u/Fantastic-Safety-713

Just found out my first FET failed (day 6 euploid). I was on a modified natural protocol (letrozole, ovidrel trigger, medrol + doxy, estradiol patches, vaginal progesterone suppositories). Clinic has agreed to re-biopsy endometrium after initial resistance because their standard protocol is not to after a doxy regimen on the basis that my CE was mild and in most cases doxy clears it. I had an HSG in May that was clear, but no other uterine cavity inspections so clinic suggested doing a saline sonogram at the same time. My research is telling me a hysteroscopy may be better than a saline sonogram because if they find something, it can be removed at the same time. Am I misunderstanding that? Just wondering why my clinic would suggest a saline sonogram over a hysteroscopy (is it cheaper/easier workflow for clinic)?

Clinic also didn't express a strong view about whether to repeat my prior protocol, add PIO, or try fully programmed (they believe I ovulate naturally making my chances roughly equal either way, but are willing to try something different for the sake of trying something different after a failure). For those that have done both (vaginal suppositories and PIO), did you think it made a difference either way? Fwiw, my progesterone was 23 ng/ml on transfer day and 9 ng/ml 10dpt (when my hcg came back negative) - not sure if that big a drop suggests that my progesterone support was insufficient with suppositories alone?

Cycle 1: 13 retrieved > 5 mature > 5 fertilized > 3 blasts > 3 euploid

We were devastated when we learned only 5 of 13 were mature, but thrilled when we got the news that all 3 blasts were euploid

We had been so defeated that we began a second cycle before we even got our PGT-A results back

Cycle 2: 17 retrieved > 13 mature > 11 fertilized > 3 blasts > PGT-A pending

We were so relieved when we learned 11 fertilized (versus just 5 last time), so it was a huge gut punch when we learned only 3 made it to blast (same as last time, despite starting with more than 2x fertilized)

Has anyone else experienced similar - specifically, much worse-than-average attrition in multiple cycles, but at different steps in the process? I'm struggling to understand why the fertilized to blast drop-off was so much worse the second time, and if I could have done anything differently

Protocols were very similar both times (notable changes in cycle two: primed with estradiol patches for 5 days before starting stims to improve follicle growth synchronization and added dexamethasone, stimmed for 3 days longer)

Was mixing Novarel for dual trigger (Novarel + Lupron). 1,500iu dose from 5,000iu vial (3mL diluent into 5,000iu vial, draw up 1mL of reconstituted medication). After pushing out air bubbles, total liquid to inject was ~a line shy of 1mL. Would you switch needles back to the mixing needle, reinsert the syringe + 22g mixing needle to draw up a little more reconstituted medication, switch needles back to the 27g injection needle, and then inject, or would you assume 0.85-0.9mL is 'good enough' and just inject whatever liquid is in the syringe after air bubbles?

AMH in low-3s
AFC before cycle 1 was high-teens
Cycle 1 retrieved 13 eggs, only 5 were mature

Cycle 2
Applied estrogen patch within one week of first retrieval and removed it right before first stim shots of second cycle (did back-to-back cycles)

Also added dexamethasone pill (steroid) every morning

Otherwise protocol generally the same (evening gonal-f dose upped slightly)

Will likely trigger tonight or tomorrow but this morning’s scan showed asynchronous growth again. Counting low-teens total follicles and again MSD in the range of what will likely yield a mature egg (1-2 will likely already be post-mature, same as last cycle, measuring in the low-20mm range today)

Has anyone else experienced similar? Are we just part of an unlucky bunch or is there a protocol tweak I haven’t made but should consider? Was hoping the estrogen patch this cycle would have made a difference

Did the skylight calendar undergo an app update? I can no longer toggle between weeks and months via arrow buttons in the top left corner. I reached out to customer service and they said now you have to use your laptop touchpad to scroll between periods (weeks or months). But I use my desktop computer to input events (no touchpad). The interface on my actual skylight device also changed and now doesn’t show me see the full week’s calendar in a single pane (ie, each day, morning to night, for 7 days). Finally, why can’t you see the time when you’re zoomed out of a single day? It is incredibly inconvenient to not have the current time displayed in all views.
Anyone else hate the recent changes? I asked customer service if there was a way to revert to the prior version and they said no. Would love to hear if others have had success getting old functionalities back.

First cycle, very poor maturity rate (5/13). 3 M1 matured overnight via IVM, and ICSI was performed. However, day 2 check (one day post IVM maturity + ICSI) showed 0/3 had formed two pro nuclei (2PN). REI said we should not place much hope in these moving forward but as of last check they had not yet arrested / degenerated, so the lab will continue to watch them. Based on my reading, the chances of them progressing after not developing 2PN one day later are very low, but I’m curious if anyone has any success stories. I’m feeling very down because my numbers have disappointed at each step