SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

So as you know IVF 2 failed. BETA was a 5.

I know a lot of us are trying to figure out next steps after our failed cycles so below is info about how my follow up consult went if you want it as a reference.

We met with Dr. Z for about an hour today between our talk and getting more BW taken and him writing scripts and then had to set up an appointment.

So heres what I got from it. The embryos we put back were good quality not great, they were BBS. He said he thinks 1 implanted but it was not chromosomaly normal and thats why I had the chemical and it didn't stick. We went over all of my embryos that fertilized and basically a lot of them were too slow or Cs. He said he was hoping I would had an AA or an AB but BB was still good. He said it could be an egg or a sperm issue but again we don't know. Story of my life.

The two we have frozen are AC and BB. He says the BB is middle grade and the AC has a lower chance. He said we would know more if we did PGD but he really doesn't rec that at this point. I flat out asked so how our chances this will work. He said I can't guarantee it will work but the chances are still good. Basically he said we just have to keep on trying. He said having 2 to freeze and 2 to transfer is still good. He talked about how patients have gotten preg on lesser quality etc.

I asked about further testing. I said I want to do whatever we need to in order to get more answers. I asked about the endo biopsy even though I have no signs. He agreed this would be an option. He also brought up the office Hysterscopy (sp?). He said he would do those tests now to rule out anything. Then he said even though I only had 1 loss (chemicel) we can run bloodwork to see whats going on.

I brought up immune testing. I said I know many people don't believe in it but in my research I came across it. He said well theres only one Dr. in LI who does it and isnt even a RE. Obviously I knew who he was talking about. He quoted studies and talked about stats and basically said immune testing wasn't supported. He said if you want to do it you can but he doesnt rec it. I asked about Levonox and he said if it was needed he prefers Heprin.
He said he rather me spend money on PGD over immune testing.

I asked what the FET would consist of. He said Estrace and PIO. UHHH he thinks PIO is better than Crinone in FET cycles.

SO I think we will get all of this testing done and then do a FET with him. I don't have high hopes bc the embryos aren't the best. If it doesn't work I think I will go to SIRM in the city over the summer when I'm off since I'm a teacher. My DH really likes Dr. Z and says he doesn't just wanna jump around when he knows us so well and is very knowledgeable. DH feels that he really wants to get us preg and is as disappointed as we are.

Okay so heres the plan so far:

I had CD 3 BW today to test FSH and whatever else.

I will get an endometrial biopsy and an office hysterscopy on Saturday. FUN. ( I had an HSG and Saline Sono in Feb)

I have a script for a ton of BW and will get that done on Monday: lupus anticoagulant, anti-cardiolipin antibodies, anti-beta 2 glycoprotein antibodies, anti-phosphtidyl serine antibodies, activted protein C resistance, factor V Leiden mutation analysis, protein C and S activities, anti-trombin 111 activity, fasting homocysteine level, MTHFR mutation analysis, TSH and prolactin levels (my Prolactin was a little high last time), free T4, anti thyroid peroxidase and anti-thyroglobulin antibodies, fasting glucose and hemoglobin A1C, chromosomal analysis, and AMH. I have no idea what any of that is but I hope an answer lies somewhere.

DHs script: chromosomal analysis

If you have read this all you are awesome.

Taking this month off of meds and trying to get healthy since I have gained weight with all of this crap.

Any feedback? Let's hope some answers lie in here.
Thanks ladies

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

I have no advice but I am glad you are being proactive and are pushing forward.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

So sorry to hear that you are going through this D.

With that being said, I'm very happy that you are going to have more testing done. After 2 losses before seeing Dr. Z, he ran those same blood tests and they provided some answers to my problems. I also had the endo biopsy done (provided no answers, but was good to rule out). I loved him and I felt like he tried so hard to get us pregnant, so I know he's doing the same for you.

Keeping you in my thoughts!!

Keep the faith girl, you will get there.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

I'm glad you are looking into some more options. Your Doctor seems to be just as determined as you are to look for more answers!

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Ok I made sure to read every word. Sounds like exactly what we went through after our first ivf didn't work. He said it was embryo quality. To increase embryo quality both dh and I needed meds. Dh took Clomid and I took metformin. Well our second ivf I transferred a AA and AB so my re knew what he was talking about.

I'm happy your are being very proactive. Take a break and regroup. It WILL happen.

Message edited 10/26/2013 9:59:08 PM.

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

I'm so sorry. I was once in the space where I did three failed cycles overall. I say get the immunology panel done. It is what lead my to my miracle dd.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

That all makes sense what he told you about the quality. My RE also believes quality is our issue. Please let me know any meds he puts you on to improve. I was only put on micronized DHEA.
I had those BW tests.. all very good info on loss.
I was thinking ab doing the same as to wait for the summer to travel to SIRM being that DS will be off and it's easier with sitters.
Sending you so many ! You are one strong girl and I know your persistence will pay off!!

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

the bw looks like a fairly basic thrombo panel. i will say that all of that is great but half of what causes thrombo issues which lead to chemicals/mc/failed implantation/cycle failure is immune related. so testing and treating that is OK - but its not EVERYTHING you can do . its sort of like getting the flu and taking nyquil for the cough. you are treating the symptom not necessarily the cause. but saying he prefers heparin over lovenox is somewhat of a red flag IMO. a heparin protocol would at minimum double the shots you need every day of your pregnancy. a vast majority of thrombo patients stay on lovenox and only switch to heparin at the end before delivery. if its necessary i would be very proactive in getting his reasoning on that and do your homework cause as someone who has a basic understanding of thrombo and treatment it sounds like thats just really old school unresearched logic on his part. not saying it wouldnt work, they basically do the same thing, it just seems a bit old school and like maybe he was just prescribing it with only basic knowledge, background and research.

allll that being said, his treatment plan would prob work perfectly fine for many people. just remember that the more they know about YOUR body, the better your chances. immunology isnt endocrinology - they both have value and its only a matter of time and research before REs gain the acceptance and knowledge and treatment plans as immunologists. its sort of like how some OBs still honestly believe everyone ovulates on day 14 and will date your pregnancy that way no matter what...it takes a LONG time to break medical molds...just keep that in mind when dealing with dr's that dont believe in it. if you do and they dont, and things dont work out, you will resent them and beat yourself up for not switching earlier. you have to make the best decision for you and decide what you believe in, and stick with whatever doctor will best support that because you need to be a team in this. good luck!

Message edited 10/26/2013 11:31:54 PM.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

I would encourage you to have your DHEA levels tested before using DHEA. SIRM has a few articles about negative effects with DHEA supplements if your levels are normal or high. My RE changed his mind about having me take it after my levels were tested.

There is also research showing that waiting a month between cycles is optimal, so it seems like your plan to take a month off is a good one.

Message edited 10/27/2013 2:58:25 PM.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Well said Flowerwife.

First, sorry that you had a failed cycle. Chemicals stink. I think having consults and second opinions and doing all relevant testing to bring you answers as to why it failed, is the right direction. It sounds to me more like quality of embryos which can sometimes be an easy fix with changing your protocol to suit your needs, not the standard. I'm not sure how your RE can say he knows one implanted and it wasn't chromosomally normal without having done PGD or CSH testing on them before transfer. You can have other reasons for implantation failure and can still miscarry perfectly healthy embryos which is why some of the ladies suggested immune and thrombo testing. Some
Drs may never change their old school mindsets and ways, which is why they lose patients. Do your own research and be your own advocate.

:

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Thanks ladies. I appreciate you taking the time to read what I wrote and all of your advice. So much to figure out. Lots of BW in the am...

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Good luck!!

Message edited 10/27/2013 9:13:33 PM.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

If you do have some immune issues and are not going to have anything tested you may want to cut out Gluten and Dairy.

Gluten sensitivity causes inflammation in the body. It is detected by the use of IGG antibodies. It is the long term effects of gluten on the inflammatory portion of the immune system that affects the implantation of the embryo and causes fertility problems.

Dairy has also been researched to affect ovulation.

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Re: SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

I was in the same position. My RE said that quality was the issue too and while he was probably right I pushed him on getting the immuniology testing. I really insisted against his wishes that he do it. It was found out that i have have a clotting disorder that i would have not known about. Even after telling them about the mc i had (yrs ago) but did not get tested for after.
I was put on Lovenox prescribed by a Hemotologist>as the others posted it seems weird to be put on Heparin since its only got a short window till you need another shot and no one wants to do that along with PIO. If you are allergic like i was you will have to do the suppositories and they worked just the same.

Good luck to you but getting a second opinion doesnt sound bad.

SUPER LONG: I had my consult after my 2nd failed IVF-lots of info

Thanks ladies. 20 vials of blood today...feeling drained. I'll see what turns up there and then go from there. You all have great advice! I'm doing my research and hopefully I will figure out a plan that works.