# Round #3 - What next for me? Looking for support and/or advice <3



## Pucca2018 (Oct 22, 2018)

Hello everyone,

I am having a bad day and just looking for some support and hopefully advice too. A bit of history from me:

Me, 34 - have endo and adeno, my AMH level is 16.9 and AFC 11/4. Hubby is 36, has chronic prostatitis and sporadic low morphology/low normal forms issue (also some DNA fragmentation). 

During my first ICSI cycle (long day protocol -  buserelin, menopur, gonasi trigger) I overstimulated so they coasted me and this resulted in 9 mature eggs, 3 embryos. The ET was cancelled due to cervix canal problem/pain - so freeze all. Next two FET cycles were cancelled due to fluid in my uterus - turns out it was bloody polyp. So far three attempts and didn't even reach the dreaded TWW! My third FET (fourth attempted cycle) went smoothly but ended up in an early miscarriage. My fifth ICSI cycle was a short antagonist protocol (gonal-f, ganirelix, buserelin trigger, prontogest) as my doctor felt this might yield better results for me. Well it was the worst. 17 eggs collected but only 7 were mature and 6 fertilised. They transferred 2 day 4 embryos and the rest perished so none to freeze. I just had my BFN yesterday. All of this happened between Oct 2018-present. So my last year has been a roller-coaster!

What has gone wrong here? I have been trying since I got married in August 2016 and it's been over three years. I'm just devastated and don't know what to do next.  I think it's time to change clinics but I feel so nervous. I have two average quality embryos on ice but I'm scared to use them. I'm 34 and feel like I need to do another fresh cycle to get better quality eggs before I get older. I feel so much pressure and guilt to do things quickly because of my age. In the meantime, my career has just plateaued and I'm not progressing anymore. Infertility has literally killed my career aspirations and it's hard to leave because they are understanding of my health issues and I'm prioritising my treatments. 

I've been waffling, sorry. I'm just feeling quite desperate and sad for myself. Thanks for reading.

Pucca x


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## Londonwriter (Mar 18, 2015)

Pucca - so sorry this has happened to you   It feels as if the problem is with your clinic. They seem to be messing up your cycles and not have any good ideas of how to get a better response (beyond a short protocol). I also think they should have investigated the fluid in your uterus sooner.

I think you need to look for a better clinic with better success rates and then go 'all out' with investigations, etc. to ensure your next cycle is a success. Infertility can feel like a waiting room and, yes, it wrecks your career so the faster you can get out of the waiting room, the better.

I wouldn't worry too much about your age. I had my DS at 36 and am currently pregnant with a second DS at 39. Your AMH looks okay - it seems like the problem is the endo, adeno and sperm issues.


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## Pucca2018 (Oct 22, 2018)

Thanks so much for your reply Londonwriter, feels nice to know people here understand. My friends and family have not experienced this and just cannot relate. I think they think I need to take time out and relax, which I find so insulting! 

I think you may be right about the clinic. It was the only option as went through an NHS referral at first, and then we just stayed there as they are very caring and we got used to them. After each uterine fluid issue they did investigate with hystereoscopy and lap, but never on the immunes side. I agree with you and think it's the endometriosis which is causing uterine problems, it is notorious for causing implantation failure. I am in the process of trying to find a new clinic now and have shortlisted a few. 

It really does feel like a waiting room. I feel like I'm playing snakes and ladders and back to square one with nothing to show for it. I feel like I'm constantly mourning losses (my dad also passed away 18 months ago) and don't know when it will end. 

Oh so good to hear you had your baby at 36, gives me hope. I know 34 is still considered young in the IVF world, it's just that my dreams of motherhood started 3 years ago and with every birthday it reminds me of the passing of time and how I'm still waiting while everyone else around me seems to have moved on. It's a lonely journey. But these forums really help, so thank you. x


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## Pucca2018 (Oct 22, 2018)

I feel so depressed about all this. Infertility really sucks and I have no way out of it. :-(


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## Loopie Lou (Apr 4, 2018)

Hi Pucca
We are in a similar position, I think you just had your last cycle in Oct/Nov and we were on the 2ww forum. PM me if you like for a heart to heart? I am trying to plan my next cycle while switching jobs within my organisation and moving to a different area. I decided to downgrade my job as my job is too emotionally draining and I can't cope with 2 rollercoasters in my life   . On top of that my DH is an insomniac and is having a big low and I am struggling to keep us both above water! He doesn't feel hopeful of IVF success and I really need him to be. I wonder how we will ever have success if we are both going into it feeling like it won't succeed. I can be hopeful but his negatively can drag me down. What to do?


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## miamiamo (Aug 9, 2015)

Pucca2018 said:


> I feel so depressed about all this. Infertility really sucks and I have no way out of it. :-(


agree, but if you give up, you will have no result. Unfortunately, so there is only one way to do that - stay positive. x


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## chini (Sep 26, 2017)

Hi Pucca - I'm so sorry you're having to go through all this. I cried while reading your post as it could have basically been written by me - except that I was 36 when we started ttc in 2016 and had an amh of 3.8... I have severe/extensive adeno (which they missed while we were being treated by the NHS) and probably have also developed endo during the last couple of years... My last laparoscopy was in January 2018 and they claim they didn't see any but they weren't looking for it either and I don't t trust them as that was the NHS clinic which missed the adeno so they might well have missed the endo as well... My current clinic doesn't want to investigate the possible endo as they say it won't make any difference in terms of treatment plan and would just cause unnecessary delay.

Regarding what you're telling us, I think there are many positives you need to keep in mind: you still have a high amh and good AFC numbers that you seem to be able to grow into a good amount of eggs harvested per cycle. Also you've managed to get pregnant which is amazing, even if I can only imagine how heartbreaking it was that it ended in a loss. I do think however that you've chosen the right approach by trying to get as many embryos as possible now that you're still younger and able to produce good amounts of eggs, as transfers can be done also on a later age with less risk, but egg quality and numbers can decline quite fast...

Some things I think would require more attention are: why from such a good amount of fertilised eggs you only get a couple of embryos to transfer or freeze? That to me sounds like an egg quality issue and may well be, as endo and adeno are both known to deteriorate egg quality. Are you doing anything to improve egg quality? If not, I would start immediately as eggs take 3 months to develop. A good place to begin would be to read the book It Starts With The Egg by Rebecca Fett (make sure you get the updated 2019 edition) and follow her endometriosis plan. Secondly I would look into diet and seriously consider going gluten-free and dairy-free as well as following the endometriosis or anti-inflammatory diet, as well as adding foods into your diet that decrease inflammation in the body such as turmeric and ginger. I've seen the fertility nutritionist Mel Brown and every time I've had more results about what's wrong with me she's prepared a tailor plan of diet and supplements to tackle my issues. I think by improving egg quality you should be able to see more of the fertilised eggs make it into good quality blastocysts which will then have better chances when frozen or transferred.

Is your husband taking anything for the morphology issues? My partner was having morphology between 0 and 4%, until our current consultant advised to try Fertilix low dose which I complement with vitamin D, selenium (in the form of 2 Brazil nuts per day), zinc and a multivitamin (Pure Encapsulations: One a day) and his parameters improved so much that last time we were able to do ivf instead of icsi. Also avoiding alcohol and caffeine and generally following a healthy diet is recommended, as you want that sperm to be in top shape so that even if your eggs are affected by the endo and adeno at least the sperm won't cause any problems. When I went to see Mel Brown I took my partner with me and she didn't charge extra (she just charges her hourly rate) to make a supplement and meal plan for him as well.

And last but not least, with two autoimmune diseases (both endo and adeno are considered to be autoimmune) I would definitely look into immune issues. Sadly endo and especially adeno are notorious for causing implantation issues as well as miscarriages due to the way in which they change the immune environment in the uterus - but luckily there's quite a lot that can be done about it. A good place to start is the book Is Your Body Baby Friendly? by Dr. Alan de Beer, as well as Agate's immunes FAQ on this forum. Also, diet and supplements are good initial steps to take as that's something you can start immediately. Reishi and mesima mushrooms as well as damiana herbal tea regulate hormones and the immune response, and EGCG (green tea extract - just make sure to get a decaf version such as the one from Now Foods) reduces harmful immune response. But I would also have the immune side of things investigated. It's not cheap but I think it's well worth it. And you can do the tests in batches - such as go first for the ones which are most dangerous if they're not right (e.g. thyroid panel including antibodies, NK cells, cytokine ratios and MTHFR, maybe also a uterine biopsy), then add others later if you're still having issues. Our last two cycles I've been having treatment at the Lister but immune support by Dr Gorgy at the Fertility and Gynaecology Academy. The plan he's made for me for our current cycle is completely geared towards supporting implantation so I think he believes implantation is the main hurdle for me due to the adenomyosis.

Oh and exercise and stress reduction are super important too. I've only lately discovered that there's a wealth of yoga for endometriosis, yoga for egg quality and yoga for ivf videos on YouTube, as well as amazing amounts of fertility meditations, affirmations and hypnotherapy and meditations and affirmations for happiness. I've especially enjoyed the channel by an Australian yoga teacher Bettina Rae which I would wholeheartedly recommend. She's got some great yoga and meditation videos which you can easily incorporate to your daily life and once you start doing daily meditations even if just 5 or 10 minutes per day it really makes a difference in stress reduction I've noticed. And if I'm really stressed I often do 2 or even 3 different meditations in a row so at the end I'm super relaxed and feel much more positive!

Your plan to change clinics sounds like a good idea as well, but I'd make sure you research the consultant in addition to the clinic. When we were considering the Lister I made a list of all the comments that I was able to find on the forum about the different consultants there - let me know if you'd like me to send that to you? If you're considering other clinics it's fairly easy to make your own list by using the forum's search function - it takes a bit of time but will be very helpful when making your decision. Sadly at least in my experience the NHS has very much of a one size fits all approach and they don't follow the latest research and also so busy/pressured that they easily miss key issues (e.g. my vitamin D was WAY below the range when we had our first tests done on the NHS but nobody picked it - it wasn't until we saw Mel Brown that she noticed it and told me to start supplementing immediately as vitamin D is key for fertility)... If you're at all a more complex case, I think the NHS is not the right place for you, sadly. Which clinics are you considering?

I'm sending you a big hug and hope that you find any of the above helpful! Please feel free to ask here or send me a PM if you have any questions or would like to continue exchanging experiences. Wishing you all the best!! <3


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