IVF help (first round failed)

[LovelyLamppost]

Hi all, really hoping for some tailored advice and that you can understand where I am coming from! My husband and I are 35 and have been ttc for over 3 years. We live in north London.

After 1 year we went to the doctor who sent us for tests which found nothing. Everything seemed fine. So we were referred to UCLH for further tests.

I could cry even just repeating this, but the first appointment with them took over 8 months. Between every appointment was a few months. Sometimes I had to have another appointment because an old blood test had now run out. All this time we were still unable to conceive but trying since "nothing was wrong".

UCLH tests found I had PCOS. Despite regular 28 day periods my eggs weren't maturing. So they put me on Metformin which made me a hit hopeful. I was otherwise just waiting for the next appointment never knowing how long it would take.

Finally, we had our first round of IVF this month, aged 35 (after starting this whole journey at 32!). I managed to have 5 embryos, one was freshly implanted and everything looked good but it failed. So 4 are frozen. We also discovered on the day of the transfer that my husband has 70% antisperm antibodies, which makes me think we were never going to get pregnant (and why wasn't this tested earlier?).

I'm now waiting to officially tell them it's failed to be put back into the system for round 2. I believe round 2 will be about implanting a frozen embryo. My concern is that we wanted 2-3 kids, and with only 4 frozen embryos and the best fresh implant failing, and being 35, and the ridiculous wait times the whole way through, I just feel like everything is against us achieving that. I know there are worse scenarios but navigating the NHS and wait times has been traumatic really. I am concerned what else might be going on that isn't being properly explored. I don't know why my body rejected the nice fairly good quality embryo.

So what do I do? What would you do? I think my goal would be to do another round of freezing embryos before implanting for pregnancy so at least the eggs will be as best they can given age. Would the NHS/CRGH allow this? We could pay privately if needed.

I also would like to do more tests eg to check I don't have antibodies destroying the embryos. At this point I'd happily pay for that to be privately done - any pointers? Anything else I should look into?

Hmm I can't seem to edit the post, but to add we are in the North Central London Commisioning Board and their IVF policy seems to be that they count any IVF cycles towards the 3 cycles the NHS offers, so if we did a private cycle to get more eggs and embryos then it would mean we would only have 2 cycles left. The policy seems to be you have to use all the frozen embryos first.

I'm not sure if there's a loop hole if you only create the embryos but don't implant from that cycle though :/

Hi OP. Usually in an NHS cycle, you have to use all of the embryos before you are eligible for another cycle. That's frustrating if you are looking to the future and wanting more than one child but unfortunately that's how it is.

If you wanted to do embryo banking (i.e. have more embryos frozen before starting to transfer) you'd probably have to do that privately, and it might also impact whether the NHS would pay for your future transfers.

Please don't feel disheartened that your very first embryo transfer didn't work. It doesn't mean anything. A lot of embryos, although they might be graded as good, have chromosomal abnormalities (this is the case even in the most naturally fertile people!) and these can't be seen unless the clinic does PGTA testing on your embryos.

I recommend considering PGTA in future, if you do more cycles. I am currently pregnant after a round of IVF with PGTA testing. We tested 5 embryos and although they all looked good, only 2 came back as normal ("euploid") - which means that if we had tried them all, 3 of them would never have had much chance of getting me pregnant, and if they did, there might have been health conditions/ disabilities etc.

It might be too late to do PGTA testing on the embryos you already have frozen, but do consider it for any future rounds. I think it saved us a lot of heartache from failed transfers. Some embryos are just not suitable to cause a pregnancy and that is just nature, it's not your fault, it's the same for everyone. The whole thing is a bit of a numbers game.

PGTA is expensive though and it's not offered by the NHS sadly. We had 2 failed rounds with the NHS and had to go private for our third, which worked.

It's a really difficult journey you are on - I really hope it all works out for you.

Also if you are looking for a private fertility clinic at any point in the future, I really recommend The Lister. They are fantastic.

I had two fresh and two frozen transfers (ICSI) and the 'worst quality' embryo is now the brightest 6yo you can imagine. She was in the freezer for seven months before transfer. The 'better' embryos all failed.

You are very early days and it is an emotional rollercoaster. I went private so can't comment on NHS, but I know it isn't easy at all. Sending you the very best on your journey.

Thank you butterflycr and Latenightreader! It's been a really hard day. My first day off work where I have been able to process things and went straight into planning mode - it is an awful journey!

Thank you for your guidance, I appreciate it. I will look into the Lister too, I read some good things online about them finding immunological issues after 11 failed transfers by other clinics, treated it, and the woman had a healthy baby.

I've read mixed things about PGT-A, but think I appreciate now the importance of a round working if not just for financial reasons. I had no idea each FET costs so much until today!!

How would the NHS know you'd done a private cycle? You choose the allow a private clinic to inform your GP or you can state that you don't want them to inform your GP.

They won’t fund more than three cycles total, regardless of if they are nhs or private so if you do a private one you’ll only be eligible for one more. I also enquired about PGTA testing my frozen embryos with UCLH and they said that would take me out of NHS funding and I’d have to pay for my own transfers. (But I wasn’t 💯 sure this was true, maybe worth checking)

Honestly considering your age and how many embryos you got on your first round (good number!) I’d probably stick with UCL/CRGH to at least try a frozen transfer with your current embryos. You have a good chance of one sticking, and if you are having issues with implantation it will allow them to investigate that and see what treatment you can get before paying for a private round.

The NHS funding is only to get one child, so they won’t support embryo banking for siblings, whilst you can always opt to go private at any point, it is obviously a significant cost, especially if you stick with CRGH which is quite an expensive clinic. It’s hard but I guess it depends on your financial situation etc.

There are lots of supportive threads in the infertility boards if you want to come over and say hi.