Six failed IVF cycles

[ttcsince2017]

Hi All,

Reaching out to this community as I am absolutely heart broken today following our sixth BFN.

We had a good feeling about this cycle as it is the first one where we had a blastocyst transfer. I was on the lowest dosage of menopur I have ever been on and collected 12 eggs, only one survived to a day 5 blast.

I am now at a crossroads where I just don’t know what to do.
I am 33 and my husband is 36. Do we stay with our current clinic (care) explore ARGC who are more thorough with their tests. Or accept our fate and start exploring DE routes.

Any thoughts/personal experiences appreciated.

My previous post with history for info:

Hi All,

I just wanted to reach out to the mumsnet community and see what options I should explore.

I am 32, have endometriosis and have had five failed IVF cycles.
We collect a good number of eggs each time approx 12. However, the embryos are either highly fragmented, not dividing as expected, slow growers or poor quality. I have had a mix of day 3 transfers and a day 5 transfer with embryos which haven’t quite reached blastocyst. None of my embryos have ever reached blastocyst so I haven’t ever had any to freeze either.

I have tried combinations of Accupunture, fertility massage, healthy eating, supplements as recommended by “it starts with an egg” but nothing has made a difference so in my recent cycle I just decided to go with the flow instead and have a balanced diet with folic acid, vit d and coQ10.

I have been on a prostap followed by a combination of menopur and gonal f recently 450ui but still had no luck.

There are no Male factors as we have done all the tests.

Does anyone have any advice on what we should think about next please.

Xx

Hi @ttcsince2017 I'm sorry about your recent transfer. I just found out today that my third transfer has been unsuccessful

The main things jumping out to me are that you have endometriosis and that embryo numbers and quality is an issue. So I think looking at clinics who focus on these areas is your best bet. Are there treatments for the endometriosis that could be pursued? I'm on the Reddit infertility forum there are lots of people on there were endometriosis and information on it in the wiki. So that would be worth a read. Most of the people on Reddit are in the USA and they tend to do a lot more in relation to tests and treatment.

I know some ladies here on mumsnet have had good results with natural modified IVF, so that may be something to consider as well?

My issues is a bit different to yours as I have recurrent implantation failure, so the tests I've had have been:
-PGT-A testing the embryos, which is only useful when there are a lot of embryos to chose from.

• ERA/EMMA/ALICE, this is useful to know if you need treatment for the microflora and for indicating how long progesterone is needed for in a medicated FET.
• A HSG, you may have had imaging in the past because of your endometriosis but for those that haven't, a HSG or saline Us followed by a hysteroscopy if indicated can be helpful.
• Recurrent implantation failure blood tests, I was checked for autoantibodies and had a thrombophilia screen.

Thank you so much @Gardenlady543 and I’m sorry to hear about your failed cycle.

I had a laparoscopy and hysteroscopy for endometriosis back in 2019. I am no longer symptomatic so I have not been keen to undergo anymore investigations as they say you damage follicles each time you have the procedure.

Egg quality does seem to be the main issue and this is why now I am confused as to how many times do we keep trying before we move to egg donor route.

@ttcsince2017 I am sorry to hear of your failed cycles. I had several failed cycles (short protocol using menopur) and decided I needed to do something different so I did natural modified IVF (using very low dose bemfola) which was successful

@MabelG
I think my recent cycle was classed as natural modified but it would be good to know what yours involved.

My protocol was:

• Day 2: clomid 100mg for 6days and menopur 150 daily
• Day 5: cetrotide 0.25mg daily
• Finished with a combined trigger of gonasi and buserilin

Personally at 33 I wouldn't give up on your eggs yet. I had poor egg quality when collecting 14 eggs each time but had twins when I changed to natural modified IVF and was only collecting 2 so I'd explore that first?

ARGC get results but it's very expensive - a single round can cost £25k and it's more like a boot camp with daily scans/blood tests

@ttcsince2017 I didn't have clomid, just 150 bemfola from day 5 (having checked natural hormone levels by blood test during those 5 days). Scans and blood tests every other day during stims and double ovitrelle trigger when the lead follicle was at the appropriate size. I think there are several ways of doing it, I think I have seen tamoxifen mentioned on here too.

@ivfgottwins @MabelG
May I ask what clinics you used please?

@ttcsince2017 it was Create

@ivfgottwins that is really comforting to know. Did you get any blastocyst transfers when you were on conventional IVF?
I did have a consultation with ARGC and I must admit I felt so overwhelmed by it all that I chose to hold off and stick with Care for another cycle

@MabelG ah I have considered Create, the consultant at the Birmingham clinic really confused me.
He sent me quotes for both mild and natural ivf, however, the medication was the same for both.
I struggled to understand what the difference was and what was best for me.
This is why I ended up with Care and asked them to do a version of natural modified ivf.

@ttcsince2017

I was also with Create (Birmingham)

I did 2 cycles of short protocol IVF with ICSI - both times got 14 eggs so total of 28 eggs but less than 30% fertilised, not great quality on day 3 but managed to just scrape through and got 4 blastocysts. I PGS tested 2 and neither were normal. I did 3 transfers and had 2 BFN and 1 ruptured ectopic (but not convinced that was an IVF baby as we also tried naturally that month!)

Then with natural modified IVF with ICSI over 2 cycles I got 9 eggs - 100% fertilised and all top quality on day 3. Got 4 top quality blastocysts - 2 are my twins and I have 2 more frozen

Was there a reason you stuck with Care with through so many cycles?

[quote ttcsince2017]@MabelG ah I have considered Create, the consultant at the Birmingham clinic really confused me.
He sent me quotes for both mild and natural ivf, however, the medication was the same for both.
I struggled to understand what the difference was and what was best for me.
This is why I ended up with Care and asked them to do a version of natural modified ivf.[/quote]

Was this Dr Datta or Felix? Did you have a consultation with them or just get give a price list?

I did all my cycles with Create. My mild ivf was 225ml Bemfola daily whereas natural modified was tamoxifen tablets and 150ml Bemfola every other day so very different?

@ivfgottwins
I had three cycles at The Priory and now three at Care.
May I ask what your protocol was for the natural modified IVF please and who was your consultant? I am swayed to moving to Create now.

@ttcsince2017

My natural modified protocol was tamoxifen tablets daily from cycle day 3 and then either 150ml Bemfola every other day from cycle day 3/4 or 75ml Bemfola daily with 75ml luveris

I did a 3 cycle package which with ICSI and all drugs was £13.5k.

On the 3rd egg collection of the package I had to revert to more of a conventional protocol as tamoxifen makes my lining too thick for transfer and surprise surprise egg quality went back to crap and didn't get anything past day 3 but I already had 4 great blastocysts frozen so wasn't too bothered and just wanted to get on with a transfer

I mainly saw Dr Datta

@ivfgottwins that’s really useful to know. May I ask why you used ICSI?

@ivfgottwins sorry to be bombarding with Qs! How much of a gap did you have between your natural modified cycles?

@ttcsince2017

Originally my DH sperm results came back at 2% morphology so they recommended ICSI

With my natural modified cycles - cycle 1 and 2 I did back to back with no break so almost exactly 4 weeks between egg collections....but then it took almost 40 days to get my next period and my hormone levels were all over the place so they recommended having a break of a month but we ended up going into lockdown so it ended up being more like 3 months

@ivfgottwins hey, hope you are keeping well. So we have had a few talks with Dr Datta and we are going to try the 3 cycle package next month starting off with natural modified IVF. Feeling so nervous x

[quote ttcsince2017]@ivfgottwins hey, hope you are keeping well. So we have had a few talks with Dr Datta and we are going to try the 3 cycle package next month starting off with natural modified IVF. Feeling so nervous x[/quote]

That's great news! I was equal parts relieved and terrified when signing up to the 3 cycle package as knew they would be my last

I've got everything crossed for you that you have success this time! 🤞🤞

@ttcsince2017 when you say the sperm is normal are you just referring to the nhs Sperm analysis? Tbh this test is pretty basic. Have you had a sperm dna fragmentation test done?

My DH was normal too but the comet test showed up a fragmentation issue.

Hi @XjustagirlX we have done the DNA fragmentation test, NHS sperm analysis and a sperm analysis at private clinic x

@ttcsince2017 if you don’t mind me asking what were the sperm results, count, motility, morphology and fragmentation?

Have you been told you have an egg quality issue and it’s not a sperm quality issue? The normal limits for sperm just mean that the sperm is not in the lowest 5 percentile.

I would be requesting icsi if I were you. Has this been mentioned to you?

@XjustagirlX
No I don’t mind you asking at all. I appreciate all the help and advice we can get.
I will have to dig out the test results again.
We have been told it is a egg quality issue as I have endometriosis and the issues with the embryos were occurring prior to day 3.
We did ICSI for the past two cycles as the consultant wanted us to try Artificial Oocytye Activation to improve the fragmentation within the embryos.

@ivfgottwins another round of bad news with create.
I collected 5eggs, 3 were mature, 2 fertilised. Neither of them have divided properly and are heavily fragmented :(