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

[Where there's hope]

Hello.

One or two of you may know me from the TTC after MC pages.

As you can see from my sig, after a successful pregnancy delivering in 2005, I have lost 3 bubs in the past year. Two were caused by chromosonal error. After spending a lot of money on tests, DH and I have been found to be normal. We can only assume our losses are due to poor egg quality. We have been advised to start IVF with PGD (7 tests) and I have commenced accupuncture. I am on Day 8 - start the Provera day 19 for our long Lucrin cycle. Unfortunately we will not be able to do accupuncture on the day of the pickup/transfer as we have to travel to Sydney (though we could do it the night before). So that's my story in a nutshell.

Just wondering if anyone has any tips for the journey ahead - perhaps anything I can do to help our chances?

I would be very grateful to hear from you.

Thanks.

[Baby Dreamtime]

Hi WTH,
Oh my, I am so sorry, I can't even begin to imagine how you feel. I am not the best example (having never conceived), but I too am concerned about embryo quality and am doing every thing I can to make sure that I produce the best embryos possible. This includes a very specific diet of mostly organic fruit, veg and salad, only hormone free or organic meats, and no sugars, no dairy or white bread/pasta etc (I am slightly lactose intolerant and have a food sensitivity to processed flour etc). This also includes no alcohol (I miss my champers but the time for self indulgence is long gone, this is too important to me) and caffiene/soft drink etc. I had a naturopath test me for food sensitivities. I take Sharkey's Healing Centre herbal formula every day (if you have not heard of this, they focus on using natural herbs to support your own hormone function and focus on gut heath etc on a cellular level, all designed to put your body in the best possible position to create healthy embryos/concieve etc) and a probiotic for good digestion and to ensure that I am absorbing all the good stuff I am eating. I have also just stated taking Maca Root (I am on a pill cycle so no conflict with IVF) which is surposed to be a superfood. This plus a good quality antioxidants and mulitvitamine etc. So I believe it is all diet related, and I am very conscious of the fact that they say eggs start growing up to 3 months before you ovulate, so long term health is important. I also have just had a colonic to get rid of any build up of toxis in the lower intestine/repoductive area, and feel great from this also. So I am hoping my next stim cycle will result in some great embies (I wasn't so strict with the first two and I regret it).

Also, I don't have much experience with MC but am very aware of the importance of the right hormone levels at the right time of your cycle/pregnancy, and don't want to be ignorant but have to ask if you had your levels monitored prior to your MC to ensure that you had enough say enough progesterone support? Acupuncture is good to encourage hormonal balance also.

Sorry if I have said anything you already know, just wanted to lend by support and wish you all the best. xx

[Tam83]

Hi WTH,

I have seen your posts in the ttc after miscarriage forum and thought I would reply. I haven't gone through PGD but I have had two miscarriages.

I am seeing a FS at SIVF and they have also suggested PGD testing to my DH and I as all my blood test come back normal. However they did find that I had a subseptum which was removed on the 31/07 and have been on meds since the op so haven't been able to ttc.

Af arrived today and DH and I have decided to give it another go naturally which the FS supports. DH has another sperm test this Tuesday as he also has a pretty sever sperm problem and if that doesn't come back any better FS said we have to consider IVF with PGD to rule everything out.

I wish you luck and if you wouldn't mind in keeping me updated with your progress as I would like to know how you go. Best of luck and lots of

[Ann14]

I am the mum of 16 week old IVF twins.
The best advise I can give is try not to stress too much ( I know this is hard ).
I wrapped myself up in cotton wool so many times thinking this would help and the one time I didn't I got pregnant.
If you get the right egg at the right time I don't think it would really matters what you do.

[Where there's hope]

Wow - I was so happy to see three replies!

Baby Dreamtime. That is an amazine regime you have. But I understand. The reward is so big. I am a vegetarian and am gradually moving across to organic dairy (I have the cheese and yoghurt covered). I am taking an increasingly ridiculous cocktail of vitamins, including Megafol and CoQ10. Hate coffee, no softdrinks or alcohol. Do you know if it is safe to drink organic black/green/white tea? Would love to know your thoughts on this. I have had my hormones checked and they are all fine. I took progesterone in the last PG just out of desperation. But nothing could have saved the baby because it was a Trisomy 15 (sporadic and not compatible with life). Thanks for your response

Tam83 - I am with SIVF, too. I had an appointment with my FS today. He has spoken with a genetic scientist who still does not think I may need to take the PGD path as my losses have been "sporadic". However, my FS does think it could be due to my age. He thinks that IF I manage to fall PG with IVF using PGD, I am at least less likely to go through the anguish of yet another MC. We will also get a better picture of how many of my eggs are not good. They can only do 7 tests. But it is a start. I got an Day 2 FSH of 3 which is hopefully means I will be a good responder (and I did one in May and got 4.2). I am happy to keep you posted. PM me if you like. And good luck with TTC

Ann14 - congratulations on your twins! Do you mind if I ask your age and if you did PGD? What should my expectations be? Thanks

[Tam83]

Hi WTH,


I haven't been using BB for very long and hopeless with computers so please excuse my ignorants but what does PM stand for? I would love to chat with you. Hope you dont mind me asking but which FS are you seeing with SIVF? I am attending the Liverpool clinic.

I am seeing the FS on the 18/09/08 after that we will know whether or not we are going to go down the PGD IVF path.

Maybe we could meet on chat at a specific time that way we can chat.

Good luck and hope you get lots of excellent quality sticky embies

[~ dragonfly ~]

i have no advice, having never done IVF, but what i can offer is best wishes and i'm hoping you are very very busy with a happy bub in nine or so month's time!

[MeredithD]

WTH - I was actually thinking of PMing you tonight to see where you were up to. Now I know!!
I can't offer any advice but will follow your progress keenly given I am in a very similar boat.
I am flying to sydney nest week just for the day to see DrS in person (didn't get much out of phone consult) and have his NK test ( I assume yours was normal?).
I still don't have any chromosome results from my last m/c and given its been 4 weeks, I am pretty sure that means we won't get any. Very frustrating as that was going to sway my decision making.
We are currently leaning towards PGD so am hoping you give us a great lead in story!!

[butterfly_warrior]

WTH, we were once tossing around the idea of using PGD as we'd had three embryo transfers as part of our IVF treatment, three pregnancies and three miscarriages. Our FS actually advised against using PGD as he didn't think the extra expense was worth it and it couldn't test for all abnormalities... However, we don't have a history of trisomies like you do. I wish you every success in your treatment and hope that they manage to find the answers to the questions you have.

My story is a bit more like Baby Dreamtime's... Our first two stim cycles resulted in quite nasty OHSS. I ended up in hospital for a week and off work for a month with one of them, which was I think the milder case than the other where I stubbornly refused to go to hospital and toughed it out at home. We did not transfer those cycles, but sent all embryos to the freezer. However, we had crap thaw rates. From those two cycles we had a total of 52 eggs collected, a total of 11 blastocyst embryos, and only 3 of those embryos survived the thaw process. We have one other that may have, but I honestly believe it didn't (complicated story). All three embryos resulted in a pregnancy from those FET cycles, and all three embryos were miscarried. For our third stim cycle, I followed an extremely strict low-carb, low-GI, high-protein diet. I eliminated all junk from my diet, especially sugar... and it made the difference! We had our first fresh transfer! We had lower egg numbers (a relief!), and rather poor fertilisation rates as they took me to EPU slightly early to fully ensure that we avoided OHSS... We didn't avoid it completely, it developed with a positive pregnancy test and I'm now 21 weeks pregnant. Sorry for the ramble, I did just want to encourage you that the diet changes may be hell, but they are VERY worthwhile and I fully believe that they made all the difference for us.

BW

[Kmn]

I used PGD to avoid passing on a genetic condition. As far as what you experience as a patient, there is very little difference to standard IVF other than the expense, and also a bit more anxiety as the embryos grow and are biopsied, since most do not make it. We started with 12 eggs, but come biopsy time there were only 2 embryos that were suitable for testing. Both were OK and were transferred, and we have a son.

My Dr was strongly in favour of transferring 2 embryos - though that may not be the preference if you are having PGD for miscarriage problems rather than to avoid nasty genes.

[Where there's hope]

The weekend - yippee!

Tam - Once you have put up a certain number of posts (I have not looked it up but I think it might be something like 30) you can send Private Messages (PM) to people. It saves scrawling through various threads. I have done it with one or two people here who have been having MC's. It is useful because you can share information without worrying about anyone on the Internet reading it. Having said that, I have never been on Chat and can be a little difficult to pin down at one time. I will see if I can PM you after posting this for a test run

Dragonfly - nice of you to pop in and pass on your good wishes.

MeredithD - so good to hear from you, hon. How are you doing? You know I am so sad for what you have been through and I think going to Sydney will be very good for you. Unfortunately it looks like my NK blood test will not be valid (awaiting result). I did it the first cycle after my MC expecting AF to be on Day 29 like afte the last two D&C's and it came a week later. So I probably tested when I O'ed and that is too early. Good luck with Dr S and let me know how you go...

Butterfly Warrior - hi there. Thanks for you message. Your story is an inspiration. I am very worried about the whole OHSS thing. Seems to be so common (though they only quote 1% in the IVF brochures). They are starting with 200 units of Puregon and I am about 58-59 kgs. This would mean something to an experienced one like you. What do you think? Is it a nice conservative amount? When you eliminated sugar from your diet, did you use a sugar alternative?

KMN - thanks for your story. Wow, there are so many ifs with this whole process. IF you don't get OHSS, IF there is something to retrieve, IF the eggs fertilise, IF they make it to Blast stage, IF they survive biopsy, IF they are any good, IF they implant, IF they make it to term. This is what I am finding so challenging about entering this process. So much can go wrong before even getting to implantation. I am so happy it worked for you. Congratulations on your little boy.

[butterfly_warrior]

OHSS is common if you have PCOS. It doesn't seem to occur too often without PCOS because the doctors do try to do things conservatively. The problem with PCOS is that the line between no response at all and way too much response is very, very narrow. It was a 200IU puregon cycle that resulted in the baby I'm currently carrying, but it does seem to be the right place to start. With younger women they will start lower, but there seems to be absolutely no relation between weight and the dosage of puregon that will work. It's a funny thing, and all they can do is experiment.

When it comes to sugar substitutes, yes I did use them. I have tended to use stevia in the past, but splenda is currently the artificial sweetener of choice at home. There are some that I can't stand the taste of, but I can never remember which ones they are! My FS wasn't too worried about me going organic and getting other random chemicals out of my system, so I also wasn't too concerned about going natural and organic... But it seems to me that whatever the change is, it helps. I would still drink a cup of tea in the mornings, and would still have a can of coke zero with lunch most days, but I also drank copious quantities of water, switched to lactose free milk and from there it was very much meat and vegetables, as little bread/rice/pasta or other carbohydrates as possible.

BW

[Kmn]

I had to keep telling myself that by the time they got to transfer the two left were tough little blasties...

[MeredithD]

WTH - Just a quick note re NK blood test as you now have me bit worried. I was under the impression the blood test can be taken any time - doesn't matter where in cycle. The uterine biopsy IS very specific - needs to be 7-10 days post ovulation but didn't think blood test mattered.
I don't cycle at all on my own so won't kind of be anywhere when my test done next week. DrS said I would have to do "dummy" OI if wanted the uterine biopsy but didn't say anythin about BT. just told me to fly up and have it and would have results that afternoon by the time I see him.
Don't quite get why you haven't got result yet?
I have flights booked so praying doesn't matter when I test!

[butterfly_warrior]

Meredith, for those of us who don't have a cycle, the timing of the NK test isn't critical. He said the same thing to me - would have to go through ovulation induction if we needed to do the uterine biopsy. For women who HAVE a cycle, he will try to do the NK blood test around the same time as the biopsy, it seems. Don't panic, all will be fine.

BW

[MeredithD]

Thanks BW! Was imagining flying up there to be told the result would be invalid!
Unless really, really indicated, I am not at all keen on the biopsy. I'm not sure I could face going through an entire OI cycle with drugs, scans etc, only to have a test and not be able to try and concieve. Just not strong enough for that right now.

[Where there's hope]

Oh Meredith - I am so sorry to have worried you! If Dr S is not fussed than that is the way it is. He knows what he is doing!! He has not given me my result because he was waiting for the outcome of my doing the Miscarriage Investigation Program (which is with Sydney IVF). As he is with IVF Australia, he was just being respectful of my OB and waiting until I had completed the Program. I have bypassed the NK biopsy as I will be starting Provera on Day 19 and the biopsy is on Day 26. Apparently the meds affect the NK result. The whole reason I did the NK blood test was because we did not realise I had had a second proven chromosonal loss. So probably a little pointless IYKWIM. I think your visit to Dr S will be very worthwhile. I wish you all the best xx

[Where there's hope]

Butterfly Warrior - thanks for the reassurance about the OHSS. I do not think I have PCOS so hopefully I will not have to go through that. It must have been so frustrating for you to have those cycles cancelled.

KMN - good point! Happy Father's Day