Intro & looking for input! (child mentioned) siggy warning

mich_elle · March 2018

Hi there! I'd like to join you ladies-my details are in my siggy. ***siggy warning-child & loss mentioned***

We're struggling to conceive #2 so I guess I'm technically secondary infertility but that board doesn't seem as active so that's why I'd like to join you over here. I'm on the TTC +35 board now. I've been lurking here for over a month and, although I'd be new here, I will give whatever support I can!

We just had our consult with RE to review the results of the DX testing done. DH & I agree that we're going to go for IVF. Here's where I'm looking for your input ladies-I know you are a wealth of information!!!

RE recommends doing a fresh transfer of 3-4 embryos. I've got a few issues with this:
1. She said that FET had a lower success rate than a fresh cycle but that's not what I've read. She said that the embryos grow best in the uterus, not in a lab. I'm so conflicted!
2. 3-4 embryos!!! What?! She said that's the protocol given my age. Ummm, no way do I want to do that! My AFC was only 5 so maybe that's why she wants to transfer so many???
3. I want to do PGS testing due to my age and prior mmc due to a chromosomal abnormality. She said that, while it's helpful, it's not a 100% guarantee. I get that, but shouldn't we at least try?
4. She never mentioned taking a cycle off between the ER & the transfer to give your body a break from the fert meds. What's your opinion?
5. Can I just TELL her what WE want and that's that? OMG, I'm so clueless about all of this!

Our IVF consult is scheduled for 3/19 where we will make a plan going forward & sign the consent forms. I'd love to have some of your feedback before that appointment. I know I'll need to be my own advocate for what we want but, she's the expert, right? I'm a bit conflicted now. Anyone want to chime in? Thanks!

eatinwatermelonseeds · March 2018

Maybe get a second opinion? That sounds like too much contradictory information to just stick with what she says. How old are you? My friend was 40 when she did her last transfer and they refused to transfer more than 2. Seems strange to do so many, especially if you're not comfortable with it. What she says isn't the be all end all, I'd probably try to see someone else before doing anything you're not sure about.

roisis · March 2018

Hi @mich_elle. Hmmmmm - yeah a bit of that does sound a little fishy. I know all clinics have different protocols and will give different info but honestly - some of what she is saying sounds out of date. I believe clinics used to implant lots of embryos with the idea that it will help one stick - but most clinics now go for one or two (I've only heard of 3 in very rare cases). They don't want multiple births. I trust my clinic - so maybe I can just say what they've explained to me?

1. If possible they will intend to go for fresh transfer of one embryo - if more embryos reach blast by Day 5 and have at least a BB grade they will freeze these for future FETs if you want them. Only high grade embryos can be frozen - my clinic will only implant more than one fresh embryo if they are of medium/low grade (rather than bin them - they'll implant them). However sometimes (as in my case actually - OHSS) you can't do a fresh implant at all - so FET is the way to go.
2. Yeah 3-4 sounds a bit mad. I'm 38 - my RE only wants to implant 1. And AFC is an indicator as to how many follicles will grow - not how many embryos should be implanted. That sounds weird to me.
3. It's true tha PGS is not 100% and it is expensive, but if it's something you want to do for peace of mind you should have the option. Does your clinic offer it? Not all of them do - and she may be just trying to 'convince' you that you don't really need it

4. Taking a cycle off means you'd be doing a frozen rather than fresh transfer. If she's against that from the start then that's probably why she didn't mention it. But a lot of women prefer to go straight to fresh transfer in the one cycle (I wish I could have!). There are advantages - the whole process takes less time and you don't have to build up all the hormones again in 2 months time.
5. Hell Yeah!!! This is YOUR body she's messing with!
Seriously - I'm normally one for saying 'Trust your RE - they're the experts!' but honestly in your case I think I'd be considering another opinion. This is a huge process - and you'll be paying a LOT of money for it - make sure you're happy with the plan before you get into it.
I hope I wasn't too negative here - didn't mean to scare you off!! Maybe she was just pushing her own agenda? But chat with your husband about it and see what you're comfortable with.
GL

ndz2018 · March 2018

Hey @mich_elle I agree With everything @roisis says. 3-4 is crazy! I had A friend who did a fresh transfer 12 years ago and they did 3 embryos no PGS testing and they came out with 1 child from that pregnancy. I would totally get a second opinion if you don’t like what she is saying. It’s ultimately your decision and your body so if you don’t like the directions she’s going then you should def see another RE.

mcgeeva · March 2018

I agree with the others. 100% get a second opinion! I would never transfer that many and two PGS ups your chances. That is crazy. Also, if you do PGS you have to have a break in between because it takes time to get the results back. Two they should base treatment on where the issue is. If your eggs are good there is no reason to put in 4 unless you want to end up on TV

mich_elle · March 2018

@eatinwatermelonseeds Thanks for your feedback. I’m 42 1/2. I did more research and found a few articles that confirmed what she recommended. I spoke to her yesterday and she explained her recommendations a bit better. She said that, ideally, we would do the PGS testing. However, that would mean the embryos would have to make it to day 5 & survive the freezing/biopsy/thawing process. She doesn’t feel that they will which is why she recommends the fresh day 3 transfer instead. The quantity of embryos has me freaked out but she’s concerned about my egg quality and doesn’t feel that we’ll have success with only 1-2 transferred. She is willing to do whatever I want-she just provides the data and statistics and what the typical protocol is for someone in my position, then it’s up to me how to proceed. I feel better about things now.

@roisis Thank you for taking the time to respond to my post! I really appreciate your opinion. I explained a bit more (above) that I learned yesterday. She said that if we want to try to push them to day 5 and do FET then we can. Then she would only transfer 2. She’s not opposed to doing PGS testing. I will definitely be steering the process now that I know she’s willing to work with my wants.

@mcgeeva Thank you for your input! I explained a bit more of what I learned yesterday in the message above. I appreciate your feedback.

kiwi2628 · March 2018

@mich_elle just FYI, a lot of RE's are moving away from 3 day transfers. My RE clincs stance (as are many) are that if they wouldn't survive to day 5 being grown (assuming the culture is good and your RE knows how to do it properly), they won't have survived within you either, and doing a day 3 transfer does lower your chances of success while transferring more potentially increases the chance for multiples/HOM. My RE will not transfer more than 2, ever.

prudence9-2 · March 2018

@mich_elle I’m also 42.5 (next month) and I’ve done IVF when I was 41 and ended up with 4 PGS normal embryos.

***TW***
we transferred one at a one and I now have no embryos left.
First ended 6w 1d, second in a CP and third & fourth with BFN
*** end TW***

im now doing another IVF cycle and not responding nearly as good as last time. So the plans for freeze all + PGS are off the table.

My RE did mention that even though my embryos were in excellence quality after the thaw, maybe they were still affected.

Now the plan is to see how many we get to day 3. If we have 5 or less transfer everything on day 3, otherwise transfer everything on day 5.

And now at this point I’m not worried about twins or triplets. Transfering PGS normal embryos didn’t really work for me. So I doubt if more than one will implant. The risk is that an abnormal one will implant. Hopefully that won’t be the case.

So as for your questions
1) yes, maybe freeze does affect older women embryos.
2) 3-4 on day 3 is totally fine as most likely half will not survive to day 5.
3) PGS doesn’t necessarily mean success. But I agree, it is nice to know that the embryo is normal and that you’re not wasting your time on an abnormal one!!
4) no need for a cycle in between. Unless you have OHSS
5) Trust me there will be a time where you wished your RE will tell you what to do instead of just giving you all the options to choose from

roisis · March 2018

@mich_elle That's great that you got some better explanations

It sounds like it makes a lot more sense now. Best of luck with everything

mich_elle · March 2018

@kiwi2628 thank you for your feedback. It's a tricky situation for us, especially given my age and apparent egg quantity/quality issues. Best of luck to you on your journey!

@prudence9-2 Hi! Thank you for sharing your story with me. I'm so sorry for your losses-it's never easy to deal with. I think we're going to do the same exact plan as you! DH & I worry about the same issue-time. If we do a fresh transfer and an abnormal embryo implants, we won't know until months later and it would most likely end in a miscarriage that would need a D&C plus recovery. So much time "wasted", you know? But I think we'd rather go down that road and hope for the best, then push our luck and end up with 0 embryos. I'm praying for you dear!

@roisis Thank you. I do feel better after speaking to RE. Let's see what happens next month!

prudence9-2 · March 2018

@mich_elle yeah. I’m terrified that an abnormal one implants. But after all that I’ve gone thru, and based on my age, it’s a calculated risk.

Tomorrow is my retrieval and then transfer 3 or 5 days later!

mich_elle · March 2018

@prudence9-2 IKWYM, my mmc was due to chromosomal abnormality (Trisomy 10) so I'm worried that it will happen again. My next pg was achieved by TTC on our own and yielded a totally healthy DS. So who knows! I read that 75% of eggs in women our age are abnormal which is why the live birth rates are so low. It's risky but we've gotta try, right?!? I'm totally jealous of your ER count: 30R!! Holy crap! I do not think I'll be so lucky. My last AFC was only 5. Ugh, 5 follicles for me, so RE is hoping to get at least 5 eggs. Umm, that doesn't leave a lot of room for error. IF she gets all 5 and IF they are all mature and IF they all get fertilized and IF they all make it to day 3... you see where I'm going with this? Anyway, OMG, I'm so excited for you & I'll be sending good vibes to you tomorrow! FX your next ER yields high numbers too. I know that the quality & quantity are not related but it gives you more chances. (((hugs)))

prudence9-2 · March 2018

@mich_elle 30r was 1.5 years ago. Now the situation is much different. Last time I had 21m this time maybe I’ll have 8m.

My RE said we could cancel the cycle and try a different protocol. He thinks that BCP at the beginning of the cycle might have suppressed my ovaries. (Even though we used it last time as well). He can’t tell me for sure but I don’t think he thinks that 1.5 years will cause such a decline in my ovarian reserve. Anyway, I decided not to cancel and see what happens!

Do you know when your IVF cycle will begin?

mich_elle · March 2018

@prudence9-2 It's crazy how just a small amount of time yields huge changes the older we get! Well I've got my FX for you!! AFM, our IVF consult appt is 3/19 so I guess I'll know more then. She said the cycle is timed with my next period, which should be 4/1 (April Fools Day-trust me, the humor is not lost on me!) My last period came 6 days early soo we shall see!

prudence9-2 · March 2018

@mich_elle that’s the thing my RE doesn’t think it was all my age. He thinks it was the BCP start that suppressed my ovaries this time.

I think that Aptil fools day is a great day to start a cycle

mich_elle · March 2018

@prudence9-2 Sorry, I must not have read your other message well. I really know nothing about the BCP & IF. But that's an interesting connection. Maybe I'll ask my RE about it Monday and share what she tells me with you!

prudence9-2 · March 2018

@mich_elle BCP suppresses the ovaries. Last cycle it was fine but this cycle I didn’t respond well to that. There are other protocols that don’t start with BCP. From what you said above you’re waiting for your period. So that means you’re not using BCP in your protocol. So that’s good!

mich_elle · March 2018

@prudence9-2 How did your ER go today???

prudence9-2 · March 2018

Going there soon!!!

Hopeful_mom · March 2018

@mich_elle I'm so sorry from your previous loss, having a MC at that stage or any stage is truly devastating. Amazing that you still were able to have your DS and all of that was natural and thats amazing, how old were you? If i'm doing my math correctly I would say upper 30s?? I still have to update my siggy but wanted to chime in since I've been at this for 3-4years (its in the spoiler box) and the decline in your 40's is true for some and not all BUT having an AFC count of 5 I get why your RE made the suggestions she did. I read many comments and understand there thoughts BUT wanted to share your RE isn't that off the wall

I'm glad you have a better understanding now! You just need to keep talking to your RE so you do understand and feel better about the process, keep asking your questions!!

My RE didn't put me in the DOR category as I didn't have all the signs, first AFC count was 14...but not during my actual IVF cycle and I didn't respond to the drugs well, she thought I would get at least 10 and I was looking at 5 or 6 eggs. I do have low AMH so for me regardless of my age the low AMH meant my clock was and is ticking!!! I started taking supplements to try and keep the eggs I have as strong as I could. The great thing is that you did have a normal pregnancy so lets hope your body can do it again!!

***TW - It first took 3 cycles before I got to ER and transfer I did a fresh transfer. My RE went with the stats that yours seemed to have given you. I was so excited to get to ER I wanted to get my lil embryos back in me stat. I've always dreamt of having twins so i was down with transferring more then one...I wasn't looking to be an octomom BUT its highly unlikely!! I ended up getting pregnant with twins and it was the most magical thing ever now I did lose them at 10wks and it was the worst and most painful experience I've ever been through. There is no why as to what happened for me, and thats hard too as they assume one of the babies was abnormal. The day of the MC I had an US and they were both perfect so it was not easy. I want to share that the one baby I was able to test did come back normal and the other was inconclusive so nothing is a guarantee...BUT I will say once you go through such a loss of course you want to do everything in your power to never have it happen again. Its also tougher at our age which my dr explained the same thing as yours. I was 40 while pregnant with twins and statistically the live birth rate from that is maybe 2% its low, I thought I bit the odds but sadly I did not.

My concerns was could I carry a pregnancy? Can my body do that? So that meant for me it was time to bank some normal embryos and keep moving forward. After my MC I just wanted to be pregnant again stat!! It took me 5 IVF cycles back to back to get 5 normal embryos. I really wanted to do another fresh transfer but at this point because of what happened to me they only wanted to transfer one so then we wanted the one to be pgs normal. ***TW ( I'm currently 28wks pregnant through FET and still scared everyday!)

Didn't think my post would get so long just wanted to share and happy to answer an questions you might have. I was all OOP and didn't know I would need so many cycles but 2 cycles only gave me abnormal embryos so there was that too. Not sure why your RE thinks you need a cycle to rest in between ER and FET, I dont think I did. Some RE dont think you should do back to back IVF cycles but BCP was never part of my protocol and I never wanted a down month which I'm glad about as I had 2 normals come our of 2 cycles that were back to back.

Lastly other woman on this board that are older and have second infertility did a day 3 transfer of 5 embryos and had a CP. Now she has moved on to DE. Just sharing many people in their 40's especially transfer more then 2 if they have them!

Best of luck to you!

mich_elle · March 2018

@prudence9-2 Ok, GL and update me when you're home and resting!

@Hopeful_mom Wow, where to begin? I'll start with thank you! Thank you for taking the time and effort to respond to my thread-it really helps me...a lot.

DS is truly a miracle! After being dx DOR due to my AMA and low numbers across the board along with a blocked right tube, he was conceived naturally from a normal egg that I ovulated from my right ovary but was picked up by the left tube! I was 39 yo throughout pregnancy and turned 40 the day before he was born! We almost shared a birthday

We had been TTC since May 2012 & I got KU Nov. 2014 (got my BFP the day after Christmas!) and he was born August 2015. We began TTC again shortly after his 1st bday but then learned about a trip to the Philippines so that got put on the back burner. Then we were told to abstain *another* 6 months due to the threat of Zika! So picked up again this Sept w/ no luck. I thought that my body would "reset" since I was able to get pg on my own, had a boring pregnancy and easy delivery. Wrong! So, here we are. After reading more articles online, I see the reasoning behind my RE recommendations. She didn't mention the break in between ER & FET, I read that here somewhere. I'm so looking forward to our upcoming appointment...hurry up AND wait. That's how this game is played-at least I already know that!

I'm so so sorry for your loss my dear (((hugs))). My goodness, it can be such a bittersweet path to walk.

OMG 28 weeks!!! AAAHHHH! CONGRATULATIONS! That's freaking amazing news...I'm seriously tearing up over here for you. Let me just say that although I do find it hard to hear the news of other ppl getting pg, I'm thankful that I can truly be happy for others who've walked the tough road. I'm so happy for you! I'll pray for you as you continue your journey towards motherhood. I waited to miscarry DS every day. Every. Single. Day. Checked for blood every time I wiped, self-checked the mild cramps incase I was miscarrying again, bought a home doppler so I could listen to his heart beat-every day. Needless to say, I wasn't able to just enjoy the naivety of being pregnant! I was too busy waiting for the other shoe to drop. I hate that my experience was tainted that way but I wouldn't trade it for anything in the world. Try not to be like me-try to enjoy it. Take pics of your growing belly, take video of the kicks and hiccups baby makes and soak in every minute. Please keep me updated...unless I can stalk you here! Are you on another thread???

Thank you, again, for your time & for sharing your story

prudence9-2 · March 2018

@mich_elle they got 10 today. Which is very different than my last IVF where they got 30. I hope all the 8 mature that we saw on u/s will fertilize.

mich_elle · March 2018

@prudence9-2 ok let's work with 10 then! I'm guessing you'll know more tomorrow? This is so exciting.

prudence9-2 · March 2018

@mich_elle yes, I’ll get the fertilization report tomorrow afternoon. I just hope I’ll have a nornal one from it and it will stick!

mich_elle · March 2018

@prudence9-2 Any news?

prudence9-2 · March 2018

@mich_elle yes, unfortunately only 6 fertilized

if all 6 are still growing tomorrow we will wait for day 5. Otherwise we’ll transfer all.

mich_elle · March 2018

@prudence9-2 (((hugs))) I'm sorry your upset by the news. Grow embies, grow! FX for you.

prudence9-2 · March 2018

@mich_elle thanks! They will call me by 10am tomorrow to let me know if we’re on for day 3 or day 5 transfer. (It is day 3 tomorrow)

mich_elle · March 2018

@prudence9-2 get a good night's sleep! I'll be thinking of you tomorrow. Update as you can!

prudence9-2 · March 2018

Thanks @mich_elle I should know by 10am. If it’s a go, the transfer will be at 2pm...

Hopeful_mom · March 2018

@mich_elle All the worries you mentioned through your pregnancy I have on a daily basis it's hard! And with my first pregnancy I was always waiting for the next shoe to drop and it did so I thought I would be better during this one. I tell ppl all the time to try and enjoy it and be in the moment...funny I can't take my own advice

i still lurk on the low Amh board cheering my gals on waiting for all to get to the other side on PAIF land!!
Monday will be here before u know it! Do you have ur list of questions ready? I still need to make lists as I always forget something I want to ask!

mich_elle · March 2018

@Hopeful_mom It's funny how that works, right?!? Not being able to follow your own advice?!! LOL but not really LOL-you get it. I was thinking of joining that Low AMH board too but I am really cutting back my involvement here (was very involved on the TTCAL board & was running a weekly check-in but due to an incident a few years ago when I was TTC #1, I left suddenly & it sucked). So I toggle between here & the TTC 35+ now. That's all I have the energy for now anyway. But I still lurk over at my fellow low AMH ladies! I have very mixed feelings as tomorrow's appointment approaches & I'm really trying not to focus on it. DS spiked a high fever late yesterday so that's been keeping me preoccupied and distracted (poor lil guy!) I've got my list all ready! And, my lists have lists!!

HazelJo · March 2018

@mich_elle I'm a little late to the thread but wanted join in. I'm 37 and struggling with DOR and egg quality issues. My labs were pretty good before we started IVF, so I kind of just thought we were doing it because of MFI, but I've since learned otherwise. My RE wanted to do the opposite of yours. We've done two cycles where we push the embryos to day 5 for PGS. IVF#1, 2 made it to PGS but both were abnormal (one high quality embryo didn't make it to freeze), IVF#2 none made it to PGS. Both times I had high quality embryos at day 3. I'm wondering if the old school, day 3 transfer of multiples would work better for me - it was interesting to hear your RE's rationalization for her approach. I know it's a difficult topic, but pregnancies can be reduced if you end up pregnant with a dangerous number of multiples. I have a friend who reduced triplets to twins after IVF, and has two beautiful children today.

prudence9-2 · March 2018

@HazelJo that’s what I keep wondering. If embryos that didn’t survive to day 5 outside will survive inside. I know clinics say that they can grow them in conditions as good as the inside. But how can they be sure that an embryo that developed to be abnormal or didn’t survive wouldn’t have (or correct itself) if it was put back inside on day 3?

right now I’m waiting to a phone call to tell me how many of my embryos made it to day 3. And if we’ll do transfer today or on day 5.

I keep wondering would it be best just put all of them in and see what happens? (The plan is to put up to 5 in today. Or wait for day 5 if I have 6 growing today)

mich_elle · March 2018

@HazelJo Thank you for your input! Our IVF consult is tomorrow so I'm sure I'll know more then but yeah, my RE is leaning towards a fresh day 3 transfer. I have heard about "reduction of numbers" when you're carrying multiples and before I became a parent I thought, "well, duh, obvi that's the way to go." However, I do not feel that way anymore. I'm not sure I could do that although I'm not sure I could survive triplets or more! Real talk: I don't think that will happen give my ancient eggs. Best of luck to you!

mich_elle · March 2018

@prudence9-2 I'm dying over here...did you do the transfer today!?!?

prudence9-2 · March 2018

@mich_elle only 5 out of the 6 made it. So yes, transfer is in ONE hour! I’m just about to take the valium! Will report later

(transfering all 5 day-3 embryos!)

HazelJo · March 2018

@prudence9-2 I know - there is so much uncertainty in this whole process and it's so difficult to deal with. I think for me at this point, I'm just going to have to do some trial and error. Wishing you so much luck on your transfer!

prudence9-2 · March 2018

Thanks @HazelJo

@mich_elleGood news!!! By the time I got there all 6 were good!!! So I had two options, wait for day 5 or transfer all 6 now. And the doctor confirmed what I suspected, that embryos do better inside than outside!!! So we transferred all 6!!! It was so cool seeing them all float in the tube. Also the grading of all 6 was excellent. They mostly got grade 1 for symmetry and fragments.

mich_elle · March 2018

@prudence9-2 Aaahhh! Congrats lady!!! I'm so happy for you!

prudence9-2 · March 2018

Thanks @mich_elle and good luck tomorrow!!

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