* Author Topic: Agate's guide to learning from your failed IVF cycle  (Read 298074 times)

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Offline agate

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Re: Agate's guide to learning from your failed IVF cycle
« Reply #170 on: 9/10/12, 16:03 »
so i can go armed with facts, all the tests listed in the fantastic summary at the start of this thread, will a standard GP authorise them or do you have to go to a fert clinic. blood tests etc i imagine should be availalbe but i know my GP doesnt want to pay for any tests!! if i start asking for DHEA tests i am sure i will get stone walled but i wondered where i stand in demanding them of NHS - rather than paying privately (again!).


its all a lottery I'm afraid - apart from karyotyping, all the level 1 tests are routine labs which can be done anywhere but whether your gp will do them for you seems to be entirely the luck of the draw.

HMB:  no worries.  best of luck for your 2ww

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    Offline blondie38

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #171 on: 13/10/12, 18:45 »
    Hi
    Am after some advice please.
    We have just had a second failed DE cycle at Serum. Our first was in January, then I had all the menstrual blood tests done, tested positive for hidden C and had antibiotics for that.
    Prior to FET in May, my lining was found to be hyperplastic (22mm thick), probably due to elevated estrogen levels caused by an endometrial ovarian cyst I have (I have stage 3 endometriosis). So that transfer failed as well
    Greek hysto carried out in July and implantation scratches made. DH's sperm tested for DNA fragmentation, results excellent.
    This cycle we had 3 5-day blasts transferred, I had intralipids and saline wash of uterus the day before ET. My meds were 10mg Predisilone daily (started these a few weeks before ET), 40mg Clexane daily, aspirin, folic acid, 8mg estrogen orally and 400mg progesterone pessaries daily.
    Despite all this I had a brief but heavy bleed with clots 4 days before test day. Subsequent tests have all been negative .


    I was so sure it would work this time and feel rather at my wits end.
    Is there anything else we can try?
    Also, is the fact that I always bleed heavily before test day significant as I thought the progesterone would keep it at bay.

    Thanks in advance
    Joanne x

    Offline agate

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #172 on: 13/10/12, 18:53 »
    so sorry blondie:

    if you bled before test day, that would tend to imply that either there was a failed implantation that came away quickly,or more likely, your progesterone levels dropped too low triggering your lining to be shed (taking any potential implantation with it). 

    I think I would ask to test P4 on ET day, then again about 5 days later.  My GUESS  is that your P4 levels would have been lower than ideal on ET day and too low 5-7 days later triggering a bleed.  If you find P4 is low on ET day, you'd probably start P4 jabs, or if its too low on the repeat.

    Offline Shell15

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #173 on: 13/10/12, 18:57 »
    Hello Agate,

    I had my first BFN in February at this time I had 5 eggs collected but only 3 were mature and only 1 fertilised.  I had a 3 day ET of an 11 cell embryo.  I was on the long protocol with 6 amps of Menopur.  Before my second cycle I was then told by my consultant to take DHEA for 3 months due to low AMH level of 5.8.  I had my second cycle last month and this  time I did long protcol again but was on 8 amps of Fostomin and I had 8 eggs 5 of which were mature and 3 fertilised.  I had a 3 day transfer of 2 embryos one being 8 cell and the other being 14 cell where these good embryos?

    My DH has low sperm count of 2 million but his morphology was 8%.  At my recent follow up on asking why they do not implant the consultant just said that the embryos must not have been good enough and advised me if I was to have further IVF I had less then 10% chance of it working but if I were to use donor eggs I would have an 80% chance of becoming pregnant why?  Do you know why this would be?  I was so upset at the appointment I never asked everything I wanted to.   I have also been advised to increase DHEA and take again for 3 months.  He told me to take 200 mg this time as last time I was only on 50 mg.

    I have a ds who was conceived naturally 6 years ago after 3 years of trying.

    I would be grateful for your help.

    Michelle

    Offline blondie38

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #174 on: 13/10/12, 19:11 »
    Thank you so much for the very quick reply.

    I have read on your information that abnormal progesterone absorption/low progesterone is typical in patients with a history of chlymidia ( which I am).

    Do you think that I should have further tests done (level 1 - thyroid & auto immunes) or was my treatment regime sufficient to cover all bases?

    I am definitely going to have my thyroid function checked as it was in the low range of normal when last tested a few years ago. I also have a slow pulse rate which I think may indicate a sluggish thyroid function( whenever my pulse rate is checked I am always asked if I am very fit or an athlete - I'm not - because it is so low).

    Any further comments/ advice welcomed :-)

    PS not been on here for a while, glad to see your pregnancy is progressing well :-)

    Offline agate

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #175 on: 13/10/12, 19:23 »
    shell:  I had a 3 day transfer of 2 embryos one being 8 cell and the other being 14 cell where these good embryos?

    8 cells on day 3 is normal.  14 cells on day 3 is unlikely to be normal.

    My DH has low sperm count of 2 million but his morphology was 8%. 


    I had less then 10% chance of it working but if I were to use donor eggs I would have an 80% chance of becoming pregnant why?  Do you know why this would be? 

    I don't think the odds are as stark as that.  Assuming your DH's sperm DNA fragmentation and aneuploidy are actually normal (and I don't know if you tested this?), basic odds would be about 20% with OE, and I guess, yes, you could probably halve that as you are struggling to get more than 1 transferrable embryo even with very high doses of stims plus DHEA.

    The low rate comes mainly from being 39 and having had 2 failed cycles and reduced response.  But its certainly not impossible that you might still get pg - but if you stick with that plan, I would definitely try a different clinic - it seems daft to me to switch you from all menopur to all fostimon.   I THINK they should be having you on mainly fostimon/pure FSH but with some menopur/luveris.  And if they are going to be putting you on so much DHEA, they should be checking your DHEAS levels to make sure your blood levels aren't getting too high.

    But I can't see how you could get to a DE rate of 80%.  Realistically, the live birth rate would probably be more likely to be around 55-60%, but its very likely you'd have a baby within 1-3 cycles of DE unless there is an undiagnosed problem like infection, clotting, thyroid, septum etc, or the sperm DNA quality is bad.  With OE, you'd still have a chance of getting pg within 1-3 cycles if you find a good clinic, but you probably wouldn't reach odds of 50:50 within 3 cycles, so I GUESS that'd mean - if there is no other undiagnosed problem:

    with DE you will probably have a baby within 1-3 cycles
    with OE you are probably slightly less likely to have a baby than not have a baby within 3 cycles

    I don't know if this helps?

    If you want to leave no stone unturned, then it'd be logical for you to try OE but get at least 2 opinions from other (good) clinics on the best protocol to try

    If you want to give yourself the best chance of having a baby per cycle, you'd probably switch to DE at this point, or  after one more try of OE with a good clinic?

    blondie: slow pulse MIGHT be a sign of hypothryoid - ask to test FT4, TSH and antithyroid antibodies. also suggest vit D25OH, ANA and thrombophilia panel with GP (inc factor V leiden and antiphospholipid antibodies)... in case vit D deficiency, thyroid prob, or a thrombophilia that is too severe for just 40mg clex?

    presumably you were on antibs all the way through Tx and 2ww?

    Offline blondie38

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #176 on: 13/10/12, 20:10 »
    Thanks Agate - the tests you've suggested are the ones I've made a note of to have done.
    Am assuming I will have to wait a while to let my body get back to normal before having these tests? (because of the drugs I've been on for tx). If I do have to wait, how long would that be and can they be done at any point in the menstrual cycle?
     
    I was on Zithromycin and Doxy throughout tx and 2ww

    Given my history, is it worth me having an endometrial biopsy to test for CD57 cells? Or did my tx drugs cover any impact these would have had if present?

    Offline agate

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #177 on: 13/10/12, 21:35 »
    thrombophilias probably not affected, ANA probably not affected, thyroid better to wait 4 weeks.

    Offline blondie38

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #178 on: 13/10/12, 22:04 »
    Many thanks x

    Offline Jammy J

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    Re: Agate's guide to learning from your failed IVF cycle
    « Reply #179 on: 15/10/12, 20:35 »
    Hi Agate. Am hoping you can shed some light on my situation please.
    Have just had 2nd bfn and am a loss what the issue is.
    3 iui's - multiples follicles, all bfn. Amh 6ish. Now aged 42.
    Ivf 1 - 8 eggs, 7 fertilised, 2 blasts - bfn. Felt like AF on way throughout 2ww.
    Ivf 2 - 11 follicles, only 6 eggs retrieved, 100 fertilisation. Decided on 3 day transfer this time as day 5 didn't work last time. Test date was last Friday, still waiting for AF to show. No real symptoms to mention on 2ww.
    Was on Pred, aspirin, intralipids,menopur and puregon plus ab's and valtrex.
    Penny said cycle went perfectly, and had perfect embryos transferred.
    Am speaking to her in a few days but would love to get your opinion and advice on any tests I should have. Have never had the immune testing, penny didn't necessary but treated me for immune issues all the same.
    Partners sperm is perfect too so really am at a loss what the issue is.
    Is it really that my eggs are no good or would I not get such good results if they were so rubbish?
    Many thx
    JAH x