My first IVF cycle - what outcome to expect?

[cakeMaker93]

Hello, I've just started my IVF journey and I am really nervous about the outcome.

I'm 41, turning 42 next month, with an AMH of 4.9pmol/L (I think).

My baseline scan (after 2 stim injections) showed 9 follicles on the left side and 3 on the right. On my second scan, (after 5 stim injections) I had 10 follicles (7 on the left, 3 on the right).

Today I had my third scan (after 10 stim injections), which found about the same as the previous one (7 on the left, and only 2 about good size on the right).

However, I received a phone call from the clinic this afternoon, asking to go back for another scan tomorrow morning, as they want to monitor the follicles' growth more closely and act accordingly. They said that the reason is that I have some that have developed a lot (21, 18, and 17 mm) and some baseline (2 of around 13 mm) and the rest are smaller and hopefully still growing. But they want to monitor, as they don't want the already big ones to become too big...

I am getting nervous that I will end up with too few eggs for my egg retrieval day, and then after fertilisation, with possibly 0 or hopefully 1 or 2 blastocysts.

Do you have any similar experiences? What should I expect as an outcome on my egg retrieval day, and what can I expect after fertilisation?

I know it's all about egg quality and chances - so nobody can tell what is going to happen, but I'd love to hear similar experiences and what heppened in the end - even if they are not positive.

Also, is it normal that my left ovary is responding well, while my right one not that well?

Thank you in advance for sharing and for all the support :)

It’s so so hard to predict how things will turn out. For mine they managed to collect eggs from follicles that were above 10/11 I think at this stage but the smaller ones didn’t catch up.

I think unfortunately for your age you need to be prepared that you won’t produce the same number of eggs as someone in their 20s but you do only need one embryo to work! I’m about a year younger than you and am currently pregnant after a cycle earlier this year. we were very lucky in the end but only after so many up and downs along the way.

The waiting is horrible at every stage and the whole journey is really a rollercoaster. Unfortunately there is so little in it that you can control. Just try to be kind to yourself as much as you can. Keeping everything crossed for you.

Thank you so much for the kind words, @PrincessofLiechtenstein !

I am glad it worked out for you and wishing the best for your pregnancy.

I was kind of 'relaxed' so far, until they called me this afternoon. I just want to have all the answers but I know it's impossible at the moment and I just need to be patient.. but it's not easy. It's hard to work or do all other daily activities.

I'm going to ask the clining for a counselling appointment tomorrow - although I don't know how much it can help me calm down.

It's so hard to predict the outcome. Unfortunately ivf is a roll of the dice, regardless of age.
It's good they are monitoring you.
ive already done ivf before and during my first cycle, they didn't monitor me closely and I actually ovulated 2 or 3 large follicles despite taking cetrotide to prevent this. I'm currently doing another round and my clinic did tell me in advance its possible there could be a scenario where you might have a few large follicles ready to grow , and at which point they might decide to pull the trigger and retrieve those . If they risked it and prolonged stims in hope more would grow, there's always a chance the cycle could end up cancelled so I think your cycle are being mindful .
It really only takes one and yes it's normal one ovary doesn't respond well. During my first cycle my right ovary did all the work and my left ovary only grew 2 follicles. The fertility consultant told me he sees that all the time.
My amh of 60 (pcos) during my first round a year ago didn't correlate with my afc
So I only had 7 follicles, 4 mature eggs , 3 of which fertilised and 2 made day 5 blasts ( very poor grade tho) and a day 6 ( discarded) and that resulted in my now son.
I'm turning 40 this year and amh is currently 40, I can't remember how many follicles on my right but there's 5 follicles on my left ovary.
Honestly, even if you were in your 20s,produced an abundance of high quality eggs, unfortunately it's still pot luck if any of them will work first go

Im in a different situation to you, but went through IVF cycle. I was 35, and it was male factor infertility. My cycle was pretty text book physically, but it took a huge mental toll on me. Oh, the waiting! 😭 I had 20 eggs retrieved, 10 fertilized, 4 day 5 embryos and 2 day 6 embryos. We were over the moon! Did the transfer with a grade A day 5 embryo and it failed to implant. I was devastated. After everything going smoothly… I couldn’t wrap my head around why it didn’t work. I then started to doubt myself and took a little break from it all. We went back after a few months and luckily it worked! I now have a 9 week old baby girl 🩷 What I want to say is even if you could control all the timings, meds, your own body, it’s still out of your hands. It works when it works and there’s nothing you can do to make it happen. I wish you the best of luck 🤞🏻💕💕

Thank you so much for sharing, @Kaybee1989 and @VioletMoon!

It helps me feeling better and stop blaming myself for not taking care of my fertility it until I'm too old... (I wish I had preserved some of my eggs when I was younger...)

@VioIetMoon , you said "If they risked it and prolonged stims in hope more would grow, there's always a chance the cycle could end up cancelled " -> in which case would they cancel it? If they grow too much ?

@Kaybee1989 , it's good that you didn't give up - and had a happy ending - I wish you the best for your baby girl !

@cakeMaker93 after the follicles reach a certain size they are ready to be retrieved as they hopefully contain mature eggs. Anything under they are likely to be immature and they will discard immature eggs as they wont make viable embryos. They also don't want them growing too big either as otherwise they would be over mature and over mature eggs are unlikely to fertilise, which is why the monitoring is so important. I do think it's great your clinic are keeping a close eye on you

IVF is a massive roll of the dice and in my experience, clinic dependent.

I’m 37 with low AMH (1.9) and we also have MFI.
First 2 cycles with one clinic got us 4 eggs, no fertilisation at all.

New clinic got us 7 eggs, all mature. 4/5 fertilised (2 eggs didn’t survive ICSI). Out of the 4, we ended up with 3 embryos. Currently nearly 5 weeks with my grade 4AB and have a 4BB and 4AC on ice

Hi @cakeMaker93 I had similar that one ovary had more growing follicles. I had 12/13 follicles at thr start of each egg collection cycle but in the 1st round they thought only 5 looked like they'd get to the right size and I felt quite upset, as they'd told me they were pretty confident of 10. They did collect 8, but 5 mature and 4 fertilised, 1 blastocyst. For round 2, they changed my meds and dosage, the same thing happened that 5 grew well at first but they closely monitored, gave me a few extra days of stims and a different trigger shot (initially I was going to double trigger, bur changed last min) I got 9 mature eggs from that round, all of which fertilised, 7 embryos, 5 euploid and I'm currently 10 weeks pregnant with our 2nd transfer from that batch of frosties.

It is such a roll of the dice, but I think tweaking meds can also make a difference and unfortunately one round can be a bit of a learning curve for thr future. Wishing you all the best for this cycle, and if you do any future ones that your clinic can take good learnings - they should be willing to change things up if needed!

Thank you all for sharing your stories - it really helps to know I am not going through this alone and that other people were there as well, and although it was not easy they made it happen.

So, I had my EC last Friday and they managed to get 9 eggs. They called me on Saturday to say that out of them, 5 fertilised normally, 1 partially and 1 abnormally.
I had another call this morning (Day 3) and the news were not that good... The 1 abnormally stopped growing at all, and out of the remaining 6 only one is growing normally and is of good quality. The rest are growing slowly and are of poor quality, but they said they might catch up - although chances are lower.

I'm pretty disappointed - as the embryologist said that I should expect that only 30% of those of day 3 will survive till day 5 and make it to blastocyst - so I have 30% chance for this only one that is good enough...

I know I should keep my hopes up, but it doesn't sound very hopeful for this cycle...

@cakeMaker93 Oh I’m so sorry to hear this. It can be so disappointing sometimes. We can easily get obsessed with the numbers and statistics because it’s really all we’ve got to hold on to… buuuut it only takes one, and fingers crossed, that little embryo is a strong one and will be the special one to make you a mummy 💓

Not far off our day 3 update and a couple of the slow ones did catch up. It’s hard to balance not losing hope with having too high expectations but it’s not over yet.

thinking of you during the tense waiting

Thank you so much @Kaybee1989 and @PrincessofLiechtenstein for being realistic but hopeful!!!
Sending you both a huge hug. I wish I could have people in real life I could speak about these things and them being as supportive and as kind as you are...

Trying to keep my mind occupied so I don't overthink about growing embryos all the time... at least it was my birthday today, so this kept me somehow busy for a few hours in the evening.
Tomorrow morning the embryologist is going to call us for the Day 5 updates and based on that we should either rush to the hospital ASAP for the transfer or not...
It's hard dealing with uncertainty but I am slowly managing to cope with it, and learn how to take it once step at a time...

We're used to having all answers instantly, so this uncertainty feels so hard now, because of how we have trained our brains...

Your post resonated with me as I'm going through my first cycle and don't have as many follicles as I expected which is stressing me out.

They are expecting to collect around 6 eggs and don't seem concerned but I'm finding the wait difficult. Currently on day 8 of stims and going back for another scan tomorrow. The follicles are growing at different rates so I'm anxious about timings!

I'm 33 with AMH of 8. My AFC was 23 at the end of last year but started with 12 this cycle which is frustrating.

Thank you for sharing, @PurpleLake ! It must felt disappointing that your follicle count dropped that much this cycle, but at least you know there is potential, so even if it doesn't go well this round, maybe in the following cycle you can collect many more eggs.
Yes, the waiting is difficult for sure.. but you did great so far reaching day 8 of stims, so just a few more to go, and you will know very soon how many they have collected.

After the eggs reach the lab there is nothing we can do, but I found that the waiting for the next update call from the embryologist was very hard every time.. I was keeping my hopes low, and was prepared for the worst case scenario, so I could cope even with the bad news on day 3...

I also try to keep myself busy with other things so I stop thinking/worrying all the time - which helps a lot.

I pray for you to get the best results on your collection - keep us posted, if you'd like.

I am waiting for a day 6 update tomorrow morning, to see how much the embryos have grown. If they have grown enough tomorrow, then there will be a very long wait until we hear back about the biopsy results...

@cakeMaker93 thank you, my fingers are crossed for you! It's a bit of a rollercoaster ride isn't it...

@cakeMaker93 Thinking of you, hope you’re okay 💕

@Kaybee1989 thank you so much💕

One embryo made it to the blastocyst stage - it reached day 6 and was graded 5BC - not ideal, but good enough I guess.. We've sent it for testing and are now waiting for the results.

I'm getting ready for another cycle, but first I'll have a short break and a trip to relax :)

I am doing ok overall - I know it could be better, but I also know it's not unusual having zero blastocysts in a cycle at my age, so I don't complaint. I'm very happy with the clinic - from my consultant to the nurses and the embryology team, everyone has been great - so I trust we will eventually get there. I’m also confident my next cycle will feel less stressful now that I'm more comfortable with the process, especially self-injections 😅

Ahh that sounds perfect! Have a great trip and a good relax 💕

Thank you, @Kaybee1989!

That’s not a bad result at all. Hope you get a positive result from testing. Enjoy your holiday and do your best to relax. If you aren’t already I’d also throw as many supplements as possible at the next cycle. A high quality multivitamin plus coq-10/ubiquinol for both you and DH might help with the next cycle.

Thank you for useful the advice and the wishes, @PrincessofLiechtenstein !
We're already on Pregnacare conception multivitamins (both me and my partner) and also recently started some additional omega-3 supplements.

What is coq-10/ubiquinol and DH? If you mean Coenzyme Q10, then Pregnacare inludes this - but is ubiquinol the same thing?

Coq-10 and Unbiquinol annd coenzyme q10 are essentially the same thing but in slightly different forms. The Multi vitamins don’t have the recommended dose so you can look at adding in a high dose as well. We were taking one from Holland and Barrett that was 200mg.

Im not sure the science is super reliable on how much the recommended dose is. I think the recommendation comes from It Starts with the Egg. I just decided it was worth throwing everything we could at supplements as it was a relatively small amount of money compared to paying for more rounds.

DHs sperm did improve quite a bit. Although he also gave up drinking and tight boxers.

I took Ovum supplements which have a lot of the vitamins recommended in it starts with the egg, and too extra c0q10 on top (600mcg total daily). Hard to say conclusively if it worked but I think it helped! My husband also took coq10 and proxeed

Hello again.. about 4.5 months after my original post.
I hope everyone is doing well and really hope some of you would had some good results during these months.

Some updates and thoughts from my side..

So my 1 blastocyst from cycle 1 gave a 'no result' after the PGT-A testing, which is not great, as our consultant suggested that we shouldn't test it again, because of the risk of unfreezing, biopsy, and freezing again.
So, we decided to keep it on the side for now, and go for round 2.

I started my round 2 in October, after a short break, during which we kept taking our supplements (Pregnacare and omega-3) both me and my partner. We changed the protocol to a long protocol (with a nasal spray before starting the injections). Unfortunately, my baseline scan showed only 3-4 eggs this time (I had 12 in the baseline scan on cycle 1). The follicles kept growing in two batches, like they did in cycle 1, although we changed the protocol. Right before my egg collection day, on my last scan, I had 3 follicles of good size and the rest were too small. The consultant managed to get 4 eggs on the egg collection day. They were all mature, all fertilised normally and all growd well to day 3. On day 5 we had 1 early blastocyst of stage 2, and 1 morale. At the end of day 6 we had two blastocysts, a 4BC and a 4CB. I was very happy that we managed to get 2 blastocysts out of 4 eggs.

However, the PGT-A results were devastating. I know the odds for my age are against me, but I was still hoping for at least one euploid. They both came back abnormal.

So, here I am, after 2 cycles, back to square one...

I am feeling like I put so much effort, but achieved nothing. And I am trying to stay positive, but looking at the stats for my age doesn't help me at all.

Any success stories to keep me going, or any experiences to share? I know there might be people out there having similar struggles at the moment, but I just feel alone and like a failure. And I know it could be worse - I could have zero blastocysts - but at the end of the day the end result would still be the same.. to have no chance for a transfer.

Is there any hope...?

I’m so sorry to read this @cakeMaker93it’s so devastating when a cycle doesn’t work.

Have your clinic suggested anything? I didn’t end up going down that route as we ended up getting an NHS cycle but it might be worth looking at the Create mild IVF protocol? There is a long thread about it somewhere.

At your age (and mine!) 50% are likely to come back abnormal on PGTA. It’s a tough choice but are you sure you want to test if you get any more? It may be worth just transferring. There is some evidence that embryos which fail PGTA can still be viable and it’s very expensive. It’s a very difficult decision though.

if you decide to go for another cycle then I would take a look at increasing the supplements for you and for your DH. There is good evidence for vitamin d, coq-10, etc. there is lots of stuff online or the Ovum or Zita West supplements are good. It’s worth throwing everything at it.

Don’t know if it’s helpful to say or not, but I’m currently sat with my untested day 6 3bb or 1-2bb (had a double transfer) asleep on me. It’s so hard when you are older and the odds are against you but there is hope. Wishing you so much strength and hope for whatever you decide to do next