One BFN and One CP later, what to do now?

37F, secondary fertility, blocked tubes. I had a BFN back in March. It was the result of a day 7 embryo FET. I know the success rate was lower to begin with so the doctor attributed the failure to the embryo quality.

Then I did a 3rd (and last) round of ER right after. Got 3 PGS tested day 6 embryos. I felt super optimistic going into 2nd FET. It was a beautiful 5AB, hatching while transferred. Tested clear positive 6 days past transfer. Sadly the line didn’t darken enough as it should. My heart just knew something was wrong. The Beta was 30 then it dropped to 9…. Going from being overjoyed to devastation in a couple days is such a cruel cruel joke. A lot of self-doubt and guilt about what I did wrong or maybe I’m not meant to have a child.

After two weeks, I finally felt better. Just had a post-transfer meeting with my doctor. I asked for “leave no stone unturned “ testings before next transfer because I can’t take another heartbreak like this anymore.

She recommended lab work of immune system, blood clotting, thyroid (already on medication for a while. Number is good now) and blood sugar. We’ll also do saline ultrasound to make sure my polyp didn’t return, a mock cycle with ERA/Emma/Alice testing. When next transfer comes along, she’ll add some “won’t hurt” medication to make sure my body is not fighting embryo like a foreign object (my interpretation).

I appreciate this warm group of ivf friends here so much. I’d like to hear your opinions on a couple things:

1. protocol: The past 2 cycles are medication supported natural cycles. I got small dosage of Gonal-f injections to boost my lining growth then did HCG trigger. Then started Vaginal progesterone 5 days pre-transfer. My follicles growth, lining and lab numbers are right on track. I felt in someway I cheated without getting the notorious PIO shots like in medicated cycle.

I asked my physician if I should switch to medicated and will that give me better outcome. She said she always prefer natural cycle. My number were good so no strong reason to switch that. On one hand, I think that makes sense. Maybe that’s a few thing that’s been going right so let’s not mess it up; On the other hand, I already had 2 failures. Is it insane to keep repeating the same protocol? What do you think of that or your experience with protocol change or same protocol different result?

2. Did I miss anything I should be testing in next cycle? My doctor didn’t mention Receptiva I guess Emma and Alice will provide a similar angle about inflammation marker?

3. I had one blocked tube and another tube with scarring tissue at the end. No idea what could have caused that. I had my first child naturally and easily. He just turned 7. Super grateful of that. My suspicion is I had some undetected pelvic infection i just never knew about after he was born.

I read on this forum that sometimes you need to get tube removed to prevent fluid flow into uterus to create a toxic environment. What kind of test can rule out this possibility for me? I had HSG before not sure if I should have known if that’s the case.

Sorry I had no idea this would turn out to be such a lengthy post. Really appreciate any advice or encouragement! Virtual hugs to you!!!!