3rd cycle failure - what next?

[Yazoop]

I’ve been trying to get pregnant for a number of years now and have just had a 3rd implantation failure after a FET. Each of my three cycles have produced lowish numbers (I have low AMH so expected) but we always get one high grade 5 day embryo that fails to go the distance (well - one cycle produced two and we put both in and that failed as well).

I’ve had a hysteroscopy to straighten my cervix - and they couldn’t see any cysts or polyps though I do have mild to moderate diagnosis of endometriosis previously.

It seems likely to be the embryos aren’t as good as they seem on surface. But not certain of course! Nothing ever is in this process.

I’m now 39 and feel like time isn’t on my side now (given my AMH and age) and, while we’re lucky enough to have the money to self fund, it is obviously not feasible to keep throwing that sort of money around. Just feel really hollow about it all. Do we keep going? It feels possible that it could work but also impossible at the same time.

Anyone else with experience of repeated implantation failure without any real explanation?

Hello @Yazoop . So sorry for your losses. It's a heart-breaking process.

I am the same age as you. I have done 2 cycles and only did 1 transfer that failed. I had no more embryos to test/transfer from cycle 1.

In cycle 2, I had 4 embryos that looked really good on day 5. Unfortunately, when they PGT-a tested them, they saw that half of them were not viable and the rest were low-mosaic. Basically, what I am trying to say is that grading of embryos visually (like they do on day 5), doesn't always mean that they are truly good embryos. They could have gene abnormalities that prevent them from implanting or developing properly, which often increases with age (at least that's what I am told).

I would suggest doing the testing on your embryos to avoid future heartbreaks.... 💔

Wishing you all the best.

Thanks @contentsmayb - that’s very useful and I’m sorry you have also gone through so much. It is hard, isn’t it!

My (generally excellent) consultant is a bit reluctant to do the embryo testing as there is ( I guess fairly small) risk of damage and the additional cost - as she sees it, you will sort of see the outcome when it is transferred. I might need to revisit this as the 2ww is mental agony I’d rather avoid if doomed from the start - and also it will give me a bit more info on what is actually going wrong that can feed into decisions on what to do next (for example, donor eggs might not be a good option if it turns out to be an unexplained implantation issue rather than the embryo?).

Lots to think about - and not much energy to do so at the minute!

Have you had the NK cell test @Yazoop ?
What does your clinic recommend test wise?

I haven’t had the NK cell test @wtawtaw - I shall look into that. I’ve only had the standard marker tests done with my clinic. I think typically more probing will be recommended now have had three failures, as now meets the threshold for “repeated implantation failure”.

I haven’t spoken to my consultant yet in depth but will have a follow up with her in the next week or so (once I’ve had chance for latest result to sink in). A lot to discuss!

Hello have you guys had any luck or news?

I have had 3 fresh cycles and 1 FET. Total 5 embryos transferred and not even a chemical. It makes me feel like there is something wrong with me but the clinic have no suggestions.

We haven't don't PGT testing because we only ever get 1/2 embryos to day 5 despite getting 12 eggs collected each time.

On my third transfer I had a progesterone blood test which revealed low numbers. I was given lubion injections and I'm now thirty weeks pregnant. Have you had a test done on transfer day?

Ps also an advocate for pgta. I sent seven for testing and three came back normal

Hi

@Bran90 I have no advice but I just saw your post and empathize. I have had 5 failed transfers too and no advice from the clinic. It's so frustrating because I think (for me) something must be wrong. My situation is a bit different in that (trigger warning) I have a son conceived on the second transfer 4 years ago. Do you know what you will do next? Have you had a hysteroscopy? How old are you?

I had the full Emma Alice Era
Which came back with changes to make. Also a Hysteroscopy but that didn't make a difference for me personally. So glad I had both x

Im 33 this month, no hysteroscopy yet have you had one and did it show anything? The clinic have said they don't think it's worth doing. Great to hear you previously had success it means its definitely possible to have another!

33 is absolutely fine age wise. Can you get a hysteroscopy on the NHS (extremely long wait)? I did have one years ago and the clinic were suspicious I had polyps due to heavy menstrual bleeding. Nothing was seen on a normal ultrasound but it did show on the hysteroscopy and it was removed. Dunno if it helped but we did move onto IVF and transfer 2 was successful. I've been put on a wait list for another but it could be 9 months!! What drugs and dose do you take for stimming? You're right that pgtesting is difficult when only a few embryos are obtained. We are in a similar dilemma...last round got 3 embryos so not really enough for testing.

@Bran90 I'm 42 and 32 weeks pregnant. Try not to get too hung up on age xx

We sent seven embryos for testing and three came back normal. Personally I'm a massive advocate for pgta. In the Long run it can save money, stress on your body and partner and also will ensure you only transfer an embryo with a fighting chance. Just my opinion xx

@CR7 Those are wonderful numbers for 42! I will be 42 in less than 12 months time.. was that just 1 round of collection that you got the 7 embryos? What vitamins are you taking? I sent 4 for testing previously (from first 2 rounds) and only 1 came back normal, which unfortunately did not implant.. what changes did you have to make after the Emma Alice Era test? I haven't had that test yet but I think that will be the next step.

@Yazoop I also have had 3 failed transfers after 4 cycles, I have some embryos left but they havent been tested. I actually reached out to NHS today to check if I can transport the embryos to them for testing (it's relatively cheaper than what the private clinics charge) and I personally think the part NHS didnt get right was the stims and collection and fertlisation (they put me a long protocol when I would respond well with less meds, almost got OHSS and they forgot to do ICSI when they've advised on that and wasted 13 of my eggs!). The embryo transfer bit was relatively straightforward and I actually had a better overall experience when NHS did my transfer as compared to the private clinic.

I tell myself I have less than 12 months before I give up... that 42 would be the time I stop trying, so I am looking into doing another cycle (and potentially PGTA-ing what I have in the freezer) and hope I get at least 1 euploid for transfer.

I did duo stim last summer and seven out of 13 made it to day 5.

I took vaginal probiotics and also my implantation window was later than normal so that was adjusted during my following protocol as well as different drugs x

@Yazoop how did you get on? I'm of a similar age (38) and conscious embryos have not been PGTA'd. In the tww now from the 2nd FET

Hi @Sunflower360 - I actually (v unexpectedly) fell pregnant naturally that October when we had decided to take a break to restock. I’m now nearly 26 weeks and so far so good. I was always an bit annoyed by the phrase “it only takes one” but it can be true I guess!

It was unlikely to happen this way for me, but shows that there is always some hope. I have my fingers crossed for your tww - whatever happens, things will be ok one way or another x

@Yazoop that is really good news, congratulations! Yes, will see how this tww goes and then consider next steps