4 IVF Transfer fails.

[Butb1988]

Hello looking for some advice after the sad news today that our 4th embryo transfer has failed.
I am 36 in a same sex relationship so no know fertility issues when I started my IVF journey a year ago.
in my first baseline scan they confirmed I had an endometrioma cyst (3cm) on my right ovary. My clinic have raised no concerns or really even mentioned anything about endometriosis to me. They cracked on with egg collection and we successfully gained 6 5 days embryos with good grading.

Transfer 1 April 24 -Fresh 5AA failed.
Transfer 2 June 24- FET 5AA failed.
Transfer 3 September 24- FET 4AB failed.
Transfer 4 March 25- FET 3BB Failed.

I now have a 3BB and a 4CC left in the freezer.

My clinic haven’t really explored my failures and they haven’t tweaked my protocols much, I have always had a thick lining above 8mm and a triple layer. They have always given me Lubion and for my recent transfer I received a blood thinner called Claxane which clearly hasn’t helped. I had RIF bloods after my 2nd fail which all came back normal.

My endometrioma on my right ovary hasn’t changed in size this past year but In my last scan they have noticed I now have another endometrioma in my left ovary, (very small at the moment)

My gut is telling me that this can’t just be my embryos and my endometriosis is clearly affecting implantation and ability to get pregnant.

I feel my clinic aren’t addressing my endo and seems to just be throwing embryos in and hoping for the best.
May I add none of our embryos are tested.

As you can imagine I am feeling pretty hopeless that’s I’ll never become a mum
and I feel massively unsupported by my clinic.
is it worth moving my final 2 embryos?

Any advice on protocols and success after failed transfers and endometriosis would be greatly appreciated.

Thank you.🙏🏽

Hello OP,

I had two children fairly easily (unmedicated IUI), so clearly my fertility was fine, but when I went for a third (I was almost your age, a few weeks from turning 36 at the time of egg collection), there began the struggle.

I had 23 eggs, from which I got 7 embryos (they didn't give them a grade). My first three transfers were a bust. Fourth worked.

What I changed : they triggered ovulation (just to make sure the womb was absolutely ready), and I did some, ahem, self stimulation to get my lining to be a bit thicker by improving bloodflow to the area. It worked.

My doctor wanted to do some additional checks if the fourth go didn't work as he said it wasn't normal that it wasn't working. So I would push for that before using your two remaining embryos.

Don't get discouraged yet. There are still things to try and getting six embryos is pretty amazing, and an indication (though obviously not définitive proof) that your fertility doesn't seem hopeless. But your medical team does need to be more proactive.

Forgot to add - I had IUI first for my third child but it didn't work in the first 3-4 attempts, and I didn't have unlimited sperm samples as I wanted my third to be the same donor as the first two, which is why we moved on to ivf.

Again thank you so much for taking time out of your day to post and give me hope…
I’ll definitely be demanding more from my clinic going forward, tbh they have been pretty awful.

Can you change clinics maybe ?

Also bear in mind that grading is not the be all end all of what makes an embryo stick. Friend of mine had multiple transfers, the only one that worked was a slow-developping embryo that seemed pretty hopeless. He's six now.

I have no fertility issues, first son was conceived with no issues. Then 5 years of nothing, all investigations found nothing. I eventually had my daughter on the 5th transfer, the last 2 were doubles as well. So out of 7 embryos transferred only my daughter implanted.
no reason was ever found for these failures, I was just told that my rounds were “text book” and it was a numbers game.
ive since gone on to have another son that was conceived with no intervention so there really was nothing wrong with me, it just didn’t work for that period of my life 🤷‍♀️

I guess the point of me telling you this is that although there may be something that the clinic can be doing/not doing/investigating - there also may not be. IVF is expensive and the clinics can pray on your desperation for it to work so maybe just listen to what your consultant has to say and what they advise next for you. If you’re unhappy with them anyway, then you can request copies of your notes and take them to another provider to ask them what they would do differently. I did this and although the last one worked before I changed, it did help me feel better because I was doing something

This was true for me too actually, the embryos that ultimately turned out to be my daughter were ungraded P1’s. My day 5 hatching blasts - absolutely nothing 🤷‍♀️

I'd transfer the last two embryos together rather than separately. Don't drag it out.

All your embryos are from a single egg collection so it might have been a bad month for egg quality for whatever reason. It might be worth going for more egg collections or try your partner's eggs. Is the sperm definitely good? That's a factor too and you could change the donor.

I had four failed cycles and got pregnant with twins on the fifth. Also good embryos - textbook cycles. For the fifth, we stayed with our clinic but used an immunotherapist ivf specialist alongside. He added in clexane, steroids, aspirin, intralipids, progesterone injections.

@Butb1988 Sorry to hear of your experience. Make sure they check your P4 level prior to transfer and trigger. If your P4 is above 4 (UK). Then they should abandon as a higher level than 4 will indicate asynchrony between the embryo and the uterine lining which makes implantation close to impossible as the window closes sooner.

What was the fertilisation rate of the oocytes collected? I did 6 cycles and the two that worked were the cycles where everything collected fertlised. This was with mild IVF and this seemed to be the key to improving egg quality.

I am a bit puzzled about use of IVF rather than 'sperm insertion' at ovulation time, sorry i do not know much about it but if you are desperate for a child is that worth trying?

The success rate is of IUI is 10% and you pay per sperm sample so it end up a lot more expensive than IVF which can have a 70% success chance with one sperm sample for people with no fertility issues. It's quite logical to go straight to IVF.