WTF appoint with RE

RE had a cancellation so we went in an hour earlier and we were his last patients for the day. So appointment ended up being over 30 mins. It was not rushed at all so after covering all the concerns I had, he even chatted about some things he learnt at a seminar he recently attended. When we arrived he asked what I had on my mind and since I always like to get his point of view first before expressing my concerns/dislikes, I asked him his thoughts as to why this FET failed.  He admitted that the problem was most likely was an immune issue as I have said all along. With my ANA now negative with the immune therapy, I am really distraught that I've had another chemical. He agreed to let me have a a "natural cycle". He agreed we have nothing to lose since I will either have an adequate lining and they will transfer or they will cancel. He didn't say anything about cancelling if it fell on a weekend like he did when I asked about natural cycle before. so I didn't bring it up either.He said transfer would have to be next cycle though because they don't like transfer to be that soon after saline sono. So this month I will do opk's to see if I am still surging around day 12 like I was a few months ago. He thought it was good that I have been monitoring my ovulation when not on BCP.

I also want to have the Endometrial receptivity array (ERA) test done. They are finally offering it at my clinic. RE said this will delay me by a month because it takes a cycle to do the biopsy and testing.  I have noticed that my LH surge has gotten earlier (CD 12 instead of CD 14). So perhaps my earlier ovulation also means that my implantation window is earlier? RE said it certainly won't hurt ( the biopsy itself I know will hurt physically yes but ykwim)

http://www.ivigen.com/tests/endometrial-receptivity-test-era/

I asked him about the possibility of mitochondrial errors in the egg.  He it was a possibility. I asked about IVIGEN's Mitoscore test for embryos. He said it was a controversial topic. He said that mitochondrial testing on embryo as well as endometrial transplant (3rd party IVF) is illegal in the US. The UK has approved it (they are always the ones to make breakthroughs regarding fertility) so hopefully the US will follow in their footsteps soon.   DH said he doesn't have much faith in our donor's eggs. RE replied that this is understandable after 4 failed FET's. Well, I am not giving up on our underdog "BB"frostie.  He/she is genetically normal and I feel they have a good chance if I just let my body do what it does naturally and keep my thyroid under control. All of the eggs couldn't possibly have gotten mitochondrial errors right?!


As to the gender of our last loss, he didn't have the result yet. *groan* He explained (emphasizing that this did not apply to us) that no-one could agree on when it was ok to reveal gender, 1st u/s or later. Since it is a guarantee program,they cannot risk telling their patients sooner might stop their meds if the embryo might not be the gender they wanted. Obviously in my case, I just want to know because I had a chemical and it was too early to test POC.

I wrote Dr H. (MFM) an email asking her to order thryoid bloodwork for me next week and to renew my synthroid prescription. She responded that she would. Since Dr H will be monitoring my thyroid, I didn't even bring up my thyroid with RE, other then to say that the reason I wanted to do a natural cycle was to avoid taking the del estrogen because it messes up my thyroid levels.  I have done hormone replacement replacement therapy protocol 4 times! My thyroid has reacted adversely to it and that was proven this last FET. So I am happy to be having my natural cycle finally!

Why PGS normal embryos can have mitochodrial errors and end up as aneuploid embryos after transfer

There is a new test that can detect mitochondrial errors in embryos, even when 5day embryos appear normal.
http://www.ivigen.com/mitoscore-new-mitochondrial-biomarker-will-increase-implantation-rate-vitro-fertilization/

This is what Dr Braverman has to say on the subject. Our egg donor had 40 follicles and 30 eggs were retrieved. I feel that perhaps over-stimming damaged the mitochondria in the eggs.

We, at Braverman Reproductive Immunology (BRI), now recognize that other conditions such as Endometriosis, PCOS, Diabetes, Obesity, Autoimmune Disease, as well as EXCESSIVE IVF STIMULATION can also dramatically affect the oocyte quality. In particular, these conditions affect the mitochondria, one of the key organelles involved in oocyte quality and necessary for the correct division of the future embryo (you need normal mitochondria to supply the power for nuclear division, if mitochondria function is abnormal even a genetically tested normal embryo will fail to divide correctly and end up as an aneuploid embryo after transfer).

Some unsettling news about PGS/Gestational Carrier while waiting for WTF appointment..

My nurse patiently listened to my rant yesterday. I told her that I was considering a gestational carrier should our last embie not stick and we have to start over with a new egg donor. Then I went to the Resolve website to a thread I had been following about failed cycles with PGS tested embryos. A lady had updated in July. After she had 2 miscarriages at 7 1/2 weeks with PGS normal embryos, she decided immune issues were definately the cause, so she found a gestational carrier. Her Gestational carrier had a HB at 6/12 weeks and same thing happened to her, at 7 1/2 week no HB. How could it be an immune issue if her GC miscarried at the exact same stage of pregnancy?!

https://www.inspire.com/groups/finding-a-resolution-for-infertility/discussion/miscarriage-of-pgs-tested-chromosomally-normal-emryo/?page=3#replies

Could it possibly be error at the mitochondrial level occurring?  I have read this can happen when egg donors are stimmed with too high doses of meds. Our donor produced alot of eggs. Maybe it affected the quality of her eggs? Dh has low morphology and we were surprised that all the eggs fertilized.  Maybe we need to look into sperm and egg donor next time? Or did all our embryos have a mosaicism that PGS cannot test for? So many questions and it seems the more research I do,the more confused I am as to which is the correct answer in our case.

Remembering Paula

It has been 4 yrs since my sister in law Paula lost her battle to breast cancer. We miss her every day. We are so ready to have some some happiness in our lives for a change. It seems all we have been experiencing is loss of loved ones and pregnancy losses.

I had my miscarriage on Sept 12th.  Since my last 3 losses were too early to have tested, I have buried them all in the pot with our Hawaii (honeymoon) plant. That plant has come back to life. It had lost all but 2 leaves and now it is lush, has a ton of leaves and has never looked healthier.

Waiting for impending miscarriage

My beta Sept 7th confirmed that this is a chemical and HCG had dropped to zero. I had been having severe headaches and I knew this was a sign of my hormones dropping rapidly. I phoned Tuesday morning, the 8th, to schedule my WTF appoint and never received a call back!! So I phoned again this morning and they wanted to give me the 25th Sept! Feeling so angry, yet trying to be as calm and polite as I could, I told the receptionist that I needed something sooner because I'd like to discuss having a saline sonogram and a natural cycle for my next FET. I added, that my nurse in on vacation and I didn't even get so much as a phone call from my RE (which usually happens after a miscarriage or chemical). I know he has been back from conference since the 8th because he told me in his last email that he saw my first beta and was hoping for me. So the receptionist felt badly for me and moved my appointment to 18th Sept. I have my list of questions and concerns. He told me I was not hypothyroid and not to take the synthroid. Then Dr Hamersley phoned me to tell me I had become hypothyroid and needed to take the synthroid immediately. Feeling angry that this chemical should not be happening.

Chemical Pregnancy

A squinter on IC HPT this morning, so my Hcg is less than 10.  I have a killer headache, so hormones are crashing. Beta tomorrow hopefully will be zero so I can stop all the injections. Pregnancy #8 will not be not our Rainbow.   5 clinical miscarriages (4 with Heartbeats) and now my 3rd CP. Technically my FET in March was a BFN because I got faint positives from 6-8 dpt but beta 2 weeks after transfer was negative. The way I look at it though, that female embryo was normal and I feel that her life needs to be validated. In another uterus, she probably would have thrived and grown into a healthy baby!  My breasts are still very sore and swollen. I just want to be able to stop all the injections so this headache will stop. Eric and I had planned a babymoon or  BFN getaway. So looking forward to going to Chincoteague island on Sept 25-27th to see the wild horses of Assateague. I have read all of Marguerite Henry's books when I was a child. I've looked forward to going there since I moved here, but being constantly pregnant/miscarrying plunged me into a depression and I kept putting off going to the shore.  Eric kept telling me that I needed councelling because I was no longer the same person he married.  I denied that I was depressed. Until I started the prednisolone again and my depression lifted and I felt human again. The pain is gone. Depression felt like I couldn't breathe under this heavy dark cloak. In the last 5 yrs have spent most of my free time researching miscarriage and genetic issues, talking on Babycenter's Miscarriage groups, IVF, Donor egg and PGS threads. Crocheting baby clothes for all my pregnant friends and our babies that never stayed. Like Eric pointed out, not healthy for my mind or my soul. I just finished crocheting a pair of grey boots for this little lost soul (6 months for the age they would have been next winter). They each have their gifts, depending on length of pregnancies. I have 2 blankets, one I made for our Trisomy female and another I made for George, our 8 week IVF loss. Then I have several hats, booties and mittens. Gardening and Gluten-free baking are the two hobbies I did that helped me stay sane.

We have One PGS normal embryo left.  Eric and I have decided to do a natural cycle next. Dr Hamersley suspects that my becoming hypothyroid is the cause of this PGS normal embryos' demise. She feels that del estrogen hormone messes with my thyroid levels. (my TSH was perfect at 1.67 the day I started injections, then jumped to 3.8  two weeks later). A natural cycle is a much better choice. However, I risk my FET getting cancelled if falls on a weekend because my clinic won't do FET's on weekends for donor egg cycles. My longtime childhood friend in Canada is now 10 weeks pregnant after doing a natural cycle. Del estrogen didn't agree with her either. She has adenomyosis and it made her lining way too thick. Her doctor prescribed Intralipids for her FET.  I have tried in vain get any doctor in Maryland to agree to RX it.

Part of me is afraid that Eric and I have that rare HLA issue that Braverman spoke to me about during our pone consult. Eric doesn't think we would be SO Unlucky that we would have BOTH chromosome issues and then now with PGS Normal embryos also have immune and rare HLA issues. We could get the HLA matching tests done but would cost us over $3000, just to determine that we need a gestational carrier which we cannot afford. We have spent so much already on Donor egg, PGS and 6 ivf transfers. I had sent my Re info on it after he told me that "Donor egg fixes that and HLA is a very rare occurance anyway". I may have posted this before, but Dr Braverman told me that my RE is an idiot for telling me that DE would fix an HLA issue. The woman's body is attacking the dna from the sperm in the embryo, not the egg! So another solution would be both sperm and egg donor. Or embryo donation. This link explains HLA. I have read it so many times but Eric refuses to admit it could be a possibility.
http://www.preventmiscarriage.com/Reproductive-Immunology/HLA-Genes.aspx

Since my ANA is negative from my immune system being suppressed for almost 2 months now from the prednisolone, Eric and I think I should just go straight into another FET. I have more than met my 3000 deductible for my insurance this year. So bi-monthly thyroid tests,u/s's and prednisolone and are lovenox are covered until the end of the year. If the next embryo is another BFN or chemical, then we will have our answer.

11dpt-Beta HCG

                                                                             27.9   

I was driving to acupuncture when I got my beta result this morning. Only 27.9 (11dp6dt)  Sadly, looks like a Chemical with another PGS normal embryo   This morning's hpt has gotten lighter. I could tell by the nurse's  tone of voice it was bad news.  She said to continue meds and go in for repeat beta on Sept 8th but agreed that  it looked like my hcg was dropping, since I had my first positive hpt at 5dpt, which was a whole 6 days ago. My due date should have been Mother's day 2016.

 I poured my heart out to my acupuncturist who I has been treating me weekly for 4 yrs now.  He gave me gave me a "miscarriage prevention protocol treatment"(needle on my front then I turned over and he put them in my back). He really wants this to work for us. He treated Eric for 2 yrs and it improved his 2 % sperm morphology to 5%

We have one embryo remaining. Thinking of going right into another FET in November. Will be asking for a natural cycle.  I feel the hormone replacement drugs made my thyroid go all out of balance. The problem with that is if it falls on a weekend my FET will have to be cancelled because they don't do "donor egg" transfers on weekends. The majority of women in a donor egg program at my clinic don't ovulate naturally I have been told. But I do! Arrghhh! The irony of that is just sad.

10dpt

1 day till beta day. Praying! IC is only slightly darker so I tried a dollar tree Assured one that was positive, so I am thinking it has to be well over 25 miu. Breasts more veiny and sore. Bladder still bursting in the middle of the night.

9dpt

A bit darker line on Hpt. symptoms: Sore swollen veiny breasts. still waking up to be at 4 am to pee, pulling/pinching in uterus. Very hungry. Praying!! 2 more days until beta..

8dpt- BFP!

I finally got a decent positive on FRER this morning.  I have turned into a POASoholic this FET! With only one PGS normal embryos remaining, Eric and I are really feeling the urgency for this to work! It touched my heart to see him line up my hpts and get excited about the line progression

Progression of internet cheapies 5dpt-8dpt:

The tightening feeling in my throat is gone, so the thyroid meds seems to be helping. Also, I was falling asleep during dinner. Went to bed at 8:30 pm, woke up 2:30 to pee and went back to sleep till alarm went off at 7am! Woohoo! A whole 10 hours sleep! I feel so much better today!
 I'm praying every chance I get! We decided to include my MIL and my parents from day 1 this time. We need their prayers!  Waiting till beta on Sept 4th to tell my parents about BFP because I have had 2 ivf chemicals, so still being cautious. Pregnancy#8 please be our THB!