Egg quality - another retrieval cycle or transfer?

emmaj2020

Hi there,

I posted a little while ago about low HCG levels. Sadly, that pregnancy was ectopic. So scary but all okay. This was our second failed transfer so feeling pretty defeated. 

We are regrouping and debating about doing another transfer cycle right away or starting over and doing a retrieval. We have two embryos left both PGS normal but 3BC quality - a day 5 and a day 6. Our RE thinks we still have a good shot and recommends doing anther transfer. We sought a second opinion and that RE thinks we have a very low chance because of the quality and recommends a totally different type of transfer and retrieval cycle using human growth hormones for egg quality and letrozole for the transfer. Our is insurance doesn’t cover anything so starting again would be a huge financial burden but if we have a better chance we’d do it. 

Anyone in a similar boat? Any advice? 

Thank you!

mbradfo2

Some journal articles have suggested that quality matters less than we think. I have a little girl from a day 6 embryo (4BB). Since your insurance won't cover future retrievals, I would make a go of trying with what you have -- but see about getting pre-cycle testing like ERA, immunology testing, etc, so you can make sure you're covering all your bases. Your issue might simply be that you are transferring at the wrong point in your cycle or need some medicine to assist with implantation. Did you do any blood thinners with your cycle?

After that, you can always decide if you want to face the financial hurdle of another retrieval with a different protocol...that option isn't going away. I've heard good things about human growth hormone protocols. And if you do the pre-cycle testing with your last transfers, you'll know a lot more about what's going on and those embryos will have the best shot possible.

emmaj2020

Thank you so much for your comment! I actually did the ERA and test for endometritis before this last transfer. Forgot to mention it. I was receptive and no evidence of endometritis. Good idea re: immune testing. My clinic in NY does not “believe” that immune issues affect transfer success but I will push them on it. 

mbradfo2

Maybe you can get a consult from one of the RE's who do specialize in immune testing? Dr. Kwak-Kim is in IL but I've heard of her doing phone consults with patients. Basically, she'd just recommend what to test for and then review that and suggest a transfer protocol. Might be hard to get in though, she's highly rated. 

FuzzyDust

We had success with not-so-great rated embryo, so I don't think your doctor can predict the chances this way. I'd chose to transfer first, to see if it works, especially if you'd have to pay out of pocked for another cycle that you might not even need.

[Deleted User]

I would try to trust your doctor and go for the repeat transfer.  I'm also currently pregnant with a 4bb (non pgs) while other better graded embryos did not stick. 😔 You really don't know until you try! GL