# 2 failed IVFs - Assisted Hatching the answer???



## Jasmine3 (Nov 9, 2010)

Hi Ladies

I would like to know if anyone out there has had a BFP after the use of Assisted Hatching.

I have had two failed IVFs, and for the next (and final round) of IVF my consultant has suggested using assisted hatching due to my age/potential egg quality issues.  The clinic do not offer Immunology testing of Array CGH and both of these methods have been dismissed by the consultant as not proven &/or useful for me. 

So the only thing he is suggesting to do differently in the next round is Assisted Hatching, so basically I will be pinning my hopes on this.    

I would appreciate any advice or information on previous experiences & successes!

Jx


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## gerry42 (Feb 13, 2009)

Hi Jasmine, just stumbled across your post somehow.

From my signature you can see I had 2 failed cycles and on our third we asked for the assisted hatching.

We were lucky and we are sure this made the difference.

We also made sure they were hatched for our 4th cycle as well.

I also know of two other FF at my clinic who were lucky with assisted hatching.

If you want to PM me to ask anything please do.

Sorry not much more detail but feeling very ill so off to bed.

Best wishes Gerry.


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## faithfullyhoping (Nov 22, 2007)

Hi Jasmine

Yes I had 2 failed IVFs and embryologist suggested I had assisted hatching for my 3rd cycle last May.  I got a bfp but unfortunately had an Heterotopic pregnancy (twins but one ectopic).  

I also did a different protocol (short cycle with cetrotide) which I think must have made some of the difference as all of the embies made it to blast and were hatching out by day 5. So whether it was the assisted hatching or the change of protocol or both I don't know but I'd definitely give it a go.  I'm in the middle of my 4th cycle at the mo, egg collection booked for Friday and will be doing assisted hatching again.

Really hope it works for you

Faithful x


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## Jasmine3 (Nov 9, 2010)

Ladies

Thankyou for taking the time to respond to my note – I am freaking out a bit as this next round will be my last attempt so i am determined to throw everything at it! 

Great to hear that you have both had positive results with Assisted Hatching – apologies if this is an obvious question – but do they wait till the embryo reaches blastocyst stage before they do the assisted hatching?? What were your stats in terms of grading, no of cells etc & when how long after EC did they do the transfer

I guess my concern is on my first cycle my embies didn’t develop very well so they decided to do a 2dt and on the second cycle they did a 3dt – they had one to keep and observe but it didn’t make it to blastocysts stage.  So I am a bit concerned that if they wait to blastocycst my embies may not even make it that far??

I am due to have an meeting with the embryologist in a couple of weeks time so hopefully I will be able to bombard here with questions.

Gerry42 - Congrats for your girls - you give us all hope  
Faithfullyhoping  - Good luck with your EC on Friday    

Jx


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## elinor (Jul 4, 2008)

Hi Jasmine

I had AH with 2 (defrosted) day 2 embryos - one stuck! - so they don't have to wait till blasto.

Hope this makes the difference for you - I looked into a whole lot of stats and papers about it, and there is reasonable evidence for it if you are over 40 (and using own eggs) or for FET, they don't do it routinely otherwise (in most clinics) because for the _average_ cycle it doesn't make a statistical difference (but no individual is ever 'average') if you are not in these categories - but that doesn't mean some younger women won't benefit from it.

You mention that your clinic doesn't do immunes, and the consultant 'dismissed' them.... My last clinic didn't do testing, and were clear that the evidence is not yet available for routine treatment, but were happy to put me on prednisilone and clexane for my last treatment anyway. Do you have any family history of immune issues that might lead you to suspect this plays a role? (arthritis, asthma, diabetes... Can't remember the list, but you can check out Agate's incredibly helpful and informed thread on immune issues). If you are worried, and this really is your last go, then there are things you can do that don't involve medication - some of the things on the list include simple dietary changes or supplements (eg some fancy supplement recommended by a number of US clinics - also available for free in apples! Lycopene - again, you can get fancy supplements, or add extra tomato puree to your soup/pasta/ stew). I'm not saying this is an issue, but if you are worried, then some of the simple (cheap!) lifestyle factors are certainly not going to do you any harm.

Hope the assisted hatching makes the difference it did for me for you as well>
best wishes
Elinor x


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## faithfullyhoping (Nov 22, 2007)

Hi Jasmine

From what I understand they prefer to do assisted hatching before they reach blast as it gets too complex at that stage.  So for me they did a 3 day transfer and hatched them on day 3 just before they put them back.  However they can hatch them on day 3 and if you've got enough suitable to go to blast let them go on to blast once they are hatched.

Last time I had two frontrunners that were a grade 1 and grade 1/2 both 8 cell so they put them back on day 3.  I think I had about 8 embies altogether.  In retrospect though the embryologist said that they should have left them to go to blast as they all made it to blast and were pretty good quality on day 5.  In fact they were so advanced they couldn't freeze them.  

Will you be doing the same protocol?  I'm fairly sure the protocol must have made a difference with me last time as I've never had that good quality in previous cycles?  I was nervous about changing protocol but in the end it paid off.  Has your consultant discussed this with you?

Feel free to pm me if it helps at all.

Faithful x


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## Jo Macmillan (Mar 19, 2007)

Hi Jasmine,

I had AH on my recent DEIVF cycle and got a BFP.

I was told it was because all the embryos (I had 16 embryos by day 2) had a visible hard outer shell that the embryologists noticed, and they felt AH was necessary because of this.

I did some research into this at the time, and discovered there are some slight increased risks when AH is performed, such as a higher incidence of identical twins. Also, it is quite a complex and delicate procedure that, if not carried out by a skilled embryologist who is experienced in carrying out the procedure, there is a risk of damage to the embryo. I spent quite a while talking it through with the embryologists at my clinic, and was happy that the lab manager who would carry it out was experienced in doing it.

They performed the AH minutes before ET for me, so on day 5 blasts.

Good luck with whatever you decide,

Jo x


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## Jasmine3 (Nov 9, 2010)

Thanks to everyone for the additional information, its given me lots of ideas for questions I can ask the embryologist.  I have looked into AH further  and I seem to fit the criteria very well (its making me think, why didn’t they do this the last time??!!) 

Elinor re Immunology stuff – I am fortunate to not have any family history of immunology issues such as diabetes, arthritis etc, so no real reason to think that it could be an issue for me, but I just wanted to be checked out & cover all bases. This time I have started to take a preconception supplement and am spending a fortune on eating the right things and even more healthy (why is healthy so darn expensive??!)   I will also continue with the acupuncture as it seemed to make a huge difference to my crop on my second cycle!

As a back up plan I had approached Care Notts to see if they think Immunology or Array CGH would be of help to me, and I have struggled to get past first base.... they basically have said your AMH is so low so  get lost...! I called them yesterday and explained donor eggs were not an option for me, and they have asked me to come in and have an Antral Follicle Count Scan – if that supports the findings of my low AMH ( that I have only a few eggs) then they will NOT  be able to do anything for me.  If it shows a high number of follicles, then will consider given me a consultation to see if there is anything they can do.

Not quite was I was hoping for!! – I am booked in for a scan next tues so watch this space!

Faithfullyhoping – On both of my previous cycles I was on the short protocol and responded better than expected – in fact the consultant said I was defying the odds (due to AMH) so he has advised that we dont change too much, as on both cycles I had more eggs that anticipated.

Jo – thanks for sharing your experiences too – when I had my EC on my second cycle they were concerned initially as they were all ‘irregular shaped’ – when I asked what this meant, the embryologist said they can distort after the trauma of EC & fertilisation – on ET day she was very optimistic about them as they were 8 cell grade 1-2 (much better than the first time).  I will add the question re hard shells to my every increasing list !

It looks likely that I am going to have to put all of my faith in AH for my last roll of the dice, thanks once again for your input and for giving me hope – its amazing how much you can learn from your FF – much more than any medical website!!     

I will keep you all posted

Jxx


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## faithfullyhoping (Nov 22, 2007)

Jasmine - It seems strange that they are worried about the number of eggs when you got 11 last time!!!  Hope the scan goes well and that the next cycle works for you.

FFH x


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## IzziLu (Feb 18, 2010)

Hi Jasmine, just stumbled across this thread and read with interest.  I had AH mentioned to me in passing by my first consultant after my first failed IVF when the embryologist noted a hard shell around my eggs (bit like yours by the sound of things Jo -    fancy seeing you here!) The embryologist thought this might be the reason for failed fertilisation.  My consultant then went on to say that on my next round they would be using all ICSI and as this makes a small hole in the shell of the egg AH would be less beneficial.  That tx I didn't even get a mature egg and tbh by round 3 I had completely forgotten about the whole discussion but through ICSI we did manage to get 2 grade 1 embies at a different clinic although they didn't implant.  

Now I'm wondering whether I should request AH on my next go since my understanding is that the hole made by ICSI is much smaller than AH and also AH is done immediately before transfer so contrary to what my first consultant said I can imagine it being very beneficial.  Does anyone else know of AH being done following ICSI?

How're you doing Jasmine - any further forward with your plans?   

Izzi xXx


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## Jasmine3 (Nov 9, 2010)

Hello ladies!

I hope you are all doing well – I just wanted to update following all of my recent appointments!

Meeting with Embryologist – this went well, she explained the process of AH, sold me the benefits of AH and poo pooed the whole Immunology stuff as being ‘so five years ago’... and that it hadn’t proven to make any difference.  

AFC Scan at Notts – They found 11 Follicles and agreed that this didn’t correlate with my low AMH and recommended I was put forward for a consultation and possible treatment with the Consultant

Meeting with New Consultant Notts – I went to the meeting with my DP,  who was very cynical and V V V anti moving clinic (he likes my current consultant and the clinic is 6 mins from where I live!) and to cut a long story short, the new consultant suggested doing the Level 1 and 2 Tests, and already picked up a potential issue with my thyroid.  Much to my amazement DP was completely sold on moving to Notts (1.5 hours away) and was happy to pay all the extra costs for the tests....  

Notts dont believe that success rate is increased by AH – and was questioning if the embryologist had spotted a hard shell last time, and if so why didn’t they do AH then??

On the basis that this is probably the final attempt for me,  I want to have all basis covered and I really need DPs support and buy in , I have decided to move to Notts and go for the immunology tests and also have my amh redone.  This means I will have to cancel my next IVF treatment which was planned to start next Tuesday – and hold off the next cycle potentially for a couple of months whilst the immunology results come back & the relevant drugs rebalance what they are supposed to.
A very very difficult decision as I have been on this IVF roller coaster for a long time (and life is on hold!) but I think in the long term, I need to feel I have done whatever I can to have the children I so desperately want.  

Thanks for all of your input & support and keep your fingers crossed for me!    

Jx


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## AmandaB1971 (Feb 19, 2006)

Jasmine

Just read your latest post and wanted to say well done for being brave enough to a) move clinics and b) wait a couple of months.  I think given that you are on your last go what's another couple of months if it might be the difference between a BFP and BFN.

The very best of luck at your new clinic!  Have you gone to Care at Notts now?

Axxx


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## Jasmine3 (Nov 9, 2010)

Hi Amanda

Yes I have officially moved to Care Notts - a very tough decision! - I was due to start my treatment tomorrow and cant help thinking... have  i done the right thing?  

I spoke to my old consultant last week, who was very upset I was moving and thought I was wasting my time moving clinic and that given my AMH I really couldn't 'afford to wait' - I must admit I broke down after I spoke to him.......   Its so confusing when you have two very opposing views from 'Professionals'. What are us mere mortals supposed to do?? How are we supposed to make sense of it all and make a decision?

The only thing I can do is   and try to stay   - and busy, not easy - hopefully just the change of scene will make all the difference.  Keep your fingers crossed for me !


Jx


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## AmandaB1971 (Feb 19, 2006)

Hun

Care Notts have an awesome reputation and perhaps a fresh pair of eyes will offer you something different.

Wishing you all the very best that this gamble pays off for you! Sending lots of    

Axxxx


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