3 rounds IVF failed - what next???

[Racinglikeapronow]

Hi all, I have done all my research and my head is spinning with what move to make next.

1st round ICSI - 7 follicles, 5 eggs collected, 1 immature, 4 mature eggs all fertilised no embryos male factor and all dropped off day 4

2nd round ICSI - 9 follicles, 6 eggs, 2 immature - 4 mature eggs all fertilised no embryos egg quality issues and all dropped off days 2-3

3rd round ICSI - 12 follicles, got 7 eggs, 1 soft, 2 chromosonally abnormal, 2 immature, 2 mature eggs both fertilised, 5BA hatching blast on day 6 transferred BFN, 4AA expanding blast frozen.

Meds increased from 150 gonal f to 250 gonal f and 75 menopur to 450 menopur. Took DHEA and cleaned up diet for round 3 so high protein no sugar etc.

My AMH has dropped a lot each time and my AFC has also dropped. AMH is currently 9.9 at 34 years old. I’m a poor responder with egg quality issues. I don’t know if there’s something in the rapidly falling AMH too.

I plan to now fo check to see if my tubes are clear (my AMH was 25 at 1st round AFC 12 and we had severe male issues so they didn’t bother to check), do genetic testing (karyotype Etc), do Chicago immune bloods. Already had an ERA /ZFB all came back fine.

I don’t know if it’s just a fluke we managed to make embryos this time And it was actually our worst egg collection. We want to keep the frozen and do another egg collection but we don’t know whether to do same again and hope we get lucky, or go to ARGC for proper attentive treatment and boot camp, or to go natural modified given I get so few eggs anyway. Or go go Serum/Lister one of the other clinics known to be good.

It’s very hard to know what the next step should be and all the clinics seem to just recommend what they themselves offer.

Anyone any thoughts or advice or been in a similar situation? We’ve actually only had one embryo transfer and I know they say it can take up to 3...

I was a poor responder with mild male factor, I did natural modified my amh was totally in my boots 1.8 at the last measure. After 3 failed standard rounds we did the three cycle natural modified freeze cycles at create . Cycle 1 was bust no embryos but went on to get two blasts and a day 3. One of the blasts was successful. I also had all the immunes at FGA alongside my transfer. Good luck in total I did 7 rounds of ivf and 1 iui before success it's a harder game when you don't get the eggs I averaged around 5 eggs with 1 embryo per cycle on all rounds.

@Racinglikeapronow sorry to hear of your dilemma. I would like to follow this thread as I have just had an unsuccessful funded round and I am considering having two self-funded rounds with manchester Fertility.

@Misty999 please can I ask how old you were? I have AMH 3.12 and aged 41 and have been told that my chances are only 5% and the doctors have both mentioned donor eggs, but I'm not ready to consider this :(

@Sian7919 I was 34 when I had the last test i only ever had an AFC of 4 with really small ovaries fsh was also 19.

Create gave me a 10% chance over three cycles.

To give you hope I'm 38 now and am currently 27 weeks with a naturally conceived miracle there really is no rhyme or reason to infertility. I was a classic poor responder the nhs tried to refuse me ivf aged 34 based on my hormone profile.

@Misty999congrstulations and thank you for sharing your story which does give me hope. Xx

ARGC is horrendously expensive but they do get results....

Personally i wouldn't bother having a hsg test to check your tubes as it's pointless if you are doing IVF anyway? If you had hydrosalpinx that would have been seen on the scans you've already have?

Wouldn't bother with karyotyping as know loads of people who've paid for it and still had chromosomally abnormal blastocysts confirmed via PGS testing

Immune testing also probably too early to do - you've only managed one transfer so far. It's not something I'd pay for unless you'd had recurrent miscarriages or multiple failed transfers

I had similar rubbish results over 2 IVF cycles with ICSI cycles although did manage to make a couple of average blastocysts but had 3 failed transfers

I changed strategy completely and changed to natural modified IVF with ICSI and my fertilisation rate shot up from 30% to 100% and over 2 cycles and 9 eggs and got 4 top quality blastocysts (currently pregnant with twins with 2 of them)

Hi @Racinglikeapronow firstly I'm so sorry things have been so hard. I know well that feeling that it will never happen when it feels like everything is stacked against you. I do want to, gently, point out that your last round wasn't a failed cycle - you have two Frosties and they may well turn into two babies. I know that feels like an impossible dream right now tho.

Whilst there are definitely some bad clinics out there (I have been to one in the past), most of them aren't bad but it's important to trust your clinic. I think we need as much peace of mind as possible during this process (not that we get much!) so if you feel that you would prefer a different clinic then switch. For me, it was about not having too many regrets if it failed.

I am at ARGC if you want to know about it. It is a lot to take but happy to answer any questions if you want.

Wishing you all the best xxx

Ps hi @Sian7919 sorry I haven't emailed back yet! Will do soon xxx

Thanks everyone for your helpful replies. @Misty999 loving hearing that you ivf worked after failed rounds and that you are now pregnant naturally. That’s the dream for us! Congratulations. I am arranging a consultation with create as I just respond terrible to IVF so what’s the point really if trying to do normal over and over.

@ivfbeenbusy I’d like to see if my tubes are clear even re trying naturally - we’re considering taking a break and trying naturally while figuring out our next steps and just to know if that’s a waste of time or there is some chance. I’ve also heard sometimes there would be stuff leaking out of tubes if they’re not clear and harming embryo.its good to hear you’re another create success story!!
I guess on immune Tests my ZFB did come back normal and that’s a bit of an immune test so maybe I don’t need it yet.

@Janefx40 thanks so much. We have a consult lined up with ARGC next Monday. I agree re no regrets. We’re just so confused as to what the next move is whether try again with our current clinic and hope it wasn’t a fluke we got embryos or go the create route given I never get many embryos or go throw the kitchen sink at it in ARGC. We just don’t want to make the wrong decision. Unfortunately it was a negative on one of our blasts so we only have one frozen left. We are scared to use it given it took 3 rounds for us to get embryos. We would like to try get some more embryos or do another round and see if it was a fluke and if we don’t get embryos next round then do every test we can think of before putting the frosty back as we were told donor eggs was a possibility before this round.

@Racinglikeapronow I’m sorry to hear it hasn’t worked out this time for you 😞 I’m going to be cycling with Argc in one month but it’s has my last natural pregnancy monitored by them . It failed but pretty sure that was chromosome issues due to a few factors. I have to say they threw everything at it to try and make it go the distance . It was intense but you get a sense they do look at you as an individual ( my file had to be reviewed by the head doctor after every test or scan for his recommendation- it often meant waiting all day for results which was hard but it shows it’s not a cookie cutter place) for ivf it’s daily bloods and scans every couple of days , so you’re monitored closely hence the cost ! My bf has two kids with them but she had good stats to start with x

Regarding tests I found a list on the zita west site if you search under immune testing level 1 tests . If you have insurance like Bupa sometimes they cover some of these , my GP also surprisingly said quite a few they can do too ( lovely GP) I was also looking at a hystereoscopy to check lining etc . I did karotyping and nk cells both normal but understand it’s still good to write those off and get them done. Keep us updated hun x

Oh also my consultant said that if you don’t respond well to ivf drugs they will revert to a natural modified approach, it would be if the situation was quite bad though . I’m not sure when in the cycle they realise it’s not going to work out and switch but might be worth asking more about it on Monday as it’s the best of both worlds as you get a shot at ivf ‘proper’ but the opportunity to switch if it’s not working . I didn’t ask for too many details on it but that was the gist xx

Really interesting to hear everyone’s thoughts. @Janefx40 no problem hope everything is ok. I’ve had a bit of a rubbish day today feeling sorry for myself this afternoon. Hopefully I’ll get a good night’s sleep and feel better tomorrow. I’ve decided to do two rounds with Manchester Fertility and if they don’t work do natural modified with Create x 3 cycles.

I was booked onto a webinar with Create about the Natural IVF stuff but couldn't go. I will try to book another tho. It might be worth thinking about at your age.

I'm interested in it but I would like to see the evidence that the level of stims makes a difference to egg quality.

The problem with all of the research is that it can't tell you what will happen to you - because as you know it only takes one good egg - so there is an element of luck as to whether that egg comes out during a cycle or not.

I also wonder whether some of the intensity of ARGC might not agree with my body. My only successful pregnancy was at a terrible clinic who screwed everything up but also gave me minimal drugs. I've always thought it was a miracle DD was born but maybe it was the lack of intervention that helped. Impossible to know.

Sorry @Racinglikeapronow for misreading your original post - and sorry for your BFN - so upsetting.

Let us know what you decide

@Sian7919 sorry you've had a shit day

Xxx

@Janefx40 yes I agree with you I do wonder about the toll all the ARGC meds and blood tests etc will take. I’ve terrible veins too it’s always an ordeal getting blood out. I plan to ask my consultant if increases Stims increased quality or just quantity. I also had my best egg collection on lowest dose of Stims with 4 mature eggs that proceeded past day 3, unfortunately our sperm issues were bad then.

My DH has suggested doing another round with our clinic but asking for a lower dose of Stims to help us see if natural modified might work for us. If we get nowhere then we will go ARGC but if we have a similar outcome and eggs seem good enough quality then we will go create.

We’re in Ireland so with Covid we would need to move to UK for the treatment as we can’t be quarantining Each end and flying over and back. So it makes our decision even tricker to make. Also the worry clinics will close.

We can likely do another round in our clinic in November/December.

Worry there is they won’t do natural modified as well as create do and we might not get the result we would with them. You are lucky in the U.K. we are with Ireland’s most advanced clinic and it’s still pretty poor. Only 2 scans during Stims, only one blood test before egg collection etc.

@Sunshinelove8 that’s very interesting re reverting to a more natural modified. I also like the idea of close monitoring that ARGC do. We don’t get any funding over here so we’ve spent 25k so far with nothing to show for it so given we’re spending so much l would rather go to UK where clinics are more advanced.

I have my consult with ARGC Next week so I’ll let you all know what they say. Create are a pain as they want you to book some ultrasound with them which I can’t do before making an appointment so I’ll call them and see if they’ll accept patients from abroad with no scan.

My experience is in line with PP with lower dose and therefore fewer eggs being the trick;

1st EC, 150 Menopur for 10 days and got 12 mature eggs which created 3 blasts. 1 fresh transfer BFN, followed by a FET 2 months later BFN and then another FET a month later also BFN.

2nd EC, 150 Menopur for 8 days and got 14 eggs but only 8 mature and most dropped off by day 2. transferred x2 poor quality day 3 embryos which was BFN.

3rd EC, 115 Menopur for 10 days. Only 3 eggs and had to puncture my uterus to get them as my bowel was in the way so no fresh transfer as needed antibiotics and time to heal. 2 fertilised and frozen on day 1. 7 months later when I could bare it as obviously expecting poor quality again, both were transferred and I'm now 30 weeks with one of them.

So for me, fewer eggs on a lower dose actually gave me my baby. As you can imagine, having already had no success with 3 blasts, I had zero expectations for those frozen day 1 embryos and just agreed to transfer them in March so that I could change clinic and try again later this year. IVF just seems a more gruelling path for some of us, but talking to a new clinic and having something to look forward to gave me the motivation to carry on.

@Racinglikeapronow when’s your consult with argc ? X

Hi @Sunshinelove8 I had my consult today! The doctor seemed very nice and very thorough. It does sound so intense though. I have terrible veins and they always struggle to get blood out so the daily tests will be tough and then he was talking about doing maybe a split transfer of one embryo at day 3 and another at day 5 but I usually have transfer under sedation as I’ve a dodgy cervix so 3 sedation in 5 days sounds a lot. When I raised it he said they probably wouldn’t put me under so then there’s the worry of the pain!!

Hard to know what to do really. They do seem thorough and they do consider immunes and also monitor progesterone but then I worry all the drugs will have an adverse impact.

We have a consult with create in a few weeks so I’m looking forward to hearing what they say.

I was saying to DH it’s so tough having to make these decisions of what direction to go in essentially on our own as clinics do have their own agenda and want your money!!!

Yeah you will spend money there for sure but then it’s because they monitor so much . I’ve had so many bloods there and normally end up bruised to pieces when bloods are taken but the blood clinic they are associated with are AMAZING at taking bloods and I’ve had no bruises or issues with my non existent veins . Guess check out create next and weigh it all up x

I'd see if you can improve spermatozoon quality before full cycle and check PICSI and MACX these are procedures to select best sperms. I had 9 eggs both cycles. Success after 4th transfer (2 fresh and 2 FET). FET is so much easier than full cycle I would try the remaining frozen embryo first. In the end lots of it is down to luck.