WTF discussions about implantation.

Cmartin6706 · October 2011

As anyone talked to your RE about not being able to get past implantation? We are getting the signs of implantation such as the cramping on day 6 - 7 and brown blood on day 8, plus we had that c/p, but no sticking after that.

Has anyone talked about doing genetic testing on the embryos?

We are thinking it's a blood thickness issue, but I wanted to see what, if anything, you ladies have talked to your REs about in your WTF appointments.

Chris

emmypants · October 2011

I feel like a moron, but I've googled and looked at the glossary. What does WTF mean in this context? Embarrassed

sekura · October 2011

I have nothing useful to add on implantation issues; I just wanted to say I'd been wondering how you were doing. Sorry that you're not getting past the implantation; I hope your doc (or the other ladies of the board) can give you some useful info!

adoruhbul · October 2011

I have. It seems like I'm going to go through another c/p this month. Basically he said with the first one that blood clotting problems are often to blame and put me on baby aspirin every day. Now that this one is likely happening I'll do a RLP test to see if it's something likely genetic. Usually the problems with recurrent c/p is implantation failure which can only be cause by a few things, insufficient uterine lining, genetic mutations, poor embryo quality. PGD is usually only done if genetic testing is done and there is a known issue.

Have a good majority of the eggs made it to blast? If quality was an issue you'd already known about it likely. From what I understand the best steps to take would be the repeated loss panel which looks for certain mutations that can cause c/p or implantation failure. If it comes back fine the other two things left are actual embryo rejection and lining issues. They can do testing to look for NK cells that show that immune rejection is the issue and in that situation they give IVIG or intralipids (some RE's do not believe in IVIG). The other thing is to have her lining biopsied at 7DPO and make sure it matches up where it should be in a cycle.

I think if you are concerned you could be dealing with more than the unfortunate 25% implantation rate failure that you look into some of those options with your RE. The repeated loss testing is simple bloodwork there is an issue though...you use a donor so if she comes back having a genetic issue there's no way to find out if the donor does unless it's available through the cryobank. The step after that is the uterine biopsy usually and then finally the rejection testing. Some REs automatically give intralipids to people who've had c/p so I'd at least ask about it.

Sorry this got long and winded, but Ive talked to my doctors tons about it and done a lot of research as well. Was her test completely stark white? Was there any day you saw a possible very faint line. On my first injects cycle I one day had a light light line passed it off as a evap line.. Later in the day same thing but lighter, gone the next day. At the time we thought it was nothing now that I've been having recurrent c/p it was likely another one. I also had what appeared to be implantation cramping and bleeding. For me, I have very distinct cramps actually that are different then regular cramps, so I don't need to test to know at this point, just wish I could stay pregnant. Good luck to you too, I hope it works out better this cycle.

Mitzi Bishi · October 2011

I had similar issues... we are doing acupuncture this cycle and I stopped taking aspirin, which I was taking daily. I've also been drinking red raspberry leaf tea and eating fresh pomegrantes.

If we get beginning signs of sticking, but no sticking again we'll definitely look into other things. When it happens once they kind of go with "well, these things happen." When it continually happens I think they'll pay more attention.

We're also partially covered by insurance, so we're trying to play by their rules. In the US I think they'll largely do anything you want if you're willing to pay.

Good luck!

Cmartin6706 · October 2011

emmypants:
I feel like a moron, but I've googled and looked at the glossary. What does WTF mean in this context?

It means what you think it means...What The F!? Why isn't my wife getting pregnant!

emmypants · October 2011

Cmartin6706:
emmypants:
I feel like a moron, but I've googled and looked at the glossary. What does WTF mean in this context?

It means what you think it means...What The F!? Why isn't my wife getting pregnant!

Ah, ok. I've seen it on IF too and was confused.

Cmartin6706 · October 2011

sekura:
I have nothing useful to add on implantation issues; I just wanted to say I'd been wondering how you were doing. Sorry that you're not getting past the implantation; I hope your doc (or the other ladies of the board) can give you some useful info!

We are hanging in there! The lady and I are enjoying a glass (each!) of wine tonight and....a little BD later! What! What!

RovinChick · October 2011

I think it would be worth it to get the RPL panel done and see if there are any clotting issues, as I've seen that baby aspirin can help with implantation. I was also googling endometrial biopsy last month before my procedure (to test for infection) and I found some sites that suggest doing a biopsy to improve implantation success. Here's one of those sites: https://ivf.ca/forums/topic/22789-endometrial-biopsy-to-improve-implanting/

Cmartin6706 · October 2011

adoruhbul:
I have. It seems like I'm going to go through another c/p this month. Basically he said with the first one that blood clotting problems are often to blame and put me on baby aspirin every day. Now that this one is likely happening I'll do a RLP test to see if it's something likely genetic. Usually the problems with recurrent c/p is implantation failure which can only be cause by a few things, insufficient uterine lining, genetic mutations, poor embryo quality. PGD is usually only done if genetic testing is done and there is a known issue.
Have a good majority of the eggs made it to blast? If quality was an issue you'd already known about it likely. From what I understand the best steps to take would be the repeated loss panel which looks for certain mutations that can cause c/p or implantation failure. If it comes back fine the other two things left are actual embryo rejection and lining issues. They can do testing to look for NK cells that show that immune rejection is the issue and in that situation they give IVIG or intralipids (some RE's do not believe in IVIG). The other thing is to have her lining biopsied at 7DPO and make sure it matches up where it should be in a cycle.
I think if you are concerned you could be dealing with more than the unfortunate 25% implantation rate failure that you look into some of those options with your RE. The repeated loss testing is simple bloodwork there is an issue though...you use a donor so if she comes back having a genetic issue there's no way to find out if the donor does unless it's available through the cryobank. The step after that is the uterine biopsy usually and then finally the rejection testing. Some REs automatically give intralipids to people who've had c/p so I'd at least ask about it.
Sorry this got long and winded, but Ive talked to my doctors tons about it and done a lot of research as well. Was her test completely stark white? Was there any day you saw a possible very faint line. On my first injects cycle I one day had a light light line passed it off as a evap line.. Later in the day same thing but lighter, gone the next day. At the time we thought it was nothing now that I've been having recurrent c/p it was likely another one. I also had what appeared to be implantation cramping and bleeding. For me, I have very distinct cramps actually that are different then regular cramps, so I don't need to test to know at this point, just wish I could stay pregnant. Good luck to you too, I hope it works out better this cycle.

I'd say you did great! This was long, but very, very helpful.

1. Because of Nicole's blood clotting disorder she is on baby aspirin everyday even when not TTC. She is on 30mg once a day of Lovenox additionally right now to thin her blood while we are TTC.

2. All of our 10 embryos that fertilized made it to grade 4A (highest) level blasts. The RE and the techs are amazed at how beautiful they all look.

3. We are pretty sure all of them were stark white. Maybe one had a pink evap, but nothing more this time.

Thanks for all the information. I hope both our embryos get to implanting soon and I'm sorry to hear about your c/ps. We will talk to the RE about this stuff!

Thanks again,

Chris

lynn0926 · October 2011

Does your RE have her take anything after transfer? If I had made it to ER, I would have been on predinsone, vivelle patches, and baby asprin. I dont know if any of this helps much or what the purpose of it all is, but might be worth asking your doctor about. Also, maybe ask them about AH, I heard that is supposed to help with implantation. I am so sorry you are in this position.

Cmartin6706 · October 2011

lynn0926:
Does your RE have her take anything after transfer? If I had made it to ER, I would have been on predinsone, vivelle patches, and baby asprin. I dont know if any of this helps much or what the purpose of it all is, but might be worth asking your doctor about. Also, maybe ask them about AH, I heard that is supposed to help with implantation. I am so sorry you are in this position.

Our clinic does AH already with all IVF. Nicole is on Dexamethasone, which is a immune suppressant.

Thanks for the other ideas!

RileyGrace · October 2011

My RE likes to discuss adding baby aspirin in some cases. It wasn't a conversation we had, but I know it's on their list of things to try. Maybe worth asking about, since it's so low risk/non-invasive.

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