the quality of my eggs / future embryos? The consultant doesn’t seem keen on mild or natural IVF - they said I actually responded quite well to the last long protocol of standard IVF and they’re hopeful I’ll produce more eggs with a higher dose. Should I be worried about higher stims meaning lower quality embryos?
iii. In the past year / 18 months of building up to / going through IVF I’ve been consistently very strict with my healthy diet. No caffeine or alcohol, obviously, but also low carb, high protein (especially fish, beans, eggs and chicken), no sweet treats, masses of fruit and veg and 3L water daily. I’m taking pregnacare conception max (for methyl-folate), 1000 iu vitamin D, NAC 600mg, DHEA 75mg and Ubiquinol 600mg (on the clinic’s instruction). I was always slim and healthy before IVF but I suppose I’ve become quite obsessed with diet etc as something to control in the chaos and stress of infertility and I have lost a bit of weight in the process (I now weigh 55kg which puts my BMI at 19). My question is, should I stick with this healthy diet or could being so strict with what I eat and being at the lower end of BMI actually lower my chances of success? My clinic don’t give any advice about nutrition beyond “eat a healthy well-balanced diet” - the diet choices I’ve been making are based on my own research relating to egg quality. Should I stick with this, be less strict or is there anything else I could be doing for egg quality?
I know this is a long and rambling post because (like so many mumsnetters in the infertility group!) I’m feeling stressed, hugely knocked by the fresh miscarriage and FET failure, and desperate for IVF to work for us. I’m actually embarrassed about how long this post is! If you’re still reading and can help me with my questions / worries then I would be really grateful! Or if you can suggest anything else I should try / consider? Thank you so so much!