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Advice please - what would you ask?

Million$$BabyMillion$$Baby
in Infertility

Tomorrow I have my WTF appointment. I'd love any advice you have on what I should ask my RE.  Here's a brief background:

 IVF #1 in September - took bcps, then Menopur and Bravelle and Ganirelex. Was oversuppressed from bcps. 7 eggs were retreived, 4 fertilized but all fragmented badly. 3 transferred - bfn.

IVF #2 in Oct/Nov - RE completely changed protocol to avoid oversupression. No bcps and Lupron instead. Stimmed on Follistim, Luveris and Lupron. Much better response - 16 eggs retreived, 10 fertilized. All had some fragmentation again, although not nearly as bad as IVF #1. 3 embryos were transferred and resulted in a chemical pregnancy. None made it to freeze.

My obvious concern is egg/embryo quality. I plan to ask about wheatgrass and PGD. I also made a note to ask about assisted hatching, but I know very little about this. My RE only does 3dt so I'm not sure if assisted hatching can be done at all.

Any suggestions on what else I should ask/discuss? I am SO anxious to hear what he has to say. Thanks!

 

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Re: Advice please - what would you ask?

  • nrjf01nrjf01
    I have no advice but I wanted to say good luck!
    After 2 years TTC with mild endo and an elevated FSH. We were successful with our second IUI after Lap surgery. Our daughter born 12/2009. Currently trying for #2. IUI#1-miscarriage, IUI #2-BFN, IUI #3- BFP Pregnancy Ticker
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  • oct11bride03oct11bride03
    I don't have any advice but I wanted to wish you good luck!! ((HUGS))
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  • pria2004pria2004
    1. def ask about 3 dt vs 5dt
    2. are your baselines okie?
    3. is your lining too thick/thin?
    4. i am not sure if you have ICSI,but is this an option?
    5. def ask about AH
    6. you and DH's DNA testing
    7. RPL panel testing ( usually dont for recurrent preg loss,but no harm asking)
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  • duke'sgirlduke'sgirl

    I think you are on the right track. I have no advice. I always get so tongue tied at my WTFs and completely blank :(  Good luck!

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  • SheWoreScarletBegoniasSheWoreScarletBegonias

    I don't have any advice either, just wanted to wish you good luck. I def. agree that you should write down all your questions, and leave space below each question to write in the answers you get right as you ask them.

     Good Luck!

    Jenn

    My Blog: When Will Hope and Faith Pay Off

    "The Sisterhood of Infertility" Blog

    Cycle#18=BFP....M/C @ 7w2d...heartbroken
    IUI #1 (cycle 25) = Chem PG, IUI # 2 Cycle 32 = BFFN! SURPRISE--- We're PG!! Break Cycle BFP November 2009!!!! M/C # 2
    Sadly, a Mommy to 3 Angel Babies
    "A dream you dream alone is only a dream. A dream you dream together is reality." John Lennon
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  • TryingtogetpregnantTryingtogetpregnant member

    I would definitely ask (or maybe demand) a 5dt. You can see more of what is going on with your embies then.

    Ask for karyotyping blood work - this will show any chromosomal abnormalities. This can rule out genetic issues with your embies.

    I would ask more about your protocol. It seems like they were SO different that maybe you can get a great idea as to what the real issue is.

    Good luck!

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  • epphdepphd member

    Couple of things I can think of - ask what the criteria are for a 5dt.  Sure, it sounds like those transfers are always better, but that's not technically true.  Success rates are usually the same for 5d and 3d, but typically more embryos are transferred at a 5d.  Obviously the risk of waiting is that you'll have none come day 5.  Usually you need a certain # of embies on day 2 to merit a 5d transfer.

    AH can be done on 3d embies.  I had AH on my last cycle, and the embryos looked A LOT better afterward.  I think it can't hurt.

    With respect to PGD, if your embryos aren't surviving past 3 days (i.e. if you have none to freeze) then PGD might not be possible for you.  And honestly - PGD doesnt guarantee that an embryo will implant.

    I would ask about luveris.  Is it necessary?  I felt that my embryo quality was actually worse in the cycle that I used it. It's use is somewhat controversial, so ask about perhaps leaving it out, unless your LH is way supressed.

    I can't think of much else because really it's such voodoo science.  Egg quality is what it is to some extent - we are born with all of our eggs and there is little we can do to change the intrinsic quality of them.  That said, if you DO hear of some trick to try, PLEASE share!  Despite my age and all indications to the contrary, I think I am stuck with crappy (yet abundant) eggs...

    Good luck!

    Elizabeth

     

    image
    image

    I am a runner, knitter, scientist, DE-IVF veteran, and stage III colon cancer survivor.
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  • Million$$BabyMillion$$Baby
    imageepphd:

    Couple of things I can think of - ask what the criteria are for a 5dt.  Sure, it sounds like those transfers are always better, but that's not technically true.  Success rates are usually the same for 5d and 3d, but typically more embryos are transferred at a 5d.  Obviously the risk of waiting is that you'll have none come day 5.  Usually you need a certain # of embies on day 2 to merit a 5d transfer.

    AH can be done on 3d embies.  I had AH on my last cycle, and the embryos looked A LOT better afterward.  I think it can't hurt.

    With respect to PGD, if your embryos aren't surviving past 3 days (i.e. if you have none to freeze) then PGD might not be possible for you.  And honestly - PGD doesnt guarantee that an embryo will implant.

    I would ask about luveris.  Is it necessary?  I felt that my embryo quality was actually worse in the cycle that I used it. It's use is somewhat controversial, so ask about perhaps leaving it out, unless your LH is way supressed.

    I can't think of much else because really it's such voodoo science.  Egg quality is what it is to some extent - we are born with all of our eggs and there is little we can do to change the intrinsic quality of them.  That said, if you DO hear of some trick to try, PLEASE share!  Despite my age and all indications to the contrary, I think I am stuck with crappy (yet abundant) eggs...

    Good luck!

    Elizabeth

    Thank you - this is some good info! As for the Luveris, I was on it for my second IVF and not my first and actually responded way better when I was on it. I apparently have LH issues since I don't ovulate on my own.

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