FET after MMC testing

[smurfy]

Hi all

We have been trying for over 4 years and started IVF in the summer could not have fresh cycle as had OHSS got 7 frozen blasts so that was good, had to get over OHSS and had transfer in October resulted in positive pregnancy and we saw heart beat just under 7 weeks but at 9 weeks baby had stop growing so was a missed miscarriage. Had Surgical removal last week after waiting over 2 weeks but nothing happened, all went as well as can be expected.

We go to see our consultant next week, did any of you have further tests before transfer or after miscarriage, trying to see if there is anything else I can do to be successful next time. Also looking for any advice of getting body recovered after miscarriage.

Thanks all

 

[3chords]

Hi smurfy,

I'm so sorry to hear about your MMC, I know that it is a very painful process, both physically and emotionally. I hope that you are taking care of yourself and that you recover soon.

I was in a very similar position to you except that we transferred during our fresh cycle, saw heartbeat at 7 weeks and then diagnosed as MMC at 10 weeks with the MMC happening a few days later. This was our second miscarriage, which I think is of importance and I am not sure whether for you this is the first or not.

If this is your first miscarriage they will probably just chalk it up to bad luck which is the most likely case and just do nothing differently, though you can push for 2 embryos to be transferred this time.

Because it was our second miscarriage we decided to do EVERYTHING to try to prevent the next one, I am not sure everyone would make the same choice but we were emotionally exhausted. Here is basically what we did, which is really going all out:

1. Decided that we would not transfer the remaining 2 frozen embryos (for now) and instead do a new fresh cycle. This is because we wanted to do PGS testing on embryos and you CANNOT do that on frozen 5-day blasts because they can't be thawed, biopsied and then re-frozen. So basically the ones in the freezer are what they are, we don't know if they are genetically normal or not. We are keeping them as our last resort.

2. Did full panel immunological testing.

3. Did full recurrent miscarriage panel which revealed potential coagulation issues (anti-thrombin III deficiency). This means I now inject heparin with all future attempts.

4. Did DNA fragmentation testing on DH's sperm. We were told that late first trimester miscarriages are pretty often tied to DNA fragmentation in the sperm.

5. Karyotyping for DH and myself.

In short, this is pretty much what you can do if you want all your bases covered. But it is (a) expensive, (b) time consuming and (c) maybe not warranted if you have "only" had one miscarriage.

I'm glad we did it but it took us about 6 months between IVF attempts, and I definitely wish we wouldn't have had to wait that long.

 

[smurfy]

Hi smurfy,

I'm so sorry to hear about your MMC, I know that it is a very painful process, both physically and emotionally. I hope that you are taking care of yourself and that you recover soon.

I was in a very similar position to you except that we transferred during our fresh cycle, saw heartbeat at 7 weeks and then diagnosed as MMC at 10 weeks with the MMC happening a few days later. This was our second miscarriage, which I think is of importance and I am not sure whether for you this is the first or not.

If this is your first miscarriage they will probably just chalk it up to bad luck which is the most likely case and just do nothing differently, though you can push for 2 embryos to be transferred this time.

Because it was our second miscarriage we decided to do EVERYTHING to try to prevent the next one, I am not sure everyone would make the same choice but we were emotionally exhausted. Here is basically what we did, which is really going all out:

1. Decided that we would not transfer the remaining 2 frozen embryos (for now) and instead do a new fresh cycle. This is because we wanted to do PGS testing on embryos and you CANNOT do that on frozen 5-day blasts because they can't be thawed, biopsied and then re-frozen. So basically the ones in the freezer are what they are, we don't know if they are genetically normal or not. We are keeping them as our last resort.

2. Did full panel immunological testing.

3. Did full recurrent miscarriage panel which revealed potential coagulation issues (anti-thrombin III deficiency). This means I now inject heparin with all future attempts.

4. Did DNA fragmentation testing on DH's sperm. We were told that late first trimester miscarriages are pretty often tied to DNA fragmentation in the sperm.

5. Karyotyping for DH and myself.

In short, this is pretty much what you can do if you want all your bases covered. But it is (a) expensive, (b) time consuming and (c) maybe not warranted if you have "only" had one miscarriage.

I'm glad we did it but it took us about 6 months between IVF attempts, and I definitely wish we wouldn't have had to wait that long.

Thanks so much for your reply very helpful and informative. Sorry for your loses, having a missed miscarriage is awful, I always thought if I had miscarriage I would not be finding out having a scan, the shock of it was so bad, along with actually losing the baby. This is my first miscarriage and first try with IVF. That's interesting regarding the PGS testing in that you can only do before freezing them. The other tests immunity from your points 2 to 5 could these be done independently of going through another fresh cycle in case embryos are ok ? Also did you have blood tests down through your pregnancy to check hormone levels ? I see you had OHSS again hope your recovering it is a hard balance of getting enough eggs and not enough.
Which clinic are you at? Thanks

 

[3chords]

You can do all the immune testing and recurrent miscarriage panels independently of doing another cycle. They can help you for your next FET because the RE can do things like give you anticoagulants (heparin) if you have clotting issues or put you on steroids to reduce immune responses.

The DNA fragmentation and karyotyping would not be helpful for your blasts because they are already there. This is more for any future IVFs.

I did get my beta HCG tested 4x after the first positive (it was always rising appropriately, more than doubling every 48 hrs).

 

[smurfy]

You can do all the immune testing and recurrent miscarriage panels independently of doing another cycle. They can help you for your next FET because the RE can do things like give you anticoagulants (heparin) if you have clotting issues or put you on steroids to reduce immune responses.

The DNA fragmentation and karyotyping would not be helpful for your blasts because they are already there. This is more for any future IVFs.

I did get my beta HCG tested 4x after the first positive (it was always rising appropriately, more than doubling every 48 hrs).

Thanks I might suggest the immune and recurrent miscarriage panels just in case this happens again as that would confirm at least 2 areas of issue. If it then happens again the S you state a fresh cycle would be needed.

Good luck with all will keep you posted next week on next steps. Please let me know how you get on. Hoping to park things for a few weeks over Xmas to take some down time take care

 

[3chords]

Take care of yourself!

I also wanted to mention that it took a long time for my HCG to go down to zero after the suction & curettage so don't be worried if that happens. I also wanted to have a couple of "normal" cycles before moving on just to give my body a good chance to recover.

 

[smurfy]

Take care of yourself!

I also wanted to mention that it took a long time for my HCG to go down to zero after the suction & curettage so don't be worried if that happens. I also wanted to have a couple of "normal" cycles before moving on just to give my body a good chance to recover.

thanks I can imagine - I plan to have a scan next Friday which will be 2 weeks after the operation but 4 weeks after the missed miscarriage. I will probably ask for blood test too to confirm HCG levels thanks