Failed IVF - what do we do next?

I've just had a failed June transfer (fresh) I'm 29, my DH is mid 30s. We've got a DC who is 2 and was conceived first month of trying. TTC for just over a year and just had our first IVF privately. Results: 13 eggs retrieved, 8 mature, 1x day 5 embryo, 2x day 6 embryos. None euploid. Those sound like terrible results for my age?! AMH is 13 so not terrible. A million investigations have been done on myself and DH (hormone profile, hycosy, follicle counts, scans, semel analysis... to name a few), no issues found at all. Has anyone had a similar case? Do we need to adjust the protocol? Change clinic? What questions would you ask to the doctor?
Like
Share Mobile
Share
  • Share

Show your support

Sorry to hear about your failed transfer. It does sound like egg quality might be the issue here. Have you read the book “It starts with the egg?” I am 41 and had 3 ivf cycles. I followed the book for supplements half way through ivf - in all cycles I had similar stats as you, 16/13/10 eggs collected, with 3/4/2 blastocysts. In total I had 7 transfers (w 3 miscarriages, 3 failed & the last one was my 6 months old little boy). We only did PGT in the last cycle: tested 2 embryos both came back normal! We were very surprised given my age. Good supplements definitely helped! We believe what made a big difference was immunological tests & meds though, considering the history of recurrent miscarriages. I was put on steroids & intralipids before the successful transfer. Not all fertility doctors agree on immunological treatments though so it’s worth asking. From what you said I would probably suggest taking a few months to improve egg quality. You’re young so there’s plenty of hope!

Oh man that’s so frustrating!! I’m so sorry this round didn’t work out. I’m sure your clinic will have a plan for you — but like the other comment said, there’s a good chance it’s a quality issue. I know that a lot of my clinic’s patients had a lot of success with Metformin to improve their egg quality and transfer success. I can’t fully explain it but the Metformin helps stabilize and lower blood sugar for a lot of people and that has a really positive effect on egg quality and on keeping things nice and stable for a transfer. My clinic puts everyone on it — it’s not just for diabetics or people with blood sugar issues! Only downside is that you have to adjust your diet a bit while you’re on it - low glycemic index diet (which also helps with the stabilizing of blood sugar). I’m not saying it’s a cure all but I can personally attest to an increase in embryo quality in the rounds I’ve done with Metformin vs. without. Definitely talk to your doctors though!

@Kate @Wanyu Thing is, my husband and I both watch what we are and drink so so much - both have stopped eating red meat, stopped drinking, I’ve effectively given up any added sugar and pasta / rice / carbs (to the extent that’s feasible - I still eat fruit here and there for example). I’ve read “it starts with the egg” and I take my prenatal, additional vitamin d and ubiquinol… not sure what else to do

So basically only half your eggs were mature. So looks like you lost 5 eggs to wrong timing/dose not high enough. The first round is an experiment as they don’t know how your body will respond to the stimulation. I’d ask your FS what protocol they’d do next time, and if they say nothing different, change FS. It’s pretty normal to need multiple stimulation rounds, so as disappointing as it is, it might have been a bit of bad luck but not anything wrong with you. It’s a dice roll. Even so, you could try working on egg quality. I had a problem with egg quality, I doubled my mature egg count and quality (now late 30’s). I took high dose Omega fish oils, Vit C, D, E, Ubiquinol, Melatonin, DHEA, magnesium, probiotic, pregnancy multi and Activated folate. Selenium from diet. Daily for 3 months

@Olivia thanks so much for a detailed response. I've read a lot about how changing protocol could help, to make more eggs mature of the ones retrieved, to improve the quality of the ones retrieved... but the thing is I don't know HOW. And I understand I should ask my fertility consultant what he would change in my next protocol but I don't know what the correct answer from him would be because I'm not a fertility consultant myself? For example he could say "well give you more Gonal" or "we'd give you less Menopur" and I'd have no clue whether that's the wrong decision or the right one, all I can do is nod!

My consultant said it’s a lot of guess work for them as well because every body responds to meds differently. Not all follicles grow at the same rate so they need to ensure the largest ones (usually the best quality) are not over stimulated while having sufficient smaller ones. So I guess there’s no point pondering about what protocol works best for you because not even the professionals could know without actual observations. All we know is keep rolling the dice and it will work out in the end!

Yeah I agree with Wanyu. You are never going to know if it is the correct answer, because nobody can know, including the FS. A lot of it is trying it and seeing what happens. This is why people do multiple rounds because with each round you learn what does and doesn’t work for your body.

@Olivia @Wanyu thank you!! But then you said, @Olivia , that I’m looking for my FS to say they’d do something different with my protocol rather than keep it the same. Is that just to basically see if they’d try SOMETHING different to try to get better results, but we don’t necessarily know if that something will positively impact the outcome, just seeing if they’re trying other things?

Yes that’s what I mean. As long as the FS acknowledges that there were immature eggs and can give you a plan moving forward. For example. On my worst cycle (my first) 70% were immature. the FS just shrugged and said she didn’t know why, and made zero suggestions and said she’d just do the same again. So I switched doctors who first changed protocol which didn’t work, then same protocol but higher dose and voila 100% of eggs mature.

@Olivia amazing, I think I understand now. Thanks so much!!

Read more on Peanut
Trending in our community