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.

@YouKidsIsCrazy

If the dr really thinks that you have little to no chance of success, would you like them to lie to you and have you do several more cycles?

Don’t think I haven’t thought of this myself. But honestly anybody who has been through ivf knows that it can be a journey much longer than 3 cycles. There are women with one ovary, cancer, endometriosis etc whose doctors persist. Does anybody think my doctor has given up too easily?

Would you consider getting your eggs frozen so using donor sperm in the future may be an option? Having friends who've done the years and years of IVF they all wish that they'd done this.

Egg freezing is really not worthwhile past the mid thirties. And I doubt any clinic would do it given the OP’s track record. I’m so sorry OP I know what it’s like - I was told at 39 that my ovarian reserve was too low to try again.

@Inkpaperstars

I think getting two positive tests from the first three cycles is actually pretty encouraging, and every cycle you ended up with transfer.

When you put it like that it was actually only one cycle which resulted in 3 transfer. One fresh after collection and two frozen.

@Washimal

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

I agree with this.

Imagine if he only said positive things and you kept going and you didn't conceive. You can still try he has just said that it will be a low chance of success which given all the information is true. If you do continue to try IVF very good luck, I hope it works for you.

I think you are inflating your chances and he is trying to reset your expectations. You don’t seem to have had many embryos on ice, how many would you expect from another cycle? Personally I’d carry on and do another round. I think you should hear what he’s saying though.

But honestly anybody who has been through ivf knows that it can be a journey much longer than 3 cycles.There are women with one ovary, cancer, endometriosis etc whose doctors persist.Does anybody think my doctor has given up too easily?

Everyone is different though, and for every woman with one ovary, cancer, endemetriosis whose drs persist, there will be more who did not.
No-one here can tell you if your dr gave up too easily, they haven't seen your files. Why would they give up unless they thought it was right? For what reason?

@mikkyr. I realise it is only successful when you have a live birth, but 2 out of 3 is a pretty good response. I would say to you not to give up yet !

I realise it takes a massive toll on your body, emotionally and physically, and on your relationship, but if you can finance it, I would keep going.

It depends what you mean by given up. The doctor might feel that he was just informing you of the stats for people of your age, and they have a lot of stats in these places! It's right to be informed of those and of other obstacles. It should then be up to the patient to decide if knowing all that, they want to persist. A low chance is not no chance, and you have to decide what to do with that information. I would change doctor though because once you start to feel these doubts about them it's not good. You don't want a doctor who makes false promises, but you want one who can understand that if you decide to keep trying, you have accepted the odds aren't great and are still wanting to try and throw everything at it. Once that is established, there is no point endlessly repeating the negative.

I’ve had six failed IUIs, three IVF miscarriages and a miracle “natural” birth.

I understand your pain. I would have done ANYTHING, and the financial, physical and emotional costs nearly killed me. People told me to stop but I told them I would stop when I was dead.

You could change clinics, if you feel disheartened with that one. Or just ask to change consultants. You still have money to throw at it so that’s something.

I know you don’t want to hear about donor eggs or sperm. I got upset when they were mentioned. But I have a friend who had twins at 50 using double donation and it was the best thing she ever did. Certainly not for everyone, but I know I would’ve done it in a heartbeat if the alternative was never be a mum.

Wait now ...... you have actually done a single full IVF cycle, with 3 transfers from that ? (2 FET's and 2 positives)

Don't stop just yet !

Just seen your update. So you have only had one cycle of stimulation, from which you got at least two embryos suitable for freezing, and another transferred fresh? Two of them resulted in a positive test?

I don't know your personal medical info, and I do know the odds are bleak reading for older couples. I can only say if it was me, I wouldn't give up just yet.

@Zug2

Wait now ...... you have actually done a single full IVF cycle, with 3 transfers from that ? (2 FET's and 2 positives)

Don't stop just yet !

Yes. One egg collection cycle. One fresh transfer of 1 embryo. Miscarriage at 8 weeks. One frozen transfer 2 embryos. Chemical One frozen transfer 2 embryos. Failed

You can't make an informed decision if they told you there are high chances of success but reality is low chance of success. IVF is a physical rollercoaster & would be irresponsible to encourage you to do that with unrealistic expectations.

Is seeing another doctor an option for you? Or even an entirely different fertility clinic.

Obviously the IVF outcomes aren’t great at 41 but you know that. There’s a reasonable chance that abnormalities were behind the miscarriages unfortunately.

I’d be tempted to go once more & embryo bank over 3 back to back cycles, PGS test them, and see what comes from that.

That's only one IVF cycle, OP, then, not three. I would do another in that case, but you should still reset your expectations beforehand. The chances are still low, but you don't have the additional negative of three failed cycles, just one (and I'm not trying to minimise what you've been through saying that)

It’s also fairly easy to move semen straws so don’t let that hold you back in changing clinics.

Have you done a recent AMH test? Is it in line with your previous result? This is really key as well as you follicles count.

These can change a lot in 2 years and might mean success change falling drastically. The two miscarriages are more likely to be due to quality hence another concern.

You can do SOME genetic testing but it will only give you an indication of what it tests for. My friend's child disability wasn't picked up through any tests not even the amiosynthesis.

The doctor is obliged to give you the full picture, even if it is negative, so you can decide what to do based on all the information. If you decide based on this to go ahead and outline your thinking to the doctor, he will probably agree to another try. He just wants you to think through all the implications of this. The financial outlay, the emotional strain on you and the physical implications of going through egg retrieval and a further IVF cycle.

Isnt is something like a less than 1% or worse than 5% for success at your age... when you add in the issues with your husband it's a very hard situation. The doctors need to be realistic with you. If they filled your head with dreams and continued taking your money then they'd just be lining themselves up for a scandal.

If you want to do it you need to understand the real chances. Maybe he could have said it in a nicer way, but you need to have open eyes for this so you can make a truly informed decision.

@jcurve

Obviously the IVF outcomes aren’t great at 41 but you know that. There’s a reasonable chance that abnormalities were behind the miscarriages unfortunately.

I’d be tempted to go once more & embryo bank over 3 back to back cycles, PGS test them, and see what comes from that.

That’s the option we need to decide on. I’m just so disappointed that he didn’t sound more positive. I understand that testing is an expensive option so if hoping that he just assumed the cost would put us off. (We don’t live in a country where people can generally afford that option and ivf isn’t state supported at all)

@ChocoholicMama

That's only one IVF cycle, OP, then, not three. I would do another in that case, but you should still reset your expectations beforehand. The chances are still low, but you don't have the additional negative of three failed cycles, just one (and I'm not trying to minimise what you've been through saying that)

Thanks for the correction. I’m not great with all the terminology. Basically in my head I’ve hung upside down three times after a transfer. But only been under an aesthetic once to retrieve eggs.

Oh, op, that must have felt devastating. I have no experience of this so nothing useful to offer: I always prefer hcps to be brutally honest with me and to prepare me more for the worst outcomes than the best, but that's clearly not been helpful for you. I would second pp who say to think about accessing a different dr/ clinic. And I wish you the very best of luck .

It sounds like a crushing experience. Is it worth revisiting using donor eggs and sperm and unpicking why you don’t feel it’s an option?