Very low quality embryo transfer

[Clt1983]

Hi all, I’ve just completed my second round of IVF at age 37. AMH, follicles etc all ostensibly fine with the only known complication being a fibroid but doctors aren’t concerned due to size and location. No sperm issues with my partner and overall diagnosis is unexplained fertility.

First time round was 7 eggs retrieved, 5 fertilised but just one embryo of good enough quality to transfer back at 4BB and nothing to freeze. Resulted in BFN.

This time round I was on stronger stims and had 12 eggs retrieved with 8 fertilised. By day 3 I had just one 6 cell and one 8 cell. I’ve gone in for embryo transfer this afternoon and I now only have one embryo remaining and my embryo is too low to grade properly so it was just at grade 1. After having been on stronger meds but generally feeling well and positive all the way through be, the fact it had all been for one low quality embryo was all too much and my partner, the nurse and embryologist had to comfort me as I broke down.

I’m trying to be positive but it is a bitter blow and I’m already thinking about the next cycle. Has anyone been in a similar situation and where did you go from here? Donor eggs, genetic testing etc?

I haven't been in your exact scenario in terms of repetitive rounds, but was in the situation of only having one fairly crap embryo on day of transfer! Ours wasn't even grade-able as it hadn't reached blastocyst stage by day 5, which statistically gives it a pretty poor outlook, but the clinic were still adamant it was worth putting it back in. 26 weeks later it's still hanging on in there and growing nicely! They wouldn't put an embryo back in if there was no chance of success, so try not to give up hope completely, although I can understand why you're feeling distressed. I felt exactly the same.

Your drop off rate isn't hugely abnormal, and lots of people can come through rounds with hardly any embryos. It does usually take 2-3 rounds to achieve a live birth (on average). I appreciate none of this is particularly helpful, as I am sure you already know it, but statistically your experience doesn't sound hugely abnormal. I suppose a follow up consultation with your clinic if this transfer isn't successful would be the starting point. I'm sure others will have far more helpful comments than me. Wishing you luck.

Thank you MGee123, hearing that someone else has been in the same boat definitely makes this a little less lonely to navigate. Good to hear yours is progressing and all the best for the rest of your pregnancy, really happy that you’ve come so far with your little one. I can’t fault my doctors, really happy with the treatment so far but I think we were so focused on getting the egg number up as they had expected more first time round that now there may need to be a shift in focus. Going to get through the next two weeks and then I can take stock properly.

The whole process is just such an unknown and so unpredictable isn't it. Like you, I was okay until we hit transfer day and then hearing we'd done all that for what felt like no reason was really gutting. I naively assumed we'd get at least one decent embryo if not more! In reality, our doctor said that with our numbers we did well to get our one dodgy one (6 eggs, 5 fertilised). And yet you hear people who get three eggs and end up with three good embryos 🤷‍♀️ I'm sure there are some technical explanations behind success rates for individuals but I can't help but feel there is a bit of luck associated with it too. That's great you've been happy with your clinic though. As you say, try and keep busy and get through to OTD, then take it from there. I am sure they will be well placed to advise you on possible changes, and it's good you have confidence in them, but I really hope you have a positive outcome this time round.

Whilst I would get 2 blastocysts from each of my short protocol IVF aged 36 they were average quality and PGS showed chromosome issues. I changed to natural modified ivf and had twins with my own eggs x

Thanks @ivfgottwins Was natural modified IVF suggested to you by your clinic or was it something you decided independently as your best option? It’s not something I’ve looked into but will be doing some reading. PGS wasn’t suggested after my first failed cycle but it’s something I’ll raise with the doctors if this time doesn’t work.

Definitely had my low moments in the past 24 hours. I’d managed to avoid the frantic Googling so far this cycle but hard to resist it now.

@Clt1983

My clinic only does mild IVF or natural modified- after I had 2 failed mild rounds I actually raised it with my clinic as wanted to try something new. My theory was that if I was only going to get 2 average blastocysts out of 14 eggs each time then why not try just going for 2 eggs in the first place? By that point didn't really have much to lose (well money obviously). Previously my fertilisation rate was only 30% but this jumped to 100% with natural modified

Thanks @ivfgottwins That’s interesting to know.