Wanted to share my story in hopes it helps.
My husband and I did IVF because of unexplained severe male infertility. I did three retrievals 101 eggs total. (I was told my numbers were rare) In the end, we realized only 4 euploid and 1 low grade mosaic. Our doc was great at helping us do the math on the attrition rate so we found this a great outcome given our condition.
After the first transfer, we had a perfect baby boy. 2 years later we went for the girl and had a failed transfer and of course was disappointed couldn’t repeat our luck.
But here is where it get’s interesting…..
I truly believe I took this whole process for granted and ignored clear warning signs. Prior to the transfer I was severely stressed with work, kid and caring for my parent who was losing their battle with cancer. I was just powering through. I had what I thought was a yeast infection and self-medicated which didn’t help. Then I went to gyn for a swap and results determined I had Bacterial Vaginosis (BV). I still thought no big deal, took the 5 day antibiotic and proceeded to schedule my transfer. Even after the treatment I noticed some slight bleeding from my cervix and little only mentioned it to my fertility doc 5 minutes before the transfer! Obviously we still went through with it and it failed. The bleeding continued so my fertility doctor suggested we do an endometrial biopsy which determined I had endometritis. Both endometritis and BV can be insidious, chronic and reduce IVF implantation rates. Being 43 yrs old at this time I was desperate to have a baby girl and be done with this fertility journey.
Don’t be like me. I made many mistakes.
The FIRST MISTAKE was assuming the second is like the first. Chronic BV after having a baby is common and I didn’t know this was a big deal. I should have done another swab after the treatment to confirm it was gone because it wasn’t. I’m still battling BV and am trying another course of treatment before transfer #3.
The SECOND MISTAKE was not trusting my gut…literally. I have history of GI issues and was worried about the 2 weeks of doxycycline antibiotic I took for endometritis and top of the 5 days of metro antibiotic for the BV. This completely wrecked my good bacteria (both gut and vaginal) and I didn’t do anything about it. I’m now taking oral and vaginal prebiotics while doing a second round of metro antibiotic for the recurring BV. I’m going to try a peroxide/water douche*** because I suspect the BV developed a protective biofilm that made it resistant to the first treatment. This time I will use the Evvy home test and ask my gyn to swab me again to see if I have negative test. I will not do another transfer until I get confirmation it’s gone.
The THIRD MISTAKE was not understanding how to advocate for myself between my gyn and my fertility doctor. I made too many assumptions about their roles in this process but the truth is they are on my team. I’m directing. There are no medical protocols that require them to put a plan together to maximize my outcomes. My gyn said they typically don’t test for endometritis unless there is a more severe symptom and it is usualy the domain of the fertility specialist to test for it if there are negative IVF outcomes. Neither of these docs raised the potential GI issue because they aren’t GI docs and frankly I didn’t ask. I’m not saying this is a bad practice. It’s up to me to be aggressive. It sucks it can’t be a one-stop-shop but this is the state of women’s health in the US, unfortunately.
So please add “vaginal health” to your IVF journey priorities. Because of my age and the severity of our infertility I don’t want to chance losing any more eggs to treatable vagina / uterus conditions. Ask more. Test proactively vs reactively to failed transfers. I know this just adds to seemingly never ending expense related to this journey but you didn’t get this far to not maximize your outcomes.
Hope this helps. Best of luck.
***EDIT*** My BV has persisted after boric acid suppositories, metro gel, and having my husband take a partner treatment. My provider put me on a second round of metro gel as the next step but I’m very skeptical. The peroxide douche is NOT a recommendation. I’m only sharing I’m going nuclear on the BV because it was advised to me from women to also had no luck with the usual clinical treatment plan and I’m fairly confident my microbiome is already severely compromised (I’m going to take the Evvy test to confirm) and I need to rebuild it either way. I hope no one finds themselves in this situation. I only hope to encourage more questions to connect the dots in the process.
***EDIT TWO *** Love this sub. I learned two things today that I will immediately ask my gyn about instead of douching. 1. Taking Boric Acid WITH my antibiotics to break the biofilm because prior did not work for me. 2. Taking Clindamycin (this was in the partner treatment but not mine) instead of Metro. Ugg. I wish this stuff would be suggested to me vs asking. Thanks for the pointers.