3 failed cycles - MFI what's next?

[Viletta]

Hi all,

We have severe MFI both 33, TTC for years. Had 2 failed fresh cycles and 1 failed FET, never saw 2 lines. The two private clinics I was in both think it's MFI and we just need to keep trying possibly with DS. Donor is not something we are considering at the moment. I'm wondering whether there might be something wrong with me? Last cycle I was on prednizolone. Why they are not implanting? My endometrium is thick, my hormones are all good. Is it just bad luck or are we missing something? We didn't do PGS but we had 3 good quality blasts last time. One is still in the freezer but I'm paranoid it won't work... I read conflicting information. Nice guidelines say 3 cycles should work, while another study claimed it takes on average 6-9 cycles.. How long did it take you? Would you ask for more tests? I'm so confused...

I'm in a similar position (2 failed cycles, 3rd cycle first FET has failed).

We're getting a lap and dye plus hysteroscopy as I didn't have them before being put on the IVF train and my gynaecologist thinks this is a good idea to rule out hidden endo.

I'm also getting my GP to re-run my bloods and do the level 1 bloods.

I'm considering an ERA, sperm DNA fragmentation too.

I don't think I could do any more transfers without more tests. It could be that we've just been unlucky but I haven't even come close to a BFP so decided I need to be much more proactive.

Logic tells me if that 3 cycles is average, up to 6 would be a reasonable number to do.

Similar position, same questions so very sorry but I have no answers. Age 35, husband 39 TTC since sept 2015 and on initial testing told that DH had a count of 7million. That's since gone up to 28 million but we're still having ICSI.

First fresh cycle had 1 x 4BB blast transferred BFN.

FET of 1 x 4BB BFN

FET of 1 x 4BB BFN

Had the implantation bloods that were normal, saw the consultant and embryologist who both said there's nothing wrong and it's just the luck of IVF.

Second cycle - disaster. Of 14 eggs retrieved, only 3 fertilised and they weren't great quality. Had x 2 transferred on day 3 that was BFN. From follow up they don't know why the quality was suddenly so poor but suspected it was because they had triggered me on day 8 of stims so wrote that for the next one to leave me to say 10 minimum.

Third cycle - on egg collection couldn't get to my ovaries due to my bowel. Had to puncture my uterus and only managed to get 3 out. 2 fertilised and they were frozen on day 1. I'm now on antibiotics as a result of the puncture and seriously wondering why I'm in this position. Only happened this week so not had follow up but from Internet research it's just unlucky and happens to 1% where they have to leave good eggs behind and puncture the uterine wall for access to some.

Why, when there's nothing wrong with me have I had x 5 embryos transferred and never had two lines. Nobody has been able to answer my question. They've scrutinised my uterus, measured my hormones etc and there's no reason. I'll have another x2 transferred next month, but I just feel it's madness to be hopeful for them to work when my experience is simply that it won't.

Do we throw more money at this? What if 3 more cycles down the line we're still here, except £25,000 lighter and me at my wits end because of the psychological torment of keep doing this to myself.

In terms of further tests, maybe ERA. Everything else is done, as I'm sure the issue is me as it's an implantation issue. The embryologist said the 3 blastocysts we got on the first cycle were good quality so I'm sure if we had a sperm issue it would have shown in the embryo quality - please correct me if I'm wrong though.

Please tell me if you have any thoughts or answers as because my husband is so wonderful he will support me whatever I want. I want a baby, but at what cost?!

Hi both, similar situation but only one cycle in ( I think ahead!!) we are going to do another cycle and see if that works but in the meantime I have gotten DH referred to a Urologist and some a DNA Frag test which came back very high. Apparently if it’s very high surgical removal of sperm or PICSI/MACS can help. So if this next round doesn’t work we are going to move to a clinic that does these procedures. Apparently DNA Frag can lead to embryos not making it / much higher chances of miscarriage so it’s not implausible that it would impact on implantation too.

Hi all,

Thank you for your thoughts. It's definitely not a easy journey. One of my friends told me it's psychosomatic (I.e. deep down I don't want to have kids or too scared, I need to calm down).. I just wanted to punch her in the face! @FingersXssd83 I was thinking of hidden endometriosis and will chat about that with my doctor in September. Last time when I emailed doctor assistant with a generic question what can I do to improve implantation I was sent 3 pages of blood tests and was suggested to do a mock cycle with endometrium biopsy to see if it's receptive. I've got one blast in the freezer, I think we might try it before thinking of further investigation.. I am still not 100% sure about PGS testing.

@MrsC2018 it's so not easy.. also impossible to tell where the problem originated: is it the embryo not developing, is it endometrium or just bad luck and embryo reacting on the change of environment. I will see what my doctor says in September.. if nothing reassuring we might try another clinic. I heard food things about a clinic in Greece.

Hi @Viletta, my lovely best friend in the world advised me to relax and go on holiday. Knowing full well the amount of failed treatment I have had in the last 18 months and that we have been TTC for 5 years.

I've also lost count of the number of 'miracle baby' stories I've been told, but given that I've had 7 holidays since TTC, had 5 cycles before IVF starting (people love to tell the 'I found out I was pregnant just before starting IVF' one) and had one round with terrible quality embryos that didn't implant (people also love the 'it only takes one' stories) I've slowly come to the conclusion that I'm not going to have a miracle story of my own to tell.

I also just wanted to say thanks for writing this post. I've had a big think since giving my story of woe and have decided to stop and take stock and really look into further investigations as what has happened to me cannot be normal in spite what my clinic have told me.

I've done 48 hours of research and come up with the following plan;

1. Request hysteroscopy. If not agreed via NHS then I'll look abroad due to cost. ?Serum Athens
2. Arrange implantation clinic biopsies at Coventry hospital
3. Further bloodwork including; Immune testing, Karyotype testing and for my husband, DNA frag and oxidisation.

Once the above results are in then I'll ask for another scratch and arrange ERA prior to the last transfer of my 2 remaining embryos.

If that transfer fails and the above testing hasn't found anything then our journey will be over. We cant continue this ridiculous quest where the emotional toll is as high as the financial.
However, if we find reasons why we have had the repeated failures and can reasonable expect a different result with treatment then we'll fund one last fresh cycle.

Regarding PGS testing, my research ( and I am in no way qualified) seemed to indicate that if you and your husband had a normal result from the Karyotype blood work then there was no indication for PGS testing being appropriate. So given the recent updated research on PGS testing showing that some abnormal embryos that would have been discarded can go on to develop into healthy babies I'm opting to have the bloods done instead. Might be worth you looking into that too?

@MrsC2018 good plan! I think it would be best to find a doctor that you trust. I'm not sure for example how prednizolone works.. I though it would sort out any immune issues one might have. Or if endometriosis is not seen in the ultrasound, does this mean it's not significant enough and what would be the treatment? Lots of people with endometriosis go via IVF root, I don't know whether they have any treatment prior to that. We did dna fragmentation test and result is more or less normal for our sperm count. But I believe picsi procedure where sperm with good dna is picked really worked for us. I'd like to know what treatment will be offered as a result of all those tests. It's hard to talk to friends, they try to help with advise while all we need is for someone to listen and ask how we feel, what we plan. Our friends feel hopeless and try to be helpful by giving advise like go on holiday, adopt, take a year break and relax... it's so nice having these forums and talk about our issues with people who really understand. I will also think about further investigations.. I can't believe it didn't work just of sheer lack of luck.. keep me posted on your findings. Are you planning to discuss your plan with a GP or fertility expert?

I would ask for an era

My clinic suggested it after 3 failed cycles

Whoops hit send

It showed I needed extra progynova and to be later in the xudke then day 20 - this was a fet

I did take extra - few weeks extra due to being on holiday but for scbned and lining was 1.1 and triple layer showing

That cycle - my 5th - was my only bfp in 10yrs ttc

@Blondeshavemorefun thank you! Congratulations on your bfp! I'll definitely look into this! I this this was actually suggested to me before just as an option. As I get nothing from nhs fertility wise i will check the price of this abroad.

I’m roughly doing this - but sure was £350 here to get the scrape - then sent away via igenomix and think that was £800 Ish so talking about £1100 tho mine was over 3yrs ago so costs might vary

@MrsC2018 I like your plan, it's v similar to my plan.
Why the hysterectomy? There is no treatment for endo so how does knowing help?

My DH and I have decided to do a donor cycle in 5 years time (I'll be 39 then) this means that the science can move forward and I don't have to go through the horrendous grief process for another 5 years (if at all!) realistically we could leave it 7...anyway, that's an option that works for us. Maybe it's crazy, but I like beating biology and time with science.

Hey @AliceAbsolum a hysterectomy is possibly the only thing that will stop me obsessing over this 😂

I have an old cesarean scar and in a few of the eleventy billion ultrasound scans the sonographer has mentioned that the scar looks funny and that there are ? Polyps so I've become a little fixated in possibly having structural reasons for the implantation failure.

I understand your description of the grieving process and agree, it's madness to continue. However I just can't stop at the moment. I can't tell you how many times I've told myself and DH that it's over and I can't do it again to just start looking at different options within the month. I think we're similar in that a plan calms me and makes me feel like I'm calling the shots, I hope our plans work for us and bring us peace.

@Viletta I've got a clinic apt at the end of sept where I'll ask their advice I think. What will you do going forward?

@MrsC2018 Ha ha ha, well yes a hysterectomy is 1 solution

@MrsC2018 my plan is to have a consultation with the doctor first in September. See what she thinks. We have one frostie left.. I might pop him in before doing further investigation.. not sure, we'll see what the doctors think first. If this doesn't work I will have a free online consultation with NewLife in Greece to see what they can offer. I heard they are on the frontiers of science at the moment. I agree with @AliceAbsolum I'd like to know the treatment plan before I do the diagnostics. A friend of mine has endometriosis that was removed surgically. But at this stage she had lots of symptoms. I will also look into ERA.

So I had a chat with Reprofit, they suggested immunology, trombophilia and ERA examinations. They said they think it's highly unlikely that I have endometriosis but I can do a biopsy when doing ERA test and also check my uterus for bacteria. I need some time to process this information.. I have a feeling that these tests won't really make a difference. I might do a FET as is and then investigate further with ERA and Embryo testing.. I wish someone else would make this decision for me.

I would have the era

Mine showed I needed extra progynova which maybe why the previous 4 attempts failed

The next attempt 5th worked as we did it longer then usual

Maybe it should why it irked. Maybe just a fluke

But I wouldn’t ‘waste’ an embroyo Incase the same as me iyswim

@Blondeshavemorefun good point.. Do you have irregular cycle? I used to and perhaps indeed I need the era.

Hi Viletta - decisions are so hard to make, totally get you - I also just had 2 failed transfers at Reprofit, once was an FET.

I've not had a consultation with the doctor just written correspondence via the coordinator in which I asked whether I should try other things such as intralipids, steroids, baby aspirin and clexane. They said it was fine to try intralipids and to be on clexane and steroids. The experience is quite different from the UK. you can feel like you're hanging a bit and a helping hand in decision-making would be helpful. My OH pretty much leaves it to me too which is also frustrating.

Blonds -what is the ERA and how do they check for it? Congratulations on your baby!! Your perseverance paid off beautifully...

@Viletta no I was every 28 days. Very regular

@gretal81 - they take a scrape of your lining - but like a smear - in the middle of your cycle - had to be a certain day but they tell you this

The ERA (Endometrial Receptivity Analysis) is a genetic test that evaluates the expression of genes to evaluate whether the endometrial lining is properly developed to accept an embryo

era

Hi

Was in the same boat as you, diagnosis of MFI. I had two fresh plus two frozen failed cycles. Was totally despairing of ever having a baby. Switched to the Lister (had a normal hysteroscopy and D and C before going) and we had a fresh cycle with IMSI which gave us our baby.
This is hard to hear and hard to say to you, because I've been in your boat, but it may be worth keeping going. I would get a second opinion though, it might help.

@Blondeshavemorefun hi there, I was wondering if you remember where you had your ERA test done? I'm trying to arrange one but clinic in the UK don't take me as I don't undergo treatments with them...

Hi yes. I paid private for one / think was £350 for consultant then the era fee

Was near me - have attached details - where are you based ?

But I also had another one at my abroad clinic as when I had UK one it was very painful and wasn’t enough cells scraped

abroad found that my cervix had closed so I had cervical dilation - then era - then fet and that was the only one of 5 that worked

@Blondeshavemorefun thank you the info! Did they refund anything for the one that they failed to collect enough cells? I am in south-west but ready to travel for this test.. it might be easier to fly to Czech for this tbh.. no waste of time for the consultation!

No I had to pay the consultant as wasn’t his fault he couldn’t enter me

As I was having ivf abroad I had my 2nd attempt of era at my abroad clinic by the doc who would be doing my ivf

So he know my inside iyswim

If you are considering ivf abroad I would use that clinic to get the era sample

I would have to check prices but apart from extra flights to Madrid for 2nd era the cost wasn’t that different to uk iyswim

And fights weren’t a lot for dp and I

@Blondeshavemorefun I think that's what I'm going to do. The cost of flights are same as this extra consultation here. It looks like the lab that patented ERA is in the UK so would be funny to see my sample going back to the UK lab. How did you feel after the test?