What has come from a second IVF BFN is more frustration and lots more questions. Reviewing my cycle on my own (my WTF appointment isn't until the 29th) and going over everything in my head made me realize that there has to be more to it. My lining was 12mm at my ultrasound prior to the transfer so I imagine the day of transfer it was around 15-18mm, the necessary thickness for a successful implantation. We used the embryo that was farthest long in development and they assisted it in hatching. Joe and I both had genetic testing done prior to our fresh cycle to rule out any genetic abnormalities that we might carry. I really thought that this would all be a recipe for success and I was wrong.
The outcome of this cycle has raised lots of questions, many that I didn't even know that I would be asking until I took to the wonderful world of Instagram and reached out to my TTC sisters for what I should be asking at our WTF consultation. The biggest question that we need to answer before I would move forward will be is it the embryos or is it me? From what I am understanding from the doctor, PDG testing isn't necessary on the embryos because our genetics testing came back as negative (although I am CF carrier, Joe is not), but I am still going to ask if it's something that we should reconsider doing. I'm also going to ask about PGS testing, basically testing for chromosomal abnormalities in the embryos. Those are two important tests that I feel we need to do to rule out the embryos that could have issues. There is no sense in transferring embryos that are abnormal because they won't implant or could implant and end up causing birth defects in our child. The only problem with these kinds of testing is that they can only be done on embryos that were fertilized via ICSI and I'm not sure how many of our 5 frosties were done that way.
There are also a multitude of testing that can be done on me to determine if I'm the problem. One would be testing for Natural Killer Cells (NK Cells) and other immune system issues. They can cause the body to react abnormally to an implanting embryo. To treat issues with NK Cells an infusion called an Intralipid infusion can be done. From what I've seen online this is an infusion that takes anywhere from 90 minutes to 4 hours. It's made up of natural fats containing egg yolk and soya oil and it's commonly used to treat patients with MS and cancer, but can also be used to aid IVF patients with immune disorders.
Two other options are an endometrial scratch and an endometrial biopsy. An endometrial scratch to me sounds awful, but it is something that I really hope Dr. G will consider. The only downside to this procedure is it has to be done on day 21 of a 28 day cycle so this could require waiting another month since I'm at CD1. During an endo scratch, a catheter is used to "scratch" the lining of the uterus which will cause the uterus to go into "repair reaction" which can help aid the embryo in implantation. An endometrial biopsy, or E-Tegrity test is used to detect the presence of Beta-3 integrin which is a protein for the embryo to successfully implant. I asked about the E-Tegrity test already and the nurse says that our clinic does not offer that testing, but we are welcome to ask Dr. G and possibly have it done elsewhere.
These are some issues that I never knew even existed. I had never heard of any of these things until my friend Beth mentioned the E-Tergrity test which then prompted me to seek out the help of my lovely TTC sisters & find out what else I need to be asking. I am afraid that they will push transferring 2 embryos as the solution to our problem and I am not willing to do that at this point. We want to do what we have to for a healthy pregnancy not what we have to just to get pregnant, I am certain that if this 3rd cycle doesn't work we will probably be seeking out a 2nd opinion which I would not look forward to doing. I like our clinic, and our team of doctors and nurses, they have been great, but sometimes a situation just needs to be reevaluated and looked at by a fresh set of eyes. We have a long road ahead of us before we have to come to making that decision. I am hopeful that our doctor will really listen to our concerns and take them into consideration and hopefully agree to some, if not all, of this testing. I don't see the point in going through another round and doing the exact same thing, it just seems like a waste of an embryo and a waste of our time and money. Hopefully we will be able to get some solid answers, if nothing else to rule out some of these potential issues.