So, I am all set to go forward with IVF for trying for baby #2! I am going to a different clinic than I did for #1 and they only do IVF's every other month and July is full so I have to wait for September for an egg retrieval. I have to redo all my blood work and do a SHG. I will start the birth control pills in August. The doctor said that assuming my AFC and my tests are the same as they were two years ago when I did fertility treatments, he wants to do an antagonist protocol due to high AFC. I do not have any hormone issues, or have never in the past, but do have a high AFC. I was concerned about understimming like I did when I tried IUI converted to IVF but then back to IUI due to understimming, for my 6th fertility cycle with #1. It was basically an antagonist protocol because I was on BCP's for a cyst for a month prior and then started up follitism for my IUI. Halfway through I had 20 follicles that were 10mm and they suggested converting ti IVF and upping my meds by a lot, which I did, and I didn't make enough so we converted back to IUI with 4 mature, and 3 maybe mature. This resulted in my healthy singleton. He said he will just start me on higher meds and work down, as opposed to starting lower like before and working up. He feels that we will be successful with creating 20-30 eggs ideally if I have the same AFC as I did 2 years ago. We will find out when we do the baseline and redo the blood work. We are going to do a freeze all so we can go all out with egg production. This clinic has the best rates of success in the state and are using new technology that I had never even heard of. They will be doing some sperm sample testing that they didn't offer at my big clinic I went to with #1 and that will better tell if we need ICSI. The first clinic said we would need it due to low morphology, but he said that this new test is much better and can tell a lot more, and they only do ICSI 40% of the time compared to 60% at my old clinic. Apparently new studies are showing better implantation rates if you do not use ICSI. I had never heard this. The sperm test is called acrosome reaction tests. I am surprised that my old clinic, the biggest in the area, didn't offer it. Anyhow, I am a little bummed that I cannot get into the July cycle, but September will be here soon enough and I can start birth control in August. That just gives me more time to lose the last 10-15 lbs I wanted to lose and be a very healthy BMI.
Congratulations on a great consultation! I'm especially interested in the new technology and tests available. It's fascinating how things progress, even in a short time.
My DH's sperm is great, but we did ICSI because we are doing PGD-AS testing. The specialty lab, Natera, strongly prefers fertilization via ICSI (they say that it eliminates the chance of multiple sperm contributing genetic material to the embryos) but doesn't require it.
I am very interested to hear what you learned about the possible effect on implantation rate with ICSI. It's all such a changing science, but I absolutely hope great things for you this September!
Me: 35 DOR - AMH 1.1 FSH 5.6
DH: 39
09/01/10 - First pregnancy - my sweet son was born
04/25/14 - Miscarriage at 9 weeks - Turner Syndrome
08/01/14 - Miscarriage at 8 weeks - Trisomy 9
October 2014 - Unsuccessful IUI
November 2014 - IUI month skipped due to cyst
December 2014 - Unsuccessful IUI
January/February 2015 - Failed IVF (standard long protocol) - 7 eggs, 6 mature, 4 fertilized (ICSI), 0 made it to blast, 0 for testing
March/April 2015 - Microflare IVF protocol with HGH - 6 eggs, 6 mature, 5 fertilized (ICSI), 2 blasts for biopsy!
May/June 2015 - Microflare IVF protocol with HGH - 9 eggs, 6 mature, 5 fertilized (ICSI), 3 blasts for biopsy!
06/18/15 - Two healthy embies based on PGS testing by Natera!
June/July 2015 - FET cycle with estradiol & PIO shots, a Neupogen treatment, and accupuncture
@CTinNV and @efhoping2010 we are doing PGD testing as well. The company they use is Reprogenetics.
As far as the lower birth rate, I put the link to the site below. The doctor didn't go into a lot of detail about the implantation rate or live birth rate, just said that they like to use this test first and see if ICSI is really necessary because studies have shown that the rate is better when you don't use ICSI if you don't have to. Apparently this new sperm test can tell a lot more about the sperm, like if their cone head falls off as it is supposed to, etc. And if all that looks good, he said that we shouldn't do it, even with low morphology, because it has been shown to lower success rates. I was very surprised as we had always been told at our old clinic we would need ICSI. The new clinic I am going to has this link about it and the more advanced sperm test to see if it is actually necessary for us. https://www.pomafertility.com/fertility-services/icsi/ The graph at the bottom shows something about a 5-25% decrease in live birth rate when using ICSI when not indicated (It says that below the title of the graph at the bottom of the section ICSI fertilization and success rates). Our doctor said their ICSI rate is closer to 40%, as opposed to most clinics who are around 60% (Like our old clinic). The doctor at the new clinic used to be the best doctor at my old bigger clinic, but he left and started his own practice and is about 6k less expensive and has better success rates, (66% after a transfer at the new clinic vs. 43% at the old clinic for my age group). This is my old clinics data https://seattlefertility.com/success-rates vs my new clinics data https://www.pomafertility.com/ivf-success-rates/. We may end up needing ICSI, but I figure doing the semen test to make sure cannot hurt.
IVF #1, Stimmed for 12 days, ER 8/22/14, 9 retrieved, 7M, 7F!! Freeze all due to fluid in uterus.
FET end of October 2014 cancelled due to fluid in uterus due to possible c-scar defect
Surgery scheduled 12/12/14 to fix possible isthmocele
3/26/15 transferred one 8 cell grade 4 embryo and one 6 cell grade 3 embryo = slow rising betas for 2+ weeks = ectopic MTX shot 4/29/15
Repeat c-scar surgery June 2015
2nd and last IVF cycle August 2015, stimmed for 12 days, 2 egg retrieved, both mature and both fertilized. Transferred both 8-cell embryos on Day 3, beta 9/5/15 = BFFN
Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)
IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN
IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.
IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132. Lil is here!
Yay for a great consult! Sorry for the wait but everything else sounds great. And that is really interesting about ICSI. My RE's lab also uses Reprogenetics and we are doing PGS but were told that we had to do ICSI for that. (Although it ended up not mattering for us because DH's morphology came back at 2% so we would have done ICSI any way for that).
Sounds like a great consultation. I hope the summer passes quickly for you.
Kid #1 - 09/03/12
Kid #2 - maybe???
Diagnosed with Severe Ashermans Hysteroscopy #10 - scar tissue grew back reblocking my right tube #11 or IVF with scarring still inside? 1 lone embryo from September 2016 retreival, dx with Trisomy 16, starting fresh
@ellebelle2384 we might very well end up needing it too because H also has 2% morphology like your DH, or he did two years ago anyway. It will be interesting what this test shows.
Re: Finally had my appointment!!
Me: 35 DOR - AMH 1.1 FSH 5.6
DH: 39
09/01/10 - First pregnancy - my sweet son was born
04/25/14 - Miscarriage at 9 weeks - Turner Syndrome
08/01/14 - Miscarriage at 8 weeks - Trisomy 9
October 2014 - Unsuccessful IUI
November 2014 - IUI month skipped due to cyst
December 2014 - Unsuccessful IUI
January/February 2015 - Failed IVF (standard long protocol) - 7 eggs, 6 mature, 4 fertilized (ICSI), 0 made it to blast, 0 for testing
March/April 2015 - Microflare IVF protocol with HGH - 6 eggs, 6 mature, 5 fertilized (ICSI), 2 blasts for biopsy!
May/June 2015 - Microflare IVF protocol with HGH - 9 eggs, 6 mature, 5 fertilized (ICSI), 3 blasts for biopsy!
06/18/15 - Two healthy embies based on PGS testing by Natera!
June/July 2015 - FET cycle with estradiol & PIO shots, a Neupogen treatment, and accupuncture
07/08/2015 - Transferred one lovely embie
07/17/2015 - Beta #1 136
07/20/2015 - Beta #2 529 -- BFP!!!
YAY! You have been waiting so long for that consult, glad you are moving forward
Your comment about ICSI is interesting.
My clinic requires ICSI for any type of genetic testing for embryos/blasts.
Wishing you well on testing!
ME: 35 DH: 39
Married July 2011
DD Born 8/12
TTC #2 since 11/13
ME: Submucosal Fibroid Surgery Date APRIL 14th 2015 -Left Tube is blocked by Fibroid~Surgeon removed 26 Fibroids from my Ute and Unblocked my Tube
DH:Azoospermia...Thank God we have 12 vials of frozen swimmers
July 15-Check to see if Ute is all healed
IUI #1 8/3/15...BFN
IUI #2 9/5/15...BFP on 9/17/15
Beta #1-344
Beta #2-809
Beta #3 8,390
1st u/s 8/8/15 1 bean HB 135 @ 6w5d
TTC #3 since June 2013
BFP #1 7/21/2013--EDD 3/30/14--D&C 9/24/13
BFP #2 1/28/14--MC 2/7/14
IUI #1 5mg Femara + trigger = BFN
IUI #2 5mg Femara + trigger = BFN
IUI #3 5mg Femara + trigger = BFN
~SAIF/PAIF/Everyone Welcome~
Me= 37 and DH = 41
Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)
IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN
IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.
IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132. Lil is here!
TTC#2: Trigger + TI = BFN; Clomid + Trigger + IUI = BFN.
IVF #4: BCP + MDLF + Lovenox = 7R, 1F = Transferred 1 6-cell embryo on day 3 = BFN
IVF #5: MDLF + Lovenox = 4R, 1F = Transferred 1 10-cell compacting embryo on day 3 = BFN
IVF #6: (New RE): Long Antagonist November 2014 (transferred two 8 cell grade 1 embryos and froze one blast) = BFN
FET#1: BFN
Dx: Me: Recurrent Pregnancy Loss; DH: Low Morphology (2%)
BFP#1: MC 3/1/11 at 6w1d - EDD 10/21/11
BFP#3: MC 2/8/14 at 4w5d - EDD 10/13/14
BFP#6: CP 11/6/14 at 4w2d - EDD 7/14/15
IVF #1 with ICSI & PGS: May/June 2015, ER 6/3/15, 17R/17M/15F
IVF #2 with ICSI & PGS: July 2015, ER 7/16/15, 16R/11M/9F
PGS results = 6 normal embryos (4 boys, 2 girls)
FET 9/23/15 = BFFN
Kid #1 - 09/03/12
Hysteroscopy #10 - scar tissue grew back reblocking my right tube
#11 or IVF with scarring still inside?
1 lone embryo from September 2016 retreival, dx with Trisomy 16, starting fresh