WTF Appt finally

beachy6 · January 2014

I just had my WTF apt to our failed FET from September. I really expected our RE to want to use our frozen embryo and then do a fresh cycle when that didn't work. However, because of my age (Great. Now I get to play that card.) he preferred to do another full cycle and bank more embryos to use later. So, as soon as AF starts, here we go again. I am way more upset over the whole thing than I though I would be. I already am preparing for a failed cycle, probably to guard myself, but there is also a little excitement if I look deep enough.

This month marked ten years of ttc. Our RE felt that there has to be some underlying issue here. Ya think? So, DH is getting more testing. We've mostly focused on me, because let's face it, I am a disaster! If this fresh cycle doesn't work, we'll do more immune testing before doing another FET. I'm so mad that I even have to do this again. Ugh. Hopefully, after AF comes and goes, I'll be more in the spirit. Bye, bye vacation 2014.

No real point to this post. Just a little shocked that my ancient ovaries are being forced to become grapefruit sized again.

sorrellam30 · January 2014

Well I'm glad that you at least finally got your wtf-that took long enough! I'm not looking forward to another fresh cycle either. Hopefully it's a last for both of us!

BzeetyD · January 2014

Is your DH getting more testing before this fresh cycle? Has he had a frag test or a SPA (hamster egg) test?

I'd be hesitant about doing another cycle without more info.

Hope it and the testing goes well!

beachy6 · January 2014

@sorrellam30 It did take long enough! The clinic isn't even that big. Since I had already missed work (I teach) I felt bad getting a sub again. So, I had to wait for a day when I was off. You would think they could have fit me in over Christmas break! Nope!

@BzeetyD He is having the Sperm Binding Test (HBA) and the frag test done. I hate to say it, but I hope they find something wrong before we go spending more money. Our RE said it is possibly an easy fix, depending on the results. I agree that we need more answers before moving forward. If everything is fine with these tests, I need to re-evaluate what to do. I can't see spending more money not knowing how to fix this.

DoublePortion · January 2014

FX you get some answers before moving forward. ((Hugs))

MrsC430 · January 2014

Hoping DH's testing brings you some answers. Sending hugs & positive thoughts your way!

PrettyAccountant · January 2014

I hope the additional testing brings you some answers - and that they are easily fixed!

Mrs.McIrish · January 2014

Butting in- whats a sperm binding test or what Bzeety said (hamster egg??) Im looking for any sperm tests that exist since we keep getting bad embryos. Sorry you have to cycle again. It's exhausting and 10 years is beyond what anyone should endure.

JSM0801 · January 2014

I'm so sorry for all you have been through and hope you get some answers soon!! GL moving forward!

Sophistikitty · January 2014

Mrs.McIrish said:

Butting in- whats a sperm binding test or what Bzeety said (hamster egg??) Im looking for any sperm tests that exist since we keep getting bad embryos. Sorry you have to cycle again. It's exhausting and 10 years is beyond what anyone should endure.

I don’t know what a sperm binding test is but DH had the sperm penetration assay which is done with hamster eggs. Essentially it tests the sperm’s ability to penetrate an egg. Apparently hamster eggs very close in structure etc. to human eggs. The test is probably not of much value if you are doing ICSI.

Has your hubby been tested for anti-sperm antibodies? I am not 100% sure how it affects things but DH had it done after our first failed cycle and C.CRM tested him again at our workup. As he had no antibodies both times I never really looked into it but it might be something to consider if he hasn’t been tested.

Sophistikitty · January 2014

I am so sorry that you have to muster up the strength for another fresh cycle. This process is so exhausting. I can’t imagine being at this for ten years, I am going on five and it is hard for me to even imagine another year. (((Hugs)))

Mrs.McIrish · January 2014

Sophistikitty said:

Mrs.McIrish said:

Butting in- whats a sperm binding test or what Bzeety said (hamster egg??) Im looking for any sperm tests that exist since we keep getting bad embryos. Sorry you have to cycle again. It's exhausting and 10 years is beyond what anyone should endure.

I don’t know what a sperm binding test is but DH had the sperm penetration assay which is done with hamster eggs. Essentially it tests the sperm’s ability to penetrate an egg. Apparently hamster eggs very close in structure etc. to human eggs. The test is probably not of much value if you are doing ICSI.

Has your hubby been tested for anti-sperm antibodies? I am not 100% sure how it affects things but DH had it done after our first failed cycle and C.CRM tested him again at our workup. As he had no antibodies both times I never really looked into it but it might be something to consider if he hasn’t been tested.

Thanks Sophistikitty. Yeah, we are doing ICSI and fertilization is actually the one thing that DH's sperm does well! He did have the sperm antibody test in Dec 2011 and it was normal. It's a mystery why we can't get AA embryos. Sorry Beachy for the barge!

beachy6 · January 2014

I don't mind the barge at all! Honestly, I have no idea what the sperm binding test is. At this point, I should probably know to ask, but I was just happy they had a test left that they could still run on one of us!

Here is what I found on repro.source about the binding test:

Sperm Binding Assay

Hyaluronan binding assay (HBA) determines the maturity of sperm in a fresh semen sample. The assay is based on the ability of mature sperm to bind to the substance hyaluronan, which is a major component of the external coating of female ova (eggs). The ability to bind to hyaluronan is not present in immature sperm and is necessary for proper sperm function. In addition, HBA represents a more convenient and reproducible laboratory test for identifying candidates for intracytoplasmic sperm injection (ICSI), an advanced assisted reproductive technique.

I am assuming that there won't be an issue with this since in our last IVF, fertilization wasn't an issue. But, I'm willing to do anything at this point! I'm hoping (sad!) that there is an issue with the DNA test so we can fix something before dropping a few more thousand dollars. I'm not sure what we'll do if both tests come back normal. Maybe look into immune issues sooner.

BzeetyD · January 2014

beachy6 said:

I don't mind the barge at all! Honestly, I have no idea what the sperm binding test is. At this point, I should probably know to ask, but I was just happy they had a test left that they could still run on one of us!
Here is what I found on repro.source about the binding test:
Sperm Binding Assay
Hyaluronan binding assay (HBA) determines the maturity of sperm in a fresh semen sample. The assay is based on the ability of mature sperm to bind to the substance hyaluronan, which is a major component of the external coating of female ova (eggs). The ability to bind to hyaluronan is not present in immature sperm and is necessary for proper sperm function. In addition, HBA represents a more convenient and reproducible laboratory test for identifying candidates for intracytoplasmic sperm injection (ICSI), an advanced assisted reproductive technique.

I am assuming that there won't be an issue with this since in our last IVF, fertilization wasn't an issue. But, I'm willing to do anything at this point! I'm hoping (sad!) that there is an issue with the DNA test so we can fix something before dropping a few more thousand dollars. I'm not sure what we'll do if both tests come back normal. Maybe look into immune issues sooner.

This is the test they do if they do PICSI (which they did at C.CRM for our most recent cycle). They essentially run the sperm through a maze of this protein and collect the ones that perform the very best.

There is also IMSI available, which is an extremely high powered microscope looking at sperm before selecting them for ICSI. We also had this in our most recent cycle.

The most telling test for us was the sperm DNA frag test. MIster D failed it but was put on supplements (specific to him from our doc at CCR.M) and had the test repeated, three months after being on supps and had improved by 2x. It was a HUGE thing. Our home (MN) clinic doesn't believe in the DNA frag test but CC.RM does. I really think it's one of the reasons we had such great embies. We never had any embryos in our other 3 IVFs that looked nearly as amazing and certainly never had any frosties.

Best of luck to all.

It's so hard to find these things yourself and push your clinic to do them. I pushed our home clinic to run the initial DNA frag test (after our 3rd IVF ended in a c/p) and they did it but somewhat reluctantly, my MN clinic doc said herself that she wasn't really sure what to do with the results, regardless of what they were - but thankfully our new CO clinic did.

In the end we may have had an MFI issue more than any kind of issue on my end, even though Mister D's SAs always looked good to okay. But really it took 4 years and 2 IUIs and 4 IVFs and 3 clinics to get to that.

Big hugs and lots of encouragement from me.

beachy6 · January 2014

@BzeetyD I soooo hope there is something wrong that is found in these tests. Our RE said that, as of the start of this year, they have started running the DNA frag test before letting anyone start IVF based on what they have seen over the last couple of years. The IVF nurse was telling us that she has been "shocked" at how many men have DNA frag issues even though everything else checks out fine, just like your DH. It's not often you hear a nurse is shocked! Thank you so much for telling me your story! It really gives me hope that there might be a light at the end of this tunnel. And, I kinda cracked up thinking of sperm going through a maze...if DH's sperm have his sense of direction, we're screwed!

His test is next Thursday. We will have the HSA results back the same day, but the DNA frag test takes 10 days or so.

BzeetyD · January 2014

beachy6 said:

@BzeetyD I soooo hope there is something wrong that is found in these tests. Our RE said that, as of the start of this year, they have started running the DNA frag test before letting anyone start IVF based on what they have seen over the last couple of years. The IVF nurse was telling us that she has been "shocked" at how many men have DNA frag issues even though everything else checks out fine, just like your DH. It's not often you hear a nurse is shocked! Thank you so much for telling me your story! It really gives me hope that there might be a light at the end of this tunnel. And, I kinda cracked up thinking of sperm going through a maze...if DH's sperm have his sense of direction, we're screwed!
His test is next Thursday. We will have the HSA results back the same day, but the DNA frag test takes 10 days or so.

Best of luck! I hope you get more answers, and even if everything is A-OK, that is in a way, getting some more boxes checked off.

chucktgirl · January 2014

Good luck on your (surprise) upcoming cycle, Beachy. I hope your RE has time to get all of these tests done before AF! Ten years is beyond heartbreaking. I wish there was an easy checklist so we could just say, yep, we've already done that. So frustrating!

SKLH · January 2014

Maybe a fresh start is what you need! A new batch of embryos. I'm hoping for the same. Just liike you, I feel like it's already going to fail but who knows? Maybe we'll be surprised by a success. Hang in there. I'm totally in shock that my ovaries have to do this all over again too. Argh

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