Seeking Advice - Starting IVF Cycle 2 in Jan 2025

[CaipirinhaForBuddha]

3 FETs after 1st IVF cycle egg collection a year ago, no success. Had OHSS. ACH, blood tests, ultrasound scans and sperm tests were all "normal" = unexplained infertility.
Inquired about PGT-A but King's Fertility did not recommend it.

Planning for 2nd cycle of IVF egg collection in Jan 2025 with ICSI and PGT-A to follow. Been TTC for 4 years (initially chalked up to covid or work stress). Frustrated we didn't do any extra tests in 1st IVF cycle.
Seeking advice from the lovely community:
What do you wish you knew or have done, if you were to do a daunting IVF cycle again with OHSS risk?

There is only so much you can control within a (sometimes unpredictable) IVF cycle

I was at risk of OHSS in my first round. It was a long protocol with NHS (which I think is their standard for first timers above 35). That was my only long protocol cycle. So check if you satisfy the conditions for the short protocol (also called mild IVF) to reduce OHSS risk.

I've done 6 collections in total (1 NHS / 3 with Create / 2 a duostim done abroad). We did ICSI, MACS but not PGT-A; decided against PGT-A because my euploid didn't implant and we only had 2-3 embryos each time.

Husband and I ate really clean during stims (heavily reduced sugar, decaf coffee etc.) including all recommended vitamins. The clinic abroad doubled all the U.K. recommended dosage re. vitamins, and advised to drink at least 2.5L (ideally 3) of water everyday.

@MsPeony Thank you so much for sharing your experience! I'm starting soon and doing the short protocol indeed - got all the medication already! Switched trigger injection to a non-HCG one, which King's fertility doctor said should minimise OHSS risk. Fingers crossed!

@CaipirinhaForBuddha hiya, 33 (f) solo with sperm doner - also had mild ohss with the 1st round and waiting for my FET now, bit nervous as there's only one embryo so i'm conscious of potentially having to do another round and think the 'what would you do to face again' question is good, definitely would drink more water and work less - it fell in a tricky period at work and I just couldn't avoid some long hours = more stress. The clinic also said next time they would start me off at a lower dose since I overresponded, so I guess making sure they give you the records of your first round so you know what to ask for.

How're you doing now, have you started? Hope all goes well & no ohss to worry about

@Ginny91 thanks for the message - I have started indeed! Egg collection is tomorrow! I actually was put on a higher dosage 2nd time around as I'm one year older from 1st round. The clinic said they'd reduce my dosage if there were more than 20 follicles developing, but that was not the case. Trigger injection I only needed one out of the 2 they gave me, also to reduce OHSS risk.
Good luck to your FET - as they say you only need one good one! But if you do have to do it again, see if a non-HCG trigger could be in the treatment plan.

@CaipirinhaForBuddha oh good luck with the EC tomorrow! Let us know how it goes :) and thank you, I had it today, all went well & embryo on board settling into the tww. Glad there's a few people doing it this Jan too so I don't feel so isolated with it all 💛

@MsPeony if you have any good clean eating tips or recipes that'd be appreciated! It's silly but I already ate an unwashed apple today without thinking so am going to try a lot harder to be on it.

@Ginny91 I definitely wash my apples before eating since starting the IVF journey😁

We only drank decaf (and sticking to it now).. other tips are:

• Lots of water and water only
• Limit sugar (I only ate dark chocolates)
• Swap white for wholegrain
• Lots of leafy dark greens
• Lots of crucifers type veg
• LOTS of brazil nuts (before collection/fertilisation for husband / after transfer for myself)
• Lots of natural unsalted nuts and seeds in general (not peanuts)
• Lots of lean meat protein (mostly chicken, oily fish and prawns)
• Beetroot juice and avocados after transfer

Recipes wise, I didn't follow any specifically. Just lots of salady type food (Love a warm roasted veg salad with bulgar wheat/couscous/quinoa etc.). Also, bean type salad🙂

All the best in the tww! I was planning for a Jan transfer too, but postponing it now as we have a few travel plans coming up.

@CaipirinhaForBuddha Good luck today!

Thanks @MsPeony ! So helpful 💛

Hi both @Ginny91 @MsPeony , some good news from egg collection but embryo development till day 3 has a sharp drop off. I had 21 eggs collected, 11 fertilised and now 5 good embryos made it to Day 3. Hoping we will have embryos for PGT-A in the end!
I was in quite a bit of pain after EC but feeling much better today despite bloating. The nurses from King's have been very nice and checking in every other day.

Hi @CaipirinhaForBuddha well done!! Hoping for you too <3 I don't know much about PGT-A I think, would the aim be to do a fresh transfer? Very glad your pain has subsided & that they are checking in on you thats good!

Hi @CaipirinhaForBuddha I'm also with Kings and had EC on Wednesday. Similarly to you I've also had quite a big drop off with 1/3 of my collected eggs rated as good quality today. I was told I would have to do a freeze all due to OHSS risk, which I'm glad for now as I think I've developed mild OHSS. Will you be doing a fresh transfer or sending all embryos for testing? Fingers crossed for your D5 update

Hi @ForeverHopeful17 & @Ginny91 , I am doing freeze all both this time and last time due to OHSS risk, also PGT-A. Had a roller coaster D5: in the morning it looked like we might have zero for PGT-A & freeze but at the end of today we have ONE!

@CaipirinhaForBuddha so glad you have one!!! Ugh the rollercoaster never stops does it - I'm sorry you've been going through it <3

@CaipirinhaForBuddha So pleased you have one to send for testing, it's such a rollercoaster of emotions especially waiting for updates. I had to call them twice yesterday to remind them I was still waiting for an update. Is there any they are still observing to freeze today?

Final count = 2 just made it over the line! Slightly relieved and now nervously waiting for PGT results. Doctor also mentioned endometrial test at Warwick U- but the wait is so long - earliest available video consultation is in May!

hi all can you please let me know how your experince was at Kinds fertility. In terms of care and cost and success.

very confused doing some research and Kings seems to be the option we are considering at the moment. Please help any information would be useful. Thanks

@A38yo We've been going to King's Fertility for 2 years, primarily funded by the NHS. The facility is pretty new and spacious, and nurses and doctors are generally good and attentive, but they are also busy (need to factor in scheduling delays). Cost-wise King's is probably middle of the road, but cheaper than CRGH or Lister for the same tests or procedures. King's offers a decent set of add-on treatments, but you have to ask for those. For example, King's has endometrial biopsy tests (ERA/EMMA/ALICE), but does not offer immunology testing (NK cells). Location is convenient if you are in South London, I understand NHS sends S/SE London patients either to King's or Guy's.
Success: If I had to do it all over again, I wish King's had suggested more tests before pushing ahead with embryo transfers after failures. It was difficult to stick to 1 consultant, so we went with whoever had availability for consultation/treatment plans. By the time we had 2 rounds of egg collections and 3 failed embryo transfers, the 4th consultant finally suggested both PGT-A and endometrial testing. My husband also insisted to do a DNA fragmentation test and see an andrologist, which showed he can also improve things his side. We just did our 4th embryo transfer - fingers crossed for positive results!
All in all, think our experience overall at King's has been OK. Were there mix-ups and bureaucratic delays? Yes, but it might be expected as they are affiliated with King's Hospital (NHS) and not as pricey as some privately owned clinics. Hope this helps!