[Helen Wilce]

Feeling very uninformed – Since finding out I have blocked tubes and IVF was out only chance, we’ve done 2 rounds and the latest result was a chemical pregnancy and miscarriage at 5 weeks. I’ve miscarried before at 6 weeks. During my scans I was diagnosed with PCOS despite no symptoms. I also have hypothyroidism. Before we start our 3rd attempt I’ve been reading alot about early miscarriage and considering motoring my thyroid and possibly my insulin.Has anyone got advice on how to monitor my levels and figuring out what might be having a negative impact. I’m considering Zoe but it’s so expensive and not specifically for fertility.

[Fran]

Hi Helen,

Welcome to the IFVN community! Really sorry to hear about what you have been through.

There is research to suggest that an overactive or underactive thryoid can impact pregnancy outcomes. Some clinics routinely test for TSH now before starting IVF and will prescribe thyroxine if needed. I think its a good idea to get your TSH levels checked either at the GP or by the clinic prior to starting. ZOE is great but agreed its very pricey – if you want to monitor your blood glucose levels (blood sugars) then you can buy a blood glucose monitor quite cheaply of amazon and then monitor daily to make sure you stay within the range of 4-7 mmol/l. https://www.diabetes.org.uk/about-diabetes/symptoms/testing#target

That may help but i think the best thing would be to look at your TSH level first – so ask you team at the clinic to perform a TSH test.

Hope that helps.

Fran

[Jemma Archer]

Dear Fran,

I am currently deciding between two clinics for IVF Treatment. Both clinics have advised on the antagonist protocol but the fertility drugs that each clinic intends to use are so different that I find it confusing as to which might offer a better outcome or work best for me. I am over 40 with diminished ovarian reserve. A low AMH and AFC. I have regular cycles, no PCOS or endometriosis. I have not had IVF treatment before. One clinic recommends a protocol of Menopur (450IU) and Leterozole (5mg). Another plans Gonal F to start with followed by mix of Pergoveris and Meriofert. Again at the highest dose of (450iu). Appreciate you will be unable to advise explicitly on what protocol is ‘best’ but if there is anything I should be considering with each, it would be helpful to know. Thank you.

[Fran]

Hi there, Apologies that I missed your post! To be honest – the research doesn’t really show any difference when it comes to fertility medication. It really is down to the preference of the clinic and what they use most routinely in their treatment protocols.
Antagonist cycles are generally better if we are expecting a slower or a reduced response as they are quick and don’t tend to shut off your cycle as the long protocol would. Those with a lower AMH do tend to do slightly better with a combination therapy of medication – so a mixture of the meds. But this is down to my experience really and the research isnt concrete to say it makes a difference.
Hope that helps!
Fran

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