3rd failed embryo transfer - help.

[Scotty500]

My husband and I are going through IVF, it is an absolutely tortuous process and it’s breaking my heart.

I am 32, husband is 30 and we have MFI. All other tests have been normal.

We used ICSI and managed to make 7 blastocysts.

Frozen Transfer 1: BFN
Frozen Transfer 2: BFP, chemical pregnancy at 5 weeks.
Frozen Transfer 3: BFN.

Is this normal for it not to have worked? Has anyone had success after so many failed transfers? I’ve lost all hope.

Hi OP, I'm so sorry to hear about your experiences.

We also have MF issues. I'm mid-30's now and we have been trying since I was 31, so it's been years of this. I completely relate to your frustrations with your clinic and the waiting list.

The first thing I'd ask is, have your embryos been PGT-A tested? This is worth doing as it vastly reduces the chance of miscarriage/ not getting pregnant due to genetic abnormalities in the embryos. If you have PGT-A testing then they will only be transferring a genetically normal embryo.

Secondly, I don't know what your financial situation is, but we wasted loads of time because we wanted to use our NHS funding. We stayed with a clinic that was really terrible because of it, and probably wasn't giving us the best treatment, was not very empathetic, etc.

We went to a private clinic and our experience has been 100% better, with an attentive and knowledgeable consultant. I'm not pregnant yet but it's saved both of our mental health just to feel looked after and like they understand and know what they are doing.

Waiting until March for an FET seems absolutely insane when it's a procedure that takes minutes to do.

If you can in any way afford it, I'd cut your losses and go private. I recommend the Lister if you're anywhere near London.

Please do remember OP that your situation will be different from others on here.

If you are 32 and have normal fertility, you may well not need the medications and procedures that some other people do. Everyone is different. It's very easy to jump to the conclusion that you are missing out on something - especially with your frame of mind (I get it completely) - but the truth is, it may not be that simple. There is limited/ mixed evidence for a lot of treatment add ons if you look on the HFEA website.

However, as I said above, I'd recommend the PGT testing if they will let you, even if you have to pay extra for it.

It does give peace of mind knowing that the embryos being transferred are genetically normal, especially if there are MF issues with your partner - that is quite likely the reason they are not implanting.

This is a really, really tough journey and it sucks. I hope you're OK.

Hi all,
Thanks for your replies, they really do mean so much. Sorry for the slow response, I had some time away for the internet!

We have been told that our clinic ‘don’t do’ embryo testing, they seem really against it!

We have just found out that we are going to be doing an HRT cycle next time (waiting list still says after Christmas 💔) and the only reason they are doing HRT is ‘to try something different’

They have told me it’s unusual that it’s not worked yet so it’s not looking good for it ever working. I’m completely heartbroken, how can I carry on?

@rustyowl thanks so much for
your advice, it makes a lot of sense. Can I ask how much PGT testing costs approximately? And is it definitive? Xx

That doesn't sound very positive from your clinic. Do you have confidence in them? We were beginning to get a lot of bad feelings about our previous clinic, they just didn't seem to care and didn't explain things to us properly, hence why we cut our losses and went for private IVF at the Lister. The difference is unbelievable.

I am finding the embryo testing extremely reassuring. It cost us £500 per embryo so it's not cheap. But my consultant has thoroughly explained it to us and my friend, who was struggling to get pregnant at the same clinic I was previously at, has also moved clinic and had PGTA testing, and is now pregnant.

It just means they know the embryo has the right number of chromosomes and is more likely to result in a pregnancy/ live birth. Obviously, it is not a guarantee. But it could save a lot of heartache from miscarriages and BFN's.

I'm surprised they told you it might never work because of 3 failed FETs, especially when they didn't even know the embryos were euploid. It doesn't even sound like they have tried that many different things or are looking into it all that deeply.

We switched to donor sperm in the end, so I don't know if that's something youw could consider, but this cycle is looking very good so far - we have 5 embryos in the freezer which is more than we've ever had.

You're young, please don't give up! xx

Has your husband had the testing for DNA fragmentation?

My DH had a very high fragmentation rate, and although we could make blastocysts, the truth is that they probably never would have resulted in pregnancies and live births because of his sperm defects (we tried ICSI but it didn't work, so we moved to a donor).

Have they thoroughly tested his sperm and know about any issues there that might be impacting the embryos?

Just because you can make embryos does not mean they are normal/ able to implant and result in a birth.

We weren't offered PGTA testing back when we were doing ICSI with my husband's sperm, but I strongly suspect that the embryos we made would not have been genetically normal and probably would never have really had a chance of making a baby.

I feel like by doing HRT they are just randomly assuming the problem is with you, when if you have MFI, it's probably much more to do with your husband's sperm and the resultant embryos xx

@rustyowl five in the freezer is fantastic, congratulations!! Are you waiting for a FET just now?

Our embryologist is really against testing the embryos, he thinks it’s just random and not conclusive. If we have to make more embryos I’ll def push more for testing them I think. Can I do that while using an NHS round (I would be happy to pay for the testing)

No, they haven’t. They just did two semen analysis and said “ICSI”. I asked about DNA fragmentation testing but they said it wouldn’t change anything as we are already doing ICSI. I asked about donor sperm as well but they basically said my DH sperm wasn’t ‘bad enough’ and we would get similar results from a donor.

Ive been pushing for steroids as well but was told today that prednisone is basically just a gimmick and not needed! I feel like it is? At least they will be giving me progesterone in the HRT cycle.

I’m so sad that we are being told it’s unlikely to work, three embryo transfers (from one round) feels like it’s just the start of the journey but they are making me feel like failure is just inevitable.

I don’t want to be pandered, WHY ISNT IT WORKING?! the doctor just says ‘there is lots we don’t understand about conception. But you are unlikely to succeed given the three failed FET’

Hi @Scotty500 sorry for this long post. I hope this will help as I'm also 32 with only male factor that we're aware of.

I personally don't have any NHS experience as I would never be willing to wait as I know how precious time is once you're in your thirties. We use our local London Women's Clinic for treatment. We can usually get an appointment within a matter of weeks and there's no waiting list for treatment. The very first time we did medicated timed conception, it worked that very first attempt when I was 31 and we have a daughter.

We were given low odds with timed conception of 10-15% each time, so for attempting a sibling we went straight to IVF as the odds are better. We went through GAIA on a special non credit plan, where we pay for our medicine but it's a set price for three egg collections and unlimited transfers using the embryos collected in order (so you use all the embryos from the first transfer before moving to the next collection). If we were to have no living child after all of that treatment, then the full GAIA fee is refunded. Our price was very similar to the price of one egg collection and one frozen transfer direct with the clinic excluding medication, so it was such a reassurance to have all those collections and transfers locked down and paid for. Also Asda pharmacy sell IVF medication at cost, which can be half the price of clinics and other pharmacies so it's worth knowing!

I had my first ever egg collection last month, then had a fresh transfer on day 5 of a 5AA embryo (my age didn't seem to cause an issue). We were able to freeze three other embryos. Two excellent and one fair.

I'm currently 5+3 weeks pregnant from that first transfer. I inject lubion daily as well as using three utrogestan pessaries a day. I have had one miscarriage before at age 30, but I have no known issues myself, this is just what the clinic feels is appropriate to support an early pregnancy from IVF. I also take microaspirin and supplements. Hopefully all remains well for our scan at the clinic in two weeks.

If I was you and I had the funds, I'd look into options like GAIA (there are others out there too) and start getting the treatment I deserve now before getting any older. I wish you the very best for your journey and I hope you have some good news soon!

I can only agree with @Zeeha OP, about just changing clinic.

I don't know the answer about adding the testing on your NHS round. But frankly from what you've said, I wouldn't be all that happy with your clinic either.

PGT is not 100% (no test is), but is' not 'just random' - it tells you how many chromosomes your embryo has. It increases the chances that the embryo chosen is euploid and will result in a live birth and lowers the chances of wasted time and heartache.

You never know, you might get all your embryos tested and realise that they are all aneuploid and would never have worked. That would answer a question, rather than just putting you on further random medications 'just to try something different', despite the fact that you are perfectly healthy as far as they know. Why don't they just try doing a DNA fragmentation test or PGTA? - it's much more likely to be to do with the male side if you are normal as far as you know.

Sorry, I'm feeling a bit frustrated with your clinic on your behalf!

Your consultant is also fobbing you off by saying you'd get similar results from a donor, without even properly testing your husband's sperm or your embryos they can't possibly know that. Donor sperm is generally very good quality and our fertilisation rate with donor sperm was about 10x that with my husbands sperm, and we got 5 embryos to freeze. None of the embryos made from my husband's sperm were good enough quality to freeze.

The NHS really don't like donor use though - another reason we went private is that we sat on a waiting list for over a year for our third round of IVF, only to be told that they wouldn't let us do it with a donor, it had to be my husband's sperm (even though it had been clearly demonstrated that it wasn't good enough).

So we waited a year and were then turned down for NHS funding because we had severe male factor issues and wanted to use a donor.

Honestly - if you've got the money and can do it - I would just go private. You'll save yourself so much heartache and frustration.

@Hopefulsummer35can I ask what was the low dose steroid you were on and why was this given to you? Also those hormones seem crazy high. Was there a rationale for giving you so much? Currently on second failed transfer of euploid embryo. Had so many tests and scans including laparoscopy. I’m at a leading clinic so I’m getting top rate care. Consultant has recommended blood thinners for 3rd transfer but nothing else so I’m just trying to make sure I’m not missing something else. Thanks