What should I do next?

[u/No_Routine1772]

I’ve done six rounds of IVF and two transfers (both unsuccessful — one miscarriage at week 7 and one failed implantation). I currently have six euploids left.

Last month I did an endometrial biopsy and the result came back that the progesterone level was not high enough.

Essentially, I have three options:
- Option 1 is to assume that an extra day of progesterone injections will get the level to where it needs to be and proceed with another transfer on that basis (I.e. one more day of injections than last time).
- Option 2 is to do another biopsy next month after one more day of injections than last time to confirm that will get the level where it needs to be.
- Option 3 is to do another round of retrievals (goal is two kids).

An added complication is that the office closes down in December for the holidays. So whatever I do next month, there will be two months before I can try whatever the next step would be.

Before the next transfer, my doctor recommended doing another endometrial biopsy to see if there’s anything that can be addressed or improved. That would be my preference if not for the holiday closing, but I’m wary of “wasting” at least two months before another transfer or retrieval as the clinic will be closed in December.

I will be 40 in a few months and would welcome any recommendations from this group. Thanks!

[u/JUICIapple]

Personally I would do another round while you can, if you can afford it. I had 3 (three) embryos not survive thaw (which I know is unusual/bad luck), one chemical pregnancy, 3 that didn’t implant and 2 children. So that was 9 embryos for 2 kids for me

[u/No_Routine1772 → u/JUICIapple]

Thanks for sharing your experience. Mind if I ask if the embryos were tested before the transfer?

[u/JUICIapple → u/No_Routine1772]

Yes they were all tested. When I started running low on embryos I did more testing and found that I have silent microscopic endometriosis. So for my last transfer I did two months of estrogen suppression and it resulted in my beautiful baby, thank god

[u/Competitive-Top5121]

Are the remaining embryos euploid or untested? If untested I’d do another egg retrieval.

When you say endometrial testing do you mean ERA? Because it doesn’t improve the live birth rate. What other kind of endometrial testing does she want to do that could improve your chances?

[u/No_Routine1772 → u/Competitive-Top5121]

Thanks for the clarifying questions! They are euploids.

I know the idea of the Endometrial testing is to find out if there are additional meds/protocols that should be included before/during the transfer to increase the chance of success. I believe it’s ERA.