Infertility

Question about testing and protocols *loss mentioned

I know that every RE is different but I'm just pondering some thoughts. After my failed Ivf, I met with my RE. only to feel rushed out of his office. He just said, there's nothing wrong, ill get pregnant. We'll just transfer two this time. I felt rushed and did not get to ask much.
I had the initial testing for Ivf but I've never been tested for any implantation dysfunction issues or any autoimmune issues. I only had one pregnancy and it was a blighted ovum. I read that it can be the result of an implantation issue. I was just curious to see if anyone has been tested for this and when you had it done. I am scheduled for a FET on 2/19 and I don't know what the testing consists of or if it's too late to have it done.

******Siggy Warning**************

Me 29 - no known issues ( Highest FSH 10.1??) 
DH- 36 - quite the perfect man!
TTC since 1/2011
IUI #1 March 2012 
BETA #1  BFP
B/O at 6 weeks D&C @ 10 weeks 
IUI #2-7 (2012)= BFN
IVF  Jan 14 - Follistim, Ganirelix
22R, 8M, 8F
ET  (1-14-14) - 1 Grade A 8 cell = BFN
FET (2-18-14)  1 grade A 12 cell and one early morula!
BETA #1 (3-3-14) =1,389  p4 17.4
BETA #2  (3-5-14) = 4,553 u/s showed one small g sac
U/S #2      (3-17-14) Shows two little beans with heartbeats!!! TWINS!! 
                                   Heartbeats were 119 & 120 beans measured (6 weeks 1 day) (6 weeks 2 days)
found out at 20 weeks that baby B went to heaven
11/12/14 Baby girl arrived :)
FET (1-24-16) Grade A early morula 
BETA #1 300 p4. 11.1 
BETA#2 1300
u/s d 1 tiny babe :)
10/7/16 another sweet baby girl
4/18 SURPRISE + HPT 
Beta #1 6 weeks 16,202 p4. 13.2




Re: Question about testing and protocols *loss mentioned

  • I am sorry for your loss. But your RE is following a fairly normal track if you've had the one loss and it being a blighted ovum. You shouldn't be concerned with implantation or autoimmune when that has nothing to do with your last loss. Usually autoimmune testing is done if there indications or multiple loss where there is no other obvious cause. And if your FET is next Wed, I would say it is late to throw testing into the mix.

    I know it is hard and you want all your bases covered...but sometimes it really does just come down to bad luck this far. FET stats are great esp if you have a good frost embies. Try to feel positive moving forward a nd good luck.

    TTC since July 2009. Dx MFI & LPD. 
    IUI#1&2&3 (2011 & 2012) BFN
    IUI#4 1/23/13 on 75iu x9 Follistim = BFP then chem preg m/c (Feb 2013)
    IUI#5 BFN (April 2013)
    IVF w/ICSI Oct. 2, 2012 - 13R, 11M, 7F, 1 frozen blast 4BB grade - - - FET Nov 15, 2013
    BFP! Beta 1:104 @ 10dp6dt, Beta 2:178 @ 12dp6dt,  beta 3:366 @ 14dp6dt
    Saw heartbeat twice before missed M/C at 8w3d on 12/27/13, missing my little angel boy
    JUNE 2014 IVF#2;  5R, 2M, 1F Three day transfer 6/7.  Beta 6/18 - BFN
    Child Free Now?
    S/PAIFW , S/PALW

    My Blog

    image



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  • I am going to disagree with katib77, which I don't usually do.  My RE ordered some immunological testing after IVF #1, which was canceled before transfer because our embryos stopped growing.  Nothing in IVF #1 indicated that we needed testing, but my RE wanted to cover all of our bases before we paid for another IVF cycle OOP.  I am glad we did, because my blood work did show slightly elevated NK Cells, so Intralipid infusions were added to my protocol.  We have now done 3 IVFs, with no success so we obviously have more issues than just the NK Cells.

    I think the big factor for my RE ordering the testing early is that my clinic is pretty big on diagnosing implantation dysfunction disorders.

    imageimageimageimageimage

     

    image

    TTC #1 since August 2011

    My Blog

    September 2012: Start IF testing

    DH (32): SA is ok, slightly low morph, normal SCSA  Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA

    October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos

    November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues.  Converted to freeze all due to lining issues.  2 blasts frozen on day 6!

    January 2015: FET #2 Cancelled due to lining issues

    April 2015: FET #2.1


    PAIF/SAIF Welcome!

  • @twinkie0612,
    Is it a blood test to check? Do you recall how long it took to get the results back? We're also completely OOP.

    ******Siggy Warning**************

    Me 29 - no known issues ( Highest FSH 10.1??) 
    DH- 36 - quite the perfect man!
    TTC since 1/2011
    IUI #1 March 2012 
    BETA #1  BFP
    B/O at 6 weeks D&C @ 10 weeks 
    IUI #2-7 (2012)= BFN
    IVF  Jan 14 - Follistim, Ganirelix
    22R, 8M, 8F
    ET  (1-14-14) - 1 Grade A 8 cell = BFN
    FET (2-18-14)  1 grade A 12 cell and one early morula!
    BETA #1 (3-3-14) =1,389  p4 17.4
    BETA #2  (3-5-14) = 4,553 u/s showed one small g sac
    U/S #2      (3-17-14) Shows two little beans with heartbeats!!! TWINS!! 
                                       Heartbeats were 119 & 120 beans measured (6 weeks 1 day) (6 weeks 2 days)
    found out at 20 weeks that baby B went to heaven
    11/12/14 Baby girl arrived :)
    FET (1-24-16) Grade A early morula 
    BETA #1 300 p4. 11.1 
    BETA#2 1300
    u/s d 1 tiny babe :)
    10/7/16 another sweet baby girl
    4/18 SURPRISE + HPT 
    Beta #1 6 weeks 16,202 p4. 13.2




  • My RE ordered two blood tests, one for APA (Aminophospholipid Anibodies) and one for Natural Killer Cell Assay. It took a few weeks to get back because it was sent out to a third party lab. As a warning, the tests aren't cheap. I think for the two tests, my bill was around $450 and that was with a self pay discount.

    imageimageimageimageimage

     

    image

    TTC #1 since August 2011

    My Blog

    September 2012: Start IF testing

    DH (32): SA is ok, slightly low morph, normal SCSA  Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA

    October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos

    November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues.  Converted to freeze all due to lining issues.  2 blasts frozen on day 6!

    January 2015: FET #2 Cancelled due to lining issues

    April 2015: FET #2.1


    PAIF/SAIF Welcome!

  • Oh wow, I assume it isn't covered my most insurance? My insurance covers testing just not anything toward a treated cycle. Thank you so much for the info and I'm so sorry to hear about your failed cycles. IF totally sucks.

    ******Siggy Warning**************

    Me 29 - no known issues ( Highest FSH 10.1??) 
    DH- 36 - quite the perfect man!
    TTC since 1/2011
    IUI #1 March 2012 
    BETA #1  BFP
    B/O at 6 weeks D&C @ 10 weeks 
    IUI #2-7 (2012)= BFN
    IVF  Jan 14 - Follistim, Ganirelix
    22R, 8M, 8F
    ET  (1-14-14) - 1 Grade A 8 cell = BFN
    FET (2-18-14)  1 grade A 12 cell and one early morula!
    BETA #1 (3-3-14) =1,389  p4 17.4
    BETA #2  (3-5-14) = 4,553 u/s showed one small g sac
    U/S #2      (3-17-14) Shows two little beans with heartbeats!!! TWINS!! 
                                       Heartbeats were 119 & 120 beans measured (6 weeks 1 day) (6 weeks 2 days)
    found out at 20 weeks that baby B went to heaven
    11/12/14 Baby girl arrived :)
    FET (1-24-16) Grade A early morula 
    BETA #1 300 p4. 11.1 
    BETA#2 1300
    u/s d 1 tiny babe :)
    10/7/16 another sweet baby girl
    4/18 SURPRISE + HPT 
    Beta #1 6 weeks 16,202 p4. 13.2




  • katib77 is right that it's too late for your FET on the 19th. Hopefully this FET will work for you so that you never have to worry about this!


    **********************siggy/ticker warning**********************

    ***Losses mentioned.*** TTC #1 since May 2012. Me: 37, OH: 41. Ectopic August 2012 => tubal damage. :'(  Stage 1 endo removed June 2013. IVF #1 Oct/Nov 2013: Long Lupron with Gonal-F. 7R, 7M, 7F. 2 txfer@3d. Nothing frozen.  => M/C @ 8 wks. :'( Selected RPL panel all normal. Very hyper and brittle response to stims. IVF #2 (antagonist protocol) Feb 2014 => Converted to IUI (Perfect conditions). BFN. IVF #2.1 w/ new RE June 2014: Antagonist protocol. 33R, 31M, 30F, 19 blasts to test!!! I made it through without crashing!! :) Hats off to Dr. Fancypants!! ET of one 5AB blast. BFN. 13 10 CCS'ed snowflakes! FET #1 PUPO as of 7/29 Betas: 8/7@24, 8/9@97, 8/11@334 (etc.) Two sacs on 8/15, one seen on 8/18 after a bleed. U/s 8/25 (6+3) "perfect": 5.9 mm + HB@120bpm! U/s 9/4 (7+6): 15.9 mm + HB@172 bpm! Please, PLEASE stick this time!!!!
    http://i955.photobucket.com/albums/ae39/catfreeburg/866da40f5178fed79efe23fc8a4e8a_zps4498a9cc.jpgimageimageimageimage
    image
  • I agree with PPs that it may be too late to get the results by the 19th. My clinic said it takes 2-3 weeks, 18 days later and I haven't gotten my results back.

    My RE strongly reccomended the whole RPL panel after our failed IVF. And I resisted, because I thought it seemed like a waste of money. In the end we went for it because I don't want to throw away another cycle if there's some underlying issue that's affecting implantation. My REs exact words were "you had two perfect embryos, perfect lining and perfect hormone levels, so either its bad luck or there's something we're not seeing on the surface."

    Also on the time issue, we almost didnt have it done because the results wouldn't be in in time. But our cycle has been delayed 12 days because of my progesterone so now the results will be in on time. You just never know what's going to happen. Good luck!
    Me: 30 DH: 30 ~ TTC #1 Since August 2011 
    BFP #1 2/28/13, Ectopic, Tubal surgery 3/25 
    Began RE testing 8/8, Dx Unexplained, 
    IUI #1 11/1=BFN Moving on to IVF 
    IVF #1 12/2 ER 8R 7M 4 fertilized
    12/7 Transferred 2 "perfect" little blasts 12/17 BFN
    New DX= DOR, I fu*kng hate IF
    1/14 Hysteroscopy, new clean uterus!
    IVF #2: bcp, Lupron, follistim 300, menopur 225. 2/21 8R 4M 3F. 3dt of 2 perfect embryos. 1 little penguin 
     3/10 BFFN
    Regrouping. Seeing reproductive immunologist Dr. Kwak Kim 6/10 
    Kwak Kim protocol: Metformin 1000mg, vitamin D 4000iu, vitamin E 400iu, baby aspirin, Metanx, levothyroxine 75mcgs 
     Surprise BFP 9/21!!! Beta #1 247, Beta #2 630. Miscarried 10/13

  • Also, id be seriously pissed if my RE made me feel rushed after a failed IVF cycle! He should be taking his time to answer all of your questions and really make an effort to examine what could have gone wrong. But that's just my two cents!
    Me: 30 DH: 30 ~ TTC #1 Since August 2011 
    BFP #1 2/28/13, Ectopic, Tubal surgery 3/25 
    Began RE testing 8/8, Dx Unexplained, 
    IUI #1 11/1=BFN Moving on to IVF 
    IVF #1 12/2 ER 8R 7M 4 fertilized
    12/7 Transferred 2 "perfect" little blasts 12/17 BFN
    New DX= DOR, I fu*kng hate IF
    1/14 Hysteroscopy, new clean uterus!
    IVF #2: bcp, Lupron, follistim 300, menopur 225. 2/21 8R 4M 3F. 3dt of 2 perfect embryos. 1 little penguin 
     3/10 BFFN
    Regrouping. Seeing reproductive immunologist Dr. Kwak Kim 6/10 
    Kwak Kim protocol: Metformin 1000mg, vitamin D 4000iu, vitamin E 400iu, baby aspirin, Metanx, levothyroxine 75mcgs 
     Surprise BFP 9/21!!! Beta #1 247, Beta #2 630. Miscarried 10/13

  • I had my follow-up for a failed IVF (my first, too) and he said pretty much the same thing- nothing was wrong, just didn't happen, but because we didn't get a lot of embryos we would try different meds to work on that (Lupron). I asked about the steroids some of the women on the board are on to help with implantation and he said that he didn't think it was worth the potential side-effects and that one failed IVF didn't indicate an implantation issue. If #2 also produces good embryos and we don't get pregnant, he will try and get us into a study for an investigational drug to help with implantation which would cover the costs (I believe he said of the whole IVF cycle) I've never been offered any of the other tests mentioned and we are OOP.

    ***************************Loss Mentioned***************************


    Me 37 y/o, DH 45 y/o; DH vasectomy reversal (his 2nd marriage) 11/8/12; TTC since 12/8/12. IVF due to MFI. DOR diagnosis April 2015.

     

    IVF #1 BCPs/Antagonist w/ICSI Jan 2014 = BFN

    IVF #2 MDL w/PICSI March 2014 = BFN

    IVF #3 EPP/Antagonist w/PICSI May/June 2014 = BFP!; MMC 6w4d

    IVF #4 No suppression/Antagonist Nov 2014/Converted to IUI #1 = BFN
    IVF #4.1 Feb 2015 = cancelled
    IVF #4.2 April 2015 - Lupron Stop Protocol with ICSI = PGD testing of embryo indicated it was abnormal
    IVF #5 June 2015 EPP with Antagonist 

     

    image
    Everyone welcome!

  • Thank you all so much for taking the time to reply to me. I am going to ask my RE. I rarely see him, only when I schedule apts with him. He doesn't do email or phone calls, everything goes through the nurses. I assumed that I didn't have issues with implantation because I got pregnant before but after reading stuff, I cannot rule it out. 

    @Carol77b, My Re has me on baby aspirin starting on day 4 and I will start an antibiotic and steroid about 3 days before the FET. 

    Oh yeah, 
    HAPPY MONDAY!! 
    :((

    ******Siggy Warning**************

    Me 29 - no known issues ( Highest FSH 10.1??) 
    DH- 36 - quite the perfect man!
    TTC since 1/2011
    IUI #1 March 2012 
    BETA #1  BFP
    B/O at 6 weeks D&C @ 10 weeks 
    IUI #2-7 (2012)= BFN
    IVF  Jan 14 - Follistim, Ganirelix
    22R, 8M, 8F
    ET  (1-14-14) - 1 Grade A 8 cell = BFN
    FET (2-18-14)  1 grade A 12 cell and one early morula!
    BETA #1 (3-3-14) =1,389  p4 17.4
    BETA #2  (3-5-14) = 4,553 u/s showed one small g sac
    U/S #2      (3-17-14) Shows two little beans with heartbeats!!! TWINS!! 
                                       Heartbeats were 119 & 120 beans measured (6 weeks 1 day) (6 weeks 2 days)
    found out at 20 weeks that baby B went to heaven
    11/12/14 Baby girl arrived :)
    FET (1-24-16) Grade A early morula 
    BETA #1 300 p4. 11.1 
    BETA#2 1300
    u/s d 1 tiny babe :)
    10/7/16 another sweet baby girl
    4/18 SURPRISE + HPT 
    Beta #1 6 weeks 16,202 p4. 13.2




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