Any tips for how to pick yourself up for cycle 2 after unexpectedly bad response?

[Bethsh]

We’ve just finished our first round of IVF. It’s been such a roller coaster and just all so disappointing. We were given a lot of optimism by our consultant before starting, I have one slightly polycystic ovary and a high amh, so there were lots of comments that would get lots of eggs and be able to bank embryos etc etc and they were mostly worried about OHSS. I had 32 antral follicles on this scan so naively was expecting the number of eggs collected to be in the 20s. On 225 of meriofert I had much much less of a response than anyone predicted. By our last scan we had 7 follicles and they collected 9. We’ve ended up today at day 5 with only 1 freezable embryo and 1 maybe that they’ll reassess tomorrow. I’m so so disheartened and sad, I think because of what everyone thought would happen which I therefore then expected would be the case. We decided to go again for another stimulation round next cycle as we’re on a 2 cycle package but I feel so beaten and worried what if the same thing just happens again even if they adjust the meds which they’ve said they will. Has anyone had this happen before? And any suggestions as to how to get your head ready to just go again? Thank you x

Sorry to hear things haven't gone as well as expected. I have had very similar in terms of the clinic thinking we'd had a great outcome as I'm 28, AMH 34.9 and AFC 38, no issues found on scans etc. I had 24 eggs collected, 19 mature, non fertilised. Huge shock to us considering from 19 eggs we'd have expected multiple embryos never mind many more fertilised. The clinic were shocked and don't know what happened. I was told it was less than a 1% chance but unfortunately once you've had total failed fertilisation it can happen again. We're making tweaks and trying again soon.

Part of me can't face the whole thing again from an emotional point of view but then I know in x years time if I don't try again I'll regret it. The fear of regret over possible disappointment and the whole "if you never try you'll never know" is sort of keeping me going. But I completely emphasise with what should have been a really good outcome not going as planned. I'm pleased that you've got an embryo though and could potentially get more from another go! Good luck with it all 😊

Similar kind of experience here - first cycle was in my early 30s, normal AMH, no concerns about fertility issues (same sex couple so needing donor sperm). Consultant was very optimistic I'd have a good response. I didn't at all, and at egg collection they only collected 4 eggs, and only 2 mature. I had more follicles on scan, but consultant felt the eggs weren't mature and sticking to the follicle wall which is why they couldn't be flushed and collected (empty follicle syndrome). We were also on a 2 cycle package, but one which required us to use embryos from first egg collection before proceeding to a second egg collection. We were fortunate that our 2 mature eggs both made very good looking 5 day embryos. Fresh transfer was a BFN and I started bleeding just 5dp5dt so always felt like my hormones must have been totally off and that it never had a chance. Subsequent FET was a CP.

Needless to say, I felt emotionally wrecked after egg collection - so disappointed about numbers, couldn't really understand it, and felt like our prospects of a family were really bad. We took a bit of a break before doing the second egg collection, as I just needed a bit of time to mentally feel up to it.

Second egg collection we changed protocol entirely, as I felt really reluctant to try the same thing as first cycle. So we changed from long to short protocol, changed stims, changed trigger, increased the size they let my follicles grow to and increased the amount of time between trigger and egg collection. I also massively had to readjust my expectations - I went into it knowing I wouldn't respond well and knowing not to expect many eggs to be collected. That cycle we got 6 eggs, all mature. All made it to day 5 but only 3 suitable to freeze - they left the rest to day 6 but none were frozen, and I generally think most day 6 embryos aren't frozen so I'd prepare yourself for that (we did a freeze-all cycle that time as, so fucking ironically, after retesting my AMH to try to figure out why I responded badly they decided my AMH was slightly high and I was at risk of OHSS.... yeah right, kick in the teeth that one was).

However, that second egg collection was an absolute winner. First FET is my DD. Second FET is my current pregnancy (36 weeks) and still have 1 embryo frozen.

So even if you're feeling like it all feels pointless just now - it absolutely can all be turned around.

I think all you can do to pick yourself up is to reframe everything. Stop thinking you're going to get large numbers of eggs (though I would still say 9 is really good!! I would have been overjoyed with 9 eggs!). Start seeing everything as 'quality over quantity'. I threw everything at our second egg collection - I went to acupuncture (actually quite enjoyed it!), took co-enzyme q10, ate a tone of protein and used the mindful IVF app. But conversely, I also stopped putting my life on hold waiting for a pregnancy to happen - we did our first FET just before Christmas, so I just got on with Christmas as usual. I interviewed (and got!) a new job on the run up to the embryo transfer as well.

I'd maybe speak to your clinic about your progression rate - as I said 9 eggs is actually really good. Maybe look at whether there are any sperm / egg quality issues you could work on for your second cycle that would help improve the number of embryos you're getting from your eggs.

Wishing you the best of luck with your next cycle

Hi @Bethsh I'm sorry about your first egg collection and can totally understand the disappointment and demotivation.

My case is quite different because I have a relatively low AMH, so I was never expecting to get many eggs, but the first round was horrible because we had 8 embryos developing on Day 3 (from 9 eggs collected), but no good blasts on Day 5. We had one early blast transferred (BFN) and nothing to freeze. I was gutted and the clinic had no explanation.

In our case, we kept the same protocol, just upped the meds a bit but, like @notanothernamechange2024, we threw everything at the second round (new supplements, lifestyle changes, mindful IVF, etc) - obviously I have no idea if any of it made a difference but I felt a lot better going into it, and much more prepared that this might become more of a marathon. We got 6 eggs that time (so there was some disappointment there since less than the time before) but we had 3 good blasts: the first, fresh transfer is now my 2yo son. We had an FET with the second that failed, but I'm now pregnant with a girl from the last one. So, I definitely agree: quality over quantity, and a disappointing first round doesn't necessarily mean further disappointment. I also think that the mindset going into it does affect things - both my successful transfers were at more relaxed moments, work-wise but also emotionally, and we also went away briefly during the tww because I don't cope well with the wait and need distractions.

I hope you have a nice surprise with your embryo from this round working but, if not, try to pace yourself and put this round behind you. Very best of luck! xxx

Thank you everyone, I honestly felt so much calmer about it all after hearing about your experiences and that it all seems to be so variable per cycle. The lazy one did catch up by day 6 so that cheered us up a lot too x

That's so good to hear, thank you for the update. How are things with you currently?

I started my period yesterday so I start injections this evening. Since Friday I've just hit a really anxious/nervous feeling with the cycle. I wonder if it's my hormones and where I am in my cycle impacting as the last couple of weeks (luteal phase) I've felt a lot calmer but I seemed to get some sudden PMS anxiety on Friday and it's not really left yet. Hopefully it will soon and I'm just really hoping for a better outcome this cycle 🤞