Two failed PGS transfers; time to switch clinics?

[Anonymous]

SGF patient here. My official blood test for my second FET is Monday, but based on at-home tests, I’m not optimistic. Both transfers were with PGS normal 5-day blasts, and transfer time was based on personalized ERA results (I’m pre-receptive). In short, I covered all the bases I could and it still hasn’t worked. I have one more frozen PGS blast. Is it time to transfer to a new clinic and try the final transfer there? Do one more transfer with SGF and figure it’s a numbers game? Time is an issue; I’m 39. If I transfer, will a new clinic make me start at square one with tests again?

It’s cliche, but I just didn’t expect to be here. After my first egg retrieval yielded two PGS normal embryos, my medical team was surprised I wanted to do another egg retrieval to bank another blastocyst; they were sure I’d be successful with transfer one.

[Anonymous]

Anonymous wrote:SGF patient here. My official blood test for my second FET is Monday, but based on at-home tests, I’m not optimistic. Both transfers were with PGS normal 5-day blasts, and transfer time was based on personalized ERA results (I’m pre-receptive). In short, I covered all the bases I could and it still hasn’t worked. I have one more frozen PGS blast. Is it time to transfer to a new clinic and try the final transfer there? Do one more transfer with SGF and figure it’s a numbers game? Time is an issue; I’m 39. If I transfer, will a new clinic make me start at square one with tests again?

It’s cliche, but I just didn’t expect to be here. After my first egg retrieval yielded two PGS normal embryos, my medical team was surprised I wanted to do another egg retrieval to bank another blastocyst; they were sure I’d be successful with transfer one.

Hi!! I had 3 failed frozen embryo transfers with shady grove fertility with PGS normal embryos. I quickly switched to CCRM Fertility Northern Virginia for more personalized care. At SGF I felt like my doctor was being dismissive about my concerns. I have two PGS normal embryos left, and Dr Payson from CCRM will be doing the transfer.

[Anonymous]

I’d stick with your clinic and transfer the last embryo. Unless you hate the doctors and clinic and really want to change, I would stay where you are. It will take months and months to transfer clinics given wait times, Covid restrictions, and doing any other testing a new clinic may put you through before you can start a cycle. Having multiple high-quality PGS tested normal embryos puts you in the 1% of infertility patients. Not every embryo takes, and that’s honestly completely out of any doctor’s hands. People change clinics when a protocol is not working to get the quantity and quality of eggs retrieved and fertilized and/or hatched to embryos. Your clinic is doing an outstanding job with that process. I would not mess with it. Hopefully, the next cycle is the one that works. I know it is hard to hear, but a perfect embryo does not always take. Nothing is a slam dunk or guaranteed with IVF. But you are way way way ahead of the game with the awesome blasts you are able to get, even if it may not feel that way. Good luck.

— 4 transfers of grade A embryo transfers before getting pregnant

[Anonymous]

Anonymous wrote:I’d stick with your clinic and transfer the last embryo. Unless you hate the doctors and clinic and really want to change, I would stay where you are. It will take months and months to transfer clinics given wait times, Covid restrictions, and doing any other testing a new clinic may put you through before you can start a cycle. Having multiple high-quality PGS tested normal embryos puts you in the 1% of infertility patients. Not every embryo takes, and that’s honestly completely out of any doctor’s hands. People change clinics when a protocol is not working to get the quantity and quality of eggs retrieved and fertilized and/or hatched to embryos. Your clinic is doing an outstanding job with that process. I would not mess with it. Hopefully, the next cycle is the one that works. I know it is hard to hear, but a perfect embryo does not always take. Nothing is a slam dunk or guaranteed with IVF. But you are way way way ahead of the game with the awesome blasts you are able to get, even if it may not feel that way. Good luck.

— 4 transfers of grade A embryo transfers before getting pregnant

What clinic were you at?

[Anonymous]

If you're not having success with Shady Grove, ensure your Vitamin D level is above 60. Then check your TSH to make sure it is below 2.0 (FET tend to fail when TSH is above 2.0 But Shady Grove will do a FET anyway - your money be damned.) Then refuse PIO shots. Some women are allergic to the carrier oil. You can use the suppositories and get the same progesterone boost without the risk of an immune reaction.

I went to a different clinic after Shady Grove and they were not big fans of PIO (progesterone in oil) as it caused an allergic reaction in some of their patients and the pregnancies never stuck if the side of their butt was itching.. (Just one RE's observation. He said it kinda joking, kinda not. )

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’d stick with your clinic and transfer the last embryo. Unless you hate the doctors and clinic and really want to change, I would stay where you are. It will take months and months to transfer clinics given wait times, Covid restrictions, and doing any other testing a new clinic may put you through before you can start a cycle. Having multiple high-quality PGS tested normal embryos puts you in the 1% of infertility patients. Not every embryo takes, and that’s honestly completely out of any doctor’s hands. People change clinics when a protocol is not working to get the quantity and quality of eggs retrieved and fertilized and/or hatched to embryos. Your clinic is doing an outstanding job with that process. I would not mess with it. Hopefully, the next cycle is the one that works. I know it is hard to hear, but a perfect embryo does not always take. Nothing is a slam dunk or guaranteed with IVF. But you are way way way ahead of the game with the awesome blasts you are able to get, even if it may not feel that way. Good luck.

— 4 transfers of grade A embryo transfers before getting pregnant

What clinic were you at?

Overseas

[Anonymous]

Yes. If you’re asking the question it’s time to move on. Consider NY and CO also. Don’t waste time.

[Anonymous]

Anonymous wrote:If you're not having success with Shady Grove, ensure your Vitamin D level is above 60. Then check your TSH to make sure it is below 2.0 (FET tend to fail when TSH is above 2.0 But Shady Grove will do a FET anyway - your money be damned.) Then refuse PIO shots. Some women are allergic to the carrier oil. You can use the suppositories and get the same progesterone boost without the risk of an immune reaction.

I went to a different clinic after Shady Grove and they were not big fans of PIO (progesterone in oil) as it caused an allergic reaction in some of their patients and the pregnancies never stuck if the side of their butt was itching.. (Just one RE's observation. He said it kinda joking, kinda not. )

This is good advice. My transfer at SGF worked but they brushed off my concerns about my thyroid levels. I went to an endocrinologist on my own.

[Anonymous]

SGF is the worst, we moved to Dominion and the RE there told me about my low vit D. Why do they bother testing for things then not tell the patient they need to supplement?

[Anonymous]

For the record, most REs (not just SGF) will not treat thyroid if your TSH is under 4-4.5, while for optimal fertility and egg quality it should be between 1-2. I went to CFA, GW, and then SGF, and none of them bothered to treat my TSH which was under 4.5 but in the suboptimal range all along. It took me doing my own research and working with a fertility coach, then going to an endocrinologist (who did want to see a TSH below 2-2.5 for TTC/fertility purposes) to get treatment for my suboptimal thyroid. (And somehow the next IVF cycle worked -- surprise, surprise.)
Also, most REs don't treat a vit D level above 30, while for optimal fertility it should be between 40-60 (at least). Both GW and SGF dismissed my vit. D level in mid-30s.
On this journey you have to be your own advocate and double-check all the doctors regardless of the clinic you go with.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’d stick with your clinic and transfer the last embryo. Unless you hate the doctors and clinic and really want to change, I would stay where you are. It will take months and months to transfer clinics given wait times, Covid restrictions, and doing any other testing a new clinic may put you through before you can start a cycle. Having multiple high-quality PGS tested normal embryos puts you in the 1% of infertility patients. Not every embryo takes, and that’s honestly completely out of any doctor’s hands. People change clinics when a protocol is not working to get the quantity and quality of eggs retrieved and fertilized and/or hatched to embryos. Your clinic is doing an outstanding job with that process. I would not mess with it. Hopefully, the next cycle is the one that works. I know it is hard to hear, but a perfect embryo does not always take. Nothing is a slam dunk or guaranteed with IVF. But you are way way way ahead of the game with the awesome blasts you are able to get, even if it may not feel that way. Good luck.

— 4 transfers of grade A embryo transfers before getting pregnant

What clinic were you at?

Overseas

Were they PGS tested?

[Anonymous]

Anonymous wrote:For the record, most REs (not just SGF) will not treat thyroid if your TSH is under 4-4.5, while for optimal fertility and egg quality it should be between 1-2. I went to CFA, GW, and then SGF, and none of them bothered to treat my TSH which was under 4.5 but in the suboptimal range all along. It took me doing my own research and working with a fertility coach, then going to an endocrinologist (who did want to see a TSH below 2-2.5 for TTC/fertility purposes) to get treatment for my suboptimal thyroid. (And somehow the next IVF cycle worked -- surprise, surprise.)
Also, most REs don't treat a vit D level above 30, while for optimal fertility it should be between 40-60 (at least). Both GW and SGF dismissed my vit. D level in mid-30s.
On this journey you have to be your own advocate and double-check all the doctors regardless of the clinic you go with.

I agree with all of this. GW is not focused on thyroid or Vit D.

Pp, who did you see for the thyroid? I want a second opinion to compare to my GW endo.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For the record, most REs (not just SGF) will not treat thyroid if your TSH is under 4-4.5, while for optimal fertility and egg quality it should be between 1-2. I went to CFA, GW, and then SGF, and none of them bothered to treat my TSH which was under 4.5 but in the suboptimal range all along. It took me doing my own research and working with a fertility coach, then going to an endocrinologist (who did want to see a TSH below 2-2.5 for TTC/fertility purposes) to get treatment for my suboptimal thyroid. (And somehow the next IVF cycle worked -- surprise, surprise.)
Also, most REs don't treat a vit D level above 30, while for optimal fertility it should be between 40-60 (at least). Both GW and SGF dismissed my vit. D level in mid-30s.
On this journey you have to be your own advocate and double-check all the doctors regardless of the clinic you go with.

I agree with all of this. GW is not focused on thyroid or Vit D.

Pp, who did you see for the thyroid? I want a second opinion to compare to my GW endo.

I'm the PP above; I go to Dr. Michael West in Farragut North. He doesn't have the best bedside manner, but I basically went there because I felt I needed thyroid treatment/meds ASAP and he was the one I could get an appointment with (all other practices convenient to me had a 1-2 month wait time or did not take my insurance). He does the job of adjusting my medication based on my levels just fine (has been monitoring me pretty closely through my pregnancy, too). But my diagnosis is just generic hypothyroid, FWIW (i.e. not Hashimoto's), so I am not sure if he'd be good for more specific conditions. Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:For the record, most REs (not just SGF) will not treat thyroid if your TSH is under 4-4.5, while for optimal fertility and egg quality it should be between 1-2. I went to CFA, GW, and then SGF, and none of them bothered to treat my TSH which was under 4.5 but in the suboptimal range all along. It took me doing my own research and working with a fertility coach, then going to an endocrinologist (who did want to see a TSH below 2-2.5 for TTC/fertility purposes) to get treatment for my suboptimal thyroid. (And somehow the next IVF cycle worked -- surprise, surprise.)
Also, most REs don't treat a vit D level above 30, while for optimal fertility it should be between 40-60 (at least). Both GW and SGF dismissed my vit. D level in mid-30s.
On this journey you have to be your own advocate and double-check all the doctors regardless of the clinic you go with.

I agree with all of this. GW is not focused on thyroid or Vit D.

Pp, who did you see for the thyroid? I want a second opinion to compare to my GW endo.

Gw (Dr F) required my TSH to be below 2 for FET. YMMV

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:


Gw (Dr F) required my TSH to be below 2 for FET. YMMV

GW is not consistent then. Dr. F was fine with my thyroid at 4.0 until my endocrinologist said it needed to be under 2.5. He was fine with it at above 2.0. But I went to a new endocrinologist who is pushing for it to be under 2.0. And this was a few weeks ago!