Has anyone gone back to Femara after failed FET(s)/fresh IVF cycle?

MamaK225 · July 2018

**TW: repeated fertility treatment failures**

So I've had five (yes, 5) FET failures in the last 12 months - losing a total of 8x5-day embies (all excellent quality). We've only got 4 left and are trying to get our minds back in the space to try again ... not to mention our wallets. 0% fertility coverage is the worst. So, I've talked with my OB and he's agreed to let me do as many cycles on Femara while I "take a break" from the stress of FETs.

I did a 3-7 day cycle this month (Jul 4-8) and thought I had ovulated yesterday (day 17) given the light cramping on my right and pinkish, slightly stretchy CM. However, this morning, I had mild bleeding (fresh, red, mixed with a little CM) and know it's way too early for ANYTHING: implantation, AF, everything. I just had an SHG about 7 weeks ago, so I know there are no uterine polyps and my ovaries look great (no cysts). Has anyone else done this or had weird cycles on Femara? It's been like 5 years since I've done a cycle, so I can't remember any of it. I've got non-insulin PCOS and am anovulatory - if allowed to cycle without medication - and the last month that I did go med-free, I had a 39-day cycle without ovulation.

TIA!!

JamieH2000 · July 2018

@mamak225- so sorry to hear about your failed FETs! Has your RE offered to do an ERA? I would highly suggest it. If there is no other reason for the failures, my guess is you are one of 15% of women that have a displaced window of implantation and need either more or less than the standard 5 days of progesterone before transfer. Definitely worth looking into in your case and if your RE won't do the test, I would find one that will. I had 3 failed transfers, including 1 with 2 perfect DE blasts and we found out I am in the very small group that needs to transfer on Day 4. without this test, I would never have gotten pregnant.

Also- if you want to learn more about the ERA- check out the recent Beat Infertility podcast about this test. The RE on the podcast is actually my RE in CHicago and she is great. She has had huge success with repeated implantation failure cases by using the ERA.

MamaK225 · July 2018

I forgot I had cross-posted (secondary IF) and should've used the same post - all that information was in there.

**TW - pregnancy, child mentioned**
Yes, I did ERA between #3 & #4 and we adjusted the window up a day for #4 & #5. I also found that weird because I had a successful FET (I couldn't do a fresh transfer after IVF because of the threat of hyperstimulation) with my FIRST transfer that resulted in my daughter. And - IF ANYTHING - that transfer was done late because of a 1,000-year flood that had hit our area ... and I nearly missed the transfer window completely. And that was only 18 months before the ERA, so I thought it weird I would've had a three day difference. But, given that I've done SO many of these cycles, I've developed an allergy to the PIO medium and can only use suppositories (yay!

) ... but the ERA was done with the exact same regimen I used with #4 & #5.

We've even done Karyotyping testing for both of us (since we refuse to do PGS, given they are already frozen (so would require an extra thaw/dethaw that likely increases the chance for failure - still not enough research on this for me to feel comfortable doing it), and I've been tested to death for just about everything else. None of any of the tests or U/S & labwork during any of these have come back even remotely close to abnormal - in fact, I'm operating creepily in the middle for everything, even my damn lining reads in the middle of the range (within 0.2mm) each time. Argh.

Which is why I'm considering sliding back into quasi-archaic methods (Femara), compared to the cutting-edge/high-tech stuff we've been trying for the last 3 years. Something's got to work!

MamaK225 · July 2018

@embryoman - Have there been any further studies about performing PGS on already-frozen embryos?

We had 13x5-day (all AA, AB, BB quality) and because of that, our doctor said that we could choose to do PGS but was also comfortable foregoing it, given the high yield (25 follicles, 24 fertilized, then the 13x5-day). So we froze all of them. For each of the 5 transfers (1, 1, 2, 2, 2) each embryo thawed great right before, but all resulted in BFN. And as I've read in some posts (including one of yours), only some of the cells from the "outer shell" (can't remember the T-word at the moment) are grabbed during PGS and those cells aren't necessarily reflective of the inner mass - though, of course, there is a high correlation.

JamieH2000 · July 2018

@mamak225- o wow, so you really have done ALL the testing. I am honestly not sure what to suggest

Have any other REs reviewed your case (either at your same clinic or a new clinic) just for new ideas? It seems crazy it would be this hard since you have already had a successful transfer/birth. I will say I love my RE (Dr. Rodgers from the Beat Infertility podcasts) and she does skype consults for pretty cheap I think if you just wanted another RE to consult for ANY other ideas they would have...

MamaK225 · July 2018

@JamieH2000 - That's exactly how I felt (all the tests!). And, yeah, my RE is stumped and has consulted with everyone in their practice. On the last FET, he removed "his" charge from the costs of the transfer and has even had the clinic cover the cost of some of the tests in trying to figure this out. I told him that he should start some studies off of me to cover the costs of all these FETs

LOL.

We (me, Hubs, and RE) have tried thinking outside of the box as much as we can and he's open to entertaining anything that I feel comfortable with, though he's hesitant on some of the older studies (e.g. NKa Testing) because a lot of them have either been disproved or haven't been able to be definitively proved. So ... while I'm taking a little time to think things over, I'm going to try a few rounds of Femara, "just to see what happens." Worst case, I'm a few months out ... best case, we get lucky. We only have 4 embies left and - considering we've been through 8 since last July - I'm terrified that we'll go through all of them with no results. We don't have Infertility Coverage and have already been through over $60,000 in expenses in 3 years. At this point, it's no longer the money, but more of the combination of heartache-from-failure AND then *still* having to pay more money.

But the silver lining is my OB is also super supportive and is also open to discussing any ideas I might have (within reason). He and his wife did IVF for their second child, so he has both the medical knowledge and personal experience - which is why I love him. And also why I'm trying Femara out again. FX.

JamieH2000 · July 2018

@mamak225- aww i am just so sorry. Its all just heartbreaking to go through so much and spend so much. I kinda understand since we went thru 3 IVFs, then decided to do donor eggs, then our first donor got pregnant at baseline, then we found another donor and our first DE transfer of 2 didn't work despite 90% success rate at my clinic... then 2 ERAs to find out I am one of the rare post-receptive people like you.. TW- our transfer in June finally worked, but I have a large SCH and we lost one of the twins at 7 weeks... so I am still waiting for the next thing to go wrong haha. Anyways, just wanted to let you know you aren't alone and we are all here for you! I am not sure I believe in it, but have you tried all the alternative stuff like accupuncture and gluten/dairy free diet, etc? I'm sure you have since you have tried everything, but thought I would mention it. I may have missed it in your history, but your RE has gone in and done a hysterscopy to just physcially look at everything internally?

sungirl39 · July 2018

Have you tried the autoimmune protocol? Could be worth looking into...

MamaK225 · July 2018

@JamieH2000 - Thank you, it's just more frustrating than anything. OMG, congrats to you! I know it's difficult (and only adds to the worry) that one stopped developing ... I'll keep my fingers (and eyes and toes!) crossed for you. That's so exciting and encouraging!! And I know what you mean about beating strong statistics. I really should play the lottery ...

As far as other holistic things, I have started going to a chiropractor (1-2x a month) and I've cut out a lot of processed (though I never did eat much of it) foods and I've even changed a lot of things in the house to be "toxin-free" like our detergent and cleaners, etc. My dad actually has celiac disease, so I'm well aware of GF, but I rarely eat much of anything with it in there (the exception is pasta, which I might eat 2-3 times a month). I am open to alternatives, I've even researched taking additional vitamins at different times in my cycle (when I'm not actively doing an FET, don't want to mess with that!). But everything is already pretty clean (which is hard to do, BTW, with a Toddler). Which is even more frustrating. LOL.

My RE's clinic requires a hysterscopy every 12 months, so I've had several. I've had SO many U/S so even my ovaries have been checked out. My endometrium's been tested, my histamine levels, all the hormones on/off cycle. Everything. Like you said, it's just perplexing to my RE & discouraging to us. I've even started considering looking into surrogacy ... which would be cheaper than trying another round of IVF. Just trying everything that *I* can be comfortable that I've given it every effort.

MamaK225 · July 2018

@sungirl39 - I've looked into it and do a modified version of it; in all of the tests I've done and the specialists I've seen, there is either no inflammation or the inflammation is so minor that it's not detectable. I do strongly limit a lot of the items on the list and I've even been following a food wheel that is related to Blood Types (I'm B+) and I did notice a difference. *TW* Also, when I had a successful FET with my daughter, I was doing none of that. Just ingesting everything/anything I wanted without restrictions.

mayflower513 · July 2018

@MamaK225

im sorry you’re not having luck or answers even after all the FETs and testing. Have you tried acupuncture?

MamaK225 · July 2018

@mayflower513 - I would like to consider it, but the closest practice is over an hour away and it just isn't practical which is really disappointing

My RE is already a 5-6 hour roundtrip (that I get up at 4:30a just to make it into work by 10-11) that I've had to make more than 20 times in a year (50 weeks).

MamaK225 · July 2018

@mayflower513 - I'm hoping this is a sign, but I re-checked for acupuncturists and there is now one locally. I'm going to try to get a consult and consider going. Thanks for bringing it up! (and you, too @JamieH2000, I got hung up on the diets and testing lol)

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Has anyone gone back to Femara after failed FET(s)/fresh IVF cycle?

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