Ivf. Doctor seemed overly negative.

[mikkyr]

So husband and I have had 3 failed ivf cycles in the last 2 years. I am 41 and husband has had a vasectomy (previously married). Given the time constraints we decided that a testes biopsy was the best route to go instead of a vasectomy reversal which may not be successful and then still need to do a sperm extraction via biopsy at a later stage.

My last cycle failed completely whereas before I have had two early miscarriages. Without going into all the medical jargon I retrieved a fair amount of eggs for my age, they were reasonable quality, the embryos were not A grade but also not the worst. Everything seemed pretty average.

My appt with doc yesterday was terrible. I went in feeling so full of hope that we would be able to do another egg retrieval, ICSI and transfer before Christmas. But the doctor was so negative. He didn’t have anything hopeful to say. Basically I’m old my eggs have aged. My husbands sperm is less than great because it’s been extracted via biopsy and a vasectomy after 10 years rescues the quality. Our embryos are poor. The chances of genetic abnormalities are high. Our track record of 3 failed cycles leaves such a small percentage of success in the future. It’s costly.

We told him that money was not an issue (that sounds pretentious but we have enough to do another few cycles)

I’m just so disappointed in his atttitude. It’s like he doesn’t want me to do another cycle. I thought this whole process was about hope and that these doctors would be able to try and try. 3 cycles seems very little compared to what I’ve read and I’m surely not the only 41 year old who is seeking fertility help when there are 41 year olds falling pregnant naturally?

I don’t know what to do.

I'm sorry you're going through this. It sounds more like the doctor was trying to be objective rather than negative, but I can understand you wanting to hear something more hopeful. What was the outcome?

No expert but from the comments about egg and sperm quality, would donor sperm or eggs be something you would consider?

I'm sorry you've had to experience this. The doctors at ivf clinics have to be brutally honest (I'm saying this from experience)

A lot of the time, it's not what you want to hear.

I was once told "you're in your reproductive prime, everything is great and we can't see why this wouldn't work"

So as you can imagine, when it didn't work I was crushed beyond belief and felt like I was a failure.

Have you heard of Zita West? She does a brilliant book, I believe this really helped me with our successful round which gave us our son.

Our situations are completely different, I wish you all the luck and again I'm so sorry you've been treated with such negativity

How old is your DH incidentally?

The outcome was that I would go away and think about it. But he didn’t give me anything but bad information to think about.

45

I had lots of IVF treatment so I sympathise, and I know that I would have tried and tried for ever if I hadn’t got lucky when I did.
However, the doctors have to be more pragmatic and less emotional . They have to consider statistics and probabilities. They also have to be mindful of the potential risks of IVF, weighed against the chances of success. And also, sadly, their clinic figures. They want to be able to publish a certain success rate.
But in my experience different doctors have different attitudes, and if you are keen to try again and the clinic will permit it, perhaps you could see a different doctor there.

Did the doctor suggest a way forward? Sometimes they suggest donor egg/ sperm if worried about the quality.

I’m sorry OP, that’s very stressful ❤️ I’m sure it’s not that the dr doesn’t want you to try - more that he doesn’t want to give false hope and has to be realistic about prospects. He just wants upon to make your decision knowing realistically what the chances are, because some people might only choose to proceed if they had really high chances.

Remember that a less-good chance isn’t no chance, and if you’re able to meet the financial and emotional cost there’s no reason not to proceed even if things aren’t absolutely as good as they possibly could be

It sounds like he's trying to make sure you are continuing with a full awareness of the obstacles you face. It would be unethical of him to give you false hope and just keeping trying.

I know that must have been very hard to hear though

As horrible a situation as it is for you I think it’s much better he sets a realistic picture rather than you optimistically going ahead and spending more and more money for the result to sadly be the same each time.

I can't imagine what you must going through OP but can understand how desperate you must have been for encouraging news.

Your consultant gave you realistic clinical facts. Sadly, the reality is that your chances of carrying a pregnancy to term are very low. He just doesn't want to give you false hope and for you to turn around and accuse him if it, for the purpose of money making in the future.

But remember that in the end, it's your body, money and destiny, not his. You are in control, you can do what you want. It's in your hands to manage the odds.

If you both are mentally, phydically and financially ready to try again, then go ahead.

We have decided that donor eggs or sperm is not an option for us.
They were so optimistic in the beginning. Basically that I was a fit healthy relatively ‘young’ women and that the only obstacle was my DH vasectomy which on biopsy had ‘lots of good moving sperm’!

It sounds like the Doctor was trying to manage your expectations and not give you false hope. But I can see that it must all be very disheartening and not what you would want to hear. Sorry you're going through this

It’s crazy. For anybody who has been through ivf will know that hope is what gets you through this. I just always thought your doctor would be the one providing it through confidence. Possibly even give us some good news stories. But honestly I feel like he was trying to tell me not to do it anymore. Surely there are these women that do 10 cycles? Do they do it on their own will in the face of adversity from the very person you are hoping is going to make it happen for you?
I’m devastated.

Unfortunately it would be ethically wrong for a doctor to encourage people to keep going with the health and financial risks of IVF if it’s very likely to fail. It’s right that you know where you stand before you take on further treatment.

You can still have further treatment though? I would ask for a second opinion before deciding- just to get peace of mind.

@mikkyr
I sadly think he's being realistic with you. That's a double whammy of issues at play.

It may be worth considering and looking into either one or both of donor sperm and eggs. If costs are not an issue, then there are many clinics in the UK. Equally, Europe has many clinics that have great success. Some with 50% plus success.

I’m so sorry it wasn’t what you wanted to hear - there are lots of women who fall pregnant naturally in their 40s but you won’t know about the many thousands who try and never manage to .

Ultimately it’s your decision but he’s being realistic (I had IVF and I know how brutal it is to hear this stuff).

Fwiw you can also abroad run tandem cycles where you have your own embryos put back along with the de.

And those people I knew who did repeated cycles were in their early 30s so a very different scenario.

So sorry, OP, but I do think the doc is just trying to be realistic rather than provide any false hope. Even with no other known problems, chances of successful IVF drop after about 3 cycles, and the chances of successful IVF at all are not overly high (I did one, unsuccessful, cycle years ago and was surprised that success rates are quite low per cycle... It's often talked about as the answer to infertility). That's not to say you shouldn't do more cycles or that it won't work, but better to have realistic expectations.

I think he was just being realistic. Sorry that it was bad news

Unfortunately, objectively, the chance if success is low for you, unless you use donated eggs. The doctor is just trying to manage your expectations.

If you look up the stats for people of your age they’re really poor. Then you have the sperm issue putting the odds even less in your favour. Your doctor is being realistic. I’ve been there too and it’s hard to accept.

Unfortunately your doctor is being realistic.