Giving up IVF

[NowTimetoGiveUp]

Hi all,

I'm looking for some advice/thoughts. I've just finished my first cycle of IVF. They collected 16 eggs but only 5 fertilised and none of them have made it to blastocyst stage. They said that DP's sperm morphology was pretty poor, and they were struggling to find enough healthy sperm to fertilise the eggs. This came as a surprise to us as the consultant didn't seem too bothered by the results before she referred us for IVF.

I guess my question is - how do you know when it's time to give up on IVF? It looks like lots of people do multiple cycles, and I was expecting to do this too, but with 16 eggs resulting in zero blastocysts, I'm wondering whether it's worth carrying on or whether we should accept our childfree state. We've now got a long wait for our review meeting but I'm curious to see what others would do in our position as I'm conscious that the provider has a vested interest in advising us to go for another round even if we've got poor chances of success.

I wouldn't give up after the first round if you can afford to keep going (and also have the mental and emotional commitment to go through more rounds). The first round is often a bit of a tester cycle to see how you respond (except no clinic will ever admit to that when they are taking payment of the best part of £7k or more)

Did you do ICSI? That's usually the next step with poor morphology. Also looks at supplements for dna fragmentation

It took us 5 egg collections and 4 transfers to get our twins x

I got my daughter on the second cycle x

Like @twinningatlife said the 1st go is a bit of a tester as no-one knows how your body will react. I did ICSI also due to poor sperm x

Hi, I'm really sorry you're first cycle hasn't gone well.

16 eggs is a good number. Do you have a diagnosis for your fertility issues? And am I right that you did ICSI? If it's actually your DP with the issue then there are lots of lifestyle changes that he can make to improve his sperm. Healthy diet, limit alcohol, loose clothing and good supplementing, plus frequent ejaculation. Sperm takes about three months to be made so it typically takes about that before you see improvements.

He could arrange an appointment with a urologist as fertility clinics tend to focus on the woman. Lastly, if he improves his sperm then it's worth asking about more sophisticated sperm sorting techniques like IMSI and a new zymot chip that is being used in other countries.

You could also ask your clinic about whether they would use calcium ionophore when they are fertilising your eggs as there is evidence this can improve fertilisation rates.

It's very personal in terms of how far you go, or how long you carry on for, but there is nothing you've posted that suggests the only reasonable option available to you is to throw in the towel after this first round.

Hi everyone

Thanks so much for your responses - this is really helpful. We did use ICSI, which I was initially slightly sceptical about but was obviously very much needed in our case. We never got a proper diagnosis for our fertility problems - I have PCOS but I'm ovulating with regular periods so it feels unlikely that that could be the cause. It feels far more likely to us now given the fertilisation issues that the issue is with DP and the sperm morphology.

These are all really good pointers, thank you again everyone.

Hi there, I got 19 eggs the first cycle and only one early blastocyst which was poor quality.
The second cycle was totally different, with 15 eggs and 4 good quality embryos. I think it's worth doing one more cycle as for me, they were totally different x

Hi @NowTimetoGiveUp. I’ve had two failed cycles and about to start my third. The first cycle was very much a trail run which resulted in a 4BB embryo but the second cycle turned out worse with an ungraded embryo despite more eggs being collected. Our third cycle is different again with milder IVF with ICSI instead.

I’ve always said I can keep doing this physically and financially for longer than I can emotionally. In my head, 4 attempts is the magic number. But who knows how I’ll feel once I get there.

In your shoes I would give it another go. One round isn’t enough to truly know how you’ll respond and another cycle should give the opportunity to make tweaks and tailor your treatment. But likewise, there’s no shame in saying you don’t want to go through it again. It takes a lot from you emotionally and physically and I’ve always been quite clear I don’t want to be a shell of who I am, only focusing on getting pregnant through IVF and feeling broken each time it doesn’t work. I’ve been trying to refocus my life a little recently. Thinking when I’m having a lie in or a selfish day of doing exactly what I want or thinking about a big holiday that I may not be able to do that with a baby and trying to appreciate that there are things in my life that I get to do because I don’t have that commitment. As much as I want to be a mum, I don’t want to think that my life is empty because I’m not.

Hi, from what everyone is saying it sounds like the number of eggs collected doesn't necessarily correlate to the number/quality of embryos, which isn't what I was expecting. When we were told that they'd managed to collect 16 we both felt really optimistic, so to end up with zero embryos felt really disheartening, hence why I've been wondering whether we should put ourselves through the process again. It sounds like other posters have had better results in subsequent cycles though, which is really encouraging.

Hey, definitely... It's so not how many eggs! I've been on threads where women have had like 4 eggs collected and I had my 19...and they got 3 embryos with 2 frozen. I really believe every cycle is different and worth a go xx

I'm so sorry to hear the outcome of your first cycle. I would definitely recommend an andrologist before you go again...

We had 28 eggs - 4 viable but poor quality embryos first cycle (two failed transfers and a very early miscarriage). The clinic ran some more tests on my husband which showed high DNA fragmentation so they told him to take supplements for 3 month before we tried again, results very similar (27 egg, 5 poor embryos).

We've had an initial consultation with an andrologist who actually talked us through the results (clinic hadn't done that) and he suggested there is probably something more going on than lifestyle issues (diet, booze, etc). We've got a follow up appointment next week. As someone else wrote earlier, the clinics focus on the woman. I feel like we've wasted a cycle. If I were in your shoes I would keep going but investigate his issue first

On both my cycles they only ever collected 5 eggs each time and only 1 fertilised each time.. was pregnant from both… I’m glad I didn’t produce lots of eggs as I believe quality over quantity
Good luck for the future x

@NowTimetoGiveUp I would second what others have said about urologists/andrologists to look at your partner's sperm. Far too little attention is paid to men in IVF but sperm is half of the challenge. There are lifestyle changes yes but sometimes there are also medical problems that can be treated to help with sperm. It takes a few months so start that process now rather than going straight into another cycle.

Also as @shazzz1xx says it is quality not quantity with eggs. With PCOS it is common to produce a lot of eggs many of which won't be viable - you should still have a good chance of finding those few good ones...just don't expect all 16 to be good!!

Best of luck xxx

Thanks so much everyone, we're feeling more hopeful about another cycle but we definitely want to check out DP first so we have a better idea of what we're dealing with. Does anyone have any tips for finding a good andrologist? Sounds like we can't rely on the clinic to recommend someone.

We saw Jonathan Ramsay who is a urologist in London (tho on the phone due to the Pandemic) who was fantastic. There are others tho! I'm not sure about the difference between a urologist and an andrologist.

Hello

can I ask what was the outcome of the second meeting- did they find a cause like they said?

Hi @xenawarrio , OP here. We ended up changing clinics (we'd completely lost confidence in them) and seeing a urologist separately. Tests found pretty high levels of DNA fragmentation in the sperm which was partly due to a varicocele, partly due to an case of testicular cancer. I would always recommend getting partners checked out based on our experience - our original clinic definitely wouldn't have recommended this but aside from the fertility implications, DH had no symptoms whatsoever and the cancer could potentially have spread before we knew anything was wrong.

Gosh sorry to hear that, glad it all got looked at- I hope all is well now