3 MC's. Starting IVF & PGD, any advice?

[Ann14]

Hi Where there's hope,

I was 36 yrs old when I got pregnant and 37 yrs old when I had the twins.
We only ever had the basic blood test even though it took 9 transfers for one to actual work. I never had any m/c's the eggs just didn't take in the other 8 transfers.
You mentioned OHSS in one of your post, I weight about 65kg and I was started on 250 units of Puregon then that was increased to 300 units on my second cyle and the most eggs we ever got was 12. I think it depends on your body and age. We always had the problem that out of those 12 eggs only about 3-4 were okay to use. We transfered 1 egg on 5 transfers and 2 eggs on 4 transfers. We also then had the problem that when our frozen ones were defrosted we lost about 70% of them in the process.
The hardest time I had with the whole IVF process is to accept that sometimes there are no answer to why things happen.

[Cuddlepie]

Hi WTH, sorry to hear your losses in the past year but I am glad you are exploring different options for this upcoming cycle.

I had a missed miscarriage last year and tested later was due to chromosome abnormality. Both DH and I were tested straight away for genetic testing (pardon my ignorance, not sure if it is PGD) and came back normal.

After 2 stim cycle IVF (with SIVF as well) we are about to start the 3rd around. FS suggested to test DH's sperm's DNA, I think it is called SACA. I feel at least we are doing something we haven't done before or haven't test before so there will be one thing eliminated from the list.

I just want to share the experience with you as we are similar age as well. So will be holding special interest to see how you go and all the best of luck in the world!

[Where there's hope]

Ann - thanks for your story. You are one strong cookie to make it through nine transfers - so glad your story has the happy ending you deserve. I am so surprised at the defrost rate - they quote much higher rates in the brochures! I am having so many doubts the past couple of days. If my eggs are poor quality I just do not think it will work. But I have to try everything.

Bei Bei - Hi. As it happens DH is doing the SCSA (sperm test for DNA fragmentation) done today. We also tested normally in our blood tests. The PGD is Pre-implantation Genetic Diagnosis. We are having our embryo's checked for 7 chromosonal it will be a little less likely to miscarry. Starting Provera next Monday. I took it for 5 days to start IVF earlier in the year but stopped as they found out I was naturally PG. I am dreading the massive headaches it gave me! Thanks for your good wishes. Right back at ya

[butterfly_warrior]

WTH, good luck with the provera. I remember it turned me into some sort of crazy person that I really hated being around - majorly *****y and just horrid!

When it comes to defrosting rates, I have a defrosting rate of around 30-35% (it all depends on whether you count the one that had to be defrosted on the morning of transfer because the one before it died overnight... but they start with the best ones first and work through to the bad ones, I'm convinced that if the one before and the one after couldn't survive over night, then this one wouldn't have either, but it only had a few hours before transfer - the clinic swears it was fine, but I'm not convinced), which my clinic assures me is not normal and is an indication of other problems. All of these were blastocysts resulting from quite severely hyperstimulated cycles. Defrosting rates are generally a lot better than that. Sadly, you don't know what it's likely to be for you until you are trying it, but we can certainly hope that a frozen cycle isn't necessary.

Just one more thing... my clinic had me convinced that the only way I'd fall pregnant and not miscarry was if we used a blastocyst embryo that had survived freezing and thawing - the processes of growning to blast and freezing/thawing would weed out the dodgy ones that would never work in the first place. We didn't get many usable eggs on our third stim cycle and couldn't afford to wait to day 5 and transferred on day 3. For all that they were certain it needed to be a defrosted blast to be able to work and stick, I'm now over half way through a pregnancy from a fresh day three embryo!

They may act like it's science and they know what's needed, but it really is more of an art form and just sheer blind luck as to what will and won't work.

BW

[Where there's hope]

Thanks Butterfly Warrior. We will need to do a Day 5/6 transfer because we are having the surviving embryos biopsied for PGD and this is the day they do it at SIVF.

I got my NK blood test results back and am worried. I gota normal/borderline blood test result:

number of NK cells 14.8% (normal <18%)
concentration of activated NK cells 9.2 (normal <8)

It is the second result I am worried about. What were your numbers like?

Thanks
WTH

[butterfly_warrior]

I honestly don't remember being given a number for the second one. My first number was ~13. He would normally have been happy with that, but considering that I was already on prednisone at the time, we decided that I should definitely continue with the prednisone treatment regardless of whether it was required for my arthritis or not. Has Dr S given you any recommendations regarding what to do from here?

BW

[Where there's hope]

I have asked him further about it and am anxiously awaiting his opinion!

[Tam83]

Hi WTH
My DH also done his second SCSA (sperm test for DNA fragmentation) yesterday as his first one showed >30 DNA fragmentation which usually means anything above 29 you are usually infertile or have recurrent miscarriages.

I also Have my first u/s after the op which was to remove my sub septum on Friday.

Then we go to the FS to get the results next Wednesday so counting down the days

Good luck with your DH results.

[Cuddlepie]

Hi WTH, I hope your DH's SCSA test went ok yesterday and fingers crossed for the result.

Sorry to hear your NK cell test result, are you having an appointment with your FS to explain the result as well as advise for next step? I haven't done this test before but I am sure he will have a plan of attact to treat/bypass this and seems your second number very much on the boarder line anyway...

Good luck and let us know how you go...

[Where there's hope]

Hi Tam - sorry about the high number for the SCSA for DH. But wow - now you are getting somewhere (and you still have youth on your side). I wonder if PGD will help out? It is a double-edged sword to find out something is wrong - but so good to get some answers. Hope your US goes well and good luck with your FS appointment.

Hi Bei Bei. Both Dr S and my FS ended up being ok with my NK result, even though the second number was borderline. So I guess we won't be doing anything about it. I have to wait two weeks for the SCSA result. I truly do not think there will be a problem. Unfortunately, I believe our issue is related to my age

[Sara69]

Just joined this forum today and wanted to say hello.

Not sure if this is the right forum for me. I haven't done TTC but will start IVF with PGD in late October due to a genetic condition.

I was diagnosed about six years ago and became pregnant. The CVS showed that the baby had the condition as well and I had an abortion in week 14, subsequently my marriage went apart, I am now trying to have a baby with my new partner.

I am with Dr Gee at SIVF, she told me that due to my age (39) the chances to have a successful cycle are only about 15%, my partners (42) semen analysis SCSA also showed bad DNA damage (>30?), we have tried a few things and done another test last Monday - we'll get the results on October 1. Dr Gee said this may mean we'll have to use PICSI.

I've also done a blood test for hormone levels today and will have a pelvic ultrasound on Monday, I have had one before but it didn't show anything since I was on the pill.

Would be thankful for any advice. Has anyone experience with PICSI?

Good wishes for all of you

Sara

[Where there's hope]

Hi Sara

Are you saying your chance of a successful IVF cycle with PGD is 15% or 15% naturally TTC? I have had PGD figures for aneuploidy sent to me and it showed if you get to Egg Transfer you are looking at roughly 45% chance of a heartbeat for over 38 years. I am counting on this! Also does PICSI mean IVF with PGD and ICSI?

WTH

[butterfly_warrior]

Another possibility is ICSI with polscope - a special light source that helps them do ICSI without damaging the egg itself. I have no idea what it may actually be referring to, though.

BW

[Kmn]

I think that PICSI is a sort of ICSI where the sperm are screened in some way before being injected.

The cycle "success" rate depends most of all on the number of eggs that fertilize, which is a strong function of age. And with PGD for a genetic condition, some of those embryos won't make it to biopsy; some may have the genetic disorder; some may not survive biopsy.

Once you have a "good" embryo, the chances of it making it to heartbeat stage (if there are no other issues) are around 40%, pretty much regardless of maternal age.

[Sara69]

Hi WTH, KMN & BW,

Thank you very much for your replies.It's really good to be able to speak with people who do this as well.

KW: I agree with you I think PICSI is a special way of screening the sperm before ICSI but I don't really understand how it works will ask my Doctor when I speak to her.

WTH: The 15% is only a very rough guess which I made after my doctor showed me some figures of the PGD cycles of women of my age last year. The way I understand it the challenge will be to have an embryo to transfer. My genetic condition is a dominant condition so statistically 50% of the viable eggs I produce will be screened out as they will have the condition. I am not sure how the PGD works that you describe but hopefully it means you have to screen out o a smaller percentage. Good luck with you talk to the FS and the SCSA

Hi Tam: We're in the same boat my partners result was similar. Good luck with the SCSA results!

Went to the baseline ultrasound today and had a real fright. The technician said she only saw one follicle in one of my ovaries and none in the other. Thankfully she then got the doctor who saw another one or two in the first ovary and detected that what the technician thought was the second ovary was actually something else and then found the second ovary which had four to six follicles. That's probably not very good either but I was much happier with that result as just one! It was just the fourth day of my cycle so hoping that when I really got for IVF next month with all the hormones it may be a few more which would be great.

Sara

[Kmn]

Sara,
Have you thought about whether you would like to put 2 embryos back if you have them?
We also used PGD to screen for a dominant gene, and my Dr felt strongly that if there were 2 good embryos they should both go back in, since the process of getting them was so expensive and trying.

He did get me to see an obstetrician who specialises in twins first, to make sure that I could handle a twin pregnancy without excessive additional risks.

[Sara69]

Hi Kmn,

That's interesting the idea about the two embryos, was going to ask if you did it but just saw your earlier post about your DS, that's great, it gives me hope that it worked for you.

My Dr seems to think the opposit, she recommended to only use one and freeze the other if there are two (not that I expect that to happen anyway). I am not sure what I'd think about having twins, in one way it would be good as then the baby would have a sister/brother as I think I'll only be able to go through this once.

I have an appointment with an obstetrician on Oct 3, will ask him what he thinks about this.

Sara

[Where there's hope]

Hi Redlady - thanks for the explaination. You are right - just getting to transfer is a big step in itself as in so many cycles there is nothing to transfer (roughly half for what they sent me for my age category). So I guess that takes it to more like 25% - more in keeping with what you said.

KMN - I have been tossing around the two embryo idea, too, though we have been advised against it. My fear is that if I had two put in, and one was of a poorer quality, that both may MC

Tam - still awaiting the SCSA result. I am sure they have it, but we meet with our OB next week so not too long to wait

BW - good news. No provera headaches this time. Taking them at night instead. Soooo much better and I am falling asleep in minutes. Lucrin injections start tomorrow... It is great to have you drop in on this thread and learn from your experiences