If you get a BFN w/GSN embryos, can you EVER get a BFP?????

[Cultured Pearl]

Hey all, long time no see. I've been busy, unfortunately not in a good way. Had my first PGD/IVF cycle. The plan was a day 5 biopsy with GSN and go straight to frozen.

The ER was December 15th. I was on 300iu Bravelle and 75iu Menopur. They were going to lower my dose when I got a high AMH score, but I was worried I'd underrespond because of my lack of response to low doses of drugs during my two MS/IUI cycles that didn't work three years ago. Anyway, they never lowered my dose and I ended up with 34 eggs, 26 mature, and 20 fertilized, then none of them were expanded enough by day 5 to biopsy, so they grew them out to day 6 and I got five blasts biopsied and frozen. Two weeks later, we found out four out of five were GSN normal, and two of those were normal XX.

ET was February 23rd. I did a natural FET, which means no real hormone drugs until after I O on my own, then PIO shots and Estrace. Both embryos survived the thaw and we transferred both. My beta is tomorrow, 12dp6dt, but I've been testing every morning w/FMU since 8dp6dt and it's been BFN every time, not even a shadow of a line. So I'm definitely not pg.

I feel so defeated. I thought the biggest hurdle was getting GSN normal embryos of the desired gender, and we did that. I'm relatively young (still 29) and they gave me 70% odds of it working. How did I come out on the wrong side of that? I did worry about the huge number of eggs ruining the egg quality (in fact, this may sound familiar as I believe Kristin was ghost-posting for me back in December during my ER cycle, thanks lady if you're reading this ;) ), but if they were genetically normal and grew to blast, isn't that enough? Or could they still have been fried, plus maybe a little too old and didn't like being out of the uterus that long?

I'm just worried because I remember while researching PGD back when I was pg w/DS3 two years ago that GSN-normal embryos were like the holy grail, and it seemed like anyone who had them automatically got successfully pg except rare cases. Because I didn't, does that mean I'm way more likely to never get this to work for me?

And what would you recommend for my next cycle? Obviously I'm going to take a lower dose of drugs, but I'm also hoping to do a fresh cycle w/day 3 biopsy and GSN. My clinic really wants people to do day five biopsy, but the fact mine took so long to make it to blast makes me wonder if that didn't hurt them, plus the two month plus wait between ER and ET is gruelling. I know it's not that much in the long run but there have been so many several-month waits in this whole process that I'd like to avoid them whenever possible at this point.

[purpledream]

I'm so sorry, I hope you get a nice surprise on beta day. Why did you do a natural FET? Was your lining thick enough prior to ET? See, the medicated FET is much more predictive because you are on meds from the getgo and there are no questions about when exactly you ovulated, is the thickness enough, etc., etc. Back when I had to choose which way to go, I opted for the medicated and everything was folowing a calendar. Needless to say that I got pregnant, but lost the baby at the end of the first trimester due to unknown chromosome issues, so it wasn't me the reason for failure. There is no much monitoring and ultrasounds in the natural FET, so it's more of a guessing game. You do spare yourself from another round of Lupron shots, but at the end you know when, what and why. Good luck on beta, you are still in the game-PUPO untill proven otherwise!

[jils04]

So sorry you've been getting bfn on the stix,its so not fair after everything we go through. Most ladies here believe gsn bfn's should be looked into further with immune testing,uterine testing and other exploratory tests before another cycle and transfer.Hopefully the experts in that area will help you.
I truly hope you have a miracle at beta, otherwise i hope you get to the bottom of it.
Best wishes

[Bambina]

I'm so sorry, I hope you get a nice surprise on beta day. Why did you do a natural FET? Was your lining thick enough prior to ET? See, the medicated FET is much more predictive because you are on meds from the getgo and there are no questions about when exactly you ovulated, is the thickness enough, etc., etc. Back when I had to choose which way to go, I opted for the medicated and everything was folowing a calendar. Needless to say that I got pregnant, but lost the baby at the end of the first trimester due to unknown chromosome issues, so it wasn't me the reason for failure. There is no much monitoring and ultrasounds in the natural FET, so it's more of a guessing game. You do spare yourself from another round of Lupron shots, but at the end you know when, what and why. Good luck on beta, you are still in the game-PUPO untill proven otherwise!

That wasn't my experience with a natural FET. I was monitored very closely and they knew exactly when I ovulated and how thick my lining was. Your hormones are already present to support a pregnancy, so there's no need for shots.

[nuthinbutpink]

The pregnancy rates are basically the same for medicated and non-medicated. It comes down to what your clinic does best- what are they used to doing to yield the best FET rates. My clinic recommended medicated. They have an awesome FET rate. So, I went with what they recommended. I think it makes no difference though. Non medicated just means many more appointment to pinpoint O and that didn't work for me anyway.

We've had a run of 24 chromosome tested BFNs. Not all GSN. CGH has been used too. Carole in the Aak the Expert section has weighed in on this on here and in her blog and the embryo is only part of the equation. There is a huge X Factor that nobody understands. Perhaps there is an issue with immunity as some have discovered- one member discovered a uterine issue via MRI, others through blood tests.

I think the way you did your cycle is the best effort you can make- day 5 biopsy with a FET. Lots of studies are showing that FETs have a much better pregnancy rate.

Everything matters though. How well the clinic handles the embryos, where they are in the catheter, how fast they are inserted seems to even effect the outcome. So, it may just be rotten luck. I know immunity seems to be the flavor of the day and it seems to really help some but it may be bad luck too. I would try SETs for that very reason. The more attempts at transfers you have, it will work out at some point.

I'm sorry about the BFN. It's such a grueling all consuming process and very defeating when you did everything right.

[nuthinbutpink]

FWIW, at your age, that many normals is awesome. I don't think your eggs were fried. You just had a great response and some of them were not mature which is 100% normal when you yield a big amount.

[glory]

I can totally see your frustration, how disappointing and I really hope Beta surprises you.

With GSN embryos, I have been led to believe that the chances of them sticking are just that much higher, but it doesn't always work.

I would definately ask your dr what their thought was on it all, I think we have found here, that most that put in 2 GSN's- either get pregnant with both or none at all.

I would probably go to somewhere they would do day 3 testing, I really like the idea of testing them then and then if they are a bit iffy retesting on day 5. I know there is a big move for day 5 testing, but I just think for a lot of us, the growth to day 5 or 6 may be just a little taxing for our embryos.

The clinic I am with now, VERY controversially will only biopsy hatching blasts, and even then they have to be grade 1 or 2, even if they are a hatching blast and are grade 3 by day 6, they won't biopsy it, the won't even look at a blast. They just don't think that if they have grown to that stage by day 6, they won't make a very good FET. Like I said controversial, but their FET stats on tested embryos are exceptional.

I would though look into hormone/lining/immune issues before having another transfer xoxo

[babynumber3]

hi, i know how u feel, i also had a gsn xy and thought that if im pregnant ill be laughing as never had problems carrying babys or concieving, i did get bfp but turned to chemical....now that i couldnt understand as how can a perfect embroy checked for all chromosones turn to a chemical, but as some pointed out it could be a immune issue..but in your case it (if ur not pregnant) means it didnt even implant right? so that means its not really to do would immune issues? i might be wrong? but no matter what its still is a 70% and there will always be the 30% that will not get a bfp...but i have seen many get bfn but go onto get bfp on their 2nd or 3rd attempt so it def does not mean it wont work the next time....xx

[Cultured Pearl]

Why did you do a natural FET? Was your lining thick enough prior to ET?

My doctor recommended it for me because I O on my own. My lining was definitely thick enough at 11mm. And they monitored me a lot with bloodwork and u/s. But the day I Oed I Oed before they could trigger me. I'd just done monitoring two days before and my follicle was at 16mm, then there was no follicle. IDK if that means anything.


I know there is a big move for day 5 testing, but I just think for a lot of us, the growth to day 5 or 6 may be just a little taxing for our embryos.

The clinic I am with now, VERY controversially will only biopsy hatching blasts, and even then they have to be grade 1 or 2, even if they are a hatching blast and are grade 3 by day 6, they won't biopsy it, the won't even look at a blast. They just don't think that if they have grown to that stage by day 6, they won't make a very good FET.


I really really really hope that's the case for my embryos. If I was at your clinic, none of my females would have been biopsied. They were rated BC and CC, though I'm not sure what that would mean on the scale of 1 2 and 3, I think they might have been 3s. And hey, they didn't make it, so maybe your clinic is onto something. But oh my gosh, how many no transfer cycles would there be if everyone did that???? That's why I think I can't do this straight to frozen thing again.




We've had a run of 24 chromosome tested BFNs. Not all GSN. CGH has been used too. Carole in the Aak the Expert section has weighed in on this on here and in her blog and the embryo is only part of the equation. There is a huge X Factor that nobody understands. Perhaps there is an issue with immunity as some have discovered- one member discovered a uterine issue via MRI, others through blood tests.

.


Have any of those BFNs come back and gotten BFPs that stick? That's what I'm afraid of, that this was some sort of litmus test for ever getting pg w/PGD that I failed spectacularly. I had a hysteroscopy and the doctor said my uterus looked perfect. I hope that's enough. Is immunity more of an issue with chem pgs with GSN like babynumber3 said? Because that is really scary to think about. I'm really near my breaking point with all these failures, six years of trying with everything I've got and just failing failing failing. My oldest swaying opposite child will be five this year, and Thursday (the day of my consult with the doc about this failed cycle) is the three year anniversary of my first failed MS/IUI, and still no DD.



Everything matters though. How well the clinic handles the embryos, where they are in the catheter, how fast they are inserted seems to even effect the outcome. So, it may just be rotten luck. I know immunity seems to be the flavor of the day and it seems to really help some but it may be bad luck too. I would try SETs for that very reason. The more attempts at transfers you have, it will work out at some point.



I didn't want to do SET because I greedily dreamed of twins. Now I feel stupid for ever thinking I could get one baby out of the first cycle. If it comes down to luck, then I'm very very sure this will never happen, as the only kind of luck I ever seem to have now is of the bad variety! Sorry for being such a sad sack, but I'm extremely beaten down.

[Cultured Pearl]

Totally negative beta, so at least it's not a chemical pg.

[nuthinbutpink]

I'm so sorry. I know you feel so defeated. GSN success rates really aren't that much better than the old way. The percentages are silly though and it's hard not to get caught up in them. I think your clinic's FET success rate does matter though. Either they are good at it or they just are not.

Being a OHW is about luck. It just is. Most of us have to try more than once. Your question about whether the 24 chromosome tested ones ever find success is a great one. I think it is too early for us to know.

You had a great response. Have you had insulin resistance testing?

[Cultured Pearl]

. Your question about whether the 24 chromosome tested ones ever find success is a great one. I think it is too early for us to know.

You had a great response. Have you had insulin resistance testing?

Are there any examples yet of women getting pg after a failed 24 chromosome ET/FET?

I haven't had insulin resistance testing, but I am as fat as I've ever been right now. Doesn't that make it more likely? Had a helluva time losing weight after DS3, think my hormones were extremely crazy during nursing, but even after weaning the weight wouldn't come off, then I kinda stopped trying then with IVF I was scared to even exercise. I've always had weight issues and whenever I'm overweight I hate myself a LOT, so it's just one more thing to feel great about right now that I can't even do anything about. How long does insulin resistance testing take? If I don't start BCP this month and cycle next month I think my brain might leak out of my ear.

[nuthinbutpink]

You're so funny. If your BMI is high, yes, I would do insulin resistance testing. I don't know where you cycled but that is Potter's goto test after BFN. Remember charliecats? NT first cycle and then 3 babies out of the next cycle after testing positive for insulin resistance and changing protocol, adding metformin.

Not to pile it on but one of the biggest things with IVF success is weight. As much as 30% lower chances according to some studies. Now, a little leftover baby weight is one thing but an obese BMI will really reduce ones chances.

I know of one 2 GSN BFN's and one went on to have triplets and the other is pregnant with one baby. There may be more but I can't think right now. Not enough have used it to really know what it means though.

[nuthinbutpink]

Three! Just thought of another one!

[Cultured Pearl]

You're so funny. If your BMI is high, yes, I would do insulin resistance testing. I don't know where you cycled but that is Potter's goto test after BFN. Remember charliecats? NT first cycle and then 3 babies out of the next cycle after testing positive for insulin resistance and changing protocol, adding metformin.

Not to pile it on but one of the biggest things with IVF success is weight. As much as 30% lower chances according to some studies. Now, a little leftover baby weight is one thing but an obese BMI will really reduce ones chances.

I know of one 2 GSN BFN's and one went on to have triplets and the other is pregnant with one baby. There may be more but I can't think right now. Not enough have used it to really know what it means though.

The thing is, the only way I seem to be able to lose weight is through extremely low calorie intake combined with a ton of exercise. I did that after DS3 and it still didn't work. Right now I haven't weighed myself in like six months but I'm guessing my BMI is like 28 or 29, maybe 30 at the worst, like high overweight or borderline obese. I'd have to like extreme diet for six months to a year, then wait another six months to stabilize, and I just can't right now. The waiting, I just can't do it anymore. I'm so tired.

[michaela]

I do not think you need immune testing at this time. I typically recommend it if someone has had repeated failed cycles but since this is your first one I would not spend the money on that just yet.

Lillylolly used GSN a few times and is now finally pregnant. It can and does happen all the time. While we want there to be 100% success rates with GSN normal embryos, it just isn't the case. Unfortunately you were on the other side of that statistic/percentage. :(


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[michaela]

Oh and IR testing is super common and easy to have done, I would do it if that is one thing you haven't had done.


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[nuthinbutpink]

You need insulin testing.

[Cultured Pearl]

So if I get insulin testing and they give me metformin, does that improve things significantly or will my fat ass and revolting unmoveable gut keep me from getting pregnant just like they keep me from looking in the mirror?

[jils04]

how about high protein low carb, that works well for my fat bum?

[nuthinbutpink]

How many calories do you eat per day? Do you know? What do you eat for breakfast?

[michaela]

Metformin takes a minimum of 2 months to work so I would get that done ASAP. The Paleo/Primal diet is great for PCOS, pm me about it if you want to know more :) if your insulin is spiking it can possibly cause a m/c.


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[Cultured Pearl]

It's painful and upsetting for me to even think about food-related stuff, that's how much of a problem I have with it. I know how to lose weight, believe me I know, you don't have to tell me how to do it. I've done it tons of times. I was really heavy at the end of high school, then crash dieted seventy pounds away in like five or six months, but then I didn't get my period for six months. So for me, dieting has always been associated with infertility, not to mention poor health. When I was ttc #3 and using the starvation method to have a girl, I was sick constantly and covered with cold sores all the time. Last year after DS3 was born I didn't starve myself, but I limited my calories and exercised for an hour or two a day six days a week, and doing that only made me lose about a pound a week every other week when I needed to lose about fifty or sixty pounds, and the exercising was taking time away from my family and DH so I quit.

Now I'm not overeating that much. I eat cereal for breakfast (I know it's more cereal than while I'm dieting but it's not that much more), a small lunch of frozen Amy's Organic type meals that are less than 400 calories or homemade hummus and pita and carrots, then I usually have a sweet snack at some point like a cookie, then dinner is reasonable. Dessert of dinner might be bigger than it should but I'm not putting down half a thing of oreos or a pint of ice cream a night or anything. I think the BFing hormones, then the IVF-related hormones and subsequent lethargy for fear of ovarian torsion and further winter lethargy are what is doing it the worst, but really even then I shouldn't be this fat. Also I know it's not a thyroid problem because I had testing for that a few months ago and it was fine.

I can't even imagine putting this on hold to diet. I had a full year between DS3 being born and IVF and I tried as hard as I could without starving myself for nine full months. I don't see how much better I could healthily do in less than a year's time, and then I have to wait to stabilize. Thinking about putting this on hold for two months to take the metformin makes me want to cry. A year or more of waiting is unacceptable. I've waited long enough.

[nuthinbutpink]

The thing is, the only way I seem to be able to lose weight is through extremely low calorie intake combined with a ton of exercise. I did that after DS3 and it still didn't work. Right now I haven't weighed myself in like six months but I'm guessing my BMI is like 28 or 29, maybe 30 at the worst, like high overweight or borderline obese. I'd have to like extreme diet for six months to a year, then wait another six months to stabilize, and I just can't right now. The waiting, I just can't do it anymore. I'm so tired.
According to the lovely charts, body mass index of 18.5 to 24.9 is considered normal, 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese.

I would not cycle again until you lose some weight. That's how much it can hurt your chances. But whereas many on the forum cannot change a thing about themselves and have to search for something to help, you have way more control over how to make it work! I had to lose 60+ pounds after DS so I know how hard it is but it was calories in, calories burned and yes, I did have to work out. Unless you have a thyroid issue or a genetic issue, that's really all there is to it. My DD does have a genetic issue that leaves her with very little lean muscle mass and zero metabolism but we still control her weight through diet. That's even with genes working against her. If she can do it, I know you can too.

[Cultured Pearl]

According to the lovely charts, body mass index of 18.5 to 24.9 is considered normal, 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese.

I would not cycle again until you lose some weight. That's how much it can hurt your chances. But whereas many on the forum cannot change a thing about themselves and have to search for something to help, you have way more control over how to make it work! I had to lose 60+ pounds after DS so I know how hard it is but it was calories in, calories burned and yes, I did have to work out. Unless you have a thyroid issue or a genetic issue, that's really all there is to it. My DD does have a genetic issue that leaves her with very little lean muscle mass and zero metabolism but we still control her weight through diet. That's even with genes working against her. If she can do it, I know you can too.

see above reply

[nuthinbutpink]

Okay. Just trying to help. I just don't think it is something you can ignore though.

I highly recommend the insulin testing. I'm just trying to help you find a way to make this work.

[Cultured Pearl]

Does the metformin help a lot?

I looked into all this a long time ago when it became apparent that I'd be overweight while cycling because my dieting wasn't working because everything I try to do fails now, and I saw people asking about it with BMIs in the high thirties and forties. I know I'm not at a good place, but I can't be at the worst place weightwise.

.

[nuthinbutpink]

If you have insulin resistance, yes, it should help with quality which means more fertilized hopefully and a better metabolic growth rate(getting to blast by day 5). Implantation is up to your body.

[purpledream]

So if I get insulin testing and they give me metformin, does that improve things significantly or will my fat ass and revolting unmoveable gut keep me from getting pregnant just like they keep me from looking in the mirror?
You really have a nice sense of humor regardless of the circumstances...I think my BMI is close to 27-28, so brought my fatso to the gym and I know I'm loosing fat since it's hard to loose weight with having the hypothyroid crap. It looks like I'll be starting drugs ASAP for my last fresh IVF and I requested to get the IR test done prior to even looking at the calendar. My last frozen embryo was a HB on Day-6, grade 3, so needless to say, it didn't produce a healthy baby, just like I was suspecting...good luck to you and do whatever immune testing you could do without braking the bank, so at least you know that is not the reason for failure.

[Cultured Pearl]

If you have insulin resistance, yes, it should help with quality which means more fertilized hopefully and a better metabolic growth rate(getting to blast by day 5). Implantation is up to your body.

See I think quality was definitely an issue, but I'm hoping it's mostly because of the drugs.

I'm sorry if I sounded argumentative, I'm just one big raw nerve right now and my weight has been my most sensitive subject since elementary school.


It looks like I'll be starting drugs ASAP for my last fresh IVF and I requested to get the IR test done prior to even looking at the calendar. My last frozen embryo was a HB on Day-6, grade 3, so needless to say, it didn't produce a healthy baby, just like I was suspecting...

So did your IR test come back normal? What are you doing for this cycle? Are you trying for a day five biopsy again?

[purpledream]

I am just about to take it, Purl, just got the labs today as I requested it last night after all the fuss about it on the board recently. Since this is my last go, I can't afford to sit stupidly and not do all I can to make sure I helped my egg quality, because my last cycle it suck a$$ and I lost both babies-one had sever NTD and the other didn't make it past the first trimester. My RE said that most likely we are dealing with crappy eggs, but I'm not too old even in the IVF world(just turned 36). My AMH went form 1.5 to 3 and I think mainly because of taking Propolis, Royal Jelly and anti-oxidants. We shall see what all this will do for me in the upcoming weeks...I'm so sorry for your BFN and I know what it means to be on the other side of the stats and not once, but twice. I will be doing the 5-Day GSN with planned FET just like Michaela and hope for the best. That is the best I can do and the most info I will get for my embies before transfer, if I'm lucky to have one.

[jils04]

Ir testing plus positive positive thinking. Maybe get those relaxation/meditation CD's to help ?

[glory]

Hey hun, big hugs to you! I TOTALLY get what you are saying about the weight loss. My BMI is high, like 34, so high. I got a lap band about 4 years ago and since then I have lost approx 40kgs, which is 90ish pounds. I have always been big but after my ds2, who had so many medical issues I just over ballooned, but I am at a weight now that is stable and the band is adjustable so I can get it tightened and loose weight when I want. (Sounds easy but it is not).

I totally understand the wanting to cycle now and not wait. How I see it, is I could loose the weight I need in a year and a half and be fine and I know once I have this baby if I ever get pregnant, that is what I will do, but at the same time you are weighing up the time you have left with the eggs you have. I also don't want the gap between my ds3 and the new baby to be too large, I already have a big gap with ds2 and 3 because of number 2's health issues.

Last year when I was cycling in Thailand I had my band loose so I could get all the nutrients, take my vitamins etc and the results wasn't good, plus I put back on about 6kgs. Since december I have lost and extra 8kg, and this cycle there was no huge different with egg quantity, quality is yet to be seen.

I know Dr Potter is very keen on insulin resistance but it has never been suggested to me, loosing weight has been suggested but even then they have been talking about a couple of kilos, not getting my BMI down to 24. I know someone who cycled with Dr Lin and said that there was nothing wrong with the insulin results and then dr Potter said, that she must take the insulin med, I am hoping she has a better cycle but won't know till she cycles :)

Anyway what I am trying to say is, I think your point is vaild, get the test done anyway and see what your RE has to say about it. With the weight if you can try and stick to a healthy eating plan, which is what I am trying to do now and not add anymore weight on and hopefully loose some and add in some exercise it may help your chances.

[michaela]

Losing only 5-10% of one's body weight does sooooo much! You don't need to be at a goal weight or put unrealistic expectations on your shoulders that's for sure!


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