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Discussion Starter · #1 ·
I have now had what appears to be my third biochmical

My first 2 cycles were negative, third cycle biochemical - I tested positive but started bleeding a couple of days later and passed what appeared to be a fetal sac. Next cycle I had clexane and asprin and had twins.

We have done 2 cycles since then - last one I tested negative but still passes a fetal sac and this time had a weak positive and passed a fetal sac. I never have great embryo's - grade 2-3 (although grade 1/2 on this cycle) - never have any suitable to freeze but still have achieved a pregnancy with them.

My question is has this happened to anyone else, is it due to my embryo quality or do we need to be looking at something else. I have always just had cylogest, HRT (oestrogen), Clexane and asprin following ET. I am quite skeptical about the immunology stuff but do have concerns about my hormone levels. I always get a migrain just before and the first dya of AF which I believe is related to hormone changes - these are always much worse on an IVF cycle

Sorry for the long post but just hoping someone may have some ideas - this was meant to be our last cycle but I can't shake the feeling we are missing something out. My original diagnosis was tubal problems !

Andrea
 

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Really sorry to see you have had 3 biochemicals - thats hard. Have you had the recurrent miscarriage tests?  There is a thread called "Daisy's list of tests to ask for" on the investigations and Immunology board which has the most common ones and you can usually get everything except the "Chicago" tests from your GP. Maybe you have a MTHFR mutation which would mean you need to add megadoses of folic acid (and in some protocols) other B vits )? I see you have been on clexane and aspirin so there isnt much else other than maybe steroids to add if you don't fancy the IviG etc route. Anyway if you have doubts I would definitely get some more tests done for peace of mind if nothing else even if you decide you don't want to cycle again.

Best wishes
betty
 

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You poor thing. I was just wondering whether anyone has suggested it might be a sperm problem? After one blighted ovum and one biochemical my clinic have said that the problem may well lie with my DH (his sperm samples have never been particularly brilliant but never really that bad). They suggested he do a DNA fragmentation test as high levels of fragmentation can mean that fertilisation occurs but that the embryos are destined not to develop properly.

We decided not to go ahead with the test as the principal remedy for fragmenation issues seems to be a course of vitamins and anti-oxidants. Needless to say, on finding this out DH was marched straight off to the chemist's and I stand over him while he takes the pills every day.

Just thought it might be worth considering.

Good luck for the future.

Liz xxx
 

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Hi Andrea

I can completely empathise with you ^hugme^

We've experienced 4 early miscarriages/chemical pregnancies....2 naturally and 2 through treatment.

I've had lots of tests done and was diagnosed with various blood clotting and immune issues and am prescribed clexane, aspirin and prednisolone.  However, we've just had our 6th unsuccessful IVF/FET and our private consultant had previously recommended that I have more tests done, as well as my partner ie have the full karotyping and Chicago tests (as I've not had all done) with a view, to he believes, me having IVIG.

I always respond very well during treatment, despite my age (10 eggs, 19 eggs, 16 eggs, 30 eggs respectively) although fertilisation is always around 50% and highest around 70% (but they say expected due to age and also the number of eggs I get).  DP's swimmers are apparently tip top !

Our embies are always good grades (majority have been grade 1's, although on 3rd IVF we did have a single grade 2 transferred along with a grade 1 but had assisted hatching) and this last IVF we had 2 blastocysts transferred (again good grades at 2AA and 2BB).......so this doesn't seem to be the main issue.  Our problem is that the embies just don't want to stick ie implantation (I do also have several problems with my womb plus endo).  We had frozen embies from our 1st & 2nd IVFs although didn't with 3rd & 4th as we left them to go to blastocyst....3rd cycle we had a day 3 transfer (with AH) and left remaining to day 5 but not good enough to freeze.....with our 4th cycle we left all to day 5, had 2 blastos transferred and the remaining 2 blastos taken to day 6 but not good enough to freeze (all other embies on 4th IVF stopped at morula stage on day 4).  We used frozen embies from 1st IVF for 2 natural FETs (both chem pgs) and we still have 6 frosties from our 2nd IVF which we hope to use in "natural" FETs with IVIG.

I too always get a migraine before AF starts......I have naturally high progesterone levels (and a long luteal phase) and consultant believes that my migraines are caused by my progesterone levels crashing before I bleed......and I always get migraine on all fresh IVFs which I know is a give away that it's not been successful (and I've been right every time so far).

Have you had any investigations to check the inside of your womb ie hysteroscopy or pelvic cavity (laparoscopy) ?  If not, perhaps it would be worth discussing this with your consultant.  I appreciate your quandry re immune issues but maybe it would be worth considering having some basic tests done for natural killer cells, even if you don't want to fork out for the expensive chicago tests ?

Good luck
Natasha

 

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Discussion Starter · #5 ·
Thanks - have had 2 laprascopes - first following a natural ectopic and second one showed my remaining tube was knackered - this was several years ago now though.

I have always got a good number of eggs (11 last time of which 10 fertalised) - I always have a good number which fertalise but just not a great grades.

Liz - what vitamins etc did you give your dh - I did get him some well-man ones for this cycle but he wasn't great at taking them. We have never had a problem with the sperm sample though, again I would be reluctant to pay for a test if we can just try the vits anyway

I am thinking of going to my Gp and see if he can do my bloods - just FSH, progesterone, prolactin etc. I did look at the full list, but as I already have Clexane and asprin on my cycles it doesn't seem worth checking the clotting ones.

Have booked a review appt so will see what they say but at the moment dh is refusing to even discuss it

Andrea
 

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Here they prescribe something called Profert - but probably different in the UK. Got the box here in front of me and they contain:

Vitamins C and E plus Folic Acid
Zinc, Selenium and Iodine
Amino acids L-Arginina and L-Carnitina (????)

I'm guessing that any good multi-vitamin plus anti-oxidant stuff would do the trick, so Well Man stuff should be ok but they have to take them regularly and for around 3 months - something to do with the life cycle of sperm. I'm of the mind that it can't do any harm and quite frankly it's the least they can do!

Hope you get some joy from your review appt.

Take care

Liz xxx
 

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Discussion Starter · #7 ·
Well have had all the level 1 tests done which are all NORMAL - can't belive how annoyed I am at having normal tests !!

Consultant has suggested full immune testing, which I don't want to do, Or testing the sperm further, which again I am not keen on as they are either going to suggest vits and antioxidents (which we can do anyway) or Donor sperm which we wouldn't do.

They have said if we cycle again then I can have small dose steroids (1mg Dexamethasone) throughout the cycle and gestone post ET - I really want to try again as at least then I can say we have tried everything but can help feeling they are just 'tweaking' the cycle and basically quessing so not sure how much differance it will make. If we did another it would definatly be the last as there is nothing else to do. I would also make sure dh took his vits etc for at least 3 months

Anyone have any other suggestions for us to think about

Thanks
Andrea
 

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Have you discussed DHEA with your cons? There are some clinics in the US that routinely prescribe it to improve egg quality. Obviously you need to discuss with your clinic before taking it but it may be soemthing to consider..
 
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