Hi - new to secondary IF

rlpointer

I haven't been around The Bump much but I used to post on TTC mostly but moved with the recent move but have been looking for a more active support group as well. 

We conceived my daughter naturally after our second month of trying. We started trying March 2014 and after a year and two miscarriages, we went to see a RE. I was diagnosed with PCOS but they were positive about me getting pregnant again. We decided to go with just medicines for a couple cycles before adding in an IUI. After the first cycle of medication, I got my BFP. But my first betas were low (19.8) and they only went down 48 hours later. I went off progesterone and I started bleeding. Because my levels were so low they said we could start trying again right away if we were ready. But they cautioned us that we could have another miscarriage or a baby with serious birth deficits because they think the miscarriages are being caused by a chromosome mismatch. Our karotypes came back normal but they are guessing one of us is providing too many chromosomes causing the miscarriages. So they suggest going to an IVF so we can eliminate that problem. Although we aren't crazy about doing it, we are willing to do it if that's what it takes. However I'm worried that they are wrong and we will still end up miscarrying. We are doing another medicated cycle now and are going to go in for an IVF meeting to get more information and get my questions answers. 

Sorry this is so long-winded and I never know how to end these things. That's our story. 

CTinNV

Hello and welcome! Does your RE think your Secondary IF is due to PCOS or the chromosomal issues? It seems like they've given you two diagnoses. Perhaps older eggs are causing chromosomal abnormalities in the embryos? You didn't mention your age, but the latter is what I'm dealing with at 36.

If your RE clarifies that they think you have a chromosomal issue, I *think* your husband's sperm can be easily tested to see if it's related to him. Hopefully someone else on the board who knows more can weigh in on that.

In my case, my older eggs are causing the issues. We are about to enter IVF #3 in our hope to create a batch of embryos for PDG/AS testing, which is what your doctor is talking about. The IVF doesn't eliminate it, exactly, but it (hopefully) creates embryos that make it a certain stage that allow for their biopsy and testing. That way you only transfer embies that appear to be chromosomally normal, giving you a much better chance of a successful H&H 9 months.

I'm glad you reached out, and please feel free to share more with the group as you learn more from your doctor and decide what is right for you on this path.

fuzzbumble

Welcome!!!  I would definitely try a few more medicated cycles, maybe some IUIs before jumping right to IVF.  IVF is terrible awful no good very bad.  Sure its the magic answer for many, but a lot less than clinics want you to think.  I am truly sorry for your losses, and chromosomal issues are truly the probable cause (70% of miscarriages are caused by chromosome issues).  But depending on your age, you still have a good shot at conceiving a rainbow without the expense and emotional upheaval that is IVF.  As CT said, your age is very important here.  

That being said, IVF with chromosome testing is a valid treatment option that would provide you with the opportunity to have a better chance at transferring chromosomally normal embryos.  IVF with PGS is NOT a guarantee, nor does it PREVENT miscarriage.  It can simply reduce the chance of a miscarriage.  

With IVF, there are scores of hurdles to jump through; milestones to hit before you even get embryos to test.  It is emotionally taxing, hard, and a lot to jump into all at once.  However, I know the excruciating pain of a positive then negative test, or seeing a baby with no heartbeat.  I would go through IVF a million times before going through that again.  

So again, welcome.  We here have been through a lot, and know a lot about the process.  Please ask questions, as many as you need to.  It is a shitty process and infertility sucks.  ((HUGS))!!!

ellebelle2384

@Fuzzbumble has you covered and I agree with her that I would try some more before IVF.  I think it's a good idea for you to talk to your RE and inform yourself more about the IVF process before jumping straight to that.  Also it seems like your PCOS diagnosis is relatively new so I would definitely see if there's something else your RE can try now that you have that diagnosis.  I'm sorry for your losses, welcome to the board.

rlpointer

I'm 28. I turn 29 in August. My secondary infertility is due to PCOS, which was the original diagnosis. I'm on metformin, dexamethasone, letrozole, doing ovidrel injection then progesterone. I'm ovulating but I wasn't ovulating until really late which they were saying was not helping the quality of the egg. My husband has been tested and he doesn't have any issues. We are definitely wanting more answers before we do IVF. I'm not completely convinced it's a chromosome thing. We had our karytopye tested (both of us) and there were no abnormalities, so wouldn't that rule out chromosome issues? I don't know. We are new to all this. We are going to keep doing the medicated cycles and maybe even add in IUI while we are getting our answers. 

fuzzbumble

The eggs and sperm each have their own set of chromosomes, 23 a piece. When a sperm fertilizes an egg, those chromosomes combine to form a 46 chromosomed embryo. During that process, chromosomes can move around creating monosomies, trisomies, and other issues. Since we are born with all our eggs, it is common to have issues with the chromosomes in them as well since they are as old as we are. Chromosomal abnormalities, despite normal karyotyping, are the number one cause of miscarriage.

If you're not ovulating until later, like you said the egg quality can be affected. This can mean chromosomally or possibly issues with the energy source in the egg (mitochondria). There is research, and actually in the uk treatment, where they use the mitochondria from a younger egg (donor), insert it into the patients egg, and have seen great success with multiple IVF failures.

I would begin looking into supplementation for egg quality as well. I added coq10 and pregnitude for my second IVF, and our results were much different from my first. I don't know of those things helped or if it was the protocol, but I figure it's worth a shot. Just don't take DHEA, that is bad for PCOS patients.

fuzzbumble

Also, have they done any luteal phase progesterone testing, or did they just put you on progesterone because of the miscarriages? A lot of times, low progesterone can indicate a poor quality egg/ovulation and a higher dose of medication can be indicated to yield a higher quality ovulation that produces adequate progesterone on it's own.

Just some random thoughts, obviously I don't know your whole history!

jeannaqueena

Well. I want to throw my 2 cents in to the pot. I found IVF kinda easy. Yes. It is emotionally draining, expensive and the shots suck. But it's easy. You have ultrasounds, nurse calls you with results confirms med dosage and next apt is set up. I floated through it. Retrieval wasn't comfortable but it was over quickly and then transfer and then the wait. Yes it is sooo stressful and DH and I said if it wasn't so expensive we would do it again. I know for others this is different especially if you over stim. I hope what I am saying is coming across the way I intend. But I don't want you to think IVF is so horrible!

It does seems a little drastic to send you to IVF so quickly, but honestly if I knew what we would end up spending on multiple injectable cycles and end up with 2 IVFs...I wish we had saved the time and money sooner.

^^^wow! These ladies have amazing knowledge and I would recommend learning everything you can about IF. I still believe my RE was about to send me to retrieval too early on my 2nd IVF and when I stopped him, made him look at the first IVF stats we ended up stimming 3 more days! Now i have my precious DS here and worth every stick, penny and stressful moment.

Good luck with your decisions!

fuzzbumble

I totally agree, the actual process of going, doing your injections, and all that is the easiest part. It was very emotionally difficult for me, however. I feel it isn't soemthing to be taken lightly at all. it is A LOT of money, and the rest of our lives literally depend on positive outcomes. That stress was hard. I survived, obviously, and did it again. But if I felt like I had a chance with more med cycles I would have taken it in a heartbeat.

I don't mean to be doom and gloom, perhaps I'll feel different after/if I'm successful? I don't know. Right know I'm just scared.

rlpointer

Thanks for all the advice! We have a lot to consider and definitely a lot of questions to still ask of our RE before we go forward with IVF. 

1983Lindsey2

Welcome!!! I agree with maybe trying a few more cycles and adding IUI. Have you thought about adding CoQ10 for egg quality? I know PCOS can cause egg quality issues and I have heard CoQ10 and fish oil can help. I know someone above mentioned this too. Also, I think the progesterone after ovulation is also something to look into. I wish you the best of luck moving forward!