2 failed cycles- what can I do differently?

[Pinkheels]

As the title says really. Our first cycle in May 2015 was abandoned because I didn’t down reg properly. Next ICSI cycle in September 2015 was a bfn- 2 embryos transferred at day 3. Last cycle in Jan 2016 was technically a chemical pregnancy- 2 blastocysts transferred on day 5. For both cycles AF started around 10 days after the transfer.

In between I’ve had to have a private hysteroscopy for a suspected polyp which took ages to organise, had to take the pill for various cysts, and generally just be majorly frustrated and wait around whilst literally everyone I know is on their second (or third) child. Our best friends announced their second pregnancy on the same day we told them our last cycle had failed and keep going on about the struggle they’ve had because it took a year for them to conceive both times round (!!) No one seems to understand the pain that is always there in the background. It’s never ending.

We have 1 frostie from the last cycle but the clinic have warned us that the success rate is lower for frozen than fresh. If I'm honest I have no hope the FET will work and am trying to focus instead on the fresh cycle that we expect will be this summer if we can afford it.

What can I do differently next time round? Are there any tests/investigations that I should be having? Immunology? Should I start thinking about switching clinics even though I’m fairly happy with my consultant? Do I need increased progesterone support given that both cycles have ended with early AF? Should I be looking into progesterone injections? Any supplements I could try? We have a review meeting in 2 weeks so I’m trying to plan what we’ll do next.

I’m not coping with things well and these last 3.5 years of tests/investigations/failed cycles/misplaced hope have really affected my marriage, my relationships with friends and family, how I’ve functioned at work and my career (so basically my entire life!).

Any words of wisdom on how to keep sane and how to keep hope would be welcome. Right now I feel like it’s never going to happen.

[SofiaAmes]

Have you had your vitamin d levels checked? So sorry for all your struggles.

[SesameSparkle]

Hi pink, really sorry about your failed cycles. I'd suggest having a look at agate's guide to learning from a failed ivf cycle on fertility friends website as there's loads of suggestions there of things to think about. I would link, but can't seem to get onto the site just now. Ivf is much more likely to fail than work, so unfortunately there might not be any more reason why it didn't work other than that. If you're not happy with your clinic it will do no harm to shop around elsewhere, and some open days or even initial consult appointments might give you some other ideas for next steps. How old are you by the way and what's the reason for your infertility?

[Bazwoman]

Hi Pink.

I too have had two failed IVF cycles, and just had egg harvest this week for my third which seemed to have gone better (fingers crossed!). It's hard to say whether I've done anything tangible that led to a better result (I do believe a lot is random, first cycle was pretty good, second dire, third in between). But here's what I've been doing anyway.

1. I've been reading a book called, "Starts with the Egg" by Rebecca Fett, was recommended to me following my second failed attempt. Really useful read, summary:

• Try to eat well, less processed food
• Avoid BPA, phthalates ("bad" plastics and parfum)
• Cut down on sugar (spikes in insulin not good)
• Certain carbs also can lead to insulin spikes, so should avoid too
• Cut out caffeine / alchohol
• Need to eat loads of protein, literally every meal and ideally also snacks
• Lots of veg (fruit in moderation as contains sugar)

Sounds like a lot, but I guess it's about ensuring good nutrition and digestion. Issues with digestion can have an affect.

1. Check your vitamin D level, this is actually very important, there's a spray you can get that is actually very affective if you're low (apparently most of the UK is vitamin D deficient).

1. Supplements

• General pregnancy multivitamin (careful not to double up on extra vitamin D supplements though, although depends whether you're particularly low on vitamin D)
• Fish oil
• Ubiquinol in the run up to pregnancy
• All in the book, can also take melatonin (but I didn't do this)

1. I've also been doing acupuncture - to be honest, I've no idea whether it's making a blind bit of difference, just chucking everything at it this time round.

1. Avoid high impact exercise (yoga / pilates OK), it's about not exhausting your body.

Anyway, it's all in the book. Sorry, rambling a bit, long day.

Really hope it works out for you. It's such an emotionally fraught process.

x

[cheapredwine]

So sorry to hear what you've been through. I also had 2 failed cycles (NHS). we decided to throw EVERYTHING at our most recent cycle - so we went to ARGC. Full immune treatment (turns out I have a stupidly strong and stubborn immune system, almost certainly a factor in orevious failures), very medicated, insanely close monitoring. It's eye-wateringly expensive but I am currently nearly 20 weeks. Where are you based? How old are you? If finances allow, I'd definitely recommend immunes. Can your current clinic offer this? Yes possibly progesterone injections might help but I think it's more complicated than that TBH. How much blood monitoring did you have? How flexible is your current clinic in terms of EC /ET days? Will they do Sundays for example? The timing of that is crucial. Were you on Menopur for stims? That's a fixed proportion of LH to FSH and might not really suit you. For eg during stims I was only on Fostimon (FSH) apart from one tiny dose of additional LH (as Merional) on one day. There are so many factors unfortunately. I strongly believe in the immunes stuff and I have no real idea, but if you're bleeding early, would suggest you're rejecting the embryos, in which case immunes might be involved? Wish you all the best OP

[Naty1]

Yes that must be annoying them complaining of taking a yr.

Have you had thyroid levels checked?
My failed cycle the period started early and the thyroid test after was high tsh, it needs to be about 1. The ivf process can affect your thyroid.
What are your normal cycles like?
I took vit D, pregnacare conception, coenzyme q10
Also dp took the mens conception one.

I have read frosties can have as good if not better chance.

Were the blasts good quality?
Had they been growing as expected in the first few days?

Its all luck.

[sparechange]

So sorry to hear about the failures. It is devestating, isn't it.

My first thoughts are:
The frozen transfers with additional lutal support
Have you have your thyroid (TSH) checked, and if so, is it under 2.5?
Have you thought about having an endo scratch?
What about trying a mild short protocol cycle instead of long protocol? What is your AMH?

Wishing you lots of luck

[Pinkheels]

Hi all and thanks so much for your responses. I’ve had some time wallowing and now I feel more able to get a plan together for the next round!
Spare, I’ve had my thyroid checked and I think it came back normal but I ask about the possibility of it being checked when we meet with the consultant. I really struggle with scans and the ET itself was really painful so I’m a bit scared of having the scratch but if it helps matter then I think I’ll just need to go for it.
I’m 30 and have PCOS although my cycles are regular. We were told to go down the ICSI route because of poor motility but they also queried egg quality on the first round as a high proportion looked abnormal. I’ve had two short protocol cycles with different drugs each time. I think I responded better to the menopur given we ended up with 3 blasts. The one remaining blast was good enough to freeze and had been growing as expected but quite slowly. I'll need to ask about AMH because I've not been told what mine is nor asked.

Cheap we live in Yorkshire so I don’t think ARGC would be practical even though I know their treatments are world renowned. I’m going to speak to the consultant about immunes and also more blood monitoring as well as getting vitamin D levels checked. We’re being seen in Halifax which is a satellite clinic linked to Care Manchester and they’ve been great (especially as the process has left me feeling a bit bonkers sometimes and I’ve left the clinic in floods of tears on more than one occasion).
Baz that book looks really interesting-I’ve downloaded a copy onto the Kindle for when I feel brave enough to read it. Thank you for the recommendation and best of luck with your cycle.

I think it all just comes down to luck but it’s the randomness of it that feels so cruel. Thanks again for all your ideas and suggestions

[Blondeshavemorefun]

I totally understand. Same as you tho Have had 3 failed cycle - all private so emotionally mentally and financially stressed now :(

1&2 local near me in uk
3 abroad and even tho it failed the whole experience was much better

Egg collection both times in uk was horrendous and in so much pain. Had as much local as they could give me knock out a horse but worst pain ever :(

Clinic said they they've never known someone to be in so much pain



Also had to have a hamster copsy last October to remove a cyst

Cycle one may 14 one in failed. None left
Cycle two sept 14 - 3 in all failed. None left
Cycle three Jan 16 - 1 in failed but 5 in freezer

I did a post about success of fet and got positive replies - will go and bump post up for you

But yes ifv sadly fails a lot and often don't hear the failures. Only the success. After 1&2 failing only told close friends about 3rd go so most don't know failed 3 times as can't handle the sympathy

And yes have friends who just get preg. Complain About the hardened of 2 children when fell preg accidently

[Blondeshavemorefun]

hysterocopsy not hamster !!!!

Also private but did abroad as so much cheaper and at same clinic where was going to do cycle 3 Ivf

as in uk was told would be £3k ish. What was yours if you don't mind me asking?

[bananafish81]

I can echo the advice about the 'It Starts with the Egg book' - the embryo quality in my second cycle was massively better than my first cycle. For my first cycle I had only been on the various egg quality supplements for about 6 weeks, whereas for the second cycle I'd been taking them for over 3 months prior (the length of time for the egg maturation process - ie the eggs that will be in the starting block when you start stims will start cooking 3 months prior)

In my first lot of eggs none of my embryos made it to day 5 (conked out after day 3) whereas I got a handful of good quality blasts out of the second lot.

I have no idea if the supplements made any difference, but my stims protocol was pretty much the same - so am a bit evangelical about the book. If nothing else it helped me feel like I was doing something proactive xxx

[Blondeshavemorefun]

clinic did tell me to take dhea

[Pinkheels]

Thanks blondes and hello again banana. We paid just over 2k for the hysteroscopy which I think is about average.
Banana, would you be able to share what supplements you took? Hope everything is going well with you

We've been reading up about ARGC and I'm beginning to consider this as an option even though it'd be a nightmare travel/work wise.

[bananafish81]

Hi pink hope you’re doing OK (I say that given the context of the situation as it’s all no doubt very raw, big hugs)

• DHEA (micronised, 75mg daily)
  
• CoQ10 as ubiquinol (300mg daily)
  
• Vitamin C 500mg
  
• Vitamin D (I took a very high dose but get your levels checked)
  
• Vitamin E (200iu)
  
• Resveratrol
  
• DHA fish oil
  

I also took a prenatal and 5mg folic acid (I have epilepsy so have to take a high dose)

Whilst cycling I took melatonin 3mg - however the book says this can interfere with ovulation so don’t take in a natural cycle

I think the DHEA and ubiquinol have the most evidence going for them, although DHEA is only really if you’ve got diminished reserves

Like I say, I have no proof they made any difference other than to my bank balance! But the difference in embryo quality was pretty stark so I'm inclined to think they played a role...

xx

[bananafish81]

Just seen you have PCOS pink! So definitely definitely don't take DHEA - it's testosterone so the last thing you need

But the book says Inositol is well worth taking for PCOS - does a similar job to metformin xx

[Naty1]

Are you on metformin?
I think thyroid issues are more common with pcos
In my cycles too many eggs would grow and they would then trigger when they were still very small.

[Blondeshavemorefun]

interesting @cost, dare i say that mine cost £700 plus £320 for 2 return flights for df and I

[cheapredwine]

Pink I did ARGC but am not London based, I live in Wales. It was difficult and both before and after the actual cycle itself I have done a lot of day trips to London (10+ hours on the train). Ultimately it IS do-able although I was super lucky, some wonderful amazing friends let me stay at their house in Clapham for 6 weeks. Other people have done it staying in apartments, though that obviously ramps the cost up. Even if it hadn't worked for us, I would never have regretted choosing ARGC. Honestly. At the end of the day, yes it's horribly expensive, but the most expensive IVF cycle is the one that doesn't work. If you see what I mean. I know how hard a decision it is, but we decided to do a throw-everything-at-it last ditch sort of scenario. If you are seriously considering ARGC I'd definitely be careful of DHEA though, it's about the one thing they disapprove of. Work wise I was lucky and could work remotely, plus took some annual leave. You would need to be London-based for a minimum of a month though, and 6 weeks if you get a positive. Very happy to chat over DM if it would help at all

[Pinkheels]

Banana- thanks for the list! I'm going to read the book this weekend and come up with a plan. And thank you for your kind words- it's all still a bit raw especially as we decided not to let anyone know we were having another attempt but I told some of my friends last night and they were very supportive. I know we'll get there eventually, one way or another. Hope you're doing well and everything is going swimmingly

Cheap- thank you and great to hear your positive experiences of ARGC. We've been talking a lot about it this week and DH seems to think we need to just bite the bullet regardless of cost and give it one final shot. I tried ringing them yesterday but no-one picked up! I'll definitely dm you- have lots of questions about the whole process.

Naty-I'm not on metformin, is this standard medication for those with pcos?

[Naty1]

Metformin seemed to be standard at my clinic for pcos.
As it
Can reduce miscarriage risk which is higher with pcos
And improve egg quality/lessen risk of hyperstimulation.

[scoobyloobyloo]

I did argc with a round trip of 9 hrs. Currently 20 wks pregnant. Bloody hard work and very expensive but all
in all, best decision I ever made.

Someone very wise once said to me that the most expensive round of ivf is the one that fails.