Looking for advice-what would you do? Maybe ghost???

[miyaya]

Good morning. I am looking for some advice as I feel I am suffering from decision paralysis related to IVF. Lol. My siggy essentially give a good idea of my history but I will expand a tad.

I am 34 and will be attempting my 6th IVF cycle. I have been TTC #2 for nearly 4 years. I have PCOS, my dh has 40% antibodies on his swimmers which requires us to do ICSI and I have elevated LAc ( basically I have a protein antibody in my blood that "could" be related to miscarriages.) In the 5 previous IVF cycles, I have had 3 miscarriages for unknowsn reason. All except my FET, have been day 2 transfers. My FET was done with 3 great quality blasts--5AA's! Luckily I am a good responder to meds and usually yield 20 eggs or so per cycle. However, my embryo's are never the greatest quality early on. interesting how some move on to high quality blasts. But b/c they are questionable looking early on, we always decide to do day two transfers with teh theory of they are better in me than out.

I have one more cycle left as part of a pre purchased IVF package. The plan is to add steroids to my treatment plan to assist with any undetected autoimmune issue and to hopefully lower my LAc. For sever cases of LAc they will sometimes treat with heprin but my clotting rate is within normal so they do not want to "over treat" me. My RE and I also discussed assisted hatching (we have never done this before--obviously with my day 5 blasts, we did not have to).

My RE really could not recommend either way whether this would be beneficial given my history. I have done some research and cannot seem to decide. From what I gather, a lot of re's do not like to do assisted hatching on day 2 b/c they feel the embryo's are still not stable enough. It appears day three is more typical for assisted hatching. given that I am usually a day 2 transfer, one would think I should not proceed with AH. However, knowing that my embryo's have potential to making it to day 5 top quality blasts makes me ponder the idea. Should I go with transferring on day 2 without AH or take the chance and grow out to day three so we can do AH? By waiting the extra day, we obvioulsy risk not having as good quality day three embryo's and by performing the AH, we could also risk losing them....but then again, it could also help with implantation rates? My RE: said that if it were not for my history of have "lesser" embryo quality earlier on, he would recommend it....but he is unsure how to advise. He thinks its 50/50 whether it will be beneficial and left the decision up to us.

So my question is, what would you do? I would really appreciate the feedback as I feel its a big decisision knowing it is our LAST shot! Thanks!

[gi]

hey Miyaya

Think we may have been cycle buddies at some stage!!! Your story sounds exactly like mine!!! Jason has very poor quality swimmers, but we had good embryos i had 4 failed ivfs in a row including 1 course that never made it to transfer, then went on to get pregnant at 5th cycle - mc at 7 wks, pregnant at 6th cycle mc at 10 wks it was then i asked if i could review my meds and cycle plan but old clinic would not change a thing as i was getting pregnant and didnt believe additional meds would assist in maintaining a pregnancy so i changed clinics. They reviewed our history and did lots of tests and decided they would be very aggresive and thro. everything at me the idea was just give it a try it would do no harm. So on my 7th ivf i had 4 intraplid sessions, was put on glucopahge, aspirin, heperin, another injection in my belly clexane i think, at the last minute they decided to do assisted hatching and it was my best cycle ever!!! I now have a precious 14month old baby and 3 frozen embies. The docs cant be 100% sure if it was extra meds but who cares it works, we were running out of money and mental health!!! My advice just go for it and have no regrets of what if i should have tried this??? It worked for us and for that i will be forever grateful. Best of luck i will say a little prayer for you and dh xxx

gi xx

[miyaya]

gi! yes I think we were cycle buddies a while back! nice to hear from you again. Thanks for the information. I am shocked that they would let you do lovonyx injections if you did not have clotting issues. They said bc I have normal clotting they would not do heprin or the like. What was the intrlipid thing about? I have never heard this. We have this one last shot. I cannot decide aboutt he AH. my embies are never the greatest which is why we always do day two transfers. But everythign I read suggests AH is usually done day three. So my choice is to either do day two transfer without AH or grow them out a day and do AH on day three.....decisions decisions.

[gi]

Hey,

No hadnt clotting issues but they said i would benefit from the heperin....hey i was willing to do anything!!!! Intralipid drips is i think soya based and you do one 2 during 2ww and 2 if pregnant - my clinic has a high success rate with this they did tests to ck my Natural Killer Cells level and it came back very high they suspected my body was rejecting embroys and feutus which is why it took so long to get pg with ivf and then when i did get pregnant my body saw the babies as "foreign" and set out to literlly destroy. The idea behind the drips is to try combat these cells by the 3rd session my level of harm dropped to below normal, once you reach 12wks pg the baby is able to fight off these cells. Now in saying that not all clinics believe in these Killer Cells i think my clinic is the only one in Ireland that does it but again as i said i was bloody desperate and there is no side effects, whether it was a coincidence or not that i actually held onto a pregnancy is neither here nor there but i believe it did help and 7th was my charm. As for AH they only decided at the last minute they thought that maybe the outer part of the embroys were tough and did it on day 3. Again all my fingers and toes are crossed for ye xxx

gi xx

[miyaya]

gi! thanks for your great info. I called my doc today and really advocated for doing lovenox injections just to cover our bases. We have decided to plan for day three with AH. if for some reason they look terrible, we will put them back in day 2 without AH.

After you mentioned the intralipid infusions I did some research and asked my doc. My particular doc is not an advocate fo rthis mostly b/c research is still new....and not enough yet....but mostly bc I think b/c of cost. we are 100% OOP this time and b/c we have already spent so much, I do not even think its an option for us....but it was very interesting to say the least.

One thing I will do is accupuncture this time. I tried it years ago with no success but I will go all in this time....wish me luck!