3 failed transfers with top quality embryos - what next?

[ItsMeHiImTheProblemItsM3]

We've just had our third transfer and it's a BFN (this was our second fresh tf. First was BFN then 1 x frozen which resulted in mc at 6 weeks). All our embryos have been 5AAs. I don't understand why it keeps failing and our consultant just says that at my age (39) it's likely to be chromosomal issues.

We've been advised we don't have enough embryos to justify genetic testing (so far I've had 2 blastocysts per cycle). Is my next port of call an ERA? Our issues are MFI and septate uterus, but doctors can't say to what extent the uterus is impacting anything.

Has anyone been through this and can advise what we should ask next? I know sometimes it just takes multiple transfers but it's obviously killing me.

I've read It Starts with the Egg and I take every bloody supplement going. I'm a teensy bit overweight but keep fairly active. Don't smoke, have barely drank alcohol throughout this process, and give up caffeine when we're doing stims / tww.

Hopeful bump 🤞🏻

Hi @ItsMeHiImTheProblemItsM3, sorry about your failed transfers, it’s such a difficult and heartbreaking process to go through. I’m 37, also MFI and have had two failed transfers. I just had the follow up with our consultant and he basically told me at this stage it’s a numbers game, and that only 42% of similar women doing IVF would have had a positive preg test this round. I’ve taken a lot of comfort that it’s just a matter of trying again..and maybe again.

Do you have plans to do another fresh or frozen cycle?

@ItsMeHiImTheProblemItsM3sorry you find yourself in this situation. We also have MFI and it took me 2 IUIs, 2 rounds of stims and 5 transfers to get my BFP, although I didn’t have problems on my side and my age should have not been a problem. I was 32 when we started trying, 33 when doing the egg collections, and 34 when i first got a BFP. So my advice would be to keep trying. And maybe look into the group here on MN “Era Emma Alice…”

Thanks so much for replying @Runner77 and @TumbleweedAgain Both your stories have been really helpful and I'm sorry for what you are / have been going through.

@Runner77 Our consultant says similar and sometimes I work it all out and say that it should work by the fifth time 🤪 We have another frozen embryo and I do want to go straight back into a FET but I'm 40 soon and maybe I should just let myself enjoy my birthday first.

@TumbleweedAgain thanks for the advice to keep going. It's reassuring to hear it will likely happen eventually. Just hard to imagine going through much more 🙈

Hi @ItsMeHiImTheProblemItsM3

I don't have any advice but just came to say you’re not alone and I know how you feel. I’ve done 2 transfers (1 fresh which was a chemical, and 1 FET which was a BFN). I have fluid/scar tissue in my fallopian tube and they think surgery will give me a better chance but don’t want to send me for it because I’m high risk (I have Crohns) 🤷‍♀️

The doctor was very keen to reiterate to me that it’s a numbers game and if I don’t want surgery, I should just keep going as eventually we would probably get there. He also said about a 40% chance of success which in my head would mean if you had 3 good quality embryos, you’d expect 1 to work - although he said I had my maths wrong for this so who knows!!

This sounds a (vaguely) similar dilemma to me @clazbear - although they can't really say if surgery will increase our odds or not, and that if I did have the septum removed it would likely leave scar tissue.

The 'numbers game' chat seems to come up a lot. Although I'm not sure how your doctor is doing his maths, in my head 3 x 40% means 120% chance over three goes haha. I think our odds are 22% each time. So I'm trying to make peace with the idea of 5 goes - only 2 more to go 😳

PS sorry you're going through this too @clazbear ❤️

@ItsMeHiImTheProblemItsM3 Are you NHS? We have got this round on NHS but no more. Part of me is grateful that at least we get one go for free but they seem so reluctant to offer me anything outside of the very basic testing and approach seems to be surgery or you’ll just have to keep going with transfers. When I saw the doctor the other day all he could say was it’s a numbers game and all down to chance/luck, but I struggle with that answer as clearly there is a problem that needs dealing with or we wouldn’t be here in the first place!

How many more embryos do you have to transfer? We have 2 more that are both 4AA. I think them telling you the grading of them doesn’t help sometimes as you automatically think they will work with a good grading.

Sorry you are going through this too, it’s rubbish isn’t it! 💜

@clazbear We're actually with a private clinic but I wouldn't say they're any more open to problem-solving than the NHS has been for you. We had no idea how long NHS waiting list was going to be and I was in a massive panic because I was about to turn 39. Once we signed up to private I discovered we couldn't just also take up our NHS place when we got it (due to us signing up for 3 cycles with Access Fertility - we get 50% of money back if no baby at the end of those 3 cycles. But you can't engage with any other IVF services).

@clazbear We have another embryo in the freezer. After that we will have to do our third round of stims. I wish I could do a couple of freeze-all cycles before I get any older lol. But again our package doesn't allow that.

@clazbear sorry I keep addressing points separately 🤣Can't keep it all in my head each time!

It's really hard when you hear of it working first go for some people. I know they have been through their own struggles too, but I guess bitterness is something I'm really struggling with at the minute.

I'm just off to do my official bloods, which is a waste of time.

Wishing you luck with your next round. Do you know when you will go again?

Hi @ItsMeHiImTheProblemItsM3 I'm in a similar position re. transfers. First ET implanted but lost, second FET (euploid) and third ET did not implant. I was on bromocriptine the first time under NHS; second and third transfers were with Create Fertility and they dont even look at prolactin level (I feel that is partly to blame, I did ask them to look into that and wish I'd insisted on it). The doctor said they have given me everything (doubt it) and has now ordered a hysteroscopy.

I've decided I'm going abroad (Prague) for my next round and see if they do it differently outside of the UK. Funnily enough I had to get a referral for the bloods and the doctor I spoke to said she's gone through all that and would advise people to go abroad the first time as UK's technology is behind. Also, the Prague clinic has asked for initial blood tests and prolactin is one of them.

I would recommend looking into another facility after that many rounds/transfers as you can't keep doing the same thing and expecting different results.

@4thcyclelucky Thanks so much for replying. I've not even heard of prolactin and thought I'd read everything by this point! My clinic don't do a lot of bloods or scans which is something I haven't massively questioned. I suppose when they said my AMH was good I though I didn't need as many parameters checked or something! That's a shame to hear the UK is behind. I hadn't really expected that. Sorry you've been through a lot too ❤️

@ItsMeHiImTheProblemItsM3 My AMH is relatively good for my age too (41) so been quite lucky with numbers; but even an euploid didn't implant.. bloods and scans are the basic I would think so definitely insist on that. I feel that maybe I'm a relatively "straightforward" case (respond well, no issues with lining etc.) that they think I don't need more attention - very frustrating and expensive!

@4thcyclelucky Yeah good point. Think I've been looking at it as I'm straight forward other than the structural issue so haven't expected anything else. But you're right. I should just keep asking!

@ItsMeHiImTheProblemItsM3 I am booked for a 3D scan in January to confirm for definite if this fluid is there (they have been back and forth on this issue) and the doctor said he would refer me to surgeon to talk it through. My husband is really not keen on me having surgery either as I’ve had 2 major surgeries before for Crohn’s and I think they were quite traumatic for him, so he wants to just try again on a transfer. I have sort of taken things into my own hands a bit though and booked to see a visceral osteopath for the fluid/scar tissue and booked myself an all singing, all dancing blood test privately. Just want to feel like I’m doing something useful! Do you have a plan of what you will do next? Are you just going to do another transfer and see how it goes?

I also completely get the bitterness thing. My sister is in a same sex couple and they are trying to conceive in the new year and because they are doing IVF, she thinks it’s the same for them as it is for me but I just know they will get pregnant immediately as there is nothing wrong for them, it is just they don’t have a male partner.

It really is such a hard ride!

Hi @ItsMeHiImTheProblemItsM3

I’m so sorry to hear of your IVF outcome to date.

I am 34, accessing IVF due to being in a same sex relationship. No obvious issues with my AMH, AFC or uterus lining. I have also had 3 failed transfers of good quality embryos. I don’t have any more left, so have to decide if I do another egg retrieval. We are entirely self funded, as there’s no NHS access in my area for same sex couples. (I feel slightly queasy whenever I remember how much we’ve spent so far!)

my clinic have suggested I approach my GP and request the following tests to check for immuno and blood clotting issues:
—Beta 2 Glycoprotein

• Factor V Leiden Common Mutation
• Factor II Prothrombin Common Mutation
• Lupus Anticoagulant
• Anticardiolipin Antibodies

i am hoping the GP will order them for me and save us a bit of money and then will go from there.

I don’t know i this will be of any help for you to ask your clinicians about, but thought I’d share.

i wish you the best of luck going forward.

@Quickdraw23 I'm so sorry you're in a similar position, but thank you so much for that info, that will give me something to research and ask our consultant at our next meeting. Hopefully a GP will organise that without too much of an issue 🤞🏻

It's so frustrating isn't it. We were so delighted to get good quality eggs, after all we've been told constantly that it's 'quality not quantity' so to have three cycles fail is extra disappointing!

@Quickdraw23 Also that's really awful that you don't get NHS funding 😡

@clazbear I've never heard of a visceral osteopath, that sound really interesting so I hope it has a good effect!

Sometimes it feels like the universe does things to spite us. Your sister getting pregnant straight away would be just the sort of thing to rub salt in the wound 😫

@clazbear My plan is to have a good chat with the consultant before the next transfer. This is our last frozen embryo for this cycle so I just want to give it the best shot. Keen to look into some of the blood tests QuickDraw mentioned!

@ItsMeHiImTheProblemItsM3 no problem, hope it’s useful!

I maybe over simplified - we would have to fund 12 rounds of IUI with donor sperm and have them fail, and then we would be able to access ivf (no doubt after a long wait), so not strictly true that there’s no funding at all. But if you have £24k to find 12 rounds of IUI (which has a success rate I’d around 10%) it makes more sense to just spend it on IVF anyway 🤦🏼

obviously now I’ve dropped £10K on IVF and it hasn’t worked I’m wondering if I made the wrong choice anyway 😩like you said it’s so difficult!

anyway I really don’t want to derail your thread whinging about the funding, I’m on a same sex couples thread where I can do that 😂

very best wishes to you OP x

@Quickdraw23 I mean they don't make it easy do they! Feel free to whinge, 12 rounds of IUI is excessive, no? And yeah it's difficult to decide what to do for the best, which is how I made us miss our NHS place 🙈