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.

@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.).

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.

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

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.

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).

@Serendipity24 just wanted to check in and see how you're getting on. Hope all is well 🙏

@Rosequartzz thanks for checking in. Unfortunately I am having a biochemical. Despite getting positive initially my hCG levels did not rise as expected and is now declining. I have stopped medication and waiting for the bleed to start. How are you getting on with the next steps?

@Serendipity24 oh gosh I'm so sorry to hear this 😢 😞 how are you doing ?
Sending so much love and hugs. When the time comes for your consult I trust you'll have everything thrown at the next round when you're ready. Take the time to grieve and come to terms with this.

I had bloods done on Monday so they'll be available by next week. Hysteroscopy is taking place on Wednesday, hoping all is well. The Dr has said they will monitor the progesterone in the likely event this was the issue.

@Rosequartzz Thanks so much for the kind words. I had doctor's consultation today. Feeling a bit better knowing the timeline for the next FET, something to look forward to (again) I guess. Hope everything goes well for you in the coming days. 🍀

@Serendipity24 i was wondering how you're getting on. Great news on getting dates for the FET. May I ask when ?
I'm not sure when I'll find out as I have no idea on waiting times for the results of hysteroscopy.

Is the FET in UK or overseas? Apologies if its already been mentioned

Hi @Rosequartzz , just been reading your post and wanted to check in. Hope your luck has changed over the past few months? Xx

Thank you so much for checking in @Eagerlywaiting1990Eagerlywaiting1990 with the suggestions from everyone on this thread, I am 16 weeks pregnant. It still feels so surreal and ever so grateful to our most kind donor for giving us the opportunity to be parents.

How are you doing ?

@Rosequartzz oh my goodness congratulations! That is the best news! Sounds so hard earned but what a lucky little baby that will be!

I'm doing OK thanks. I've had one cycle of IVF so far but my first transfer failed and I've got an FET starting in December. I'm very worried that there are issues with implantation but I hope it was just bad luck as they don't feel the need to do anything differently. We are very lucky to have 5 in the freezer. The waiting is the hardest part as we've been sitting ducks since August.

Thank you for you well wishes 🙏

So sorry to hear of your failed cycle. Are there any changes made for your 2nd ?

Just food for thought, for my 2nd round there was quote a few changes/checks done. I had a hysteroscopy done with biopsy which found an infection. At the same time the Endometrial scratch was done.

After the infection cleared we were ready for FET. On transfer day embryo glue was used, progesterone was also tested. I was on progynova, progesterone, aspirin, clexane and lubion.

Any reason why there's a few months wait for the next FET ? I wish you sooo much luck and hope to be hearing the great news from you in the new yr x

@Rosequartzz thanks lovely. Apparently my clinic insist on a 3 month gap before they start again...no idea why. We're then also delayed by the lab being closed for most of December...just rubbish timing.

Wow you had a lot of changes. They aren't changing anything for me this time around. They said my lining was good last time and they have no concerns from any previous scans so have no reason to believe it won't work. They did suggest that if this one fails then they will do more investigations/consider lubion but I don't even know if they do endometrial scratches or embryo glue. I'll be pushing for it all though xx

Our clinic typically does all the changes and investigation after 2 failed transfers and of course I wasn't going to take that risk so they were happy to go ahead with this approach.

As the biopsy was done the Endometrial scratch was considered done as part of this. Not all clinics use embryo glue. I'm also aware that not everyone succeeds with embryo glue.

It's crazy how so much of this journey is based on luck of the draw

@Rosequartzz totally! Sounds like you did a really good job of advocating for yourself and it really paid off.

I had lots of questions to ask and then once they were answered felt pretty reassured but I'll go in all guns blazing next time if I have to. Hopefully I'll have a lovely outcome like you do at the end of it all ❤️ 'xxx