# Round 4 of IVF: What on earth to try differently??!



## BeeBee18 (Aug 1, 2018)

Hello ladies,
Just looking for some advice here and would love to hear others experiences.
Me and DH are about to embark on IVF Cycle 4. We’ve decided on a ARGC (hope the right choice!)
We have had a rocky road to date.

Our first  IVF cycle was a success two years ago...But unfortunately ended in a stillbirth, last year, in the 3rd trimester (v traumatic and think about our darling baby every day).

We then did FET no1 with an average blast earlier this year. I am an early tester (terrible habit and do myself no favours...) After getting faint bfp’s 5dp and 6dp, that elusive 2nd lime soon disappeared.

Which takes us to our last FET in June...Another average blast. This time we had strong 2nd limes from 5dp, which continued and continued long after I started spotting, which turned into bleeding with clots...Another chemical.

Which brings us to now.
I’m feeling so disheartened.
All around us our friends are popping babies out right left and centre. 
Since embarking on ivf, we both gave up alcohol (although I have had the odd glass here and there between cycles). We eat very healthily and rattle around with all the “fertility” vits we take.

Half of me now thinks, does all of this really make a difference? Even with my Just Turned Forty Hat on.
I tell myself women get pregnant all the time after downing a vat of wine; not knowing that anything even exists called ubiquinol, never mind cutting out the sugar etc etc. 
I am gazing wistfully at that full bodied bottle of red, thinking does it really make a difference??

And if it does, is there a trick I am missing out there?!

As we are now going private, we are taking a deep breath and going to the boot camp known as ARGC. The close monitoring suits me and I am wondering if my 2 chemicals point to an immune issue. Monitoring cycle starts next cycle.

I have rambled but by question is: what are you doing? Are you super healthy, off the booze? Anything else? 
And for you lovely ladies with your BFPs, what worked for you?!

Merci B xxx


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## Efi78 (Jun 26, 2017)

Beebee18

I do exactly the same things as you but no luck. Just several miscarriages. 

As you said, friends with far worse issues than me evenrually fell pregnant and the top of the iceberg is one with non existent AMH and husband having severe oligospermia. Another one conceived when 38, diabetics, other health issues, PCOS and 110 kilos. So  i am not sure what else to do really. I have ended up that eventually if it is to happen it will. It just happens for everyone else other than me. We have been trying for 6 yers. I had just turned 34 when started trying so not old at all. Good BMI, excellent AMH, no health issues just some sperm problems. Three miscarriages....I don't know what else to do tbh.


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## Baking Queen (Jul 7, 2014)

Hi Bee

I’m so sorry for your loss - that must have been so hard. I also used to get chemical pregnancies and the thing that made the difference for me was an immunes protocol. I got pregnant with my daughter the first time we followed a proper immune protocol and I’m currently 13 weeks pregnant following an FET. You’re going to see ARGC - they told me I had an immunes problem years ago - really wish I’d listened to them straight off! There are other immunes specialists around that will work alongside other clinics.
Good luck - I hope you get some answers soon. 
BQ. xx


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## Nicnik (Feb 17, 2016)

Hi Bee,

So sorry to read of your loss and experiences so far, it's heartbreaking. Sending  

I can't really offer any advice, but I just want to say I'm thinking the same way as you - after 8 cycles of IVF (with no known issues...apart from age now) and practically zero drinking over 5 years and super healthy eating, gentle yoga and walking etc I still don't have my take-home baby.  It's baffling!  One of my best friends (42 yrs old) has just had her third (unplanned) baby - this happened after a very boozy night out for her birthday and was completely unexpected.  Then I have a colleague in work who is 7 mths pregnant - fell pregnant after trying for the first time on her honeymoon, which involved copious amounts of cocktails. It just feels so unfair! 

From now on, I'm going to have a few drinks here and there, eat chocolate and crisps if I want it and get back to doing proper gym classes like Body Pump.  I feel like I've lost myself in this whole process over the last few years.  

Anyway, sorry for the rant and for not being able to offer any actual advice, but just wanted to say I feel the same as you.  

Good luck with whatever you decide to do.  xxx


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## Liz3511 (May 17, 2011)

So sorry to hear of everything you've gone through.

I am sure that you've undergone testing following your devastating stillbirth - are you negative for the thrombophillias and other elements of the recurrent miscarriage screening tests (e.g. parental karyotyping)? Have you gone through checks for any structural abnormalities of your womb?

Xxx


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## ruby100 (Oct 25, 2015)

Hi 
I’m a little bit different as I had to have a surrogate carry my baby for health reasons but the baby was my egg/ DH sperm. I did 4 cycles. 

Cycle 1: 4 blastocysts - 1 miscarriage 9 weeks, others didn’t take.
Cycle 2: 2 day 3- didn’t take.
Cycle 3: zero fertilisation!
Cycle 4: 4 blastocysts- 3 didn’t take- last one- our baby girl just arrived 27.7.18!

So what did we do differently?

- I researched the way older ladies work in ivf. I turned 40 just after cycle 4. (3 months later). I discovered that, sugar can be a problem if you have slightly higher blood sugar (not diabetic but raised compared to 20 year olds). I decided to take inositol to regulate it. I bought the inositol/folate combination powder available on zita West website.
- I also took her vitamins and boost vitamins and antioxidants for a full three months prior to stimulating.
- DH was started on proseed for men- full of antioxidants. 
- I discovered that as well as the Gonal F is been taking for stimulation, many older ladies also do better with added Menopur as gives some LH. I used a combination of both. 
- I stimulated slowly rather than quickly as I think it gives the eggs the chance to grow rather than go for bust!

Lifestyle wise- I did precisely what I liked! I did do the fasting diet (2 days a week at 500 cals) coinsiding with a few weeks prior to egg collection so may have had an effect!
I did however eat chocolate, meat, go out, etc

Good luck! 
Ruby x


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## BeeBee18 (Aug 1, 2018)

Thank you for all your replies.

I am beginning to think it’s a part luck / numbers game and possibly part immunes, and so ARGC can hopefully help with the immune part.

Efi78, have you had all of the NK / immune testing done? Possibly that is something to look into after 3 miscarriages? Apologies if it’s something you have already tried. I really do think there is something in it, as Baking Queen has mentioned (& congrats BQ on number 2!)...

Nicnik, i am completely now thinking the same as you, be healthy but not completely loose myself. It’s almost like as each year is going by I am getting more obsessed and I feel like I need to take a deep breath and actually obsess less. Not completely deprive myself from doing things I enjoy, just in case. Maybe stressing less and getting a some of “me” back. And rant away! Sorry you’re feeling like this too...

Liz, thanks yes, they ran loads of test following my stillbirth but not abnormalities of my womb - thank you for that suggestion. I think my last clinic’s mentality was I had gotten pregnant once and it was almost “bad luck” what had happened- so they didn’t change anything (aside from give me blood thinners, even though I tested negative for sticky blood) or test me for anything, hence me moving to ARGC.
I am assuming ARGC can scan me to check for the abnormalities?? Thanks again for suggestion.

Ruby, thanks for telling me your experience. I will have a look at the inositol/ folate on ZW (me & DH are on her prenatal) and the boost vits and antioxidants...(I know I just said I was going to relax more, but I will definitely take a look)
My successful fresh i was on Gonal F & menopur, so that worked for me (to an extent) too. Your way sounds like a good way, mixed in with some immunes and some close monitoring and fingers crossed maybe, for once, it will be my year...


Xx


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## Liz3511 (May 17, 2011)

Beebee - you've really been through the mill, it's so very unfair 

Glad the structural abnormality suggestion was helpful. ARGC sound like they check everything known to man, which is simultaneously terrifying and reassuring. I am actually going to my first appointment with them on the 20th - so we might be starting our journey with them at roughly the same time ... xxx


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## BeeBee18 (Aug 1, 2018)

I do feel a bit battered and bruised sometimes- but we all have our struggles right?! I’m one to have a big cry, talk and talk about it, pull up my PMA pants and keep going.
The stillbirth nearly broke me though, 33 weeks is so close and I didn’t even know stillbirth’s happened (I know that sounds stupid)

We had our initial appt last week. I thought it was good! It would be great to have someone to chat too! I was planning on moving on to the cycle board once I’ve done my monitoring cycle and have immunes come back...

Xx


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## kittykat76 (Jan 17, 2016)

Having been in a similar position I know how hard it is, Im so sorry for the loss of your darling baby, that must have been awful. I have had several miscarriages but they were all early, you must be really strong to get through such a late loss and carry on. I have immune issues and now finally have my baby boy. I really believe that neupogen was the key for me- not sure if ARGC offer that though? I know they didn't when I was cycling. ARGC are pretty thorough with their testing so if there are any problems in that area they will find it. I took ubiquinol, inositol, a good omega 3, zw multi vits, extra zinc and selenium and had Epsom salt footbaths to increase magnesium ( a hair analysis showed severe deficiency in those last 3) I used gonal and merional as just gonal didn't work for me, had acupuncture and ate loads of protein. I also used injectable progesterone instead of pessaries as my body just didn't absorb them. I was supposed to avoid red meat and caffeine but this time I pretty ate what I wanted and still drank caffeine throughout my pg as had avoided everything during my other pg's and still lost them. I also had embies pgs tested as I produce a lot of eggs and it ruled out one cause of my losses


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## miamiamo (Aug 9, 2015)

I am sorry for your loss. Unfortunately cp might happen due to various reasons such as immune or genetics.


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## BeeBee18 (Aug 1, 2018)

Thank you, hoping immune testing via ARGC will flag up if I have immune testing.

I notice some people go to Dr Gorgy...Does he test for additional things to ARGC? I’ve only heard of him from this website...


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## Liz3511 (May 17, 2011)

A few searches on Dr G. vs ARGC seem to suggest that he does a deeper level of immune testing (e.g. LAD / KIR testing, which I don't believe ARGC do) - I may well be wrong on this though!

DH and I watched the infamous Dr G episode of Panorama yesterday (I wanted to give him a sense of what some of the prices might be, for one thing!  ) . 

I really really wish I could figure out where I stand on the immune issues ... I am a research scientist and DH is a doctor so we really want to understand how much support the basic science behind the immune principles actually has. We accept the fact that there just aren't any randomised controlled trials out there on this stuff, but it just feels like there are two incredibly polarised camps who are constantly arguing, and no accessible information that helps patients take a position in the middle ground! The RCOG guideline / Robert Winston's position is very disparaging, Dr G / ARGC are relative disparaging of the RCOG position...

I think I will definitely be going to see Siobhan Quenby / Jan Brosens in Coventry before I cycle again. I understand the uterine NK cell principles a bit better, and it isn't expensive testing compared to everything else!


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## BeeBee18 (Aug 1, 2018)

Thank you, that makes sense. 
I think I will get my immunes done first, get the results and make a plan from there. Trying not to stress about it until necessary.

Are you based near Coventry? 
It’s just slightly easier for me to go via ARGC, though more expensive. 
I’ve actually already spoken to Dr Q and Dr B (not about NK etc, but they looked over my post mortem results). At that stage I hadn’t had the 2 chemicals, but I wanted a second opinion on what my consultant said they would do following another pregnancy for me.

I’ve also read up on the different view points, but I guess I’m at the point now where I think *something* has to be done differently and looked at. 
If I’m super healthy, good fertilisation rate, getting blasts (admittedly 3 were average, but good enough to freeze and defrosted well) and they are *starting to* stick...to me it shouts there could be an immune problem...
That an the intense ARGC monitoring, I am thinking will be good to try.
I had a follow up at my old clinic last week asking what they would do differently and they said put me on 3 cylogests a day, rather than 2. That’s just not good enough for me. I also have a feeling my progesterone levels were too low and had asked my previous clinic to monitor and they said no.


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## Liz3511 (May 17, 2011)

I completely agree - there's no point in just re-doing what has been done before. 

My gut tells me that the super-careful monitoring and world-class embryologists at ARGC, followed by very careful tracking if one gets a BFP, is the key to their success rates but I would put a lot of money on the bet that a subsection of women very much need the immune treatment they offer in order to achieve success. 

Whilst I think the methods of telling who needs immune treatment are still in their infancy, there is absolutely no evidence it does any harm so it makes complete sense in your position to go through the testing and err on the side of treating and trying absolutely everything they recommend ... in for a penny!

Looking forward to hearing what the immune tests show for you! I'm not based anywhere near Coventry -  I live near Newcastle, so any treatment is an epic trek. If we go forward with an ARGC cycle, a friend has kindly volunteered her spare room for me for the duration ... do you live near the clinic?

Did you find the Quenby/ Brosens opinion helpful after the loss of your dear baby, or less than helpful?


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## BeeBee18 (Aug 1, 2018)

Oh our Quenby / Brosens opinion was definitely helpful. Even for just piece of mind. On the whole they were in agreement with everything that was said / support I would get in next pregnancy but there were a couple of things they completely disagreed with (and when I challenged my original consultant, she agreed that my second opinion - I didn’t say who - was “probably” correct). Also they have a couple of alternative solutions to what was also suggested. Very pleased I got their opinion. And I have only ever heared good things about them.

Newcastle is a bit of a trek but v lovely of your friend to let you stay if you decide to go with ARGC. I live / work in London so it does make it easier. I always take off week 1 of the 2ww anyway and during my fresh, I was off from EC. Though I have read the 2nd week of stimms are intense.
I have to say, we went for some bloods last week, got there at 8am and i thought it was v well organised (we didn’t wait at all). We were impressed at our consultation meeting too. It was just under an hour and very very thorough. 

I see from your signature you have 2 day 6 good grade blasts frozen. Are you planning to move these to a new clinic or do a fresh? And I’m sorry for your miscarriage. After everything we go through, we are extremely strong to take deep breaths and try and move forward xx

And my gut tells me the same as you. The intense monitoring probably has a lot to do with it - with some control of the immunes - but as you say it’s so early and different schools of thoughts - and if there is no harm...


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## Liz3511 (May 17, 2011)

Great to hear that Dr Q and Prof B were helpful - like you, I've only ever heard good things. The confusing element of the uNK hypothesis is the fact that uNK levels fluctuate cycle to cycle, so even 2 biopsies won't show the full picture or where your levels are on the 'curve' of increasing / decreasing levels... and of course, one can't cycle (or even 'try' naturally) on the months when a biopsy is taken. At least with blood NK cells one can test them and cycle at the same time.

Really good to hear that your experience of ARGC was positive - were you able to get your immune testing done at the same time? Which doctor did you see, if you don't mind me asking?

My miscarriage was my fifth loss, and I think I am getting more numb to the miscarriages over time - just glad that it ended relatively early, if it had to end at all. I know that a later loss would be an entirely different matter. This is going to sound awful but I don't hold out much hope for the blasts, because they developed slowly (day 6 rather than day 5). I'm happy to leave them in the freezer for now and press on with a fresh cycle whilst I still get a relatively okay ovarian response. 

I am really grateful for the friend who is offering up her spare room. She is currently pregnant (has the same due date as I would have had if this last pregnancy had worked  ) but is very lovely and I couldn't possibly say no to free accommodation. Also really grateful that I will have company - I spent 12 days in Greece on my own last cycle and it almost drove me 'round the bend!

Did you leave the consultation with a plan - I have read that they don't necessarily plan the drug protocol until a monitoring cycle is done, but did you get a sense of timing for the tests and the next steps for you? I hope they suggested some things to try differently (going back to the title of your post) and gave some hope that this might make a difference ... xxx


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## Pognut (Apr 8, 2012)

I'm currently doing a FET at ARGC, but using the Coventry immunes protocol. I wasn't at all sure they'd let me, but they were fine about it. They made the same point as you, Liz3511, that you can't do those tests in the month you cycle, so there is a risk that you'll over-suppress yourself. But having had Coventry talk through why they think the blood NK testing doesn't tell you anything useful about what's happening in the uterus, I thought it was probably my best bet. 

I also really wish there was some consensus on this...


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