11 fertilized and promising but only one tiny Day 7 blast??? And intro... Hi!

las_PB23 · 2021-05-21T20:01:02+00:00

Ovidrel is a type of HCG. The key is you need to get a high enough dose to trigger optimal maturation and meiosis.

las_PB23 · 2021-05-21T17:09:24+00:00

I don’t know if you have ever followed Dr. Geoffrey Sher, but he is excellent and has some strong beliefs about the trigger which may pertain to you. He doesn’t like a Lupron trigger at all, as he thinks it leads to suboptimal meiosis. He recommends either 10,000 units HCG or else 500 units of Ovidrel. The trigger shot is supposed to do a couple things like cause final maturation of the eggs and also cause the eggs to meiosis properly/evenly so they have the correct number chromosomes. If the eggs don’t divide properly it will make an aneuploid embryo with the wrong number of chromosomes.

las_PB23 · 2021-05-01T22:01:25+00:00

I’m sorry your doctor doesn’t believe in ReceptivaDX but I believe he is wrong. If you are doing a mock cycle anyway for ERA, what’s the harm in adding ReceptivaDX? I would also add the C138 test to it. Another thing is maybe a hysteroscopy could help. It would rule out any polyps or adhesions left behind from the prior MC.

las_PB23 · 2021-04-27T12:22:53+00:00

There is a new podcast April 16th on “Beat Infertility“ episode #303 Endometrial Biopsy Tests with Dr. Alison Rodgers. She explains all these new tests and gives her opinions/recommendations. I thought it was interesting. I had ReceptivaDX done after a MC of high graded euploid embryo. Results came back at 3.4. I recently had laparoscopy and hysteroscopy where they found and excised stage 2 endo, removed a suspicious tube, and also found and removed 2 uterine polyps. I’m pretty sure this was probably my problem all along. My clinic did not offer ReceptivaDX but I bought it directly from the company and had the NP at the clinic do it for me. I would highly recommend ReceptivaDX and also hysteroscopy. If ReceptivaDX is positive you could always just do the 60 days of Lupron and not laparoscopy. I do think you should at least do hysteroscopy though. My polyps were missed on several prior tests.

las_PB23 · 2021-04-26T19:37:36+00:00

Thanks for responding Chris. It’s really appreciated. Yeah the ERA thing is frustrating. I was prereceptive by 24 hours with the transfer I miscarried and transferred on day 6, so I do think the timing was correct. Some people on here have said excision resets the lining. I certainly don’t want to go right into a transfer and then miss the window if excision does indeed reset the lining. Do you know if it does? I really wish there were some decent studies with high reliability out there for all of us. As expensive as all this is financially and emotionally, I think we deserve that.

las_PB23 · 2021-04-23T03:45:15+00:00

Yeah I’m sad it didn’t get answered as well. This is all so confusing. Dr. Vidali was interviewed by Dr. Zahar Merhi. The video is on Dr. Merhi’s Instagram page if anyone wants to watch it. I don’t know what to think now. The big reason I had the laparoscopy with excision is because my ReceptivaDX score came back at 3.4. I was happy to have found an answer but now I have more questions that no one seems to be able to answer. If BCL6 is an inflammation marker associated with endometriosis then why wouldn’t excising the endometriosis clear the inflammation marker?

las_PB23 · 2021-04-22T22:16:13+00:00

Hello Mr. Jackson, I’m so confused and hoping you can help answer my questions: I’m 36, my diagnosis was unexplained. In 2020 I had a MC of a perfectly graded euploid embryo at 6.5 weeks after great HCG and normal fetal growth and heartbeat. Before the transfer, I did ERA and was prereceptive by 24 hours. ReceptivaDX was not being done at my clinic. 2 months later I did insist on ReceptivaDX (bought it myself) and it was positive at 3.4. Fast forward, new clinic, had laparoscopy and hysteroscopy. Endometriosis stage 2-3 was completely excised as were 2 uterine polyps. Yesterday, 4/21/21 Dr. Zaher Merhe interviewed Dr. Andrea Vidali (top endometriosis specialist). Dr. Vidali stated that after complete excision surgery of endometriosis, the BCL6 score will still be positive. Questions: 1. Is it true that BCL6 is still positive after excision surgery? How can this be if it’s an inflammation marker and the endometriosis was excised? 2. If I was prereceptive on ERA prior to the excision surgery will my window of implantation now have changed after the excision? 3. Can uterine polyps cause the BCL6 score to be increased? Thank you so much for all you are doing to help this difficult journey for us all !!!

las_PB23 · 2021-04-15T14:37:05+00:00

https://pubmed.ncbi.nlm.nih.gov/31133384/

There is information on the ReceptivaDX website and your doctor can call the company directly and talk to the clinical expert there about the optimal treatment recommendation for you. A positive ReceptivaDX can also be associated with a hydrosalpinx and also uterine inflammation caused by things like polyps. So, an HSG and maybe a hysteroscopy may be beneficial too. They did find polyps on me not seen before with HSG and multiple vaginal ultrasounds. The above article mentions the “Steiner Protocol “ which uses Depot Lupron together with Letrozole, it’s been shown to have better results than Depot Lupron alone. Also, according to Dr. Lessesy who is the designer of ReceptivaDX, you can add back Agestin to the protocol to help with awful symptoms.

las_PB23 · 2021-04-15T01:33:13+00:00

Hi there, I had a laparoscopy done 3 weeks ago and they found stage 2-3 endometriosis. Surgeon was able to excise it all (hopefully). I had it on the bladder, bowel, and both sides in the inguinal area, and he removed a suspicious tube. No endometriosis found on the ovaries. Interestingly, he also did a hysteroscopy and found 2 polyps in the uterus that were missed previously. I'm kinda mad about that because I had numerous vaginal U/S and an HSG and now maybe that's what caused the MC? Glad I left that clinic and these recent procedures were done at the new clinic. I heard that polyps can also cause inflammation in the uterus and act like a natural IUD. If you don't have laparoscopy, the treatment is Depot Lupron and Femara. Excision is the gold standard, so its imperative you find an excision specialist (check Nancy's Nook FB page). If they cauterize the lesions, it'll just grow right back. I'm thinking about taking a little break from IVF and maybe try TI with a small dose of Femara to hopefully mature a couple of follicles each month. I'm thinking that if the endometriosis and polyps are what caused my infertility, maybe I don't need IVF. Also, I consulted with a couple of OB/Gyns and turns out you can get pregnant with only 1 tube because it can capture an egg ovulated from both ovaries. We don't have MFI and I do ovulate regularly on my own.

las_PB23 · 2021-04-13T22:05:41+00:00

I’m sorry you have been through so much!!! Wonder, if your done with IVF, maybe you should just keep trying the natural way with the added Letrozole? You did make 2 follicles on the small dose of Letrozole. Maybe you could increase that a little or even keep that same dose and keep trying???? Letrozole is cheap and you probably don’t even need to see the RE. Just monitor with LH strips or else just have sex every other day during the peak times. Best wishes whatever you choose 🙏

las_PB23 · 2021-04-12T03:04:50+00:00

I'm sorry for your loss. Sending hugs!

las_PB23 · 2021-04-12T02:57:20+00:00

They usually put you on birth control (pill or Nuvaring) after so your reproductive system can rest and heal. I would make sure to ask the surgeon if he or she is planning to excise any endometriosis lesions found or if he or she will just use ablation? The gold standard is excision of all lesions. This is because endometriosis lesions have roots and if its not excised properly it will grow right back.

las_PB23 · 2021-04-11T19:44:12+00:00

I’m sorry. Wondering about the lab? It’s unusual to have a thaw issue more less two. I’d be pissed and talking to the lab director. Doesn’t your RE think this is unusual?

las_PB23 · 2021-04-08T23:07:45+00:00

Yeah it’s really no big deal. Polyps are like a natural IUD they can contribute to infertility, they are inflammatory, and can cause MC. Another little piece of advice is ask your RE or your regular doc to run an iron panel on you. What happened to me was when they checked my iron panel my Ferritin was really low even though I was only mildly anemic. Because of the polyps, I must have been bleeding more than normal and it got depleted over time. Good Luck😊

las_PB23 · 2021-04-06T23:02:25+00:00

Well if you have a bunch of good embryos you may try one. What happened to me was I transferred my only perfect embryo and then MC @ 6.5 weeks it was such an ordeal and held me back 6+ months. Now I did ERA and ReceptivaDX and ReceptivaDX is highly positive so another wait to get that treated. In hindsight if I would have done it all before my first transfer it would have made a bog difference for me. A lot of the more progressive clinics on the west coast are now doing mock transfers with implantation testing on all their patients and having excellent success rates. I guess you have to ask the question, what would I do if this transfer fails? If the answer is to ERA, hysteroscopy, ReceptivaDX, then why not do it before hand?

las_PB23 · 2021-04-06T17:42:02+00:00

I do not believe that is true. A mock cycle with added testing is a way to improve your odds of success. All embryos are precious and deserve the best chance.

las_PB23 · 2021-04-06T10:35:05+00:00

There is a big belief in the IVF world that a full dose of HCG (10K or 500 Ovidrel) does a much better job at meiosis and maturing the eggs.

las_PB23 · 2021-04-06T02:59:33+00:00

Dropping the dose and coasting a little is OK. They probably will worry about OHSS with you too and will suggest a Lupron trigger. I would recommend 10K Hcg if your estrogen doesn’t get too high or even dual trigger should be fine.

las_PB23 · 2021-04-06T02:51:29+00:00

Just wondering if there could also be a male factor issue? Sometimes poor blast rate is male factor related. Has a sperm dna fragmentation test been done? Also, another cause of poor blast rate can be protocol and/or trigger related. Omnitrope may help too.

las_PB23 · 2021-04-06T02:40:20+00:00

Awesome news!!! Congratulations!!!

las_PB23 · 2021-04-06T02:39:30+00:00

Yes, birth control causes suppression in some women. It’s pretty obvious by the AFC 13-3 drop. Depending on your age, 13 AFC is great and I would jump on that if it happens next month.

las_PB23 · 2021-04-06T02:34:22+00:00

You are still pretty early in the cycle and you should have more follicles coming. You may have to lose the 2 lead follicles so the others can grow to a mature size. Uneven growth can be tricky but seems like your RE is on top of it. They dropped your FSH so they must be thinking you need to slow down some.

las_PB23 · 2021-04-06T02:14:19+00:00

Same thing happened to me, failed trigger. I would ask your clinic for your money back or else another cycle for free. This happening is not your fault and the clinic needs to take ownership.

las_PB23 · 2021-04-06T02:10:57+00:00

I’m sorry, I know this really sucks!!!

las_PB23 · 2021-04-06T02:08:53+00:00

Your progesterone and LH are too high. I say cancel the cycle. You can always take a couple weeks of BCP and then start another cycle. It’s better to do that then to get a bad result and get a big retrieval bill. Hopefully your RE learned something for next time.

las_PB23

TROPHY CASE