3rd failed transfer

[Raggity19]

Hi, I was just hoping for some advice.

We have severe MFI. My partner has a genetic condition in which his vans deferens is missing so although he produces sperm, it has to be surgically retrieved. We went through IVF in 2020 which resulted in 4 top graded embryos (not tested). Our first transfer (fresh) was a chemical, our second (FET) did not implant, our third (FET) resulted in our 18 month daughter, and our final one (FET) has not implanted.

I had my progesterone tested the day before transfer on our 3rd cycle and it was found to be really low, we added Lubion and were successful so I'm unsure if maybe the previous 2 results were due to low progesterone?
However, we added Lubion again for our 4th transfer and the embryo still hasn't implanted.

I guess I'm just wanting advice as to where we go from here - do you think maybe we've just been unlucky, or are there other tests I should undergo before going through another round? I'm not sure we would constitute as recurrent implantation failure as our first embryo did implant, and obviously our 3rd gave us our daughter. I've had the standard blood tests in terms of blood clotting, thyroid, etc and they were all normal. My AMH is low side of normal (albeit this was 3 years ago), and I was only 31 when the embryos were created.

Any advice would be much appreciated!

Hi, it's hard to say what might be going on. You could well be onto something with the progesterone and the first two transfers. Keep in mind though that in the US many doctors recommend three euploid embryos for each live birth - each euploid embryo only has a 50-60% success rate and aneuploid embryos have virtually zero. One baby from three transfers of untested embryos and then a further failed transfer is actually quite typical.

You are still young in IVF terms so there's every chance of success for further retrievals and transfers.

@Rosemarypots Thank you so much for your response, I really appreciate it. I think you're right, I think when I knew we had 4 good quality blastocysts I just naively assumed we would have more than 1 baby! But then I also know I need to be grateful to even have had her!