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  1. #1
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    Default Introducing myself after 9 FETs and 3 early pregnancy losses

    hi, I'm a long time lurker but with what is going on with me at the moment I think I need the extra support. Sorry for the tremendously long post.

    I'm 36 with PCOS. DH is perfectly healthy. We have done numerous IVF cycles and transfers over the past 2 years with no take home baby yet.

    All my cycles have been freeze all due to risk of OHSS so I have only done frozen transfers.

    IVF #1: 2 Day 5 blasts. 1 didn't survive thaw, FET #1- BFN
    IVF #2: 1 Day 6 blast. Didn't survive thaw.
    IVF #3 (with ICSI): 2 day 5 poor quality very early blasts. FET #2-3, both BFN
    IVF #4: 5 day 5 blasts. FET #4-8. BFP - blighted ovum, BFN, BFP - unexplained miscarriage at 5 weeks, 2 BFNs
    Tested for natural killer cells etc - everything came back normal
    IVF #5 (with PGD): 2 day 6 blasts tested. 1 with trisomy 4. 1 normal. No transfer at that time.
    IVF #6 (the back up cycle): 1 expanded day 6 blast on ice
    FET #9 (with the PGD embryo): BFP! Levels looked amazing

    11dp5dt - hcg 388, prog 29
    14dp5dt - hcg 1712, prog 29
    17dp5dt - hcg 6072, prog 36

    Then on 18dp5dt, spotting quickly turned into bright red blood, quickly turned into dark red bleeding with blood clots over about 3 hours. Not super heavy and no pain or cramping. Absolutely devastated. No sleep and constant googling which is the worst thing ever.

    19dp5dt - hcg 6337, prog 23. RE said not to lose hope yet, but come back in 3 days for another beta.

    20-22dp5dt - just some spotting ranging from brown to pink, a couple of times a day. A small part of is PRAYING that it is somehow a miraculous vanishing identical twin and that one baby is still in there growing but I am preparing myself that tomorrow's beta will show a definite miscarriage.

    It had been such a blissful week of amazing betas and thinking that this was finally the one. I find myself unable to contemplate going through another cycle, another 2WW, another potential BFP ending in a loss. I even said to DH on Friday during the bleeding scare that "I can't go through this again, I'm done".

    We still have one frozen, and my RE had previously agreed that she would finally transfer TWO untested embryos so being a super optimist and very very organised I already had my back up plan ready during this recent 2WW which was to do another IVF cycle and transfer two back, including the one frozen one from IVF #6. But I'm just so devastated that I don't know if it is just time to let the dream go.

    Do you have any recommendations for anything we haven't thought of yet that could increase my chances and help steel myself to try one more time? Or do you think we have just been unlucky...

  2. #2
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    Hi OP, I am very sorry to hear that you have had such an awful time with your cycles. Ivf can be so unfair and heartbreaking.
    My first thought about your recent BFP is whether you have been given additional progesterone (either injections or pessaries) to support the pregnancy? Your P4 levels sound rather low which may be why you have been spotting/bleeding.
    I hope tomorrow's outcome shows more positive news for you.

  3. #3
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    Agreed that it could be a progesterone issue. I always thought that they liked prog to be over 30 or 40 (can't remember).

    Also, what have you fertilisation rates been like hun? Mine were/are absolutely dreadful, and my embryo quality for the three I did get prior to my successful cycle were extremely poor (never even made blasty stage by day 5). What got me over the line was three months of DHEA, then Saizen injections during stims. I don't know anything much about PCOS and whether these drugs are worth trying with that condition, but might be worth asking your FS about.

    My inbox is always open if you want to PM. I'm sorry for what you're going through right now.

  4. #4
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    I would change to a new FS. Fresh eyes might see things differently. What city are you in? The girls here will be able to tell you the best in your area.

    Just because you haven't tested positive for NK cells it's only a steroid so I would try taking it anyway with your next cycle.

    I have my fingers crossed this works out for you!!

  5. #5
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    My first thought from looking at your current numbers is your progesterone is far too low. They should definitely be above 30 and heading closer to 40-60 mark with HCG levels like those. You need to be on added support (crinone, pessaries - something).. I'm a little astounded that your FS hasn't done this as a standard.
    I'd be demanding some progesterone support at your appointment.

    I too have had a long history of poor cycles and didn't get the support I felt I should and ended up changing FS. It was the best thing we ever did.

    In our most recent cycle we too have encountered two significant incidences of heavy bleeding and the first thing our FS did was increase all my Meds and triple my progesterone support and my numbers weren't as low as yours.
    If you get no joy from your existing FS get a second opinion..

  6. #6
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    Thank you ladies so much for replying, it means a lot.

    Progesterone - yes I always use 2x400mg daily. When I started bleeding my FS increased it to 3x daily. But that's because I do FETs with hormone replacement (my body doesn't naturally produce progesterone as I wouldn't have ovulated that cycle). I was worried about it until it went up to 36 which is only the day before the bleeding.

    Fertilistation rates - We actually get really good fertilisation, almost 100% naturally. In fact the cycle we did icsi was disastrous and we did 2 FETs with embryos that should never have been frozen. With PCOS I have lots of follicles / eggs, the most we have collected is 29 with 26 fertislised. Our problem is between day 3 and 5. Everything looks great at Day 3 then they all stop growing leaving us with only a couple at the end. The 'super cycle' as I call it where we collected 29 eggs we got 5 to freeze of which we had two pregnancies (and miscarriages). So I figure I have sucky egg quality. I wonder if the DHEA would help me.

    New FS - oh we have thought about it. We even went for a second opinion after cycle 3 but we hated him and ran back to our old FS. We love her. Sigh.

  7. #7
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    Oh and we are in Sydney Australia.

    In my second miscarriage, my progesterone got to the 40s then dropped to 26 when I had my bleeding. So yes I think it has something to do with it but I don't know if it is the cause of the pregnancy failing or the symptom. I was on three pessaries a day from the start with that pregnancy cos of the first miscarriage (which was blighted ovum)

    I am so nervous about changing FS. Do you think it is enough to go to a different doctor with the same clinic? Or would I need to change clinics too?

  8. #8
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    Sorry to hear you've had such a difficult journey so far. That's a lot of heartache for one person to bear. I was just saying to my DH last night that people who don't experience fertility issues really have *no* idea how lucky they are or how hard it can be.

    I'm going to buck the trend a little and say while your progesterone looks low and if you weren't on progesterone supplements then you probably should be, I don't think it's the culprit.

    Progesterone goes up when HCG rises not the other way around. Your levels actually look similar to the averages expected in a normal pregnancy. We ivf'ers get used to seeing really high numbers because we are all on support so we are seeing numbers of 50-200 when we chat in forums but the rule at my clinic is you need progesterone of 30 minimum, not up in the hundreds...

    That said it does seem a little low but perhaps the trisomy issue has been there all along and it's only the PGD cycles that you've known about it. I have an armchair theory that if there's a chromosomal issue discovered it then sort of resets your IVF clock, because it's possible most of your previous transfers had that issue but you didn't know, and you might have been unwittingly transferring embryos that didn't have a chance.

    Now that you know, with PGD perhaps it's just a numbers game of a couple more tries putting back a strong embie with no chromosomal issues...

    Total speculation here, I'm not qualified at all to theorise but I do agree with previous posters that a second opinion wouldn't go astray.

    It does seem like you're still in with a chance if you can fertilise eggs, get to transfer at least some of the time and your embryo can implant. Just might take a couple more goes?

    I also have this little theory (that my FS told me and I really hang my hope on it for everyone still cycling) that every embryo is different. Different sex, different mashup of you and your DH's genes so the previous losses don't necessarily predict how the next one will fare.

    Hang in there and keep reaching out for support, bubhub is great for that. I think every transfer that doesn't result in a take home baby is a major loss, because unlike people at home doing the deed and TTC, we know that there is an embryo going in so its a loss acutely felt even if it doesn't implant.

    I've seen many bubhubbers swear by taking a bit of a break to heal emotionally and that might be good too.

    Hugs.

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  10. #9
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    Oh one other idea, some people swear by going to naturopaths and looking at their food to try and improve pcos, I wondered if that might be something to try. Personally I'd go to a dietician instead because they're more qualified but both are options

  11. #10
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    Just an update - miraculously my levels have gone up to 9962, progesterone 34. I am still in some shock as I was preparing for them to have gone down and confirming a miscarriage. They are still ahead of the beta database average for 27dpo but the doubling times have slowed right down now.

    I am up to 3 pessaries a day and am still spotting a little bit but no more heavy bleeding. Could it possibly have been a vanishing identical twin after all?

    so the dreaded wait until the heartbeat ultrasound next week begins....

    thank you for all your advice and I am praying this one has a happy ending.


 

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