# Changing clinics or stay?



## Pepsi2 (Aug 6, 2014)

Hello,

I'm wondering if anyone can offer advice on changing clinics following a failed double donor treatment. I have 6 frozen embryos with my current clinic abroad (so I'd have to transport them if I move) but after the failed treatment I'm wondering if it's worth having a second opinion elsewhere on whether my protocol (currently just estrogen and progesterone pessaries) could be reviewed and see if anything else can be added to help with implantation. My clinic is refusing to change anything and will keep to the same protocol if I'm to try again with them nor are they suggesting any investigations (I've mentioned ERA, scratch, intralipids, aspirin, steroids, etc - all not necessary apparently). They have put this cycle down to "bad luck" and I'd need 3 failed cycles with them before investigating. I'm 48 and have adenomyosis. The clinic initially told me (before I signed up with them) they have treated many women with this condition and it does not impact pregnancy. Now, they are saying this is the cause of the failure! Is it normal to just keep trying without reviewing what can be done to enhance the chances of pregnancy? I previously had failed IVF with my own eggs at another clinic, and they put this down to my eggs. This time, I had a top grade embryo transferred and I still haven't achieved implantation so it can't be the eggs. I don't know if to keep trying with this clinic until I get "lucky" without changing anything - thereby ploughing in more time and money or to find another clinic who is more proactive and more supportive in getting you pregnant? I don't want to spend money moving only to be told I will have the same protocol as I might as well stay with the current clinic. Appreciate any thoughts/experiences you might wish to share to help me with taking my next step. Thanks


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## Miss Sunshine22 (Mar 12, 2013)

Hi Pepsi

Clinics would usually say it's bad luck, even with top grade embryos, if it's only 1 or 2 failures. They wouldn't usually recommend further testing until 3 failed transfers of top grade embryos or blastocyst. However, you mentioned adenomyosis - which is what I have. Evidence is really mixed as to whether it impacts on implantation. However, after numerous failures, I finally had success following 4 months downregulation with a GNRH agonist to shrink the adeno. So in my case, I do think it affected my transfers. I'm currently doing a FET, and the clinic again recommended 2 months downreg to shrink the adeno which has grown back. My latest scan last week showed the downreg has reduced the extent of the adeno significantly. Might be worth discussing this with your clinic? If they feel adeno is the cause of your failures, they really should be offering you an alternative to just estrogen and progesterone. Adeno is fuelled by estrogen and downregulation can help with this.


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## Pepsi2 (Aug 6, 2014)

Thanks Miss sunshine! I appreciate you sharing your experience. I’m fairly convinced my adeno is affecting implantation but all medical experts I’ve come across say there is insufficient evidence to confirm it’s impact on fertility. the Gynae I saw at Lister said it wasn’t severe yet my symptoms each month are crippling. I’m often confined to the bed for 24 hours or more at the start of my cycle. What does it mean to down reg for 2 months? I did start the treatment last month using decapeptyl which is meant to switch off the ovaries (and help with adeno) then I moved to estrogen and progesterone. I just had the one injection. I’ll certainly bring this up with my clinic so thanks for the tip! 😊


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## Miss Sunshine22 (Mar 12, 2013)

Hi Pepsi

Decapeptyl is the drug for downregulation, which is switch off the ovaries. On my successful cycle, it was for four months. I had two injections this cycle (May and June) and switched to buserelin daily injections (similar to decapeptyl but daily) with added estrogen to build up lining. The consultant said the adeno had shrunk after 2 months. 

Have you been checked for endometriosis, would this be why your periods are so painful if your adeno is mild?


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## miamiamo (Aug 9, 2015)

Hi, I am sorry you are going thought this. Unfortunately, IVF is emotionally and fnancially exhausting. I would say to stay with your current clinic if you believe in your success with them. Positive attitude plays a huge role that can't be ignored. I personally cannot stay in a clinic I do not fully trust. Good luck with your decision


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## Pepsi2 (Aug 6, 2014)

Hi Miss Sunshine,

I haven't been checked for endo but I'm assuming when I was diagnosed with adeno they would have seen any endo? I was diagnosed well before I started any IVF as I was having heavy bleeding and, along with an enlarged uterus they said I had adeno. What shows up on the scan is mild, yet what I physically experience is far from mild - well it's gotten worse over time.

My clinic has agreed to do a longer down reg but they are yet to contact me. I find the medical team there frustratingly slow to respond and communicate! They are suggesting 11.25 mg shot which I'm a bit afraid of. Did you have any side effects from the injection?


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