Three failed rounds of IVF and time to talk to the doctor

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP -- any update? I hope you've gotten your BFP (or, if not, at least some answers)!

Not a happy update. We did another egg retrieval (our second) in February, then did PGS testing on the three embryos that made it to freeze. Two of those tested normal (exactly what you would expect at my age, 35). We did a transfer of one embryo two weeks ago and got a negative beta today. I was getting faint lines on HPTs, so I think it was a CP. My theory is that the embryo hung on a little longer this time (no CPs from our three previous transfers) because I did two endo scratches. I will talk to the doctor later this week and he can tell me if my ideas are crazy or not.

We're doing the ERA process next and hoping that gives us some info we can use. Maybe my uterus is just inexplicably evil. My husband keeps saying what if the problem is him (he has MFI), but shouldn't the IVF/PGS process basically rule that out? It's got to be either me or some really shitty luck.

Sorry to hear this. Did you test for thyroid antibodies? Are you going to get a second opinion?

[Anonymous]

OP, check the ERA biopsy thread. I did it and got my BFP and just had a baby. I highly recommend ERA even though the waiting stinks!

[Anonymous]

Anonymous wrote:OP, check the ERA biopsy thread. I did it and got my BFP and just had a baby. I highly recommend ERA even though the waiting stinks!

The thing that drives me crazy is that, what, 75-80% of the time, the ERA will tell you yup, 5 days of progesterone is right. And then what? Keep trying and hope something magically changes?

I have done thyroid panels, including seeing an endo in December. My TSH had looked a little high at SG, but then it measured something like 2.3 which the endo thought was fine (along with the rest of the panel). I also insisted on SG doing a recurrent loss panel, which also came back fine. Would thyroid antibodies be on either of those or something different? It's been several months so I don't remember what was on those tests, I'll have to look.

Since the ERA will probably take up a few months, it's not a bad time to seek second opinions. (Although I doubt I would leave SG before transferring the remaining frozen embryo I have.) Who would you guys suggest seeing?

[Anonymous]

OP, I am sorry to see your update that nothing has worked so far. I actually re-read your original post a few times to make sure I didn't write it! Yes, I totally could have written that very post! We started as MFI and we had failed cycles at SG. I asked about my thyroid and about a minor blood clotting disorder I had and they said it would have no bearing on pregnancy. I went to see an endocrinologist to check my thyroid and it was crazy and I had antibodies. She said it increased the chances of miscarriage. I left SG and interviewed other REs. I found Dr. Abbasi, who I really liked. She ordered immunological and blood clotting tests and would not start a cycle until my thyroid was in good range. It turned out I had high natural killer cells and various other antibodies. I transfered my embryos from SG and did an FET with the following protocol: doxycycline, estrace, vivelle patches, baby aspirin, lovenox, PIO, endomitrin, dexamethesone, and IVIg. She also did an endo scratch the day I started my PIO/suppositories. We transferred two and now I have 8 month old twins! Leave Shady Grove! They are wasting your time and money! They weren't going to change my protocol either I was so frustrated! They kept insisting nothing was wrong with me and even told my my thyroid was fine when it wasn't! I am wishing you the best OP! I am so sorry you have had to go through this!

[Anonymous]

Anonymous wrote:OP, I am sorry to see your update that nothing has worked so far. I actually re-read your original post a few times to make sure I didn't write it! Yes, I totally could have written that very post! We started as MFI and we had failed cycles at SG. I asked about my thyroid and about a minor blood clotting disorder I had and they said it would have no bearing on pregnancy. I went to see an endocrinologist to check my thyroid and it was crazy and I had antibodies. She said it increased the chances of miscarriage. I left SG and interviewed other REs. I found Dr. Abbasi, who I really liked. She ordered immunological and blood clotting tests and would not start a cycle until my thyroid was in good range. It turned out I had high natural killer cells and various other antibodies. I transfered my embryos from SG and did an FET with the following protocol: doxycycline, estrace, vivelle patches, baby aspirin, lovenox, PIO, endomitrin, dexamethesone, and IVIg. She also did an endo scratch the day I started my PIO/suppositories. We transferred two and now I have 8 month old twins! Leave Shady Grove! They are wasting your time and money! They weren't going to change my protocol either I was so frustrated! They kept insisting nothing was wrong with me and even told my my thyroid was fine when it wasn't! I am wishing you the best OP! I am so sorry you have had to go through this!

Did you also have Dr. Sagoskin?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I am sorry to see your update that nothing has worked so far. I actually re-read your original post a few times to make sure I didn't write it! Yes, I totally could have written that very post! We started as MFI and we had failed cycles at SG. I asked about my thyroid and about a minor blood clotting disorder I had and they said it would have no bearing on pregnancy. I went to see an endocrinologist to check my thyroid and it was crazy and I had antibodies. She said it increased the chances of miscarriage. I left SG and interviewed other REs. I found Dr. Abbasi, who I really liked. She ordered immunological and blood clotting tests and would not start a cycle until my thyroid was in good range. It turned out I had high natural killer cells and various other antibodies. I transfered my embryos from SG and did an FET with the following protocol: doxycycline, estrace, vivelle patches, baby aspirin, lovenox, PIO, endomitrin, dexamethesone, and IVIg. She also did an endo scratch the day I started my PIO/suppositories. We transferred two and now I have 8 month old twins! Leave Shady Grove! They are wasting your time and money! They weren't going to change my protocol either I was so frustrated! They kept insisting nothing was wrong with me and even told my my thyroid was fine when it wasn't! I am wishing you the best OP! I am so sorry you have had to go through this!

Did you also have Dr. Sagoskin?

I was with Levy.

[Anonymous]

I had 2 failed IVF cycles at Shady Grove, went to Cornell for the 4th one, pregnant with twins on the 4th cycle. All Cornell did was adjust the dosage, in their opinion the protocol used by SG had a much higher dosage. Is it possible to consider a trip to NY and go to Cornell? My meds and scans were paid by insurance, for the IVF cycle I paid $9500.00.

[Anonymous]

I meant 3 failed IVF cycles, not 2*

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, check the ERA biopsy thread. I did it and got my BFP and just had a baby. I highly recommend ERA even though the waiting stinks!

The thing that drives me crazy is that, what, 75-80% of the time, the ERA will tell you yup, 5 days of progesterone is right. And then what? Keep trying and hope something magically changes?

I have done thyroid panels, including seeing an endo in December. My TSH had looked a little high at SG, but then it measured something like 2.3 which the endo thought was fine (along with the rest of the panel). I also insisted on SG doing a recurrent loss panel, which also came back fine. Would thyroid antibodies be on either of those or something different? It's been several months so I don't remember what was on those tests, I'll have to look.

Since the ERA will probably take up a few months, it's not a bad time to seek second opinions. (Although I doubt I would leave SG before transferring the remaining frozen embryo I have.) Who would you guys suggest seeing?

Yes, the thyroid antibodies would be on the thyroid panel. Did you go to an endocrinologist who specialized in infertility?
I agree with PP to go see Dr. Abbassi. She general is good with these types of cases.

[Anonymous]

^pp. where is dr Abassi? Do you typically have the thyroid testing done at the re or by an Endo?

[Anonymous]

Anonymous wrote:^pp. where is dr Abassi? Do you typically have the thyroid testing done at the re or by an Endo?

I believe Dr. Abassi has an office in Bethesda and an office in DC. I actually had my thyroid panel done by my primary care physician because I suspected something was wrong. When I got a copy of the test results back which showed the presence of thyroid antibodies I decided then and there to seek a second opinion and chose Dr. Abassi. She referred me to an endocrinologist who is still monitoring my thryoid 2 years later (my check-ups are now annual).

[Anonymous]

8:26 here.

Abbasi is a Columbia Fertility Associates. Go to the Bethesda office--the DC office is a mess! She worked with my endocrinologist and I was on synthroid for my successful cycle. I always forget I was on it. I am still being monitored by my endocrinologist as well.

[Anonymous]

Anonymous wrote:8:26 here.

Abbasi is a Columbia Fertility Associates. Go to the Bethesda office--the DC office is a mess! She worked with my endocrinologist and I was on synthroid for my successful cycle. I always forget I was on it. I am still being monitored by my endocrinologist as well.

In my experience, CFA has slightly worse stats than SG because they are more willing to take risky/less likely to be successful cases and more likely to be willing to deviate from the standard protocol. If I were trying IVF for the first time, had no reason to think I had unusual problems and SG would accept me, I would probably start there; if IVF had failed for me even once or I had a reason to think I had unusual issues, I would go to CFA hands down. They have way more experience with unusual cases and protocols and way more willingness to try... not least of all because the doctors have way more flexibility under office policy. My personal choice would be Dr. Sacks, but I've heard good things about Dr. Abbasi too. Definitely at least get a second consult: Dr. Sacks will tell you upfront (as he did for a friend of mine) if he thinks the SG protocol is good enough/the one he'd go with anyway.

[Anonymous]

^^ I had no big problems with the DC office, for what it's worth. (I have also heard the MD office is less busy, but DC was just so much more convenient for me that it would have had to be pretty terrible to make the commute to the other office worth it.). One billing mishap and one time they didn't call me when they were supposed to; both times I reached out to them and they were receptive and apologetic. Basically, edge to MD office, but go with whichever is more convenient if there's a meaningful difference for you.

[Anonymous]

OP here: I think CFA is a definite for a second opinion. We are in MoCo, so Bethesda office it is.

I can't really see us doing Cornell (honestly it sounds exhausting to travel for treatment, but maybe I'm wrong?). Do you think it would be worth it to set up a phone consult anyway, just to see what they say?