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  1. #1
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    Default Questions to ask my FS

    Hi ladies. Hoping some of you wonderful knowledgeable people can help me out. I've just finished my second ivf cycle (a FET) which unfortunately just like my first cycle (fresh ICSI) resulted in a bfn. Our next go will be a full stim again as we only ended up with two embies first time round. I obviously want to give myself the best chance possible next time so is there anything in particular I should be asking my FS when we have our follow up appointment? Extra tests I should ask for, different approaches etc. thanks in advance

  2. #2
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    Are you on auto immune protocol?

  3. #3
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    I was in a similar position to you, and I started by asking what the fs thought was the problem in the first two cycles and what he/she plans to do differently, and why that is likely to help - for me in particular it was why didn't I get more eggs at epu (I only got 2 even though I had 10 follicles), could the embryos have been better quality, why did the embryos only make it to morula stage at day 5 etc. I asked these after my first failed cycle and it prompted fs to do an amh test for egg numbers. After my second stim cycle had the same results it prompted me to get a second opinion and when I asked the new fs the same questions I got very different responses, and he recommended a whole range of different tests and drugs.

    I also tried to do some research myself to think of reasons that made sense to me as to why things may not be working and asked the fs directly if that could be it - like I didn't respond well to the fsh so maybe I also didn't respond well to the trigger and could that be why we didn't get more eggs at epu.

    Good luck! Don't be afraid to get a second opinion if you're not happy with the answers you get!

    Sent from my HTC_PN071 using The Bub Hub mobile app

  4. The Following 2 Users Say Thank You to phee83 For This Useful Post:

    besha  (09-10-2014),Zoepup  (08-10-2014)

  5. #4
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    @lilypily no I'm not, but I thought I might ask about getting tested for nk cells to see if I need that. I had a lap at the start of the year and they found mild endo and I've been reading that nk cells can often be high in people with endo.

    Thanks @phee83 those are good questions. I will write them on my list!
    I'm thinking about changing clinics as I'm not a huge fan of my FS, but I will have my follow up appt at least, and I'm also going to book an appointment with another doctor for a second opinion and see which one I feel more comfortable with going forward. I think my amh was tested in all the different blood tests I had when we started treatment and it hasn't been mentioned as an issue so I assume it was ok but I don't know what my number was. Maybe I'll ask that too!

    Thanks!

  6. #5
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    Hi @besha
    This is my first post as I've only just come across bubhub, but I'm in a similar boat to you - I've just had my third FET (can't have fresh due to PCO) and all though I've not had my blood test yet I'm fairly certain it's BFN due to brown spotting today (7dp5dt) so I've been scouring the internet for things to ask my FS next week.
    The things I've found to ask so far are:
    - Could I have immunologic implantation dysfunction (IID)?
    - Can I be tested for natural killer cells
    - How do we know if its a hatching or a lining issue? Are there some tests like blood tests or something we can do in the next transfer to find out at what part its failing?
    - Do I have any blood clotting issues?
    - My number 1 question is: wasn't my lining too thin and can I have some type of meds to help with this? (it was only 6.3)

    It'd be great if you could share you questions so I am armed with even more. I know I'll be asking my FS allot, but I don't want to do another transfer without changing anything as obviously there is an issue we haven't found yet. I want to be super armed because after the 2nd BFN I asked if my lining was ok assuming they check this at the time of transfer with their ultrasound only to find out that Monash IVF don't do this as standard. So I had to specifically request to have my lining measured two days prior to transfer to see if it was getting to where it needed to be. This has now got me thinking what other tests haven't I had that I could be having to help me get closer to solving the puzzle and finally getting a BFP.
    I feel that a failed cycle is hard to take, but it might be that bit easier if I was actually learning something from it to help me in the next one.
    Thanks in advance!

  7. #6
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    @Zoepup on the lining issue you could also get them to check your lining early in the cycle as well (like day 2) - this is something my second fs did that the first didn't. He said if the lining was too thick to start with it was like "planting new seeds in old dirt" and it could lower the chances of implantation. He actually cancelled my first cycle with him for this reason, put me on the pill for 2 weeks then waited for a withdrawal bleed to clear out the old endometrium before starting the cycle. He did a million things different to my first fs so I don't know what was the key for us, but we did get our bfp that cycle.

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  8. #7
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    Hi @Zoepup nice to find someone in the same boat as me...even if that boat is not a particularly nice one to be in!

    On my list of questions so far I have:
    - Can I be tested for high NK cells or other immune issues that may be causing implantation failure? Can I be tested for the presence of beta 3 integrins?
    - Would having an endometrial scratch before the next transfer improve the chances of implantation?
    - Was my lining optimal thickness? Too thick/thin?
    - Will using IMSI (digital high magnification - if available) or PICSI improve our chances?
    - I had quite a lot of follicles, but only ended up with seven eggs - how could my FSH dose be adjusted so more of those follies resulted in producing mature eggs? Or anything else to improve egg numbers?
    - Why did only two embryos make it to day three?
    - Is there anything else we can do differently this time around to try to get a better outcome?

    Plus I have some other questions specific to DHs issue as well, as we are also dealing with MFI.
    I hadn't thought about the hatching thing, I might add in a question about adding assisted hatching to our plan to my list too.

    Good luck...fingers crossed for both of us!

  9. #8
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    Thanks very much @phee83 and @besha I really appreciate your responses.

    @phee83 I didn't even know you could check your lining thickness at that point so it's definitely something I'll be asking for!

    @besha I hadn't heard of IMSI so I'll be asking about that too. Yes fingers crossed we both get our answers to make the next cycle a successful one! Keep me posted on how you get on


 

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