WWIFD do in my shoes? (this is a loooong one)

Scoop77

I got a Q for ya gurls. (Sorry for the length.)

As you can see from my sig, I got a BFN with my 2nd cycle, my 1st FET, recently. I've had the WTF appt w/my doctor and I was a little bit at a loss for how to proceed.

I liked my protocol. We've retrieved well (14 eggs last time), fertilized well (100%) and gotten three high-quality blasts, two of which thawed well after a freeze.

I've been tested for immune issues (natural killer cells came up positive) and was on intralipid for like seven cycles, which did bupkis for us in terms of helping achieve pregnancy but was wonderful at increasing the cost of each cycle.

We ditched intralipid for the FET and switched to prednisone and that also didn't work.

I had an early miscarriage from the only pregnancy I've ever had, a surprise BFP right before I was supposed to go on Clomid, which was ages ago. We had the "remains of conception" (ugh, terrible phrase) tested and everything was chromosomally normal.

My RE doesn't have great CDC stats and his office isn't as detailed as I think they should be, but I also don't have specific or serious complaints with any part of their process. I'm worried switching REs won't improve our cycles and could actually result in worse results if we don't pick a winner.

My RE was almost as flabbergasted as I was with the two failed cycles and said that we've treated every part of the equation: egg, uterus, immune system. The only thing he could think to add was Metformin for my PCOS and to change the protocol from a long to a short to try to increase the number of eggs retrieved so we'd have more chances at implantation.

Someone on the board here suggested endometrial biopsy, which I asked about and he said that it used to be a common way to test for ovulation years ago and that REs saw no increase in pregnancy rates after doing them. It looks like a painful procedure so I'm hesitant to push it without scientific evidence that it could help. Other things that I've tried include acupuncture, meditation and eating enough pineapple to drown the SS Carmen Miranda.

What should I do now? I'm on BCPs and Metformin and we're supposed to go to a consult this week, after which we'll get going on another cycle. But I go back and forth every day. Should we take a couple of months off and regroup? Or switch to another RE? Stick with the long protocol or go for broke with the short one?

And is there any way going from a long protocol--which worked very well for me--to a short protocol can wind up doing the opposite of what we want, in other words, give us fewer eggs or lower their quality? My RE said he "wouldn't be concerned about that," which is not exactly a "no," if you know what I'm saying.

It's getting down to decision time and we have to make a definite call on this cycle soon. I guess I'm saying (in a veerrrrrry drawn-out fashion), WWYD? Thanks in advance...

melkel559

I'm sorry I can't be of more help since I don't have experience with a lot of the things you are mentioning like the endometrial biopsy, having gone through different protocols, switching doctors, etc..however one thing that I can relate to is taking a break. DH and I were basically put on a forced break from July until Oct. I have to say, as much as I thought I'd hate it, it really helped us physically and emotionally. By the time we got "back in the saddle" we felt refreshed and that we had regrouped. We took time to be together as a couple again, hang with friends, work on the house, not obsess over IF. well, I still obsessed some of course. I know decisions need to be made and that "the clock just keeps on ticking" however I feel like we were just a little more levelheaded after taking a step back and this may help you gain some clarity in what you guys want to do moving forward. Best of luck!!

Ecarabeo217

I'm so sorry you're going through so much trouble...FWIW, I don't believe there is *great* data on it, but I read somewhere (sorry cant remember now where exactly) recently that endo biopsy right before a cycle might help implantation. It's relatively painful (not worse than HSG, IMO) and its a quick procedure and might be worth doing if all else has been covered already. Again, I think the catch was that it was done leading up to ET so not months before trying again. I don't know that this piece of info is much help, but thought I'd throw it in there.

best of luck to you!! 

BzeetyD

Ecarabeo217:

I'm so sorry you're going through so much trouble...FWIW, I don't believe there is *great* data on it, but I read somewhere (sorry cant remember now where exactly) recently that endo biopsy right before a cycle might help implantation. It's relatively painful (not worse than HSG, IMO) and its a quick procedure and might be worth doing if all else has been covered already. Again, I think the catch was that it was done leading up to ET so not months before trying again. I don't know that this piece of info is much help, but thought I'd throw it in there.

best of luck to you!! 

I had this done on our most recent cycle. Basically the doc "scrapes" or irritates the lining of the uterus in just the right spot to help the embryos implant.

It was highly uncomfortable but it was very quick (30sec) and one of the oddest sensations. I would do it again though, for sure.

 

Citygirl1015

I just wanted to say that I'm so sorry you're in this position. When an IVF cycle doesn't work and there is no real explanation why, it's the most frustrating thing. Have you ever considered going to a Reproductive Immunologist? I'm guessing they may be able to catch other things and have other treatment plans that a standard RE isn't aware of. I've never been diagnosed with immune issues, but I know my RE doesn't really put much weight on them anyway, so I've toyed with the idea of going to see a specialist in NYC to rule it out (or in.) Some specialists just give you a treatment plan, and allow you to continue to cycle with your current RE (if they're on board with it, that is.)

Either way, wishing you the best of luck in whatever you decide.

Juicy71

BzeetyD:

Ecarabeo217:

I'm so sorry you're going through so much trouble...FWIW, I don't believe there is *great* data on it, but I read somewhere (sorry cant remember now where exactly) recently that endo biopsy right before a cycle might help implantation. It's relatively painful (not worse than HSG, IMO) and its a quick procedure and might be worth doing if all else has been covered already. Again, I think the catch was that it was done leading up to ET so not months before trying again. I don't know that this piece of info is much help, but thought I'd throw it in there.

best of luck to you!! 

I had this done on our most recent cycle. Basically the doc "scrapes" or irritates the lining of the uterus in just the right spot to help the embryos implant.

It was highly uncomfortable but it was very quick (30sec) and one of the oddest sensations. I would do it again though, for sure.

My RE just started doing this procedure because he said there is recent research coming out that shows that it may help with implantation.  Therefore, we will be trying it for my next cycle. 

You may just want to meet with another RE to get a 2nd opinion.  It doesn't mean you have to switch but just have another doctor look at your records and see if they have a different opinion.

((((hugs))))

Scoop77

Thanks, everybody. I might give another thought to the biopsy. And I know it's a good idea to take time off to regroup. It's just hard to tear myself away from all the fun and games that is IVF. I hate it but I can't stop! It's like eating all the leftover Halloween candy. (That reminds me, there are some Whoppers no one wanted from last night. Makes as good a breakfast as any.)

BzeetyD

Do the biopsy if you can. The pain is tolerable and the procedure is definitely worth adding to the mix.

Scoop77

BzeetyD:

Do the biopsy if you can. The pain is tolerable and the procedure is definitely worth adding to the mix.

What do you mean by "tolerable"? I am a famous wimp and the HSG almost convinced me to give up TTC entirely.

Ecarabeo217

Scoop77:

BzeetyD:

Do the biopsy if you can. The pain is tolerable and the procedure is definitely worth adding to the mix.

What do you mean by "tolerable"? I am a famous wimp and the HSG almost convinced me to give up TTC entirely.

While I haven't had it done myself, I do these in my office all the time.  Most women do really well...it's very fast.  It's a small catheter passed through the cervical canal (much like a transfer or the catheter used for a sonohyst) and then with a small amount of suction, the lining is scraped with the open end of the catheter. 20-30 seconds.  It sucks and then it's over...