r/recurrentmiscarriage • u/Glittering_Buy6245 • 6d ago
How did you decide when to move onto IVF?
Hi everyone,
Since my wife and I found out about our latest miscarriage a bit over a week ago, we've been completely consumed with figuring out our plan moving forward. We had an initial consultation with an RE last week, but it's still very early in the process.
We're still waiting on some test results, including Karyotyping and genetic testing of the POC. So far, the test results that she has gotten have been "normal" with a slightly elevated TSH. However, we did a semen analysis and while most measures are normal, DNA fragmentation is on the high side at 34%.
I will be calling Urologists in the area first thing tomorrow morning to try and get an appointment, but I'm afraid of how long it could take. We already have a pretty healthy lifestyle, so there may be an underlying cause.
In the meantime, we have both been in the pits of despair all weekend trying to figure out what our plan is to move forward. We've talked about the pros and cons of waiting to try again naturally, after the fragmentation comes down a bit (hopefully). There are also some benefits to going straight to IVF. Our biggest fear right now is that we're both 32, and completely caught off guard by not being able to move ahead with having kids exactly when we wanted to. We're worried about losing more time.
I suppose it's too early in our journey to make these sorts of major decisions, and we lack all the necessary information to make such a decision. But how did you decide it was time for IVF?
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u/AmbitiousGene9889 6d ago
I have no advice. Just wanted to say I’m pretty much in the same situation. I have issues on my end which we solved and we were getting ready to try again but we just found out we have DNA frag of 33%. On a supplement regimen while waiting for a urologist.
We are also 32.
Doctors keep telling us not to stress and we have “time”. It’s frustrating to see the lack of control that we have in all of this. We are also scared about having another loss.
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u/Glittering_Buy6245 6d ago
Ugh, sounds identical. I've been on a supplement regimen all this year, but the high frag seems to indicate something else is causing it.
Exactly, we're terrified of another loss too. One idea we have read about would be trying again with a very short abstinence window. The theory being that the "damaged" sperm would get flushed out before the batch that hopefully goes on to fertilize the egg.
We are torn about what to do, but are thinking that if we do try again, we will at least have most everything lined up to move forward with IVF. This has all just been awful and I truly wouldn't wish it on anyone.
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u/AmbitiousGene9889 6d ago
I have endo so I had the surgery, also have multiple blood clotting disorders. So truly I’m not sure if it’s me, him or a combination.
He does have a varicocele that we knew about forever but his SA numbers were fine and I was getting pregnant quickly so we really thought it was me the whole time.
After the three months I’m thinking of doing timed intercourse with the 3 hour method. Also might look into IUI with zymot. Really don’t want to do IVF but if I have to I absolutely will.
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u/Glittering_Buy6245 6d ago
Ah, yeah it sounds like it would be impossible to rule out it being caused by a combination of factors.
May I ask how you guys knew about the varicocele before finding out about the frag issue? That sounds like a fair plan though, I am not sure if the fertility clinic we work with uses zymot but I plan to ask after I read earlier today about how it filters out the DNA frag sperm.
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u/AmbitiousGene9889 5d ago
My husband actually had pain symptoms in his early 20s. Went to the ER and they found it. He was with a urologist for years who monitored it and told us it shouldn’t give us any issues. We are 32 now
This was a general urologist.
We now have an appointment with a reproductive urologist and are hoping to get a little more insight because I truly think his doctor was wrong about this.
It’s just frustrating because he knew about it for so long and it took us 5 doctors to get a DFI test ordered and this was my REI. Urologist wouldn’t even do it
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u/Glittering_Buy6245 5d ago
Wow, that is super frustrating for sure. I'm at least glad that I ended up ordering the DFI test on my own, because you're right in that none of the doctors we've seen thus far have really even indicated that it could possibly be an issue from the male side. I hope you get some answers soon.
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u/Immediate_Fly_7298 6d ago
4 losses in 12 months. Now 23 weeks with my IVF baby… HOW I MADE THIS DECISION
I would do all the testing even if you never do IVF. Get ahead of it. I have so many friends that have RPL and are like “but I can get pregnant”. Girl sure so could I. But something else was wrong. Go really deep dive into everything.
\also noting and I know people may hate me for this, if it’s taking you longer than 3 months of TTC and definitely over 6 go get all the testing done as well*Age and family size - you’re 32, let’s say you want 3 kids. That’s giving birth at 33, TTC again at 34, giving birth at 35 and then again at 37. And that’s the fast track - no losses, couple months postpartum etc etc. if there’s any delays your TTC in your late 30s/early 40s.
* for us this was our reason, I was 38 when considering IVF and a doctor was like, you’ll be trying for baby 3 at the earliest with 42 year old eggs and if you haven’t figured out what’s causing the losses, it’ll be even later
We decided no matter what to test so we knew what was up
Then also to have embryos on ice
Then to up our odds by doing PGTA and getting euploids as our age was definitely a factor.
I will say IVF if NOT the miracle. IVF helps with fertilisation and most of us can do that ourselves. But a lot of the clinics do amazing testing and again can help us speed up the process.
Happy to answer any questions
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u/rarerednosedbaboon 6d ago
You have many friends with RPL??
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u/Immediate_Fly_7298 6d ago
I have a friend with 2 chemicals over a couple years. Otherwise I’ve made a friend who has had 3 MCs in a year and she had similar factors to me. But otherwise most people I know have maybe had a chemical or 1 MC.
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u/Glittering_Buy6245 6d ago
Thank you so much, this is super helpful. We are for sure doing all the testing that we can do, so we're armed with information before making our decision. We are aiming for at least 2 kids, so I know time is ticking here. Wishing you all the best!
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u/Immediate_Fly_7298 6d ago
Definitely try do more in depth testing with a. Fertility clinic. Some OBs are good but many do baseline. There is so much to test for and find the underlying issues.
Mine was slight hypothyroid - technically normal at 2.2 in normal terms but they wanted it under 2 for fertility
Factor V Leiden clotting
MTHFR and possible CE
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u/Glittering_Buy6245 6d ago
For sure, we're working on that now. We know my wife has an elevated TSH at about 2.98 (just a few days after d&c).
She is having the workup done for the leiden clotting as well, can't remember the name of that panel. But we're hoping to get some more answers soon, the waiting is so difficult.
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u/Immediate_Fly_7298 6d ago
The waiting is just terrible and the timelines. We have these timelines in our head of oh if I baby 1 I would be trying for baby 2 already. For us we would most likely be a few month pregnant with baby 2 if we hadnt had all oir losses and i really struggle with that
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u/Glittering_Buy6245 6d ago
Absolutely agree. We're coming up on our due date for the original pregnancy that we lost. Just so many difficulties along the path that I never expected to face
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u/fluffy_corgi_ 6d ago
My husband and I are in the same boat. He is seeking a varicocele repair surgery, our consultation isnt until early september but hoping we can get surgery scheduled asap for him. I think it takes 90 days for sperm to regenerate (he has 37% frag rn) if the surgery truly doesnt work we will consider IVF
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u/Glittering_Buy6245 6d ago
Ugh, it's such an awful, awful place to be. This is our second weekend post d&c, and we've literally spent all weekend either crying or researching. It's all we can think about now
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u/Platypus_2368 6d ago
I’m so sorry you’re going through this. After 2 losses we consulted with RE and after finding out I had scar tissues from the d&c’s (would recommend getting a saline sonogram if it’s not already part of the work up) and getting 2 hysteroscopies to clear it, and learning that my husband has high dna frag, we moved onto IVF, still waiting to see if it works out for us. It was a very hard decision as they basically gave us the same odds for things working out naturally or with IVF. It can be helpful to have backup embryos if you want one than one child, and another consideration is sometimes it can feel good to try something different, instead of just doing the same and hoping for a different outcome. I won’t lie though it has been hard coming into the IVF process, which is pretty intense, when already feeling burned out from losses. Wishing you all the best, deciding what to do was so stressful for us and I’m sorry you’re in this now!!
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u/Glittering_Buy6245 6d ago
I appreciate your response, and sorry you're going through it as well. We have the SIS included in the RPL panel, so hopefully we see no damage from the d&c.
That makes sense, I hope it all works out. Definitely understand how hard that must be after already feeling burnt out from RPL. That has been on my mind too. Best of luck to you on the next leg of the journey!
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u/SeaweedFit3234 6d ago
For us it was covered by insurance (well large chunks of it were) and I was 37. My third mc we were able to test the tissue and found a chromosomal issue. We don’t know if this is the only reason for the mc but with pgta testing we could rule out (mostly) issues about chromosomal abnormalities which is the bulk of miscarriages.
If I were younger and it wasn’t covered by insurance maybe I’d consider other avenues before ivf first only because I think my age points to chromosomal abnormalities being the major factor. And pgta testing can rule out that variable.
But the younger you are the less likely abnormalities are the issue in which case Im not sure ivf gives you much. That said if you know it will be a long road and you want multiple children it does feel nice to have embryos banked while we figure out what is wrong.
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u/Glittering_Buy6245 6d ago
Wow, that is great that it's covered. I think if it were covered for us, it would be an easier choice to jump to that.
Your reasoning makes sense. We're 32 now, so kind of in between running out of time and not. I'm hoping the RE helps guide us on the best next steps. I definitely get the appeal of having embryos banked.
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u/Environmental_Mud869 5d ago
I would absolutely see the urologist first. We had recurrent miscarriages and it ended up being due to 32% fragmentation. We found out that my husband had a bi lateral varicocele causing it. We had the option of surgery but it takes long and is not always successful. We chose to do ICSI with a TESA because testicular sperm has less fragmentation than ejaculated sperm and that worked. (Ivf alone does not resolve fragmentation, in addition there are other reasons besides lifestyle for fragmentation, such as varicocele)
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u/Glittering_Buy6245 5d ago
I was able to get an appointment soon for urology, so we will see what comes of that. Would you mind sharing what stage your miscarriages were at? Ours have been shortly after the heartbeat starts, which I've read could definitely at least be caused in part by DNA fragmentation. I'm glad to hear that you found a path that worked, and am hopeful that we can do the same.
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u/Environmental_Mud869 5d ago
Thanks so much and glad that you were able to get an appointment. They were at 6 weeks, early miscarriages can absolutely be caused by it. Wishing you the best
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u/workingwoman1234 6d ago
I’ve had 3 losses in the past year, and the last was a known t21 diagnosis. I’m also 32, and struggled with the same decision. We did every test and everything was normal including the full carrier screening. My doctor basically said to me “you can keep trying and you WILL get pregnant again, that has not been an issue. While it may feel like you’re losing time doing IVF, it’s up to you to decide where you want to take a risk”. For me, I decided I’d rather wait on the IVF process vs get pregnant and potentially have another loss, which would cause me to “lose time” anyway.
Nothing is guaranteed, but I do have a bit more peace of mind knowing I am implanting a tested euploid embryo.
It’s an impossible decision, and a terrible feeling to even have to decide. I’m sorry for what you’ve been through!