3 or more failed IVF cycles?

[RedPandaFluff]

Hello . . . I wondered if anyone would like to join a thread for those who have undergone three or more unsuccessful IVF cycles? I think it can be a particularly lonely place - I certainly don't have my initial hope or optimism anymore, but I do have moments where the despair lifts and I'm keen to keep trying.

I'll give my history . . .

38, premature ovarian failure, menopause
1 very early miscarriage, 2 chemicals in my late twenties/early thirties
Cycle 1 - donor eggs - 2 excellent embryos transferred but failed
Cycle 2 - donor eggs - 2 excellent embryos - took aspirin and prednisone - chemical pregnancy
Cycle 3 - donor eggs - 2 excellent embryos - failed

We have one frozen embryo that I'll transfer in Jan/Feb.

I want to do something, though . . . tests, investigations; I just don't know what. I'll definitely take the aspirin and prednisone again next time too.

Try Level 1 and Level 2 tests. Cost a bit but worth their weight in gold.

I didn't have success until cycle 5 (2 own egg and 3 donor egg) I did pay for Chicago tests years ago but knowing a lot of immunology isn't evidence based I never bothered with intralipids etc so the £1,000 on tests was a waste for me, I did have fragmin, prontogest, prednisilone and aspirin empirically though.

One of the biggest causes of repeat implantation failure/pregnancy loss is genetic abnormalities in the embryos so if you are in the position of creating a lot of blasts again do consider looking into PGS as even younger donors will often produce 40% aneuploids and it could well be what's been transferred already may have had aneuploidy, have you had a hysteroscopy? That was to be my next step to check for signs of ashermans

Hi @Cherries101 - I'll need to google Level 1 and 2 tests as I'm not sure what they are. I'm guessing Level 2 are the immunology ones that @Lauren83 is talking about? And very expensive . . . but at this point I'm thinking it's worth it.

I'm starting to wonder if there are sperm issues too. We've used eggs from three different donors and of the 12-14 collected, they tend to all fertilise, but then the numbers drop until day 5 when we only have two remaining (we've only ever had one to freeze) in spite of using ICSI. So we don't get enough blasts to make PGS worthwhile. I wish we did :-(

I haven't had a hysteroscopy - that's essentially a womb biopsy, right? I'll look into that . . .

6 x ivf here
Now with twins
Level 1 can be through gp
Level 2 are expensive
I did my lucky treatments through serum in Athens.
Be kind to yourself

Wow - 6 cycles is pretty gruelling but what a result! Twins! Congrats, @fabulous01!

We're considering doing the Access Fertility option with Manchester Fertility - 3 cycles of donor egg IVF for £16.5k. That, to me, probably works out about the same as if we'd gone abroad.

That will be a total of eight cycles, and probably time to draw a line and stop.

Mine was a serum baby too! If you are considering level 2 do your research and see what the results would open up by way of extra meds as like I said a lot of immunology isn't evidence based, doing Chicago's and getting diagnosed with high NK may mean you can have Intralipids for eg but there's no evidence to support them helping, it is worth asking what they would offer you empirically before spending thousands on tests.

You could look at having an ERA to see if your embryos are being transferred in your window of implantation. With the hysteroscopy it's a camera to see what's going on inside making sure there's no barrier they can see to implantation

Hi all, My (quick) history
2 x early natural pregnancy miscarriages age 34/35
1st ivf - 3 eggs, 1 fertilised, 2dt and bfn
2nd icsi - 7 eggs, 6 mature, 5 fertilised, 3 made top quality blast 2x 5dt bfp twins and early miscarriage. 1 frozen
1st FET, bfp, no fetal pole at 7 week scan, stopped meds at 8.5 weeks, miscarriage
3rd icsi - 6 eggs, 4 fertilised, 2 x 5dt non to freeze , bfn
4th picsi - 4 eggs, 2 fertilised 2dt bfn

Turn 40 early next year, been ttc #1 for nearly 9 years. In between the above I’ve also had 3 polyps removed which may or maybe have been the cause for earlier natural miscarriages (will never know) getting old, fed up. Have our follow up consultation next Thursday where I think we’ll be opting for donor eggs. Rather than the expensive tests my consultant also treats empirically so was on pred, clexane and Asprin for last two rounds, sad,y both bfn so have no idea if they would have helped with previous pregnancies.

Hi @Spongebob79 - it sounds as if we're in a similar situation. Something is stopping the embryos/foetuses from developing even after they manage to implant. I really hate my body - it feels like I have a treacherous womb that sets out to snuff the life out of any unfortunate embryo that's trying to nestle in.

I'm going to have another FET with aspirin and prednisone; then if that doesn't work, bring out the big guns and do some tests.

Before I started ivf I had a number of tests (blood clotting etc ) because of the previous miscarriages which all came back normal. I think if there was an actual reason for it not happening I could deal with it better but everything is unexplained and we’re left in limbo. I’m finding the acceptance of using donor eggs quite tough because of this.

Thanks for starting this @RedPandaFluff, I've been thinking about creating a thread like this for a while.

So here's my (lengthy) introduction:
I'm 40 and fiancé is 50 and we are still ttc#1. Four rounds of IVF and I feel completely lost and further away than ever from being able to start our family.

We've had a really tough year since starting treatment, beset with problems, and I have felt utterly exhausted by it all, physically and mentally. As a result I've had to step down from my demanding career (maybe a blessing in disguise), so am about to take a year out and we'll see if reducing the stress makes a difference.

My tests are all ok and AMH fine for my age, and fiancé apparently has super sperm of a 25 year old (he was very chuffed with this remark). However I have recurrent fibroids that keep reappearing and getting in the way of cycles.

History:
Sept17 - fibroid surgery
Oct17 - IVF1 (long) but couldn't transfer due to new fibroids. One sub standard blast frozen.
Nov17 - fibroid surgery
Jan18 - IVF2 (long). Two fresh blasts transferred.
Feb18 - BFP!
April18 - traumatic MMC at 11 weeks. Very ill afterwards with Anaemia and PTSD. Fibroids recurred, inconclusive if they were linked to the miscarriage.
June18 - recommenced TTC, early chemical
July18 - IVF3 (short). Disastrous cycle, incorrect blood test led to an inappropriate protocol and poor response, nearly cancelled. Two day 1 embryos on ice.
Aug17 - fibroid surgery
Sept18 - IVF4 (long). Good egg collection but zero blasts so nothing to transfer. Defrosted the sub standard blast from a year ago, partially expanded but BFN.

On paper, our consultant doesn't see why we shouldn't be successful, but has now downgraded our chances of any more IVF with own eggs to less than 10%, just based on our previous results.

We have to make some tough decisions now about what to do next. All we know at the moment is that we are having a break until at least March (despite rapidly approaching age 41), to try and reduce stress and improve physical and emotional health.

After that maybe one more fresh round if we decide to go ahead despite the low chances, then we would try the two day1 frozens.

After that, well who knows... starting to try and get my head into the DE scenario and have had some great advice on here.

My partner is optimistic. He saw the BFP and the miscarriage as a sign we nearly got there. He thinks if I can be in perfect health then age is not a barrier... I admire his hope but I do feel the pressure of expectation.

I’m really pleased this thread was created thanks @Redpandafluff it’s nice to know we’re not alone, although sometimes it really feels like it. @Botanica I’m in a very similar position to you and this recent 4th round has really broken me. I took up a new management role this April and that alongside the ivf has taken its toll. I’m currently signed off sick until the new year.

Karyotyping been done? (Where they look at all chromosomes) DH has a balanced translocation which causes exactly as you say - healthy seeming embryo of which 50% have the wrong amount if chromosomal information, so either never implant or early miscarriage. We have not done IVF though (yet - perhaps in future).

Karyotyping has for some reason been scrapped as standard in some NHS trusts so might be worth asking.

Thanks so much for creating this thread @RedPandaFluff - here's my story in brief!

I'm 37, DH is 43, TTC for nearly 3 years have had 4 rounds of IVF, 3 BFNs, we did a freeze all for the last round as I had ERA test done, only got one embryo which thankfully made it to a good quality blast so that's on ice until am ready for transfer. This last round has lasted 4 months already due to ERA and a couple of stops and starts (last issue was I didn't respond to downreg injections so we cancelled). Going to give my body a break and try again in Feb. Phew, exhausted just typing it all. Have never had a BFP ever and to be honest, I'm very doubtful it will ever happen I just can't see it.

Should have added I have low AMH and after 2 failed cycles it transpired that DH has high sperm dna fragmentation, so that was good

It's really hard to stay positive after a few cycles, isn't it? On your first cycle you're so excited and it seems so possible; on the second you can reassure yourself with "oh the first one was just a trial go, it hardly ever works first time" and then when the third one fails you start to think okay, if it hasn't worked by now, it probably won't . . .

@Dudewheresmybaby
We are thinking about doing the sperm fragmentation test.

My partner's initial tests have all been fine, exemplary in fact, but having read into it, I understand that can still be case but you would not know about fragmentation issues unless you specifically test for it.

We were advised to do SCSA and ROS if we wanted to proceed.

What were the tests you did and reasons for that (if it's ok to ask)?

The reason I am thinking we should explore further is that all of our cycles have on the whole followed a similar pattern:

• decent number of eggs (for an oldie like me)
• average to poor fertilisation rate
• good rate of survival and quality of day 3 embryos
• poor survival from day 3 to day 5

Maybe subconsciously I am clutching at straws looking for anything other than my own eggs to be the problem...

I don't want to go to donor until I know we really have no chance, but likewise, given we've funded everything ourselves, we can't keep going on the same path throwing money at an unsolvable problem indefinitely....

Also @Dude, did you change anything after the ERA?

Another thing I'm wondering if I should be looking at...

I'm considering the sperm fragmentation test for DH - same pattern as you, @Botanica, except I know that eggs aren't the issues because we've used three different donors.

Just wondering if I’m alllowed to join?

The short version: 5 fresh cycles ICSI-all failed with negative tests after the 2ww every time
Cycle 6 Donor egg icsi successful.
Smugly feeling we’d cracked it with donor eggs, we got greedy and decided to do a FET for a sibling (cycle 7)- failed.
All feels a bit deja vu.

Not sure whether it’s ok to join the thread since we actually have a child from this shit, and happy to exit it if that’s what people would prefer

Hi @Botanica - we did the Sperm Comet test through our FC. DH's sperm was perfect on all usual counts (volume, morph etc) we only picked up the issue with the dna frag test. Ended up having to do surgical speed retrieval - they tested that sperm and it was perfect!

The ERA test showed I'm receptive after 5 days of progesterone which means am 'normal' but I think it's helpful to know. First transfer was 5 days, but that was with DH dodgy sperm, second transfer was also with dodgy sperm and was a 2 day transfer so may well have been too early. 3rd transfer was with his surgically removed sperm but that was at 3 days so I may have been pre-receptive. Who knows, very aware that I'm clutching at straws and explanations here!

Think this might be the thread for me after my fourth failed transfer this week. I feel like I’m in the really slow group - IVF seems to work so quickly for everyone else.

We had our first fresh round a year ago but I reacted slowly to the drugs so they ramped them up quickly which led to poor quality eggs (I think). Only had 2 that fertilised and we transferred one on day 3 - BFN.

Tried again in April and responded much better - 5 mature eggs, 4 fertilised and 3 good blasts (one transferred and two frozen)

The fresh and first frozen transfers I had early bleeding on both cycles so I think my progesterone levels weren’t quite right.

On my last cycle (just found out on Wednesday it has failed) i didn’t bleed at all but still no joy.

I am hoping we are making progress and that now my progesterone etc is right all we need is a good enough embryo (this last one was a bit slow and also didn’t fully survive the thaw, I’m not sure of the %) - but I am worried there is something more that they haven’t found. We’re back to the clinic to review in January and hoping for another fresh round in Feb.

I am not sure whether we need any further testing and I am keen to just crack on and keep moving but I might be being naive.

Sorry so many of us are in the same boat but hopefully this thread can be a support and that 2019 is a better year for all of us.

Hi @EarlGreyT and @struggleisreal - you're both very welcome but I'm sorry we're all here at the same time, it's shit.

@Dudewheresmybaby that's how I feel - there are so many tests and so many possible reasons for failure, I don't know how to cover all the bases. We don't have endless pots of money to throw at tests and treatments. We need to prioritise according to likelihood and I don't know where to start. Although I think the sperm fragmentation test is probably a good next step.

Hi @EarlGreyT, @dudewheresmybaby and @struggleisreal, it nice to be around similar people in similar situations. struggleisreal, found out my 4th fresh cycle failed this week too, we knew it was a long short but I always hope. EarlGreyT it’s good to hear you’ve had success with a DE, I think that’s our next steps. Did you do it in U.K. or abroad?

@spongebob79 - sorry to hear this. It doesn’t get any easier does it. I sometimes don’t know how we keep getting up and going.

I feel the same about more testing. I think in a way I am just naturally cynical and so am a bit wary of delaying things with more tests. I am also not really sure where to start as you say @redpandafluff

@earlgreyt I have seen your name pop up on various forums - glad you finally got your baby. What made the decision for you to move to donor eggs?

Hi 10yrs ttc - 4 failed cycles here but our 5th worked

AFter the 3rd failure I was told to have an era as next attempt would be a fet

Basically a mock cycle and they check how receptive lining of womb is

MINE showed needed extra Days of drugs

The 5th cycle worked