Next Steps After Failed HT

Hi,

So I'm back after a failed HT attempt. I had a BHCG test yesterday, which was two weeks after embryo collection, and it came back as 10 - which is super low. I have another test tomorrow to see if it's gone up, but it's highly unlikely.

Despite the disappointment at this not working, I always try to look forward. I hated the idea of HT because I always prefer a natural approach, and hate taking any sort of meds. I don't even take a tablet for a headache, and when I swayed previously (which ended in miscarriage at 11 weeks) I took Clomid 4 times (2 months on, 2 months break, 2 months on again), and then didn't stop bleeding for two months afterwards as I wasn't dispelling everything, and had two rounds of meds to try to (which didn't work either), so I thought, we may as well try HT after all the meds I've taken! Having said that, the meds I've taken - 4 different types of injections, 4 different types of oral drugs, plus suppositories, have far exceeded what I thought I would be taking, BUT - at least I can say I tried. I think I would have regretted swaying and getting an opposite, having not tried this route when I could have. I have to also admit that, I'd seen two perfect looking, long term sways, end up with opposites and that was my push to try HT. I can't deny that it would break my heart to get an opposite, but I feel I have to try.

One thing that is making me feel slightly more positive (possibly falsely) is that, out of the 11 fertilised embryos we had, only one was male and the rest were female. I had asked beforehand whether they sort the sperm, but they said they don't because they find that they get more abnormal embryos doing that so they just pick the liveliest ones.

Initially I was told that one embryo came back with an inconclusive result, and would be re-tested, but every other one had a chromosomal defect. I was gutted. The embryologist said that there were four female embryos which were grade 5AA (the best they could be), but they all had a chromosomal issue. I asked if those four could be retested, as I'd read up on PGS a lot, and read that they test cells from the placenta, and it's a known fact that, even in a full term, health baby, the placenta is 25-30% aneuploid (chromosomally abnormal). Initially my clinic said they wouldn't retest as they used to retest 5AA embryos as standard, but they found that less than 1% came back normal after retesting so they don't do it anymore. In the end, because they were testing one, the embryologist agreed to test the others. One of them retested as normal, so I had it transferred, but sadly hasn't taken.

So I'm thinking about what to do next. I'm 41 so time isn't on my side. I have both Clomid and Letrozole which I can take, although I'm not sure, once I start bleeding (I'm still taking the meds until tomorrow which is preventing that from starting yet) if I should take them, because I may bleed for a longer time. I have been exercising three times a week for an hour a day, so I can up this to five. I already have a long period between dinner and breakfast, but I usually have a protein smoothie with avocado, chia, coconut water, spinach and one piece of fruit for breakfast. I have green juice every day, and eat low carb because of my PCOS. One thing I struggled with recently is melasma - which is hormonal hyperpigmentation. I was eating porridge with stevia for breakfast and I wasn't sure if the carbs or the stevia was causing the melasma, so I stopped about a month ago. I didn't suffer with melasma when I was swaying before. I'm sure hormonal balance has an impact on swaying, although I don't know which way!

My questions are:

1. Should I take Clomid or Letrozole? I'm fine with the possibility of twins.
2. Should I try to take Clomid/Letrozole 2/3 days into my first period or wait until next month?
3. Should I have my smoothie as a late breakfast then dinner later, or have lunch (which was usually brown rice and green veg when I was swaying before) and dinner, as the smoothie is too nutrient rich?
4. I assume I should drop my green juice again as it's too nutrient rich. Do you agree?
5. I want to try one attempt at ovulation, with bd/release 3/4 days before as it was a 3.5 day gap between previous release and sperm collection for our HT which resulted in more females being selected - although this could just be luck.
6. I've been taking 1000mcg folate, a prenatal and CoQ10 for the last 6 months. I assume it's just the folate I should continue with?

Any other recommendations?

Thank you!

Hi, I just had the same history.. 3 cycles IVF because of low AMH - we had 11 Blastos to test NGS: 4 XX abnorm [emoji22] 5 XY abnorm, 2 healthy boys.. but I wanted a girl.

We have 2 boys (5 and 10 years old) and one boy in heaven [emoji174] (2018, 14 weeks)..

I m 41 years old with bad egg quality - but DH sperm quality is excellent ..

I m doing the LE Diet, but I think I need some more supplements to tune my eggs ????

DH is doing everything to have a little princess.. so we are really motivated.

If you have any advices for my, I would be very, very happy .. I really wish everyone who needs good luck and say thank you xxx

(I m not English - sorry for wrong writing ;-)


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Rosaliaslove I really feel for you having three IVF cycle. I feel like IVF was one of the worst emotional rollercoasters I’ve been on - always waiting for test results or to see how many follicles or eggs you have.

I’m at least lucky in that my husband has great sperm, and my AMH is 21.6 (or 3.02 depending on which scale you use). I at least know we can try naturally, but not having the guarantee of the result is hard.

Good luck to you!

Wow what an emotional rollercoaster. I am glad to read that you persisted on the retesting! I wasn't aware they could test chromosonolly abnormal but then be normal? We did ivf too and had all girls except 1 boy. But hes graded our best! However we just welcomed a grade 4AB girl but transferred 2 chrom normals and only 1 took ! so not sure grades really mean that much. I wish you all the best with your next chapter. Ivf is such an emotional rollercoaster.

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Thanks Mamabird4.

I’ve read a LOT about PGS and how thousands of viable embryos are discarded every year. It’s so sad. The placenta (which is the part of the blastocyst they test) can have chromosomally abnormal cells, but it doesn’t mean the embryo has, plus the embryo has the ability to self correct if it does.

Congratulations on your little girl! Your heart must be swelling with happiness! Enjoy her! X

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Originally Posted by LA_Girl

Thanks Mamabird4.

I’ve read a LOT about PGS and how thousands of viable embryos are discarded every year. It’s so sad. The placenta (which is the part of the blastocyst they test) can have chromosomally abnormal cells, but it doesn’t mean the embryo has, plus the embryo has the ability to self correct if it does.

Congratulations on your little girl! Your heart must be swelling with happiness! Enjoy her! X

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Thank you so much! We almost lost her half way through the pregnancy and had a still birth the pregnancy before so it definitely was hard.
That's amazing news! Can I ask. What chromosome abnormality did the one that got retested as normal, first have?!

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Hey, can you bump this for me?? It's a little longer than I anticipated and I want to give you my best effort.

Oh my God, that must’ve been awful! Especially when you’ve suffered a stillbirth before. I’m so sorry for your loss. I lost a son at 20 weeks and it was really tough.

It showed as trisomy 19.

I read this article https://www.endofound.org/the-abnorm...-md-facog-facs

I don’t think PGS is as cut and dried as we’re led to believe. I’m glad I tried, but I couldn’t go through it again.

I wish you the best with swaying! IVF is very hard. Swaying is tough too! It takes A LOT of discipline. I hope it works out for you. atomic has helped lots of people on here that tried IVF first.

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Originally Posted by LA_Girl

Oh my God, that must’ve been awful! Especially when you’ve suffered a stillbirth before. I’m so sorry for your loss. I lost a son at 20 weeks and it was really tough.

It showed as trisomy 19.

I read this article https://www.endofound.org/the-abnorm...-md-facog-facs

I don’t think PGS is as cut and dried as we’re led to believe. I’m glad I tried, but I couldn’t go through it again.

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Awwweee I am so sorry! Ugh this baby making stuff is so hard!! I will read this article.

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I'm very sorry you're in this extremely difficult situation. I'm 39 with PCOS and a child with a birth defect so when I started to sway, I put many months into researching the best diet for me personally - for a pink sway but definitely focusing on egg quality too. I can say confidently - and have ran it by Atomic too - that green juices are phenomenal for egg quality and NOT too nutritious for a pink sway provided it's only greens and maybe some fresh fruit. No dried fruit, no nut butters, no "superfoods" (algae, chia, protein powders, ...) or anything but fresh greens and (a little) fresh fruit.
As a matter of fact, I've been making my own green smoothies daily for 2 years and they've helped tremendously with sticking to the LE PCOS diet. I have a fast metabolism and usually need 2.500 cals a day just so I don't lose weight, and I'm hungry all the time. So, for me, the green smoothies were a great thing. I'd say keep it up.

Thank you WelcomeBaby. I REALLY appreciate your comment. The baby I lost at 20 weeks was a result of birth defects, so it’s really important to me too.

In my green juice I put spinach, kale, cucumber, coriander, celery, lemon and either dulse or kelp. I could drop the celery (and dulse/kelp) as I think that’s supposed to sway blue. What do you put in yours?

I could drop the protein powder and chia out of my smoothies...

I see you’re expecting. Good luck with your pregnancy for a healthy baby and hopefully a successful sway.

I'm so sorry. :heart:

We can't take that you got more females than males as any kind of sign or encouragement. I wish that's how it worked, but it isn't, and people have gone from one gender heavy to the other gender heavy in other IVF rounds so I cannot draw any conclusions about what the gender of any future conception would be.

1)Letrozole only, no Clomid for a 41 year old.

2)My gut is for you to wait, but as you know time is not our friend here. Compromise would be to wait 3 days after stopping the meds and taking them then. I will admit in your shoes that's exactly what I'd do.

3)Smoothies are fine, I do have some issues with a few of the ingredients which I'll address in another post. I honestly am not quite following this question but both 2 and 3 meals are totally fine, just push the first meal back as long as you can (but not TOO long, eat at noon, no need to wait longer)

4)will address in other post

5)I really, really, REALLY think that trying for a cutoff is a very poor idea. That is not the reason you got more girls and you're not catching the trouble here - the sperm surviving in the testicles is NOT the same thing as surviving in the harshness of your reproductive tract. I think you'll have very poor chances with a 3 day cutoff, and ZERO with a four day cutoff.

6)I'd have you wean off the prenatal (do not just drop cold turkey, wean off by spacing doses further and further out till down to one per week, then you can drop them) but keep folate and coq. I'd actually suggest taking 2 folates, one in the am and one in the PM, till the end of the first tri at which point you can wean backt o amount in prenatal. If you can't stand to give up the prenatal then just reduce to 3x a week.

Quote:

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Originally Posted by LA_Girl

Thank you WelcomeBaby. I REALLY appreciate your comment. The baby I lost at 20 weeks was a result of birth defects, so it’s really important to me too.

In my green juice I put spinach, kale, cucumber, coriander, celery, lemon and either dulse or kelp. I could drop the celery (and dulse/kelp) as I think that’s supposed to sway blue. What do you put in yours?

I could drop the protein powder and chia out of my smoothies...

I see you’re expecting. Good luck with your pregnancy for a healthy baby and hopefully a successful sway.

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I would like to see you drop chia seeds and the seaweed out of the smoothies.

What kind of protein powder

:agree: I'm totally cool with smoothies - we just make sure we are avoiding anything that may be harmful (oh and PLEASE do not replace the chia seeds with flax!! Flaxseeds may be harmful! Dietary amounts only 2-3 times a week when pregnant and TTC)

Quote:

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Originally Posted by rosaliaslove

Hi, I just had the same history.. 3 cycles IVF because of low AMH - we had 11 Blastos to test NGS: 4 XX abnorm [emoji22] 5 XY abnorm, 2 healthy boys.. but I wanted a girl.

We have 2 boys (5 and 10 years old) and one boy in heaven [emoji174] (2018, 14 weeks)..

I m 41 years old with bad egg quality - but DH sperm quality is excellent ..

I m doing the LE Diet, but I think I need some more supplements to tune my eggs ????

DH is doing everything to have a little princess.. so we are really motivated.

If you have any advices for my, I would be very, very happy .. I really wish everyone who needs good luck and say thank you xxx

(I m not English - sorry for wrong writing ;-)


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I think I have a message from you rosalia - I will check!

Thanks Atomic.

Take Letrozole three days after stopping meds, rather than day three from when my cycle starts?

Just to clarify on point 5, I aim to do one attempt at ovulation, with a release 3/4 days before, no cut off.

The protein powder is a vegan one with pea, sunflower and pumpkin protein that’s high in iron, magnesium, zinc, potassium and fibre. I think I feel more comfortable not having it.

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Originally Posted by atomic sagebrush

I think I have a message from you rosalia - I will check!

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Thank you atomic [emoji1374]


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I see Atomic has already replied and confirmed that green smoothies / juices are ok - great! Here's my favorite standard recipe that I never get tired of:

• 1/2 cucumber and/or a small zucchini and/or 2 handfuls of kale and/or lots of lettuce and/or the green parts of carrots, cabbage turnip etc. (spinach is fine too, of course) - really just a mix of greens I happen to have on hand
• 1 small, ripe, sweet mango (or 2/3 of a larger mango) or 1 ripe, soft peach or 1 ripe, soft pear
• small piece of lime peel or 1 kiwi with peel (!)
• handful of parsley
• 6-8oz / ca. 200ml very cold water

Obviously, now that I'm pregnant I have to avoid the parsley, and I recommend checking for every herb if it's safe during pregnancy. Some of them seem to have strong effects on the uterus. Regarding the celery, I'm not sure how it sways - it probably won't make or break your sway but if you feel more comfortable leaving it out, then do.
The parsley and the lime peel (or the kiwi) make the smoothies taste almost like not-too-sweet lemonade - citrusy and very refreshing. You just have to make sure you use very ripe and very sweet fruits - apples, for instance, usually aren't sweet enough. But since you didn't mention any fruit at all in your green juice recipe, I take it that you don't really need the super sweet taste anyway :)
I buy everything organic so I don't have to peel the fruits, cucumber etc. (well, the mango obviously :D). It's damn expensive but given my personal history I think it's worth it. Also, of course all that stuff comes chock full of micronutrients (vitamins, minerals) but Atomic said long ago that it's really only the macronutrients (fat, protein, carbs) that matter, and that makes total sense to me.
The amounts I listed above make for a smoothie of about 25 fl oz / 750ml which is very filling. If you want to replace a meal with it, I recommend adding 1/2 avocado. (Tbh, even that never really turned it into a meal replacement for me, as I said I'm always hungry and need REAL FOOD - boy mom *sigh :) )

One more thing. The green juices / smoothies help a lot with folate intake which is very good for egg health. You will probably still take a supplement (and you should) but I strongly recommend taking methylated folate instead of folic acid. It may be harder to come by but after lots of research, I'm absolutely convinced that women our age should ONLY ever take folate.

Thank you for your good wishes! You're so right, let's hope for healthy babies above all, and if they happen to be girls, awesome :) All the best to you!

Yes, but be aware it's a gamble if you're further along in the cycle than it seems.

Oh ok gotcha. Not at ovulation, though. Day before O/day of positive OPK is by far better chance of conception.

I would have you leave it out because peas in excess may inhibit conception to some extent.

just to clarify re: micro vs. macro nutrients - the micronutrients in fruit and veg have not seemed to affect sways. Only protein, fat, calories and then the nutrients in fortified foods have. I just don't want anyone to now add in fortified foods thinking I've okayed that because it's the nutrients in fruit and veg that are ok with me, not heavily fortified foods and prenatals/multivitamins