ERA EMMA ALICE testing thread 10

[Gardenlady543]

Last thread is maxed out... happy for anyone new to join to chat about anything ERA EMMA ALICE or pretty much anything else fertility investigations and treatment related

@2021ivfagain @Enfys23 @clhiu @CailinInUK @Loz2467 @Mybabydream @ChickenT2b @kerrym87 @Sar1010 @thislittlebird @APSR @VenusStarr
@Dochas12111 @SallyLovelady @Lyrabee @Lauralozzle @Sera9 @Twigg12 @Wren123 @Summerishere83 @Vicky81B

@Enfys23 Which ivf clinic are you with? Are you able to move clinics? I don’t think they are being very helpful.

@Enfys23 Have you considered doing batching? If fsh is ok, you could do mild stims to focus on quality. Zomacton can help with growth but not always available.

@Enfys23 I’m so sorry to hear that. It is so frustrating when clinics offer nothing more. I’ve had rounds with no embryos and donor eggs suggested then rounds with embryos afterwards.

to me it sounds like the priming didn’t suit you. If you’re stuck in a package could you ask them to prescrobe letrozole to take for first 5 days along with Stims. Could be worth looking back at your most successful protocols and asking for that plus letrozole. I would also ask for a prescription for melatonin which can help you sleep and also supposed to help with egg quality. Basically get what you can out of them.

have you had sperm and dna frag tests recently? What about your own hormone bloods - so like testosterone to see if you’d benefit from DHEA.

when ru planning to go again? I’m sorry it is just so tough ❤️

do you tend to follow a high protein diet?

Thank you 🙏🏼 @2021ivfagain financially we would lose out now as we’d get max £2000 refund pulling out of package vs £6-7000 worth of a go by going ahead with the second cycle as it includes meds (which are pricey for me with low AMH and all the add ons clexane etc).

I would like to batch but there’s no packages in the UK that make it financially viable for us. I will look to move abroad if this next cycle doesn’t work though.
Also I’m anxious to transfer ASAP as I’ve been told max chances for implantation are in the first 12 months after endo excision (which is rapidly approaching now as had it done 29/11/23).

@Dochas12111 that is super helpful. I have heard others say things have varied so I will keep hope next won’t be so bad.

Did you use melatonin - I’ve been looking at it and wondering if I should try. Did you use just during stims?

They have agreed to let us go back to old protocol (high dose FSH only) mainly as they just didn’t have any other ideas but seem really averse to using anything like letrozole and they didn’t seem open to any tweaks to a standard short or long protocol. I’d asked about a stop agonist- antagonist protocol where you take a shorter course of agonist then switch to antagonist but they said it was “experimental” and they had no experience of it. They’d have let me try a full on long protocol but I’m nervous that would put my ovaries completely to sleep for a long time. DHEA really flared my endo last time (August 2023) and didn’t seem to help (as well as my cystic acne though I would put up with that if it worked) nervous to try it again.

We always ate quite cleanly but have both overhauled diet past 12 months and eat lots of plant based protein, quinoa, as well as fish and eggs. Very med style diet and low sugar. Lots of prebiotics and live cultures. My DH’s tests were all looking good - reducing the abstinence to 24h pre sample seemed to sort his dna fragmentation. Though I guess we might retest him if we get to a 6th stim.

Aim to start with next day 1 which is likely to be in latter part October. My ovulation is quite delayed this month but I have been quite stressed. I kind of feel I just need to get it done and if doesn’t work then look for someone who will invest a bit more thought and energy likely abroad.

@2021ivfagain at Manchester Fertility who have a great rep and to be fair their nurses and communications have been really good and kept me much more stress free but the consultants just seem ready to give up on us. They are offering no changes. Except to say we could try ICSI but given we had 100% fertilisation I don’t see how that helps here. They weren’t giving us any ideas in terms of hormone protocol which really is the thing that might influence eggs isn’t it.

I was previously on 450 iu recombinant FSH only, whereas this time I had FSH 300 with LH 150. I’ve read that too much LH can be bad for those with DOR. And as you say maybe I didn’t have enough FSH for fact as well that I’d had the oestrogen priming this time. I had ganirelix from day 5 (think it’s usually been day 6 before but doubt that’s difference) and then had double trigger this time with 5000 HCG and 2mg busrelin whereas in past had 10000 HCG trigger.

@Enfys23 I took it for months tbh as I was doing batching so for all 3 cycles which had some months in between. I think there is no harm to it so worth taking also as I found I stopped waking up in the night ( and googling infertility ha) while taking it. That’s odd your clinic is against letrozole. I had dreadful responses to all my rounds before adding it in and it’s only a tablet for 5 days! I didn’t realise it wasn’t something all clinics offered. But your had rounds with embryos before so maybe it wouldn’t make much of a difference.

id say go back to your most successful protocol and go from there. Diet overhaul is great hopefully that’ll help with the next round too. I’d massively up protein during Stims too. Its tough when the clinic aren’t offering much. I agree with you I wouldn’t go with a long protocol with down reg.

Hope you are ok. Its so hard to keep going with it

I could definitely do with something to help sleep right now haha @Dochas12111 did you take 3mg every night?

I think I’d be better if I had my old consultant who, while restricted by a rather crap clinic set up and policies, at least was always positive and acted like his ultimate career goal was to help me! It’s hard to be optimistic when your treating consultant is so negative! I’m doing okay though and I think getting going with new cycle will feel I am doing something.

@Enfys23 I randomly took melatonin most nights for about 10 years! I do wonder if it helped with my egg quality. For the sperm preparation did they use the chip or do centrifuge. If you don't use the chip, I would definitely do that. Re ICSI, in Europe they only tend to do ICSI, there's a variation on opinion, some say there's more competition as per unassisted fertilisation with IVF, but the Europe clinics think ICSI is better as they feel they can pick a good looking sperm and they know it's then only been fertilised by one sperm.

@Enfys23 hope you are doing play and getting some better help.
@ the positive pregnant ladies, congrats! Do I say tentative or just congrats - I'm not that experienced on mumsnet protocol.

@2021ivfagain thanks for asking.
I'm due to start norethesterone next week just prior to the fet cycle.

A little anxious about nk treatment. My blood nk high but uterus nk (gzmb only) a bit low. My lead Consultant suggests intralipids plus 20mg steroid daily. When he was on hols, another consultant told me she does not recommend steroid so that it doesn't lower the nk in uterus further. I told lead Consultant. He says its a judgement call. He would use both because of the cytokine inflammatory nk markers in bloods both being high.

Has anyone else had high nk I'm bloods but low nk in uterus and if so what was the advice/treatment protocol and did it work for you?

I'm also considering embryo glue for the first time. Has anyone else used this before?

Thank you ladies x

@Prayformiracles my nk biopsies with Coventry were normal and low. My nk biopsy with Dr Gorgy was normal. My nk cells in the blood were high. I did 25mg prednisone, intralipids and IvIg I had a couple of times too. I also took hydroxychloroquine.

@Prayformiracles I had very low nk cells in endometrium and slightly raised nk cells in blood, so I decided to not take steroids as I didn’t want to lower nk cells in endometrium and also I catch a lot of my toddler’s viruses. I had neupogen infusion near first day of progesterone and hcg infusion on transfer day to aid implantation. Both implanted so it is a twin pregnancy. However, only one heartbeat was found yesterday and the smaller baby is measuring behind.

@Gardenlady543 Congratulations. I’m pleased for you.

I’m worried. If one of the twins has not survived, I’ve been told the nipt test is less valid as they both have their own dna.

@2021ivfagain how far along are you from the IVF transfer? What did they say? Could it have been too early for the heart beat, I really hope both twins are ok ❤️ have you got another scan booked?

@Gardenlady543 I’m 6w 4d today. Well one was measuring 2mm with no heartbeat and the other was measuring 6.4mm with a heartbeat.

@Gardenlady543 I do at my clinic in London next Wednesday but really nauseous and it’s a 6 hour journey there and back so 12 hours total.

@2021ivfagain oh that's quite a big difference :( that's a really long day, is it just for a scan? Could you have one local or send them the results from this one and they prescribe the medication needed based on it?

@2021ivfagain can you try and get to a closer clinic and sooner because the waiting around is just so tough isn't it.
I did this in the past, found a pregnancy scan clinic (not a fertility clinic) and sent results to my clinic. I hope your babies are going to both be okay.

@Prayformiracles I have emailed them the results. The concern is if one baby doesn’t make it would be difficult to have a nipt test done as they are not identical twins.

@Gardenlady543 There is an unconfirmed case of chickenpox at the nursery. I’ve had to keep my son home today. Do I contact my GP as I am pregnant? Also, my husband has never had chickenpox. I did when I was 13.

@Prayformiracles Yes. I had my scan at 6w 3d in Plymouth. But it’s whether my IVF clinic are ok with it.

@2021ivfagain I don't think I had the nipt test at all in my one pregnancy.
Hope the clinic respond to you quickly.

@Prayformiracles But I did not do PGS testing and I was 40 when I did the egg collection. I had the nipt with my son and I was 38 then nearly 39.

@2021ivfagain I think the issue is if you have contact with someone who is infective, but you could call your GP for advice if you're worried.

Do you need the NIPT test, if you had it and it was abnormal would it change your actions? We used a euploid embryo so a bit different, but it would be £1k to have it in our surrogate so I'm just leaving it, it causes more stress having all these tests done if it won't change your actions.

@Gardenlady543 I think the difference is age. You were in your 30s. I was 40. Me and my husband wanted the nipt test to rule out abnormalities.

@2021ivfagain I understand your concerns about age. It's a natural worry. Hope you get some good advice from your clinic as hopefully they will know best on next steps 🤞

Hi. I'm having an endometrial scratch tomorrow ahead of FET next month. The consultant suggested a single dose Metronidazole. I have worked so hard over past year to increase my lactobacillus. I think it's just a precaution for Infections after procedures. I'm tempted not to take it so I don't mess with lactobacillus. I would ask him but he is on holiday now. Would anyone else agree just bests not to take it? Thank you

@Prayformiracles metronidazole is pretty lactobacillus sparing vs other antibiotics. I used to take it prophylactically the cycle before transfers, you can use vaginal probiotics after it too.