IVF #1 Failed

[grifter01]

Hi Everyone

I just joined as I see a lot of discussion and insight on this topic of infertility and wanted to hear some views on my and my partner's current situation.
This is a bit long but I try and include as much info as possible to help get some insight.

A couple of years ago we got pregnant but it ended in an ectopic pregnancy, we were absolutely gutted. It took us a good year to even come to terms with it, and it felt like our world was falling apart.

Anyway after it we were hoping that we might have another chance, albeit chances cut a bit slim as we only had one tube now. A year and a half later we have not had even a sniff of another pregnancy.

So we decided IVF we came across some cash we could use and got the ball rolling. We have both never had kids but now we are over 40 and didn't want to wait any longer.

I know this over 40 thing is bandied about everywhere, and I know several women falling preggers at this age, it was that we just wanted to get a move on regardless as it was causing as massive stress.

Me being me I done a ton of research on this subject, I feel like a top grade reproductive doctor now lol, and as my partner has (pcos) which i'm not sure is entirely correct (no polyps on ovaries), we decided to start on a regime of myo-inositol, Vit D, fish oil, loosing weight, we even tried Chinese meds (The herb teas), which she hated, so we stopped that. In hindsight I don't know why we never just got acupuncture, we might bring that back in.

Anyway we went to first IVF consult, and I was dreading it because I knew the consultant was going to bandy all the usual stats about old eggs and the like, which he did but accepted we wanted to try anyway. Surprisingly we got AMH of 11.4 which he said was excellent for our age, and my swimmers were - to quote lab girl - really great, actually excellent. They also done the scan on ovaries and the one that was active with most eggs was the one the ectopic was removed from. One of the nurses said her TSH was a bit high so we got that reduced, over a Month, down from 4.4 to 2.08, and started 5mg folic as well. Still taking those now.

So once all the bloods, paperwork/consents/tests were finally out the way we went for retrieval. Again, waiting to go was like death row or something! We got 4 eggs and then we waited to the 3rd day to see results, again like waiting on death row.

3rd day came, the news was quite good, we had 3 out of 4 conceived, of those, 2 were really good grade A at 8 cells and the 3rd a wee bit behind.

So the transfer day was scheduled, and we went and got that done, it was day 5 transfers of all 3 eggs. Still the eggs looked good they said.

Once that was done we then waited and waited, not a full tww as we know, there wasn't anything she reported except sore boobs and nips, I thought probably the drugs. Then on Tuesday she got a bleed and said she felt like it was period, this was about 7 or 8 days after transfer, so I thought that is a bit late for implantation bleed. She freaked out so did I a bit then we hunkered down and waited for the test.

We both just knew it had failed and it had, we really were beyond gutted. Everything looked good, we didn't go over board just quietly confident but being realistic.

We know that IVF first time is more likely to fail than succeed. Anyhow after this happened I got to thinking when we went to the first consultation she had been asked about her period and the length of it, she said it's average 40 days, however the period before IVF came a bit earlier, and I reckon this was to do with the lowering of the TSH, and then the period we were waiting to do IVF on came at 29 days. Initially the plan was to start drugs before expected period start but that never happened, evidently they were calculating the day to start based on a 40 day period.

She phoned clinic and said period has started. They then said we could start you on the drugs right now. So I'm guessing they couldn't start on the drugs to stop period, but could still get the process underway.

Reason I'm thinking about mix up of dates when period was is that if the transfer was on Sunday the 24th on November (about midday) and new period started 3rd of December, 9 full days later, is this not a very late transfer. Her period this month was about 32 days. I thought the transfer was done about midway through cycle, if this is the case then it should have been the 18th, not the 24th. I'm going to sit down and go through the exact dates with her, but does this sound right, or wrong, to anyone?

Thanks for reading this and providing any thoughts/suggestions.

Andrew

[Softscoop35]

Hi

Im not sure if im understanding the question but if the transfer was done as a day 5, then transfer was not late.
Clinics transfer on either days 2, 3, 5 or 6. Anything past day 6 they wont transfer as its deemed too late (although i am sure i e read there is clinics outside the UK that do transfer on day 7)

Any normal cycle your wife would have is bares not impact/relevance on the IVF cycle as the IVF cycle is controlled by drugs, its almost like an artificial cycle if you like.

I hope that answers fits with what you were asking.

[JeNeBaguetteRien]

IVF not working is hard but unfortunately pretty common.

As Softscoop says if the clinic were doing a fresh transfer the dates count from when the embryo is created.

As for starting drugs before period starts, there are different protocols, long protocol where down regulation drugs are taken before the period, or short protocol where stimulation drugs are started at the beginning of the period, this is a very blunt description.
I've done both, it sounds like your wife was on a short protocol and normal that she started the medication when she did.

You should have a follow up with the clinic and that's the time to ask what if anything would be done differently in a future cycle. Maybe they would do the same again.
In your position if you had 3 embryos at day 5 I'd be asking (if you don't already know) if none were good enough to freeze.
Take time both of you to process and decide next steps.

[itwasalovelydreamwhileitlasted]

You can't judge transfer day by the length of her usual cycle.....depends on how long it took for her follicles to get to right size to be collected and how the lining is looking etc

My transfers have always been around cycle day 18/19 of a 29-30 day cycle

Over 40 and chances of ivf success drop to 2% from 30% under 35

Also some people find frozen transfers work better for them - did you have any blasts frozen from this cycle?

[grifter01]

All 3 were transferred as the consultant said that is the protocol over 40. Is the point of frozen to hold the eggs off until lining is suitable? We've not had any ERA tests done, I don't know if they checked the lining before transfer. I watched a youtube account that this ERA test seemed to help their cycle work on the 2nd time. They also had pgs testing done, although it sounds to me this would risk damaging the follicle in some way. So many different variables it's hard to know where to start. Thanks for all replies so far.

[grifter01]

After thinking about the timing yes that makes sense they would transfer about 8-10 days before end of a 30 day cycle. What I mentioned above RE: ERA test might mean the transfer should be done maybe 24 hours later, I don't know tbh as haven't read into it all yet.

[itwasalovelydreamwhileitlasted]

You can try ERA but honestly many clinics don't bother offering it now as the HFEAA has said it's an "add on" that hasn't been shown to have made much of a difference to cycle outcome

I'm surprised about transferring all 3 - are you in the U.K.?? Transferring more than one embryo of different quality can affect the outcome of the whole cycle as the body puts its efforts into the less healthy ones

Many clinics get better success with frozen transfers as it gives the body time to return to a more natural state after weeks of stimming

at your age I wouldn't bother with PGS - odds aren't MOST of your embryos will be abnormal and in the U.K. you can then transfer them

[grifter01]

"at your age I wouldn't bother with PGS - odds aren't MOST of your embryos will be abnormal and in the U.K. you can then transfer them"

Did you mean to say most embryos are abnormal?

Yes in UK, should they have frozen then transferred them on next cycle?

[struggleisreal]

Medicated cycles are so different from natural ones that there’s no point comparing the days - in a fresh cycle egg collection is the ovulation date, and the egg is then transferred 5 days after - which should be the perfect time. As the medicated cycle is all driven by drugs it doesn’t matter that it is different to your normal cycle length. However, if your wife bled quite early after transfer if is worth looking at increasing progesterone for next time.

I think as others have said the ERA is still very new and untested so I am a bit sceptical about it.

[grifter01]

And transferred only one?

[itwasalovelydreamwhileitlasted]

@grifter01 yes sorry the majority of embryos over 40 years are likely to be chromosomally abnormal

In the U.K. if you PGS test and they come back abnormal then you CANT transfer them

Yes in U.K. you can only transfer a max of 2 embryos I believe and that's only if you are over age 37 and most clinics won't trimester more than 1 if they are classed as good quality embryos

[fool11]

If you are over 40 you can transfer more than one (can do 2, max 3), but you can request just have one put back, clinic can’t just tell you it has to be 3..it’s your choice. You have option to put more than one back as chances /fertility success rates after 40 are much lower and quality of embryos is not great . But it’s always your decision, if you have more embryos, that’s what our consultant told us.

[JeNeBaguetteRien]

Different clinics around the UK have different approaches, I know people under 35 who had 2 embryos put back, and I know people older than that who argued against clinic policy not to put 2 embryos back even if one wasn't good enough for freezing and would effectively be 'wasted'.

OP you and your wife need to be your own advocates throughout this process, ask questions.
Clinics will only freeze embryos they believe will survive the thaw so it might be that they would not have frozen anyvog your embryos.

Even though it didn't work out, a clinic may repeat a treatment protocol as they believe that protocol was effective as in it produced embryos. Lots of people don't get pregnant on their first IVF cycle and it's not attributable to one factor that needs to be different.
There is a lot of public perception that IVF works out more than it actually does.
Good luck.

[grifter01]

I was wondering during our ivf cycle why we didn't get progesterone support?

I've had this in the back of my mind that it seems common place to use this as part of a cycle. The only thing we had after the transfer was ovitrelle injection and that was it.

Also It did seem kind of odd that the original protocol was that they were going to do injections before period arrived to stop it, but it was too late, we told clinic period arrived, we thought probably best to wait till next cycle, and they just went ahead with it. Does this seem odd?