15 replies to this topic

[zen]

Hi all, hoping someone could share their experiences with me, my DH has a low count, we started our journey when I was 37, ( DH was 40).  Our doc advised us to undergo a mock cycle with endometrial biopsy, and then IVF.  We underwent two cycles when I was 38, with the use of day five screening and freezing of the embryos we had  three genetically 'ok' embryos.  

 

I used a short protocol to prepare for FET transfer, unfortunately our first two FET's were unsuccessful.  My prolactin level was elevated after the first FET, but has since come down, (no explanation for that one).

 

 I am now 38 soon to be 39 and very frustrated.  I cannot get a clear answer from Lifequest regarding their FET success rates for a 38 vs 39 vs 40 year old......  of course this would help us in our decision.

 

 Our doctor at lifequest seems without explanation as far as why this happened and suggested we could do another stim to bank for embryos, but another FET may not be successful, we "may" try a fresh transfer.

 

Our doc also advised if the embryo was genetically screened then there could be an implantation issue, but could not explain why my endometrial biopsy was normal to date.  

 

We have one frozen embryo left, and I am struggling.......  do we try it?  Or do we access a surrogate?

Has anyone on this board used a surrogate in Canada/Ontario?  Please share your experiences.......   

 

Watching time just flying by......

 

 

 

[If at first]

I'm sorry this is process is so frustrating and there isn't a clear cut answer about what to do next.

 

As an outsider looking at your situation, I would try to do another retrieval asap so that you have the option of trying another FET yourself and potentially having embryos leftover to transfer to a surrogate if and when you pursue this. Your last embryo isn't going anywhere and isn't getting older in the meantime.

 

That's my two cents. Wishing you all the best!

[Feisty]

We did what if at first suggested. We had 2 normal PGD embryos banked and did another fresh cycle. We normally transferred 3-4 embryos and had already paid for the IVF cycle. We had 3 normal from the last fresh cycle and transferred those. We were successful and still have our two boy embryos on ice. I would ask about having a hysteroscopy to see if there is something like polyps or fibroids that can cause implantation issues. I would also ask about prednisone and lovenox as a precaution because they can help if there is an immune or blood clotting issue that you haven't been tested for. Also make sure your TSH is between 1-2 and consider methylated folate. Elevated TSH or mthfr can cause issues too. If there is anything I can help you with feel free to PM me. These are things that helped us become successful.
Best wishes

[zen]

Thank you if at first and feisty, your posts were very helpful.  Will book a hysteroscopy with my next cycle, and take a look into our TSH levels.  We are trying to do another stimulation as soon as we can but having difficulty deciding what to do with the embryos.    

 

Feisty our doctor encouraged us to have only one embryo transferred at a time because we had done PGD, I noticed you transferred 3-4 embryos at a time, just wondering what your MD advised around that?  Keeping my fingers crossed for you both. 

[mcbee]

I'm currently almost 17 weeks pregnant with a PGD tested embryo that was created when I was 38.  FET was when I was 39.  My RE had recommended transfering only one as we had done CGH array testing, and the chance of miscarriage was very low.  

 

Could you do the FET asap, and if its not successful, do a fresh cycle immediately afterwards, so you would only be 38/39 at the time of generating new embryos?

 

Good luck!

 

sarah

[zen]

Thanks Sarah for your reply, am excited for you hope all is well with your journey.  Right now I am waiting for my next cycle to have a hysteroscopy and ultrasound.  I noticed our protocols were very similar (estrace, aspirin, progesterone).   Will be getting a second opinion regarding whether we should do a fresh transfer vs. freezing all of them for the purposes of surrogacy.  Am having difficulty accepting that two PGD screened embryos not implanting means we should go the surrogate route........  but I have never had a BFP not even a chemical pregnancy.....

[GraceM]

I would ask for a second opinion and I would get a referral to Mt. Sinai fertility urology for your DH..  Personally, I would go to Hannam, Create. Dr Au-Yueng or Dr. Virro.  You might need further testing or a set of fresh eyes to help you determine next steps before you spend more money/time.  I know too many people who learned more on a second opinion that would have really helped early on.

 

We went to a Dr. affiliated with Life Quest.  She initially found a problem with me and then with DH.  She suggested we try to change his lifestyle to improve his motility which was low.  I insisted on an immediate referral to Mt. Sinai's fertility urology dept.  Turned out DH had a varicocele which needed surgery.  Had I followed her advice, I would have wasted 6 months of my life.  He was able to have the surgery before the 6 months were up!

[Kitty Holland]

I think the approach that If At First outlined is good. Have you talked to your docotrs about it? Good luck!

[zen]

Thanks everyone for your responses, Grace M, I will look into urology for my DH immediately, was never discussed with us (!).  Did you end up leaving Lifequest?  We have a consultation with Dr. Hannam pending as our situation is not sitting right with me.  

 

Kitty Holland, we have not gained confidence discussing our situation with our doc at lifequest, his attitude seems to be we can try if we want to..... confusing....  do we do day three genetic testing and a fresh transfer to me at day five (assuming we have one embryo that is normal of PGD screening), or do we do day five testing and freeze all of them for the surrogate..........   Maybe there is no answer and that is what I am struggling with, I have to keep reminding myself that in up to 30% of folks the causes of infertility are not identified right?   

 

Please stay in touch, and I will post if I learn more as we go along.....  

 

xoxo to you all, 

[GraceM]

We got a referral to Dr. Hannam and wound up luckily getting pregnant shortly before it was due.  We carried to term and I have a new appointment with Dr. Hannam for TTC #2.  We are also getting second opinions with Dr. Baratz and at Mr. Sinai before proceeding with any treatment. Iy's not that I doubt Dr. Hannam but I do not want to waste time.

 

I know a number of people who use and love Dr. Hannam.  I have friends who ttc'd for years with a misdiagnosis that was found in one round of tests by Dr. Hannam.  Even my friends who stopped TTC love Dr. Hannam.

 

We saw Dr. Lo at Mt. Sinai for my husband and love him.  That clinic is top notch.  All of the doctors and clinic staff are amazing.

 

 

PM me if you have any questions.

[mcbee]

I'm definitely no expert on this, but I feel like there are many things that can be exploring/addressed in regards to why an embryo isn't implanting, and therefore much that can be done before moving to a surrogate.

 

I agree with the idea of getting a second opinion, especially if you are feeling confused by the answers your current doctor is given you.  You should feel confident and trusting in your doctor's advice and suggestions, so maybe looking for a new doctor is the right thing for you.

 

sarah

[Tejat]

Wowzers! Zen, I read your initial post and had some quick thoughts I was going to pass along as a successful (after many tries, severe male factor, diminished reserve due to my age, a miscarriage of only other embryo to implant or make it past 3 days and one lovely little 11 mos baby girl) "mature" candidate. Started journey at 38 and had baby at 40. Then I read everyone's responses and I can honestly say this thread is packed with so much great advice and knowledge that perhaps some of the clinics should read it

 

I second and third all of it. Get a referral to Dr. Lo as soon as you can as it takes a while to get in. If you don't need it (fingers crossed), you can always cancel. Def. get a second opinion from Hannam. I was at Create, which ended up being ideal for me as they do mini ivf's for the right candidate and I'm pretty sure that was a big factor in my success(both emotionally and physically). Helped the wallet too.

 

Turned out my thyroid was a bit wonky and I was put on a low dose of synthroid as well as prednisone and baby aspirin for 3 rounds after miscarriage.  DH and I both did ubiquanol and fertility vitamins (he had some super duper male version I will have to look up but will find out for you). My DH had severe morphology issues as well as low motility. By the time we had success, his levels were all within norm.

 

Don't know if you have looked into or are interested in acupuncture but Mary Wong is THE BEST when it comes to this stuff. She specializes in fertility and works hand in hand with a lot of the clinics in Toronto (plus is an ivf'er herself). And she is conveniently located down the street from both Create and Hannam. Some clinics in NYC mandate pre and post tranfer acupucture to help with implantation. An interesting example of modern and Chinese medicine blending but the science is there to suggest worthwhile.

 

My two cents are stick with your body right now. You've got one embie ready to go. Go for it but perhaps with some fresh eyes and tests/approaches. Just because embryo is with Lifequest doesn't mean they have to do cycle monitoring and transfer. I wouldn't bother talking to them about it if your gut says you are not getting good care there. Go talk to Hannam or Create or Baratz (did he go back to Sinai??). I'm also guessing that in talking to someone new you will get some positive feedback and cheerleading you could use right now in that you and your DH are making genetically sound embryos, that your preivious tests have come back normal and that it is simply a matter of time and maybe some new approaches before you are successfully pregnant. I know time is the kicker right now, boy do I know, but you've still got some! Use it with your own body with a dr who is truly there for YOU.

 

If surrogacy is suggested by a new RE, I do know people who have had success and eternally grateful for the option.

 

Let us know!! I have a hunch  And to the other ladies here, wow. I'm impressed not only in the fact that we learn and retain so much through this process but that we are so willing and eager to share it with someone else going through a similar struggle currently and/or after. Says a lot. Good luck to all.

[GraceM]

I second the advice for acupuncture. I also did acupuncture, vitamin therapy and saw a naturopath.  I suspect it is what got me pregnant.

[zen]

Hi everyone, firstly thank you for all the insightful responses. Wanted to share our experience, especially if it will help another couple that is going through this process.

Our meeting with Hannam left us both upset and hopeful at the same time. He does not believe that PGS through current companies is reliable i.e. falsely abnormal embryos are possible and he personally is struggling with how to advise patients. He advised if a couple ever wanted to do PGS he would refer them to Colorado. In addition, he did wonder if the vitrification process in Canada injured our embryos as there is really no explanation why our FET did not work; hence he is a proponent of fresh versus frozen transfers. He does not support the Yale biopsy (which upset me as that was money wasted), and was surprised at the high doses I had during my long protocol stim. I do wonder about potential conflict of interest in his advise saying he doesn't trust other labs to do PGS as Dr. Hannam is joining a Colorado group and will be opening up his own lab to run his own PGS this summer.

That being said, I do like Dr. Hannam much more than our current doctor. He is straightforward, direct, nice to speak with, and what I really noted was his obvious pride in his fertility rates; whereas other doctors do not disclose their fertility rates or are very shady about it and give you a bunch of vague qualifiers.

 

Alot for us to think about this weekend, some acupuncture sounds great right now.

Take care everyone,

 

Zen

[mcbee]

Mt Sinai sends their biopsed embryo cells to Repogenetics in New Jersey.  We paid 4000$ for the CGH Array testing which is more comprehensive than traditional PGS screening, as it looks at ALL the chromosomes looking for extra or missing ones.  I've read research that shows that CGH array testing is significantly better and more accurate than PGS screening, and can increase success rates of a SET to 70%+.  Another vote for Mt Sinai!!

 

sarah

[mcbee]

http://reprogenetics.com/