No idea where to go from here. If I am so perfect why doesn't it work?

[closephine85]

We have just had what has to be our final round of ivf for money reasons - I'm 7dp5dt on a natural FET and have been spotting since last night. It's the same as I always get so we are out.

I just don't know how to move forward. I'm not ready to give up (4 years of secondary infertility marked today of all days and 32 years old). Every test I have had I have been told 'looks good', your lining, AMH, FSH, ovulation etc etc are all 'perfect'.

DH has a low count, he has low morphology and slightly high DNA fragmentation but we produced 4... wait for it... 'perfect' blasts at IVF. So why didn't they implant?! Is it me after all?! For the last few years we've been told that it's his sperm causing the problem. But his count it low at about 13million p/ml however not completely obsolete. Shouldn't we have conceived naturally eventually with those numbers?!

We just don't know where to go now. We had agreed to try donor sperm via IUI next, but now I'm wavering and wondering if there is actually something wrong with me.

We can't really afford many more expensive tests... the ERA seems a little pointless if we then can't afford ivf anyway if it turned out my implantation window was out.

Literally the only thing I have come up with is that my TSH was 0.66 on my last test and although in the normal range, it seems to say online that it should be between 1-2.5 in relation to fertility. Also, I always spot for 2-5 days before AF, horrible brown sludgy stuff. Other than that I draw a blank but it's been four years now without a single BFP. It took us 7 months to conceive our son in 2011 so I think we must have been 'sub fertile' then too, we either just got lucky or whatever is going on has worsened.

I'm sorry for the waffle... I'm just hoping someone out there might have some ideas for me as it feels like the door is closing.

Please no replies saying it might be implantation spotting etc. I know my body and this is usual pre AF for me just a fraction earlier.

Have you had a lap and dye? The premenstrual spotting could mean you have endometriosis. I'm sorry your ivf hasn't worked.

Thank you. Yes sorry, I've had laparoscopy and hystereoscopy (sp!?) and also HSG. They were also 'perfect'!!

Don't want to read and run!
No practical advice but sending a big virtual hug

The brown sludgy stuff sounds like what I had and it appears that it was old blood that was building up over the years and was possibly related to endometriosis I had years ago before I went on the pill. The build up might have been affecting my ability to conceive and I was told that bright red fresh blood is what you wanted to see.

I went for a course of weekly maya massage with someone trained in it for fertility. My first period after starting the course was really heavy and painful, it got rid of all that old blood that was hanging around in there. I even had pain around ovulation time that month which I'd never experienced before. It felt like it was clearing things out and stimulating my system to work better.

And I conceived that month, she's 1 year old now!

I'm not saying this is your miracle cure after years of tests and treatments at all, but I wanted to share my experience. The statistics are good if you look into it and I'm surprised it isn't more well known. I have 2 friends who also conceived after maya massage treatment, one of whom did it in conjunction with IVF after previous failed IVF cycles.

Have you been tested for immune issues?

I know how you must feel. My five year old desperately wants a sibling.

After my lap dye I went on the pill back to back for a year stop any bleeding and calm everything down. Husband had 6 million sperm low motility. I got pregnant 6 months after this. We tried almost straight away again however it took 5 years to be successful again.

🌺 to you you're suffering I know but all is not lost

Wanted to send you I'm so so sorry. I've lurked on the secondary infertility thread and got to know your story, so I've been routing for you.
As you say, you're still young and it doesn't sound like you are ready to give up, although emotionally it's so hard to keep going. How many fresh ivf rounds have you done? Have you definitely discounted doing another fresh, could family possibly help with the cost? It sounds like your DH's sperm has maybe improved since your last fresh, in the time you've been working through frozen embryos? Have you had embryos genetically screened? I think I recall you're at Serum - there are cheaper clinics out there that could be worth considering. We used a Czech clinic who got us 5 perfect embryos despite my DH having almost no sperm whatsoever.
Perhaps it's all too soon yet to think about next steps. Give yourself some time, it's a devastating process and just so so unfair.

xx

Hi Closephine. I know how you feel, in a similar situation here trying to conceive second child. We've spent a fortune, and now fed up of Dr saying there's nothing wrong and just to keep trying. Don't see much point in doing exactly the same again if we aren't getting anywhere.

Excuse my ignorance, but what's ERA and how is that tested?

Not heard of Maya massage.....my clinic haven't really suggested much so it's good to hear of other things to try.

Thinking of you Closephine, it's horrible when you don't know why it's failing.

Sorry you're going through this. IMO (no medical knowledge) the sperm is still likely to be the problem - didn't think they could actually tell how "good" the embryos are, just see some markers.

for you, I had years of unexplained secondary infertility and it's shit.

I would like to add weight to something a pp said about old blood and spotting.

I too had spotting for the 2 days before each period which I hadn't had before. I had an early miscarrage at the start of ttc2 and then nothing for 3 years and I suspect it was related to this.

I suspect I had a number of early miscarriages during this time but as my cycles are naturally quite short the consultant considered any slightly longer ones as normal.

Eventually I had another definite miscarriage (I knew that it wouldn't take, v faint positive and no symptoms but enough to prove I had conceived) and I insisted on a d and c. I stopped spotting before my period and conceived ds within a few months.

I believe that my unexplained fertility was due to an incomplete miscarraige/retained product/ old blood/ bad lining etc.. although I will never know for sure.

I am not sure if you can just ask for a d & c but it might be worth a chat to your fertility consultant or as a pp poster said massage or acupuncture to clear your lining.

You have nothing to loose. Unmumsnetty hugs to you and best of luck on your journey.

Thank you everyone for your kind words and suggestions.

Grabby - I haven't been tested for immunes. On my first cycle of ivf I took prednisolone prescribed by the clinic as I think that is supposed to account for immune issues just in case? I didn't take it this time, they said not to as I wanted a natural cycle.

Scottish - thank you. Yes that's right, I'm at Serum - I think at the moment, without a bit further investigation, even if we could afford it going straight for more ivf wouldn't be the best move. I think we need to try and get a bit deeper into why. DH's sperm has varied - it started out at 13 million and he went on a few medications to try and improve it (tamoxifen being one of them) but it ended up plummeting to about 1-2 million for about a year. He then took a long course of doxycycline prescribed by serum, stopped the tamoxifen and it seems to have been back up around the 10-13 million mark for a while now.

Glummy - sorry you are in this situation as well ERA is endometrial receptivity analysis - so basically whether your lining is receptive to the embryo with the possibility that you might need a 5 day embryo transferred on day 6. That's a very basic explanation, there's more to it than that but I'm not clued up enough to explain.

Chilli - interesting what you say as I have toyed with the idea of asking for a D&C but wondered if they'd think I'd finally lost the plot having never had a miscarriage.

Fuck - I've also toyed with the idea of going back on the pill (not taken it since before my son was born) but it feels so rubbish to think about going on contraception!!

Loopy - you could be right. I just really don't know any more!!

Sorry if I've missed any one - I'm on my phone and will read again properly later. Thanks again to you all for replying x

Wow Salva you have a lot of infertile relatives.... unless this is more spam for ukranian clinic?!

I would be looking at full immune testing, natural killer cells, endometrial receptors as above.
I agree, that sperm isn't that bad and perfect blasts if there are enough of them should have one take...
Sorry you're having such a rubbish time. (I wouldn't worry about that tsh though - I'm an obstetrician with an endocrinologist interest)

How many cycles did you have?
It's not unusual for a couple of goes not to work for no obvious reason. Bloomin' stats! And how many embryos did you put back?

Our first cycle didn't work, though the blasts were average quality. Maybe it was that, who knows?
The second one the blasts were top quality FET (they took over 30 eggs because I was on such high drugs and got OHSS). We put two embryos in. Both implanted but one stopped growing at 5 ish weeks. No explanation. They put it down to it must've had a genetic abnormality. Will have to wait and see on the other embryo.

Everything is fine in our case too, total unexplained fertility. Good lining, plus I had a scratch both cycles. Sperm okay. On massive dose of drugs post transfer. All blood etc good. There is literally nothing more that anyone could say we could do. There's just so much unknown with infertility it's really tough :/

We went down the immunology route after 3 failed icsi cycles. Our 4th cycle twins

Have you had karyotypes done? The waiting and uncertainty is the worst. Especially when you have one and the gap is getting wider and wider.

So it looks like what I said wasn't implantation bleeding actually was. Still no AF and faint positive test at 10dp5dt however blood test this morning showed a HCG of just 9 and progesterone a pitiful 13.5. The clinic are making me have progesterone pessaries and pregnyl injections which I'm doing but all feels very pointless and I'm sure I'm just prolonging the inevitable.

Fingers crossed for you

Thanks but I think the chances of this working out are probably lower than winning the lottery.

Just wanted to say I'm thinking of you. The clinic believe there is hope if they're giving you meds, so try to hold on to that. I'm keeping everything crossed, you deserve this so much x

Thanks Scottish. Hope is pretty minimal at the moment but there's nothing we can do except wait it out for now

I have a progesterone question, I don't suppose anyone knows the answer? After my progesterone came back horribly low on Saturday (I had been having very very light spotting post what must have been the implantation bleed Tuesday) I was told to start the pessaries. The spotting has stopped and still no bleed. I'm now 3-4 days later than when I'd have expected AF to show up on a normal cycle. could it purely be the progesterone pessaries causing this?

My AF appeared two days before OTD on my failed cycle, despite 800mg daily progesterone pessaries. So in my case progesterone made no difference by the time my body decided it had failed. But in your case you've had implantation (I definitely didn't as I'd tested from 5dpt), so you won't be on your expected timings. I'm still hopeful for you

Progesterone can delay the inevitable but keep them up

You might have only implanted on day 10 hence the very low hcg