3 failed rounds, what next? Advice please

[Blossomofhope]

Hi all,
We have now done 3 rounds of ivf:
1st - 6 eggs, 4 fertilised, 1 3bb blast - bfn
2nd - 6 eggs, 5 fertilised, 2 4bb blasts - 7 wk miscarriage (empty gestational sac)
3rd - 4 eggs, 3 fertilised, 1 4bb blast - bfn

We are 35, my amh is on the lower end.(6ish)

At this point I don’t know what to do. I think it’s pointless doing anymore rounds with the same clinic. One option is move to a clinic that focus more on root cause. I’ve been sticking it out in this job for 3 years while we ttc because of mat leave and then because of treatment. I don’t think I could manage a new job and treatment but I’m tired of being stuck at home and this being my whole world. Part of me thinks I need to just get on with my life and stop feeling so trapped but part of me thinks it’s foolish to not do everything I can with a new clinic since I’ll be 36 soon. My clinic haven’t given me any indication as to what our problem is but I think it’s clear the stims medication doesn’t work well for me.

What would you do now? Anyone in a similar situation that’s had success? I really want to start enjoying life again but I’m struggling.

Only you can decide really when to keep trying and when/if you reach a point you want to stop. Your results aren't amazing, but they aren't terrible either. Drop-off rate seems fairly average for the number of eggs, and fertilisation look good. I would say you just need more time / the right embryo. Not every embryo is going to be euploid at your age, and if you're only getting 1 or 2 per cycle, its going to take a little bit of time.

I never responded well to stims despite a much higher AMH than you (and a younger age), and never got more than 6 eggs in 1 egg collection. From 2 egg collections I only got 8 mature eggs in total, all fertilised, all made it to day 5 but only had 5 blasts suitable for transfer/freezing. I've had 4 transfers (1 BFN, 1CP, 1 live birth, and currently 32 weeks pregnant). I had 4 failed medicated IUIs before that.

I would imagine that in your situation is just about a numbers game, and waiting for the right embryo x

Ovarian prp? Have you had NK cells tests or immune cells etc? Try a clinic aboard, Greece spain there labs are ment to be great,
Sorry your going ture this its really rubbish! And a painful road I know xx

@2mumlife Thank you. Thats wonderful that you’ve got there in the end. You’re probably right re embryo but it feels like so much to go through for such small chances and I can’t imagine it’s great for my body. If I was getting larger numbers I’d definitely proceed. It’s so hard.

@Clocloxx what is ovarian prp and what made you suggest it? I’ve never heard of it.
I’ve had the Chicago bloods done and had elevated killer cells so I’ve been on steroids for 3 months trying naturally and then again for this ivf cycle but still no luck. Thanks so much.

@Blossomofhope can I ask were you able to freeze any embryos from your rounds or was it just one embryo obtained and transferred per round?

@AlertPlumEagle All rounds were fresh transfers with nothing to freeze. First round I transferred one - bfn, second round I transferred two where one implanted but miscarriage confirmed at 7 wk scan and third round I transferred one - Bfn.

@Blossomofhope Have you clinic changed any of your protocol to try to stimulate more eggs? My second round we changed protocol / drugs completely and it helped (but then I was having a very poor response compared to what would be expected). The miscarriage will have been devastating, but when I had my CP clinic did say it was evidence I could get pregnant, and it was about finding the right embryo.

You could always consider just taking a break and seeing how you feel. The cycle I had my DD (cycle 7 for us), I'd also felt like I needed to get on with life. So I applied for a new job (which I got, and found out I was pregnant few weeks later 😂). Slightly different situation but it was a better position somewhere I was already working part time (was doing 2 part time jobs at the time) so I still got enhanced mat leave etc so worked well. So I think sometimes success can come when you are just 'getting on with life'. I've certainly found my 2 successful rounds where when I stopped overthinking everything and was just getting on with things.

Wishing you the best of luck whatever you decide to do.

@2mumlife Thanks for the input. I’ve decided I’m going to park ivf and work with a doctor on a more natural approach.

Hi @Blossomofhope, I don’t really have any advice as in a similar situation myself but definitely reading with interest! I am 18 months in to IVF, about to do my 4th (and last) transfer at this clinic, after 3 failed ones (1 CP and 2 BFNs). I don’t expect this one to work, I feel like we just do the same thing over and over again expecting different results under the banner of ‘it’s a numbers game, you just need to keep going’. I am also feeling a bit ‘done’ with IVF but don’t know which way to turn next, and also feeling similar to you about a new job/moving on with life. I have not changed jobs for 3 years because I keep thinking about maternity pay, stability etc but I’m getting to the point where I think what is the worst that can happen?

I would also be very interested to hear about your planned natural approach as it’s definitely something I would like to explore!

Hi all,
I have the fantastic label of ‘unexplained infertility’

Recently had a failed round of ivf. (9 collected, 7 fertilised, 1 4BB, the rest failed)
Listened to a great podcast called ‘don’t tell me to relax’
Decided before I even contemplate another round of ivf I want to try and find the root cause. We had sperm culture and dna fragmentation testing with Fertility Solutions. The consultation after was only £55 but my god was it worth its weight in gold- she noted on three other sperms test my husband volume is between 1.5 (should be between 1.5-6) no one has ever ever pointed this out before!!! My point is, it might have nothing to do with your AMH; it might be sperm related so mignt be worth a look into xx

We’re in very similar situations it seems like! Are you based in the uk? I’m in Ireland.

I actually feel a lot more positive after discovering this new clinic. The doctor seems really passionate about identifying problems and fixing them and is adamant that low amh is not a fertility problem. I have an appointment booked with her in September.

Throughout our journey I feel like at a point in time things have not been optimal but never alarming. Eg Amh and sperm morphology could be better. Although both seem to fluctuate. I’ve had low testosterone and been on tablets on and off for that but I just feel like my doctor doesn’t consistently monitor or care about our case and so it’s mainly be obsessively monitoring everything, suggesting things and following up. It’s exhausting.

Although a few days ago I really was thinking moving on and getting a new job was the way forward now I’m thinking maybe I should hang on in there, work with the new doctor and hopefully we’ll get there. My thought process at the moment is probably a bit all over the place. But I totally agree with you about constantly throwing everything at it thinking it’s a numbers game and hoping for the best. It’s just SO much to go through for what always feels like a small chance. I think ivf might be over marketed a bit.

Ah that’s great news you found something as weird as that is to say! We did the soerm fragmentation test last year before ivf so no issues there but morphology has been low at times so we have been doing ICSI - which never quite sat well with me if I’m honest.

I so hope we can find and treat the problem soon and move on with our lives!

Ovarian prp is ment to improve egg quality especially for women with low amh
I've had 2 failed cycles here in Ireland never getting a blastocyst! Age 31 amh was 3 when checked over a year ago probably much lower now, I've decided to go abroad for 3rd cycle as there approach is more tailored and focused on quality, I wasn't happy with my last clinic who just wanted to up my dose even higher even do my results were terrible, but even do I don't have a success story yet I think it's worth changing clinics changing approach

Hi @Blossomofhope I'm in a similar situation so following with interest and wondered if you would mind sharing what clinic you've changed to? I'm in NI

Ist round - NHS - x2 embryos, double transfer, BFN
2nd Round - private - x4 embryos, x2 double transfers, x2 BFN

I've just undergone my 3rd egg collection a few weeks ago with same clinic, worst round yet. I had to take 16 days of stims which pushed my progesterone levels too high for a transfer so we had to freeze our only embyro. I've just turned 42 so I'm sure it's very much down to age, although my AMH etc are all very good and my partner has low morphology. Hoping to have natural FET next month. If it doesn't work we're thinking of changing clinics.

We've done the same protocol each time so would be looking to change that completely if we have to go again. Our clinic have done zero in terms of further investigations - they very much take the stance that if there's no solid research to back it up they don't do it. I had a hysteroscopy privately elsewhere and everything came back normal but at least we've ruled out any uterine problems. I think maybe the fragmentation test would be next for us, again would need to look at having this elsewhere.

We've been engaged and ttc for 3 years, we put off getting married to focus on treatment but I'm fed up of having life at a standstill so we've provisionally booked in a wedding date for next year, not sure if that's wise or not.

Hopefully your new clinic will make you feel like you're making progress again.

Ah I’m so sorry. I’m sure it must have been crushing to get no blastocyst. With the amh I will say it can fluctuate. Mine was 12ish, then after a few medicated rounds it dropped to 5 so I’m convinced that’s because of the medication, then nearly a year later it’s up slightly to 6.
I hate so much how so many clinics just throw the same approach at everyone and keep giving us more meds. It feels like a money making racket!

Sorry to hear you’re in a similar situation, it’s just so rubbish.
When was your progesterone tested for transfer? Is it on your last scan appt before egg collection? Just curious cause that’s the last time I have a blood test each cycle.

good on you for booking the wedding.. I’m SO conflicted about it all the time. We are engaged nearly four years and I hate that we aren’t married yet so much and it’s all been for nothing.

Neo is the clinic I’ve been looking into and booked with next. I haven’t had a consultation yet though but I do like the sound of them! I just strongly believe ivf hasn’t been the right thing for me but I just didn’t know any better. I’ve just felt so unsupported during this. I so hope the new doctor with be better.

My progesterone was tested on day of last scan (day 17) , I had pushed for a progesterone test at start of cycle (day 21 with down reg). Nurse looked at me as i had two heads and then told me it would cost an additional £40. Like we weren’t already paying thousands!

going to look into Neo, thanks for that. Really hope they can provide some answers for you. A different approach will hopefully help you to stay motivated & keep going.

We are probably mad to book anything but maybe it will mark a new beginning for us whether things work out for us or we call it day.

Hope you get to start planning your wedding day soon too x

Just to say to you both, I got married in June when I was 5 months pregnant. To be fair, we planned it that way (one of the stipulations on getting pregnant again was to squeeze in a wedding 😂). Had a great day despite the bump, it we also had a very casual wedding in my parents garden. Would say to both of you if you want to get married just go for it!

https://www.mumsnet.com/talk/infertility/4477027-Things-I-ve-done-Things-I-ve-tried-IVF-ICSI

Yeah I'm not too overly worried about the amh right now because last I checked I still had a base line of 11 ACF but considering I only got 2 eggs from the last cycle even do I had 9 follicles bigger then 14mm! I must just not be agreeing to the meds! They described my eggs as because my low amh it's like scraping from the bottom of the barrel what's left isn't good 😒 cheers irish clinics have a way with words 😂,
I must catch up with everything on this thread!