1st DE transfer failed.. what to do differently next time

[Rosequartzz]

I've had 8 cycles with OE over the last 3 years. We never got blastocysts and have never made it to transfer day and finally made the leap this year to move to donor eggs.

We had a fresh transfer earlier this month with a 5 day 5AA blastocyst, which sadly resulted in a BFN. We have a meeting with our Dr on Monday and whilst she'll go through possibilities of why this didn't work we'll be discussing what steps to take.

We thankfully have 2 embryos in the freezer (no idea of the grading, however, the clinic does not freeze anything below 3AA). Does anyone have suggestions on steps I or clinic can take, any tests that should be done, considerations, changes to meds etc. At present I was on progesterone (cyclogest 2 x 400mg), estrodial (progynova 3 x 2mg) and baby aspirin. My lining was above 6.8mm with triple layer 4 days before transfer day and was not re-measured on transfer day.

I'd appreciate any and all recommendations.

[Serendipity24]

@Rosequartzz Hi, so sorry to hear about your long struggle to get pregnant. I'm on a similar boat, first fresh transfer with DE did not work. Just had a FET on Tuesday and now on tww.

My doctor didn't think there was any particular reason for the failure and thought there was no need for further investigation. He said that the first time success rate with DE was only around 50%, which means 50% would be unsuccessful and he thought it was the "efficiency of the treatment" that was the reason.

However, a tiny polyp was suspected during my scan and he said that for the peace of my mind I could get a hysteroscopy done. I did it and the polyp was removed. Only change he suggested was to go for a modified natural cycle for the FET. If you have a regular cycle and ovulate, then you could also try it. It is much easier on your body.

I don't know your diagnosis or what tests you have already done. As this is the first transfer you ever had, I doubt they will recommend many tests. I did ask my doctor about doing immune and microbiome tests etc. but he said those were not needed. You could ask your doctor about these tests ( EMMA/ ALICE/ ERA, NK cells etc.).

[Sunshinebytheseaside]

Hi @Rosequartzz sorry to hear your transfer was unsuccessful. I too have had a long journey with OE and now moving onto DE with renewed hope so can imagine how disappointing this is for you. It sounds like your lining could have been a little on the thin side depending on how much it developed in the days before transfer so that might be something to speak to your clinic about. If you have any test results from a while ago, things might have changed (assuming you’re a similar age to me, things can change quite rapidly!) so maybe worth revisiting things like thyroid function / antibodies if it’s been a while. Otherwise, I’d tend to think it’s just bad luck and hope for a better outcome with another embryo. Many clinics suggest it takes on average 3 transfers to get a positive outcome so after all you’ve been through, it must be a relief to have those frozen embryos this time. Wishing you the best of luck.

[Whatatodo79]

I think you've just got to keep going. 3rd time lucky for us on donor egg transfer. We used embryo glue and had assisted hatching but those aren't shown to be consistently worthwhile

[Rosequartzz]

Thank you all so much ! @Serendipity24 wishing you all the best in the 2ww got everything crossed for you. Do keep me updated and if you need to have someone for you 2ww happy to support.

I have the call tomorrow so will suggest all the tests and procedures tomorrow and see what the Dr thinks. Or as mentioned, it could just be bad luck.

I clearly wasn't prepared for a DE to fail and truly got caught off guard.

[PinkGold]

I think after lots of own egg IVF that when you make the leap to DE part of your thought process is that you think it will be the key to success. It might well be, but lots of people who have successful IVF don’t have success on their first transfer. If the clinic don’t suggest anything different for the next transfer that’s not a bad sign in itself. I thought that they do measure or at least observe the lining while doing the transfer guided by ultrasound but maybe don’t share it at that moment - you could ask.
I think my clinic test progesterone levels the day before transfer but it has been a while.

Take some time to process for now and good luck with next time.

@Serendipity24 fingers crossed for you!

@Sunshinebytheseaside good ñuck with your journey too.

As @Whatatodo79 says sometimes it is a case of keep trying (though if it can be sooner than 3 transfers of course that would be amazing, it can be so stressful).