# Medicated FET cancelled due to thin lining - now what? Advice needed...



## bbm09 (Feb 10, 2010)

Hi ladies,


had my medicated FET cancelled yesterday as had lining issues. My lining was only getting to 7mm (thankfully they left me a few more days to see what would happen on 4 x 2mg oral oestrogen and also 2 x 10micrograms of Vagifem - my lining actually DECREASED..... I was v shocked to hear that but on reflection am thankful they noted this before day of transfer otherwise God knows what state lining would have been in my day of transfer with my lone blast out of the freezer ready to go back.....)


Anyway, I had a nice thick lining for both of my IVF attempts (9mm) so they are a bit baffled as to why this happened as am I, and v disappointed after being 4 weeks on medication. 


So, my options are - 


a/  to do a natural FET and monitor me by scans to see what way my lining thickens with my own oestrogen. I am 40 so wonder if my oestrogen alone will do the job...any thoughts?


b/ to do another medicated FET with high dose of oestrogen from the v start as opposed to increasing half way through


My questions are:


Has this ever happened to anyone before?


What advice could anyone give me as to which option is the best? I am in another country and clinic in London so doing a natural FET will be hard to organise logistically but not impossible. The clinic says natural and medicated FET have the same success rates. What are peoples experiences of natural FET?


many thanks for any thoughts,


BBMxx


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## ElsieF (Nov 26, 2009)

Hi bbm,


I had a friend who had exactly this problem. Her natural cycle was monitored as a 'mock' cycle and it turned out ok. They reckoned it was the drugs that were adversely affecting her lining. 
And I suppose a mock cycle is the same as natural FET but with out the explicit intention of transfer if it's ok. - so what has been suggested to you sounds really sensible.
(My friend went on to have twins btw)


I have Always done natural FET, and found them Great! No drugs means no hormone hassle and it feels like the treatment is much shorter (or sort of free-er if you know what I mean!) as you don't get reminded every day about what you are doing! 
I have to admit though, the last few tx were a bit of a nightmare re being treated in another country. Our clinic is in Spain. The first time I did it I went to Spain and stayed there for 2 weeks so that I was on hand to be monitored and have bloods taken. (I got pg with this) Then when we were trying for no 2, I tried to get monitored at home and just fly over for transfer - that became a bit of a nightmare and very obviously adversely effected at least one cycle. I did this 3 times and it worked in the 3rd go, but if it hadn't worked, I decided that I was going to do the 2 weeks stay again. 


When it wasn't working for us, I asked about whether we should switch to doing medicated. The clinic said no because natural FET success rates were generally higher. They said they couldn't be specific about how much higher because it was relatively new and the data was slightly skewed. I.e. If someone couldn't do a natural FET then there was often some other factor involved.  


I was quite glad when they recommended continuing with natural. Even though trying to organise 2 weeks being close to the clinic is a pain, I much prefer it to taking drugs.


Good luck with your cycle!


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## bbm09 (Feb 10, 2010)

Thank you for your reply and also congrats on your pregnancy! I hope it goes well for you.


Thats interesting re your friend - I think my clinic are suggesting a cycle (next one once I get AF in 2 weeks) should be monitored (scanning) and if all looks OK on that cycle and my lining thickens up then I can have the transfer as opposed to doing a specific mock cycle where there is no intention of transferring the embryo. Does that make sense? 


I am only trying to get my head around it myself. I just want to give it my best shot as only have the one blast left and want it to work. 


So, do you think in your experience I would be better doing a complete mock cycle and then the next cycle doing it for real OR just going ahead with the next cycle with an open mind re transfer.....?


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## ElsieF (Nov 26, 2009)

Yes, your clinics plan totally makes sense.


If they monitor you and your lining turns out right, then yes, pop the darned thing back in!! 


My friends situation was slightly different. She lived in London and had a clinic in London coordinate with a clinic in Spain that had her frozen embies. So when she did her mock cycle in London, it wasn't so easy to do a transfer. I am guessing that's the only reason they didn't do what your clinic is suggesting.


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## bbm09 (Feb 10, 2010)

Thanks a million for taking the time to reply. You have had 3 cycles so you know more than I do! Similarly I am travelling to another country too - I wouldn't be able to be there unfortunately as I have two LO so even trying to get there for the transfer will be  feat of organisation! 


I always responded really well to the FSH in the IVF cycles, and had a nice thick lining so this came as a bit of a blow to me. I am not sure how thick my lining will get naturally as have light enough periods but we will see soon enough, and hope my cycle behaves itself.....


I thought FET was meant to be a walk in the park compared to IVF!!! I suppose for most it is, for some of us we are more tricky. 


thanks again xx


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## HopeCove (Jul 28, 2013)

Hi BBM
My FET was similarly cancelled last year because my lining was too thin, only 5mm and despite increasing my meds it had got smaller and started to break up (fluid was found in the womb). This time round I am still medicated, taking progynova three times a day and using oestrogen patches. To begin with it still wasn't thick enough but after waiting another week and using an extra patch it reached 8.7 mm. So on Tuesday we had the transfer, despite my absolute conviction it wasn't going to happen!

Like you I never had problems with my lining before, but my cycle during the trial month was irregular so I haven't been able to do the FET naturally. My instinct tells me a natural cycle might be better as there's less interference, and your body is left to crack on with something it would normally do perfectly well. Much less stress on your body as well.

So sorry that you're in this situation, good luck! X


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## bbm09 (Feb 10, 2010)

Thanks Hope Cove for responding with your story....v similar alright! 


By the time I had my last scan on Tuesday I was I think Day 24 of oestrogen and on a high dose for a week approx and I think they thought just to cancel it was easier rather than firing ahead with more oestrogen. I think I prefer that it was cancelled too as I was not getting good vibes from the whole experience! Noone mentioned patches to me so I will bear that in mind if it comes to another medicated cycle. I was at the end on 4x2mg femetab(same as progynova I think) and 2 vagifems a day (10 micrograms). I have also heard viagra pessaries are good but this wasnt suggested to me either. 


How did they discover fluid in your womb and whats the treatment for that?


When you had a trial month, is that where they monitored your natural cycle by scans? 



I know if this natural cycle is a flop as well then they will really pump the oestrogen into me from Day 1 on another medicated cycle. 


I hope I can trust my body to respond the way nature intended it to and make a nice thick lining on a natural cycle....they said they can add vagifem as well to the natural cycle to help it along if needs be....


The very best of luck on your 2WW - I hope youre not going crazy as its a tough time. Be good to yourself and hopefully little frozen embryo is snuggling into that v nice thick lining you had on your scan!


BBMxx


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## HopeCove (Jul 28, 2013)

Thanks for the good luck vibes BBM!
They never really worked out what the fluid was, it was all a bit weird to be honest. Maybe my AF starting? I know how you feel about wanting a fresh start, I wanted a break from it all as well, it didn't feel like it was ever going to work.

I've been told that my body doesn't really respond to  oestrogen tablets so the patches are the way forward for me. I have Estradot, 2 patches that stick to my stomach and need to be replaced every three days. This is the only thing that has worked for me.  (Apparently this also puts me in that tiny minority of ladies for whom the contraceptive pill wouldn't have made much difference ... Even though I was on the pill for 15 years but never got pregnant as far as I know .... until we started really going for it, if you know what I mean!).

Yes, my trial month was when they don't do anything, just scan you to see what's going on.

I really hope a fresh start is better for you. I do feel pretty sick on all these drugs but at least I reached the transfer date ok, and I'm so grateful for that, it's worth it! So it's worth trying whatever your consultant suggests, just be prepared for the side effects! Good luck xx

Xx


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## Molly99 (Apr 16, 2012)

Hello ladies, I hope that you don't mind me joining as I don't really have this experience but I am half expecting to be in this exact situation in a few weeks.  Sounds silly I know to be pre-empting  

We've had two fresh mild cycles and my lining has never really been much over 7mm, I've also had a scan during an inbetween cycle too (so completely natural) and it was also 7mm.  Sounds like that's pretty much my norm.

As we only have one shot with one little frostie, I want it to be perfect so I hassled to go on Oestrogen tablets for a week before hand.  My clinic were saying that a natural cycle can be better but it felt like my natural cycles are still 7mm and not really thick enough.  

Stupid not knowing and trying to do everything for the best.  I can see this turning out to be a mistake.  I'm 40 too BBM, I wish that I knew whether extra oestrogen is needed or unnecessary.  I guess that I'll find out soon enough.

Have you all been taking it for significant amounts of time.  I wonder what difference only taking it for a week will be?

Anyone have a crystal ball?  Wishing you all sooooo much luck xxxx


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## HopeCove (Jul 28, 2013)

Hi Molly
My clinic told me that anything over 7mm was fine so I think you will be ok?
But if it's not thick enough then you can delay it a week, take some more oestrogen, and then have another scan. At least, that's what has happened to me, and the extra week grew it by another 2mm.
Good luck! X


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## Molly99 (Apr 16, 2012)

Thanks so much Hopecove.  I've transferred twice with a 7mm lining and my clinic are fine with it.  Dr Google is a terrible thing though isn't it,  everything I've read says that 7mm is really borderline.  I had my first ever pregnancy with our first cycle and an early loss and nothing on our second.  We had the highest grade embie each time too.

I guess that if our little frostie doesn't make it this time then I'll have to accept that I'll never have a baby so I'm going a little crazy to make sure I don't regret anything.  

Its so interesting to know that you can delay a week though.  I'm an FET virgin and I thought that perhaps it was a bit more time critical.  It's so reassuring that it's flexible until everything is right. 

Thank you xxx


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## bbm09 (Feb 10, 2010)

hi ladies agian,


there have been a few more replies since I last posted so apologies for not seeing them til now.


Molly, we sound quite similar, 40 and only one little embryo in storage....I feel my natural FET will result in a thin lining as well as my periods tend to be quite light and dont last too long. The clinic said to me if the lining is looking thin on the natural FET they will add oestrogen to the cycle, vagifem to be exact, and hope it thickens it up to min 8mm. My clinic like to see 8mm, although I know plenty who transfer on 7mm. I spoke to the clinic as well last week, and in my situation they said they would also recommend a scan 2 days before transfer before the embryo is taken out of storage to make sure it remains thick. If it hasnt then I am back to a fully medicated cycle and they will put me on high dose oestrogen from the start. I am actually sort of looking forward to the natural FET this time to see what my body is doing and what difference if any there is between own hormones vs synthetic ones. I hope it doesnt let me down given the age thing.....


I am sorry to read your post that you had an early loss, that is just so heartbreaking, I think many ladies on here can relate to the gut wrenching experience of a miscarriage after trying for so long. I had a miscarriage before too and my clinic at the time said that its a positive thing that an implantation happened so please try to bear that in mind going into this cycle. Its hard having everything banking o the one embryo but maybe this is the one for you....plenty have failed IVFs and positive FETs so hopefully that will be your story too. 


HopeCove its good that your lining got to 8.7mm with the extra oestrogen - I am going to suggest patches to them as the vagifem really didnt help me in the canceleld cycle, so I dont know why they would suggest them again. Mental note to ask them if that happens.....


I hope youre doing OK on the 2ww - its great to have got to the transfer and hope this little embryo is dividing its little socks off! 


Take care 


bbm xx


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## HopeCove (Jul 28, 2013)

Thanks so much BBM! I'm trying to rest up and be positive (it's hard!). Wishing both you and Molly LOTS and lots of luck xxxx


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