3 failed IVF cycles

[whatnext2021]

Hello - looking for some advice/to hear about other's experiences....

I'm 35 years old and my husband and I have just been through our third failed IVF cycle. My husband and I have a "normal" fertility profile for our age (he is also 35). There is a little DNA fragmentation in his sperm but we are told this should not be a barrier - he has been on Proxseed for 18 months.

Through IVF and ICSI and circa 40 eggs, we have produced one good quality blast which did not take. We are told we are extremely unlucky in this regard. We discovered on cycle 3 that I overproduce LH and progesterone in my cycle which complicates doing a fresh transfer - I have an asynchronous uterus as a result of this issue.

The doctor recommends for my 4th cycle long down regulation and a day 3 transfer of two embryos, freezing any others.

They have tried a varying stimulation protocol and I am with CARE London.

Does anyone have any advice from their experiences? Would anyone recommend a doctor who was particularly good on the embryo quality side of things? Did down regulation work for those who "over leutinize"? Views on day 3 transfers vs 5?
Thanks a lot....

Hi, I haven’t been in a similar situation to you although I have done multiple rounds but when I saw you said about overproducing LH and progesterone it made me think whether you should consider a clinic like ARGC who do very close monitoring of bloods both during cycle and during TWW?

Otherwise, I suppose I don’t really understand why your consultant is suggesting a two embryo day 3 transfer.. if a fresh cycle is difficult what rationale did he give for not just freezing everything? Also the reason most clinics don’t do a day 3 is because a good embryo should make it to day 5 and otherwise you would know if it stopped growing rather than putting two back day 3 and having to wait two weeks to see.

I think it’s surprising that 40 eggs have led to only 1 blast. Has he raised concerns around egg quality?

Hi @ForeverAintEnough thanks for your reply.

We could consider another clinic - I've got one more round with the current clinic paid for....thanks for the suggestion. I am going to push for more blood monitoring this cycle.

They would like to try day 3s as we have such an issue making day 5s. The LH and P rises make a fresh transfer difficult but with the long protocol they may get my hormones in line for a fresh transfer, with freezing the rest - they want to give fresh and frozen a go if we get the numbers....freezing days 3s carries a higher risk of losing them. In short - we can't make day 5s so days 3s is the next option, and freezing all carries more risk of killing them off i.e. try fresh and frozen.

I'm in two minds whether to push for another day 5 or give the day 3 a go. Clearly the chances of success are lower with a day 3s....

My consultant has suggested it could be a bit egg quality and a bit sperm quality and together they are the perfect storm for not succeeding. She is still of the view that there are good eggs in there because of my age - I also produce a good number each time. It's really tough not to have any concrete reasons. We are told we are simply in the minority and v v unlucky.

1/40 is very bad odds

Have you had a recent amh fsh

After 3 failed I was advised to have an era to check lining and if Ned extra imputation days

AMH still fine - doctor seems unconcerned about that. ERA test will be done on next cycle. The issue appears to embryo quality

Hi there, I had 3 failed cycles post transfer (bfn) and 4th one worked for us. We looked into and done an ERA test to make sure transfer happens when endometrium is receptive. In our case it wasn't embryo issue I guess. But we definitely felt like we wanted more research before continuing with the 4th cycle. It worked though, so hopefully 4th time lucky for you too.

@Villetta

Hi there, I had 3 failed cycles post transfer (bfn) and 4th one worked for us. We looked into and done an ERA test to make sure transfer happens when endometrium is receptive. In our case it wasn't embryo issue I guess. But we definitely felt like we wanted more research before continuing with the 4th cycle. It worked though, so hopefully 4th time lucky for you too.

Our 5th after era and found needed more porgy I’ve worked

Will never know if way other 4 failed due to lining not receptive that day

Or just lucky it worked

But I feel an era is a must to rule out

@Blondeshavemorefun same! Don't know if ERA helped, my train was cancelled and I arrived 4h late to the appointment, ERA showed receptive endometrium and my next transfer was pushed back these 4 hours, and it worked.