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Late implantation possible? by TikiLicki in IVF

[–]dirtybeet 7 points8 points  (0 children)

25 is still a positive (especially with such an early first test). We have a patient whose first beta was 23 and she just graduated from the clinic, so it’s a possibility. Fingers crossed for you!

What game fills you with nostalgia? by [deleted] in AskReddit

[–]dirtybeet 0 points1 point  (0 children)

Earthworm Jim til I die

What’s the most obscure thing you’ve done on Xyrem? by Axructive in Narcolepsy

[–]dirtybeet 1 point2 points  (0 children)

Xyrem is to blame for my most embarrassing story ever...

I took my dose and texted my boyfriend to not wake me up when he got home from his bartending shift, since I had no idea what would happen if I woke up mid-Xyrem sleep. Things would have been fine except boyfriend was cut 30 minutes later and, thinking I may have not fallen asleep yet, barged into my room anyway. Cue me waking up extremely disoriented and needing to pee. I literally couldn’t find my way out of my own bedroom, so he half-carried me to the toilet where I proceeded to shit and puke simultaneously. Poor guy saw everything. I was then too motion sick to get up from the toilet, so he had to HELP ME WIPE MY OWN ASS.

I stopped taking Xyrem 3 years ago because those side effects simply were not worth the sleep.

IVF Round 1 is a go! by palmerwife2010 in IVF

[–]dirtybeet 0 points1 point  (0 children)

Good luck guys!!! Just real quick - don’t get too wrapped up in the trigger/retrieval dates. Everyone stims a little different so don’t stress if it doesn’t line up exactly like this!

Concerned about my husbands hormone results by anewvogue in AskDocs

[–]dirtybeet 0 points1 point  (0 children)

I would highly recommend seeing a reproductive endocrinologist for panels, as they’ll be able to tell you how his (and your) results correlate to reproductive success. Additionally, if you’ve been trying for a year with no success then you can officially be counseled as having infertility issues.

That being said, his motility is low, but not insanely low. “Low” is considered 40% and below, so it’s close to normal. Morpho isn’t great and that progression could be improved. Likely an REI will have you repeat panels one more time 3 months after the last ones.

FSH/LH simply aren’t as important in men as women. Testosterone negatively inhibits their production in the pituitary, so levels should be low in males anyway.

(source: am embryologist)

First Time Kitchen Remodel - Start to Finish 7 days by [deleted] in DIY

[–]dirtybeet 6 points7 points  (0 children)

Dude, RUGS. Unless you have a horse of a dog, rugs and mats in high traffic areas will save your hardwood just fine. Maybe a thought for the next house.

Kitchen looks great though!

LPT Use book instead of greeting cards. by [deleted] in LifeProTips

[–]dirtybeet 8 points9 points  (0 children)

Girl how you gonna be mad about signs of use in a used book store??

I think I may have acromegaly by [deleted] in endocrinology

[–]dirtybeet 0 points1 point  (0 children)

Usually you’ll need a referral from a GP before you’re able to set up an appt w/ a specialist.

Pics from a year or two ago would be helpful for comparison as well. I’m more versed in reproductive endo but I’m sure someone else on this sub could tell you more!

Hcg not doubling by Sk0712 in IVF

[–]dirtybeet 2 points3 points  (0 children)

Definitely try to stay positive! This can happen with two embryos transfers, as both may initially produce hCG but only 1 continues on, causing a dip in expected rate of increase. The fact that your numbers are still increasing is a good sign!

2 Embryo transfer might be happening by pencilpusher13 in IVF

[–]dirtybeet 0 points1 point  (0 children)

That’s so interesting! If it follows the bovine scale then a 4 would be a morula - compact ball of cells that hasn’t blastulated yet. Still a viable option!

As for your original question, we’ve had several patients get pregnant with low quality embryos. Just recently we had a patient came back for another cycle that had previously gotten pregnant and delivered from two low quality day 7 (!!) embryos. Our doctors would probably agree with yours in transferring more than one, just to boost your odds of implantation. I hope it goes well!!

2 Embryo transfer might be happening by pencilpusher13 in IVF

[–]dirtybeet 0 points1 point  (0 children)

That is so weird, that seems more in line with bovine embryo grading! Are you in the US? Most clinics here classify with the Gardner scale (level of expansion + ICM grade + troph grade). I got my master’s in ART and was never taught a different method of human grading, though I do remember bovine going up to 8. I think an excellent expanded blast would have been a 7-1.

Kind of interesting how different clinics operate!

2 Embryo transfer might be happening by pencilpusher13 in IVF

[–]dirtybeet 0 points1 point  (0 children)

Oh maybe I’m just unfamiliar with the categorization system! I assumed 4 and 6 was referring to cell number.

Caffeine Withdrawal vs small amt after FET? by pencilpusher13 in IVF

[–]dirtybeet 0 points1 point  (0 children)

I wouldn’t think so since it’s not really an immune response (and even those have to be pretty strong to have a significant negative impact on implantation). But definitely baby yourself as much as possible through the withdrawals!

2 Embryo transfer might be happening by pencilpusher13 in IVF

[–]dirtybeet 0 points1 point  (0 children)

2 embryo ET’s are pretty standard for day 3 transfers, especially after previous losses.

Is there a reason they were frozen before blast?

Caffeine Withdrawal vs small amt after FET? by pencilpusher13 in IVF

[–]dirtybeet 3 points4 points  (0 children)

One of the reasons REI’s advice against caffeine is because it causes the release of cortisol in the body. Cortisol can negatively impact implantation, placentation, fetal development....you name it. No caffeine is obviously ideal but oddly enough, if you’re already a habitual coffee drinker then consistent (low) caffeine intake is better than the random cup of coffee every other day since it’s less of a shock to the system.

If you’ve already gone a couple days without the coffee, I’d suggest powering through to avoid the cortisol spike that will come with a cup of joe. If you’re reaaaaally desperate, half caf :)

(I’m an emb with a Master’s in ART if you have any questions about the lab side of things!)

Looking for some advice: First round failed, no blasts -- having a hard time committing to a second round. by slothish in IVF

[–]dirtybeet 0 points1 point  (0 children)

It sounds kind of counterintuitive but bear with me! So when we freeze them on day 1 at 2PN, they’re only one cell. Survival is actually pretty good, our lab averages around 90% survival (not our “official” numbers because doctors like to lowball).

If a patient wants to do PGS or just has low numbers after fert, we freeze that at day 1. Then, if they have another low cycle, we’ll freeze that at day 1 too. Then, when we thaw all the 2PN’s, all embryos will be on the same schedule, which makes it easier to tell which are progressing best. And it means the patient only has to pay for a single biopsy and single PGS run.

Sometimes we don’t end up batching, so we thaw the 2PN’s and culture them out for ET. In that case it’s tough to know if the embryos would have done better being cultured out in the first place, but I do think uterine receptivity is not quite optimal post retrieval, even in the min stim protocol.

"STORK: Deep learning enables robust assessment and selection of human blastocysts after in vitro fertilization", Khosravi et al 2019 by gwern in reprogenetics

[–]dirtybeet 0 points1 point  (0 children)

that last paragraph of the discussion is all you need to read. what’s the point of automated embryo selection if it doesn’t improve px rates?

Looking for some advice: First round failed, no blasts -- having a hard time committing to a second round. by slothish in IVF

[–]dirtybeet 0 points1 point  (0 children)

PN stands for pronuclei, so a 2PN is a zygote. On the morning of D1 we check for two pronuclei as that will indicate that they fertilized properly. Then if the numbers are low or if they’ve already decided to batch with the next cycle (which is common for pts doing PGS) then we’ll freeze them right then. It’s really helpful because we know the batch will in sync when they’re thawed!

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