Pg after LT TTC - What did you do differently?

[Baby Dreamtime]

Hi Danyelle, thanks for your PM, here are my details:

In total, 10 cycles, 7 transfers and 1 IUI to get a BFP.

Unexplained infertility
Oct 07 BTs Day 2 FSH level 12.
Nov 07 Cycle #1 IVF down reg FSH 225, overstimmed, 20+ follies, cycle cancelled at day 8 as E2 levels were 25,000
Feb 08 Cycle #2 IVF down reg FSH 125, overstimmed, 20 + follies, EPU only, E2 at day 12 was 22,000, 19 eggs retrieved, 15 fertilised all frozen Day 1
May 08 Cycle #3 FET HRT, 1 x Day 3, 6 cell embie with moderate fragmentation. BFN
Jun 08 Cycle #4 FET HRT, 2 x Day 3, 5 and 6 cell embies with moderate fragmentation. BFN
Jul/Aug 08 Cycle #5 FET HRT, 2 x Day 5, 7 cell embies with moderate fragmentation. BFN. Out of frosties, they all seemed to be slow growing with fragmentation, maybe crappy due to high E2 levels at EPU?
Sep/Oct 08 Cycle #6 IVF down reg FSH 75, upped to FSH 100, 19 follies, 12 eggs, 9 fertilised, 3 blasts, 2 transferred, 1 frozen. BFN
FS ordered implantation failure and immunological blood tests, all clear. Decided to try Colorado Protocol anyway.
Dec 08/Jan 09 Cycle #7 IVF down reg Colorado Protocol (Prednisone and Augmentin for 5 days from trigger) FSH 100, 20 follies, 16 eggs, 7 fertilised, 4 blasts, 2 transferred, 2 frozen. BFN
FS referred me to Dr Julie Lindstrom at City Fertility Brisbane as he felt he had done all he could for me.
Jan 09 Met Julie, some implantation failure blood tests missing, new tests done, tested positive for MTHFR. Now on low dose aspirin daily for life, mega folate (5mg) daily for life and high dose B6 and B12. Recommended Clexane from ET or from postive BT (I pushed Julie for Clexane from ET as I had never gotten to BFP before). Continued to take Prednisone while not cycling at 6.25mg per day (quarter tablet) in case of NK Cells (though tested neg on BT, I never did a biopsy but Julie was happy for me to continue). Also tested thyroid levels, TSH, T3 and T4, they were a little off so took thyroid support.
Mar 09 Cycle #8 FET natural, 2 x average blasts transferred, Clexane from ET. BFN
Apr 09 Cycle #9 IVF antagonist cycle FSH 75, too low, 3 lead follies, converted to IUI. BFN but low hcg 9 and prog levels high, possible chemical pregnancy. I had sneakily done Clexane every second day from O day, I think this might have made a difference. Julie hadn't recommeded Clexane as it was not an ET.
May/Jun 09 Cycle #10 IVF antagonist cycle FSH 100, 20+ follies, 23 eggs, 14 fertilised with assisted hatching, 3 blasts, 2 transferred (1 hatching blast rated 10/10, 1 early blast rated 7/10), 1 frozen. Clexane from night of EPU. BFP.

What did I do differently?
Low dose aspirin, mega folate, B6 and B12 for MTHFR
Clexane from night of EPU (my thought was that by a Day 5 ET, it was a little too late).
Prednisone - I had 25mg tablets, CD1 to trigger quarter tablet (6.25mg), from trigger for 5 days (full tablet 25mg), then from there half tablet (12.5mg - in previous cycles I had dropped back to 6.25mg) - I had been on Prednisone since Jan 09.
I did assisted hatching for the first time, I had previously never had a hatching blastie.
This was the only cycle that I did NOT use Embryo Glue
This was the only cycle that I did NOT do acupuncture the day of ET, I had 1 treatment the afternoon of the day after (weekly treatments in the lead up).
I stopped taking Sharkey's herbs in Feb 09 after being on them for two years.
And the only cycle I had no caffeine at all from from CD1

I think it was a combination of treating MTHFR for a few months, being on Prednisone for a while, starting Clexane from night of EPU (my FS had said day after EPU), low dose aspirin, getting my TSH levels right, and nice hatching blasts.

I did self medicate by staying on the Prednisone between my Dec/Jan cycle and meeting Julie, she was of the opinion that I could test for NK cells via biopsy, if positive would then be treated with Prednisone, as I had very little reaction to taking it, she was happy for me to continue regardless. I did sneakily do Clexane injections earlier than Julie recommended a couple of times , and I stayed on low dose aspirin for pretty much the entire time except for a few days before EPU.

I hope this helps, sorry for the long post, please note I don't recommend self medicating, but I was willing to push the boundaries a bit because of my history. There are risks with doing this. But if I have to do this again I will push for the exact same cycle. I wish you all the best. xx

[Bridget]

Hi there everyone

My infertility was also "unexplained" to some degree although I did also have endometriosis and submucosal fibroids (removed about 9 months before I conceived).

What did I do differently with transfer no 10 (embryo no 12 and 13)? I certainly don't think it was anything in my mind that made a difference, I'd had cycles where I was relaxed and positive and cycles where I wasn't and it didnt' seem to make any difference. I had given up on acupuncture (it costs a lot). I didn't have any more rest than other cycles.

I took a bit of a scatter gun approach and kept trying new things like different cylces and pushing for things (it was me who pushed for a laparoscopy the year before during which they found the endo and fibroids).

The cycle that worked I did 3 key medical things. Firstly, the month before I had an injection of B12 from a GP (I managed to convince the GP I might be low because I have some funny blood test results and it wasn't any harm because your body gets rid of any excess anyway).

Secondly, I took prednisolone and clexane. It was the first cycle that I had done that. The clexane was 40g (mg?) and the prednisolone was 20mg per day. I stopped the clexane at about 9 weeks preggas due to some bleeding and I weaned off the prednisolone at 13 weeks. The only side effects I had from the prednisolone were good ones (my ezcema cleared, my asthma was better, my sinuses cleard -I could smell for the first time in years).

Thirdly, I looked back through various test results and found I was positive for something called ureaplasma urealyticum. I asked my FS to treat it with antibiotics. Most FS don't believe it causes infertility but I found some google articles linking it. My FS only agreed to treat because it can cause preterm labour if you do get pregnant.

See - I told you it was a scatter gun approach, not sure which of these things helped but my gut says it was the prednisolone. It took me a long time to convince my FS to try prednisolone. Also, I do want to say that of all my egg collections, this one was probably the worst. All but two embryos keeled over before day 2 and one of those wasn't very good so we put back both on day 2 (compared to other cycles where I'd had 4 or 5 blastocysts). Just goes to show, only takes one.

[mummyintraining]

Hi Danyelle,

I got my very first BFP yesterday morning. It's my 43rd cycle, we started trying in Jan 2007, so I share your pain.

Because we live in a remote area, I resisted IVF etc after being assured by GPs that I was physically healthy and that my partner was physically healthy. We decided to just focus on a healthy, non-toxic lifestyle and keep trying. In December I finally gave in and went to a fertility clinic, expecting to be told to start IVF or that something was drastically wrong. I was diagnosed with PCOS and put on Clomid to encourage egg production. My acupuncturist supported this by supplying me with herbs, supplements and dietary guidelines for PCOS. I have to stress, I could not have done this without my acupuncturist. I was eating so many things that antagonise PCOS, and I had no idea. Without her expert help, I would have sabotaged the Clomid each cycle by eating and drinking all the myriad things that aggravate PCOS.

This month is the 5th month I've followed a fairly strict diet of low gluten, zero soy, low dairy and zero processed foods. Previously I'd been allowing myself 3-4 alcoholic drinks in the week of my AF, sometimes in the week before ovulation, just to reward myself and stay sane, but this time I avoided all alcohol until the night before I ovulated, when I had one glass of champagne. I did this in homage to my many girlfriends who got knocked up after a big night out on the booze. I figured every little bit of luck helps!

I had acupuncture three days before I ovulated and again two days after. I was given chinese herbs that help with implantation, which I took every second day instead of every day after ovulation, which is what I was instructed to do. I know it's bad to experiment like that, but I was following a gut instinct. I also walked regularly during the week prior and during ovulation - I had endess amounts of energy and felt a strong urge to do this (I don't exercise regularly), so I'm wondering if my body was taking charge to otimise blood flow. One thing I noticed this cycle is that my body was really talking to me - everything was functioning well and I was getting very clear signals and urges to walk faster and longer or eat more spinach or don't take that herb. It was very weird.

This time my DH and I did not BD everyday for 5 days before ovulation. This time we BD'd 5 days before, then three days before, then twice on the day of ovulation. Each time I kept my hips in the air for a minimum of thirty minutes, and made sure I ogs'd only after my DH had ej'd, which is something we were not religious on before this.

Other than those minor changes, I obsessed and worried and stressed and thought negative thoughts just as much as I did the other 42 times - I don't buy into "relaxing" as the reason for finally falling pregnant, and it's the number one thing that irritates me when family or friends say, 'stop thinking about it and it will happen'. Honestly, I think any LT TTCer is fibbing just a little bit when they say they weren't thinking about possibly maybe perhaps falling pregnant!

Good luck with your own journey Danyelle, I hope the stork finds your house soon. xox