Failed FET with PGS normal embryo. Advice?

omarismyhomeboy

Hey all,

Technically I am 2 days from beta, but the reality is clear that my FET failed. I had a PGS normal embryo- the 'best looking one' at that- and it failed to implant. 

I honestly have had no implantation in the 1 1/2 years of trying: No CP, no m/c, just nothing but 1 lined tests. 

Does anyone have experience with FET failure from a PGS tested embryo? I'll have a consult next week but I want to know everything to ask my RE. I am very open to either trying again (is it really still just a numbers game?) and also an endometrial receptivity test to see if they are transferring on the wrong day. I am somewhat hesitant to look at immunology because it's such a mixed bag and seems scientifically controversial. 

Any experiences would be great. 

Colleen0516

The ERA may help! and i agree with trying again, never know when it will take! You can also look into using embryo glue with the transfer. Its an amino acid that they put the embryo in before transferring it. Ask you doctor! 

APM_SLP

I will definitely keep you posted on my ERA experience. My RE was very hopeful that it may be the answer to my failure with PGS embryos.  I should have by biopsy next week.

 I asked my RE what other things could be contributing if that doesn't end up being our issue.  He Said most likely he would add a blood thinner into my protocol and consider transferring two embryos.  He said sometimes they just don't ever really know...  Sometimes it just has to be the perfect storm (not comforting whatsoever). He also said although highly unlikely, the PGS test could have been wrong.  I think they are only about 95% accurate.  

omarismyhomeboy

@APM_SLP thanks so much. I'm very sorry to hear about your BFN as well. I hope ERA will be a fix for you. I'll definitely keep up with you about it. 

wifeinraleigh28

I'm so sorry you are getting negative tests My doctor told me that PGS testing doesn't increase chance of implantation, but that once pregnant it reduces your chance of a chemical or miscarriage. I second what @Colleen0516 said about embryo glue. Also want to add that a lot of girls have more success using PIO versus crinone suppositories, and taking a low dose aspirin as well. I have autoimmune issues so I already take plaquenil regularly to keep my lupus in check, but I've also heard of women taking it during a transfer to help with implantation if your doctor suspects autoimmune issues.

I hope you find success soon!

omarismyhomeboy

Thanks @wifeinraleigh28. I'm already taking baby aspirin but I am curious to ask about PIO (as much as I don't want it! ha). I wonder why it doesn't increase chance of implantation, just m/c. Do you have any idea about that? 

2legbaby

@omarismyhomeboy my first FET was with a PGS tested embryo and failed....I agree about the PGS helping after implantation, but also that was our first real opportunity to get pregnant, so I worried about issues on my end too. I wouldn't say the next FET may not work, but certainly agree with the others that asking your doctor to look into implantation issues before your next transfer is a great idea, we go through so much to get these embryos we want to make sure they have the best chance, best of luck to you! 

omarismyhomeboy

Thanks so much It makes me feel really good that you had success on the next round @2legbaby

jodes727

@Colleen0516 and @wifeinraleigh28, is embryo glue common?  I haven't ever heard of it, did a some quick readings about it and called my clinic to see if they use it (since they have never mentioned it).  The nurse said she hasn't seen it used but that she would talk with my RE about it and get back to me.  

MelD17011

what did your lining look like? I know I had to switch meds a couple times before they got the right ones that helped. 

omarismyhomeboy

@MelD17011 my lining is pretty consistently "beautiful" (RE's words). Lining for this transfer was 11.9. So thickness seems not to be an issue but perhaps the day of transfer (ERA) is off. 

wifeinraleigh28

@omarismyhomeboy My understanding is that since implantation relies on so many different factors (not just the quality of the embryo) that a perfectly normal embryo could still fail. But that is just the way my mind makes sense of it. PIO is not nearly as bad as it sounds. I've been doing it now for 3 weeks and will likely continue with it for another 3-4 weeks (until I'm 10 weeks) and it barely phases me now. My RE told me that PIO increases your chances of success compared to other methods, so I would definitely inquire about that! Do not lose hope, girl. You should have success soon!

@jodes727 Embryo glue is commonly used at my clinic, but I do not know about other clinics. I didn't even request it, but just happened to notice that the "embryo glue" box was checked off on my protocol sheet that the embryologist handed me at my transfer.

LeFemmeViolette

@omarismyhomeboy I'm in the same boat. Perfect everything, PGS normal embryo, BFN.

We go in tomorrow to talk to our RE regarding next steps. I'll be sure to share our plan once we have it!

Vic311

@omarismyhomeboy I've had a similar history. No CP, no m/c, no sign of a line ever on a hpt. I transferred a chromosomally normal blast and at 7dpt I'm still getting a BFN. Once I have my follow up with my RE, I'll also share any insights he may have. Not ready to throw in the towel yet!

omarismyhomeboy

@LeFemmeViolette I remember following the early part of your IVF cycle and I'm sorry to hear about that BFN. Let's definitely keep chatting about what our REs say!

omarismyhomeboy

@Vic311 so sorry to hear that. Glad you're not throwing in the towel! I think what makes me nervous about my/your issue is that we've never had implantation and what if we really do have recurrent implantation failure? I'd love for it just to be a numbers game and have FET #2 take but since I've never had a positive pregnancy test, I wonder if there's really something else going on in my uterus. 

Vic311

@omarismyhomeboy Before FET #1, we had a long discussion with my RE about a potential source of IF being implantation issues. He said if #1 doesn't take, he wants to do more workup before doing #2. I have my consult with him Friday morning. I'll let you know what he says

LeFemmeViolette

Good news! My RE was totally on board with all of my suggestions. For this next cycle we will:
1) Increase stim dosage from 150cc to 225cc
2) Incorporate acupuncture before and after transfer
3) if we wind up with more than 5 day 5 embryos, do a one-embryo fresh transfer (just for something different). We'd still biopsy and test, but we'd just know the results after the fact.
4) If we wind up with 2-4 PGS normal embryos, do a double FET.

For some reason they're making me do another nurse class to teach me how to administer the meds... despite the fact that I just had it a few months ago. And they don't have an opening until Nov 1. So, more waiting.

But at least we have a plan now!

omarismyhomeboy

I like the idea of a double FET! Go you for having a plan! I look forward to following your developments @LeFemmeViolette

Vic311

So my RE thinks I should do an ERA. He truly seemed concerned that i didn't have success with my first FET. I need to process it all--I'm really sad today

APM_SLP

@vic311 I'm about to do one next week.  I had a failed fresh (It was a CP) and a failed PGS tested FET.  I feel like this ERA science is really up and coming.  My RE has has a lot of success with previous patients and ERA testing.  I was so sad to have to take a month off to do testing.  But in the long run, it could potentially help me not "waste" any embryos.  I know how it feels to get that BFN.  I''m happy to see you have 4 left in the freezer!  Good luck!

Vic311

@APM_SLP when I spoke with my RE today he said that on Monday they are coming out with big news on the ERA. He seemed to be eluding to study results or something like that. He said it sounded promising as far as actual data, showing the validity and usefulness in improving FET outcomes. I think I'm going to do it I'd love to keep up with you along your journey! 

omarismyhomeboy

@Vic311 @APM_SLP oh wow, this is good to know! When I met with my RE he told me he was disappointed, but not discouraged. He told me that he has seen plenty of PGS normals not take, unfortunately, and that the implantation rate is actually only like 50-60%. Anyway. He gave me a choice of doing another transfer next or going straight to ERA. He was definitely leaning towards doing another transfer because a lot of the time it's a numbers game. But I am curious to see what they are coming out with on Monday!

shauna43

@omarismyhomeboy hi there. I'm sorry your ivf didn't work. I also know the pain and disappointment of having a failed ivf. It's so hard because you have so much hope especially the first time around.

My first ivf was a fail with 2 pgs normal grade A embryos. There was basically no reason the re could find.  He ended up comparing my uterus to a apt building saying the building looks good but sometimes you can't know what the rooms look like. Needless to say I changes clinics. 


My ivf #2 I was with a much better clinic that took the time to diagnose me and have a more individualized experience. I was on different meds and also protocol. They put me on medrol a week before transfer  ( which was different than fail) also used embryo glue (didn't use in fail). Also my RE ( a lady which I prefer women dr) she kept the catheter and tube in for 1 min ( timed) after she released my pgs tested embryo. Overall my experience was the best with my new clinic. The transfer was painless  ( first ivf hurt badly). Also I did acupunture right before and was super relaxed. After the transfer I went on a mini vacation  in the mountains. My ivf ended up working but ended at 6 weeks. I recently found out I have autoimmune disease which requires lovenox shots. Unfortunately I can't be on them. I start ivf #3 in a week. Even tho I have 3 embies pgs tested frozen we are doing a fresh with a egg retreival.  I hope my experience can help you a little. Good luck!

Vic311

@omarismyhomeboy Although I really like him and have great confidence in him, I think my RE can sometimes leave me feeling a bit pessimistic about my outcomes. I have a feeling he doesn't want to promise more than he can deliver. And I get that. I work in healthcare and you absolutely can't promise outcomes. For example, after my first failed IVF cycle, he really didn't seem to have much hope that I had any good eggs left. But low and behold on the next round I had 5 normals .  He did say that we could try one more FET before moving on to the ERA. I think in my situation with my age, another egg retrieval just isn't an option. So these last 4 frozen are my last hopes. He wants to make sure of giving those 4 the absolute best chance possible. Such difficult decisions. More time and more money. By the way, I have to laugh at myself. All of those years of trying so hard NOT to get pregnant. Who would have thought? Ha ha...

oxinfree

There's controversial evidence for embryo glue as much for reproductive immunology methods. Some things to look into/ask about as well:

- lovenox / blood thinner (you may have poor bloodflow to uterus)
- prednisone
- hsg saline wash before transfer * EDIT: SHOULD READ HCG *
- intralipids / IVIG

I agree the ERA test will be a good place to start. I'm like you in that I've never ever had a positive... not even the faintest hint of a line. I have my fx for you.

Carpediemstat

@omarismyhomeboy.  I know!  Young adulthood, college, marriage, life in my 20s, everytime then was "not a good time" for a baby.  Now this is all I dream about, and it's not happening!  I keep having to remind myself that everyone's path is a little different.  Best wishes