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clara

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  • "clara" started this thread

Posts: 73

Reg: Oct 5th 2006

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1

Wednesday, September 24th 2008, 8:20pm

What next - any advice?

I've spent a long time trying to work out what to do next and I think all that I'm doing is confusing myself (and DH!)
We've been TTC for about 8 years now and at first we thought it was going to be easy. DH has low count and we thought ICSI would be our saviour. Now after 4 ICSI and 2 FET I'm thinking differently. Our record is not good, only 1 pregnancy which was then termed blighted ovum and lost. We're booking an appointment with our 'baby doctor' next week and are thinking of what questions to ask.
So far I've got
1. Would having a 5 day Blasto transfer help? (only ever had 3 day, but never had many eggs - about 8 each time)
2. Is it worth taking antibiotics before the transfer to rule out a uterine infection?
3. What about assisted hatching?
4. Can I be checked for NK Cells, do you think it's likely? how would that work, is it legal here?

I'm presuming that either i have a problem with egg implantation or we're really unlucky and would like to be pro active. I'm thinking of giving up work, but now can't until next year. We've had 9 eggs transfered through all our treatments.

If you've got any more questions that you think could be asked then please feel free to add. I thought I'd put out a request, so any ideas gratefully accepted...
Thanks for reading this,
Clara


ICSIs
Dec 06 - Abandoned after E/C - no eggs,
Jan 07 - BFP - m/c 6w5d, Sept 07- BFN,
Jan 08 - BFN, Jan 10 - BFN
FETs
July 07 - BFN, July 08 - BFN

Posts: 379

Reg: Apr 12th 2008

Location: East Anglia

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2

Wednesday, September 24th 2008, 8:47pm

sorry I am on first cycle so can't help but wanted to wish you luck
6 cycles all BFN.
One last immune cycle - July 2011
06/12 - :girl:

Baby Isobel arrived on 16/04. Life is complete :hugs:

Posts: 248

Reg: Jul 23rd 2008

Location: UK

Children: Fingers crossed

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3

Wednesday, September 24th 2008, 9:03pm

DNA fragmentation tests for your DH to assess genetic quality?
AMH and inhibin bloods for you to assess ovarian reserve?
change of stimulation protocol for you (addition of steroids? DHEA priming? antagonist protocol?)
getting a second opinion at another clinic?

(I don't think assisted hatching applies when you are doing ICSI - only with IVF)

(NK cells are tested for by doing a uterine biopsy - you'd probably have to go to a specialist clinic for it)

just some random thoughts..... I don't have that much experience in this either.

C x

Posts: 1,273

Reg: Mar 17th 2008

Location: Southampton

Children: One step daughter

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4

Wednesday, September 24th 2008, 9:09pm

I can certainly recommend the Antagonist protocol! Much better quality eggs/embryos. We had zero fertilisation with 9 eggs (ICSI-long protocol) the 1st time and 100% fertilisation (half ivf and half icsi-antagonist)!
Good luck xx

First ICSI April 08 - 9 eggs, zero fertilisation :bawl:
2nd ICSI Sept 08 - 10 eggs, 100 % fertilisation ?( - BFN tho
Natural FET January 30th - BFN
NK Cells Test 22nd April - Result - Normal.
ICSI 3 - November - BFN



kar1

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5

Wednesday, September 24th 2008, 9:18pm

INITIAL AND FOLLOW UP QUESTIONS

hiya clara

like you i have failed many times

i could talk to you forever, read through the question and add what you need

i would suggest maybe talking to your gp and see if they will do a clotting screen and chromosome testing

you could ask your clinic about taking steirods, this will help lower nk cells and you can take these without having the nk cell test unless of course you want to know for sure you have high levels on nk cells

trying for blastocyst will tell you clinic alot about your embryos and will select the best embryos for transfer, if you make blasts that is

have you had any test on yourself? lap or hsg? blood flow scan?
TTC 12 years

2 early losses

lots of ops and tx

both tubes removed

5th fresh short protocol
:BFP:

Tyler May born 5/5/2010 by emergency c section. Tyler is our sunshine

clara

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  • "clara" started this thread

Posts: 73

Reg: Oct 5th 2006

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6

Thursday, September 25th 2008, 6:37am

Thanks for your answers. I've had a laproscopy and it came up fine. It was before we started treatments so about Oct 2006. Nothing to report on it - it looked good. I've not had anything else.
For the clotting screen and chromosome testing, what would they show? Is the chromo to show whether DH and I are compatible?
Clara


ICSIs
Dec 06 - Abandoned after E/C - no eggs,
Jan 07 - BFP - m/c 6w5d, Sept 07- BFN,
Jan 08 - BFN, Jan 10 - BFN
FETs
July 07 - BFN, July 08 - BFN

kar1

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Posts: 12,830

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7

Thursday, September 25th 2008, 8:02am

the chromosome will show if you have the right amount of chromosome, if not it can be unlikey to form a normal embryo, yet as always it can happen. the likey hood of it being this is rare

a sperm dna fragmentation test could also be a good idea, they are around £400. i have details of somewhere is london that do it for £330

what clinic are you with?

many don't believe in immune issues, mine don't yet will support me in any treatment that i might need resulting from my recent biospy
TTC 12 years

2 early losses

lots of ops and tx

both tubes removed

5th fresh short protocol
:BFP:

Tyler May born 5/5/2010 by emergency c section. Tyler is our sunshine

clara

Newbie

  • "clara" started this thread

Posts: 73

Reg: Oct 5th 2006

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8

Thursday, September 25th 2008, 6:44pm

Thanks Kara, Mel and Carnelian
I'm in germany and my clinic seem to be happy to do what i suggest, but don't seem to be pro active. That's why I need to know what to do next. We're paying for everything, so though we can't afford to throw money completely at this, we think there's no point in just trying the same thing over again. So I've got

1. Are they any tests we can can to find out why it isn’t working?
2. Will you do a clotting screen and chromosome testing?
3. Do you think a sperm dna fragmentation test would be a good idea?
4. Could natural killer cells be an issue for us?
5. Would a change of stimulation protocol be good for us? (addition of steroids? DHEA priming? antagonist protocol?)
6. Will you do grow our embryos on to either day 4 or day 5 blastocyst?
7. Will you do assisted hatching and is this an option for us?
Huge thanks for your thoughts - we really appreciate it.
Clara


ICSIs
Dec 06 - Abandoned after E/C - no eggs,
Jan 07 - BFP - m/c 6w5d, Sept 07- BFN,
Jan 08 - BFN, Jan 10 - BFN
FETs
July 07 - BFN, July 08 - BFN

kar1

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  • "kar1" is no longer a member of FZ

Posts: 12,830

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9

Thursday, September 25th 2008, 9:57pm

good luck hun
TTC 12 years

2 early losses

lots of ops and tx

both tubes removed

5th fresh short protocol
:BFP:

Tyler May born 5/5/2010 by emergency c section. Tyler is our sunshine

Posts: 248

Reg: Jul 23rd 2008

Location: UK

Children: Fingers crossed

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10

Thursday, September 25th 2008, 10:38pm

how about maybe....

Does the embryologist have any comments on the development of our embryos in the lab that could shed light on we've been unsuccessful? Does their development in the lab always look normal?

Posts: 1,273

Reg: Mar 17th 2008

Location: Southampton

Children: One step daughter

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11

Friday, September 26th 2008, 7:23am

Hi Clara,
Just a quickie regarding the sperm dna fragmentation test, I am not sure it would be a worthwhile exercise your dh having this done. My dh had it as on our 1st attempt with icsi we failed to achieve any fertilisation with 9 mature eggs. His result came back fine and normal. It cost us £470 to find this out! I would say that if there was a problem with DNA fragmentation you would struggle to achieve fertilisation at all and you dont seem to have trouble there. I am obviously no expert so speak to your doctor about this before speding out. I had an Antimullerian (AMH) test, this indicates ovarian reserve and my result came back bordlerline satisfactory which could be the reason we had zero fertilisation. This test could be an indicator of egg quality also so may be worth having, its much cheaper to!
Good luck with you next treatment xxx

First ICSI April 08 - 9 eggs, zero fertilisation :bawl:
2nd ICSI Sept 08 - 10 eggs, 100 % fertilisation ?( - BFN tho
Natural FET January 30th - BFN
NK Cells Test 22nd April - Result - Normal.
ICSI 3 - November - BFN



    Germany

Posts: 2,679

Reg: Nov 12th 2007

Location: Germany

Children: Twin boys born April '10 thanks to ICSI

Thanks: 1 / 0

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12

Friday, September 26th 2008, 8:42am

Hi Clara,
I'm in Germany too, my clinic also aren't very proactive either, but also generally happy to go along with anything we suggest. Last time I asked about assisted hatching, and only because of that, the embryologists checked to see if our embryos had thick shells. They did have thick shells so we did have AH, but I was annoyed that they never suggested it themselves! I have my appt today to discuss FET, am also thinking about asking about blasto, partly to see if the embies are really as good as they usually look, also if they don't make it I wont have to go through a 2ww that wouldn't stand a chance anyway.
Good luck at your appointment.


4x IUI
Mar 08 IVF BFN
Jun 08 ICSI BFN
Sep 08 ICSI BFN
Oct 08 FET BFN
Apr 09 ICSI brief BFP
Aug 09 ICSI :BFP:

Me 40, DH 38

Our dream came true,


Lukas and Finn were born 13/04/10 at 36w6d biggrin2
My diary


chatterbox

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Posts: 8,584

Reg: Nov 30th 2007

Children: Two heaven sent miracles!

Thanks: 36 / 16

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13

Friday, September 26th 2008, 9:19am

Good luck Clara!!

:D

Me 40 DH 35 TTC 10yr
peritoneal mesothelioma, cystectomy 97 & 00
peritonectomy, lost both tubes & most of left ovary Aug 07


Dec 07 BFP b/ov m/c 9.6wk
July 08 BFN
Dec 08 BFP b/ov m/c 9.6wk

July 09 BFN
Nov 09 BFP 2 x sacs 1 b/o 1 no hrtbt m/c 9.2wk
May10 BFP at 8+4 m/mc @10wk scan ERPC

Found: High NK cells, DQ Alpha match, LAD neg & PAI-1 pos...

NOV 2010 - Immune IVF at CARE Manchester
:BFP: [zx076] :girl: born 25/8/11

OCT 2012 - Immune IVF at CARE Manchester
:BFP: [zx076] :boy: born 24/6/13

Posts: 248

Reg: Jul 23rd 2008

Location: UK

Children: Fingers crossed

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14

Friday, September 26th 2008, 9:47am

Quoted

Originally posted by MelanieC
I would say that if there was a problem with DNA fragmentation you would struggle to achieve fertilisation at all and you dont seem to have trouble there. I am obviously no expert so speak to your doctor about this before speding out.


There is strong research proof that shows you can definitely get good fertilisation with sperm which has a high DNA fragmentation rate if the egg is really good quality because really good egg DNA can compensate for poor sperm DNA in the first few days and allow fertilisation and normal looking embryo development.... supposedly sperm DNA fragmentation either causes failure to fertilise (more likely if the eggs are not spectacularly good quality or the sperm DNA fragmentation is really bad), or can cause failure to progress after the blastocyst stage or implantation stage.

So multiple IVF failures could be down to fragmented sperm DNA even if you've had good fertilisation rates. There's no way to rule this out except the sperm DNA fragmentation test.... although as all the costs of different tests would mount up if you had them all, hopefully like Melanie says, your doctor could help you prioritise which ones would tell you the most based on how your embryo development has looked in your previous cycles, maybe?

Rae

Star

Posts: 1,582

Reg: Apr 20th 2007

Location: Berkshire

Children: 4

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15

Friday, September 26th 2008, 10:01am

Hi Clara

Just read all the thread and wanted to say that on our 3rd fresh go at IVF (plus 2 FETs) we had AH with the short protocol and it made a difference for us.

Wishing you loads of luck xx

Me 40
DP 43
twin boys born '93, dd born '98 [zx076]





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