Fertility Network UK

Questions to ask after a failed cycle

Just looking for some advice. We have unexplained infertility. Prior to this label my husband had sperm analysis with no issues. I had blood tests which confirmed I was ovulating and I went for hsg dye test which highlighted no issues. We then went straight for ivf on the nhs. While I am not complaining as our wait was under a year from moment we were placed on list and given I am 38 they seemed keen we progress straight to ivf. I do sometimes feel like maybe the reasons our infertility is unexplained has not been fully investigated and after our first attempt has failed and we have one more shot in a few months I just wonder if we should ask for more tests or if there is questions we should ask to try to understand more if there is a reason for our infertility then failed Ivf. I am so worried to go through it all again and get another fail if nothing else changes. Just wondering if people have advice on what I should ask or push for so that everything can be tried and all avenues exhausted before our last attempt. I feel we went through our first attempt in shock and disbelief and asked nothing and to be honest were told very little. Only when we started treatment was I told I had low amh and this was glossed over no one mentioned anything about amh at any other point and only from my own research since have I found out ways in which I can try to raise this. Any pointers/advice would be great so at least this time we can feel that we tried absolutely everything. Thanks in advance xx

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Oh and I read that you should ask to be tested for vitamin d deficiency, under active thyroid and celiac disease..none of these have been mentioned to me ever as possible causes😩

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I'm in a similar position. always been told it is unexplained but then when it comes to ivf my embryos dont survive which may or may not be the cause.

I've read lots of things about vitamin d, co10, dhea. when I'm ready to.try again, I'm simply going to take supplement and do accupuncture and try naturally for a while.

I was shocked too that ivf is like this. i only had an hsg and couple of blood tests. while on clomid they weren't sure if i was even ovulating so sent me!

My accupuncturist says Chinese medicine finds the problem and fixes it whereas western medicine treats the symptoms eg, if you have a headache, western medicine masks it with paracetamol, eastern medicine will discover what causes that headache and remove the negative energy.

I think there's elements in both that can help each other. xx

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I had a hysteroscopy to look at the inside of my uterus after my first cycle failed. They found a patch of scar tissue which they lasered to try to repair. It may have been incidental but anything to raise the odds helps. In the US I think lots of people have to have a laparoscopy and hysteroscopy before starting IVF. Might be worth an ask?

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Thank you so much Rosalietea . I will ask for sure . I take it laparOscopy and hysteroscopy are two different things? I had only the dye test thing. Xx

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Hi Vic77, Diane the nurse has a fab list of questions to ask after a failed cycle. From her an email, she's a gem! This is so hard, I googled for answers for hours & I guess there is sometimes no answer to be found. I had a good chat a clinic but no proper answers really, however they have adjusted lots for my next cycle! Good luck!xx

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Thanks so much have emailed Diane xx

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I think she is away till Monday but I'm sure she will reply soon as she can! Definitely ask for the thyroid test - it's taken my clinic about 4 months to get my levels right with different dosages - hopefully will be ok now for our first transfer in a couple of weeks. Good luck with your next steps - hope you can get some more answers

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Hi Vic77, I'm sorry to hear your first round failed. I wanted to reply because my husband and I have been under the care of the NHS for a year and are starting to tear our hair out. I've been told that all tests are normal (e.g I'm ovulating), although we know that there are some sperm issues, but the medical professionals don't really know if it's possible to conceive or not. Our experience to date has not been good. Although grateful for NHS intervention, it has been very frustrating with a new option each time we talk to a professional.

So, we decided to go private for an initial consultation. It was incredibly revealing. They looked at all my test results and identified immediately that my thyroid function test results were not conducive to conception and that even those that I am probably ovulating my progesterone levels aren't reaching the required levels to sustain a pregnancy. Also, I have high prolactin and highly likely they are all linked. All of which was overlooked by the NHS and I was told everything was "normal".

The private clinic explained that the NHS don't look at the details which are often critical to conception and that's why their IVF success rates are so low in comparison to private. She said that if we were to have IVF now it would fail and that my thyroid levels need to be optimised to aid conception.

I don't want to bash the NHS but it is widely known that it is at breaking point. Going private was an eye opener. If you are able, I would recommend going for at least an initial consultation if you can.

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Thanks so much Tinker2012 for sharing your experience. I am not bashing nhs either and I totally understand their funding issues however here in this situation we must out ourselves first. I just don't think I can go through another failed cycle without exhausting all avenues. I worry about private fri. Another pint if view though that they may want me to go for every test going whether I need it or not as I am paying for it..oh I just don't know. Off to gp next week to ask for blood test to check thyroid etc. I have never pushed the gp or hospital for anything but sadly these days I think you have too. I feel so much more informed now thanks to all the wonderful advice I have got on here. This so much. Where are you at with things? Xxx

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The clinic we went to seemed really open and they didn't book us in for loads of tests - like you I was a bit sceptical. They sent me away to go to my GP and asked to be treated for my thyroid, they did warn us that the NHS don't often have the same opinions as them as the private clinic looks to optimise hormone levels whereas the NHS just look for levels within bandings. My hormones may show within normal bandings, but are not strong enough to sustain pregnancy.

The GP wouldn't prescribe me the drug without a letter from the private clinic and unfortunately as we didn't go to the Consultant the first time (we were seen by a midwife), we've got to go back and get a letter from the Consultant. This is more £ but given that during our last appointment with the NHS consultant, she kept asking us what our results meant (she kept saying stuff like "your prolactin isn't that high is it?" - literally looking at me as if I should know), despite being told by the previous Consultant it was too high and being prescribed Cabergoline.

My husband's previous sperm analysis came back 100% abnormal morphology and then 99% abnormal morphology. The midwife at the private clinic suggested that I get my thyroid sorted which should in turn right my prolactin and progesterone and then suggested that we try naturally for 3 - 6 months to see of the sperm can do their job. If not, go back and we'll look into IVF.

My husband has been referred to urologist, so hopefully that will give us more information into his sperm abnormality.

It is so confusing to know what to do, the benefit of the private appointment is that every single result was explained to us - what it meant, how it should be and what can be done to put it right. I got to ask loads of questions and didn't feel rushed. It felt like I suddenly had clarity after months of not understanding and very vague answers.

That's my experience but I totally understand that this process is so personal, you must do what's right for you.

When the GP refused to prescribe thyroxine I was in floods of tears afterwards, I felt we'd taken two steps forward and one step back, but trying to remain positive. Our next consultation is on the 25th Nov and so I'm back to the waiting game!

I read all the comments on hear and I know that my journey is a lot less than many at this stage. It's so hard when you experience fertility issues and friends and family can't really understand. The emotions that go with this stuff are all over the place (well for me anyway!). I really hope you get clarity of your situation soon xxx

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It is just all so so difficult. I am at the point now where we are thinking of a private consultation alongside nhs so that we feel some of our questions get answered as my list is growing by the day. Am hoping tomorrow the gp will agree to test for vitamin d, celiac and thyroid so I can tick them off and I am starting a whole load of supplements this week and a major diet change and back to the gym, healthy body healthy mind hopefully and then who knows what can happen naturally😀xx

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Hi as a fertility awareness teacher I recommend to seek a napro technology Dr who will investigate why you are not achieving.I have just given a presentation at a fertility conference on the effects of low vitamin B12 levels on achieving a pregnancy .A client had been trying to achieve for 4 yrs with IVF ,Clomid ,& progesterone with no success.My request to have her Vitamin b12 & Vitamin D levels attended resulted in supplimenting with Vit b12 & a much wanted pregnancy was achieved 4 mths later.From my research low folate levels in both partners can cause infertility as well as the genetic mutation MTHFR which has only recently been discovered so many Drs are not aware of its devastating effects on the human body.Sadly all vitamin deficiencies are not recognised in today's world where drugs & hormones are prescribed only. Wishing you every success for further info check b12awareness.org or Dr Ben Lynchs website re MTHFR.

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Thanks so much Marylyn. What advice do you give if vitamin b12 is low..supplements I take it? How is this deficiency identified? Blood test? Do I just ask to be tested? Xx

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Depending how low & if you have any neurological symptoms like pins & needles ,memory loss ,tingling or numbness.Can you find an holistic dr ask for following tests active b12 which is more accurate than serum folate,iron ,ferritin,Vit d ,thyroid & antibodies.read through the info at the b12 awareness.org site there is sublingual or spray vitb12 or if it is really low <300 it warrants injections .

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I wouldn't trust the nhs as far as I could throw , we were tested I have an under active thyroid , treated for that had all other tests to be told unexplained infertility . Through some changes in the criteria we decided to go private . My first consultation I had a trans vaginal scan and showed I had endometriosis ! Also my hubby had slow motility ! We started treatment with private clinic 1 failed next one ICSI took we are now 15+3 days pregnant X

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My goodness leah30 . This is my worst fear that something has not been picked up by nhs and I put myself through our last nhs attempt to fail again when perhaps there is another reason..what would you advise? I was thinking of making a private initial consultation while we wait for nhs 2nd cycle and am off to gp tomorrow to ask about thyroid, vitamin d. That is the best news for you guys.huge congrats..if you were to go through it all again what would you do differently? Xx

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So sorry not replied it might be worth having a private consultation, we saved a lot and was able to afford it but some companies offer plans for payment xx

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Hi, I am sorry it didn't work for you. I agree with vic77, and suggest asking if it is possible to have vitamin D level tested, and also consult if pgs ngs/pgd increases chances for having positive results in yr case

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Sorry for the delayed reply. Yes they are two different things. The hysteroscopy is where they use a camera to look at the inside of the uterus in the same way as they do an internal ultrasound. The Laparoscopy is where they make small holes in the abdomen and look at it from the outside and can see the other organs around it, its shape and position etc. The dye test is not a camera inside but the insertion of a radioopaque dye into the Fallopian tubes and then X-rays to determine if it can flow through them or not and therefore if they can allow an egg to flow down to the uterus. Hope that helps and not all too late.

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Hi... this resonates so much with me.we too had same nhs tests & they couldnt see any reason why we were not getting pg & same diagnoses. at the stage we were getting the nhs investigations 2016(..blood test/hsg/sperm analysis) i was 40 & had had one natural pg at 38 which miscarried at 6/7 weeks. Then nowt.by the time our turn came roundin 2017 i was 41.we got an ivf schedule for sept 2017..the day they had me in,in june, for initial ivf scan they spotted another pg..( think they were flummoxed by our lack of excitement.im just v pragmatic & knew what had happened before so didnt want to get hopes up) but it was gone within the week.i was more worried theyd chuck me off the ivf than i was focussed on dealing with a "chemical pregnancy"miscarriage..after all i had ivf to look forward to!😉😕.we did the ivf in much same mental state as you describe..not well educated on it, not knowing what to ask & trusting the nhs know best.it didnt work.(6 eggs/5 fertilised/only 1 blast).doesnt matter how sensible i was about knowing the low stats fr my age..i still had hope & found it upsetting.i think it was also the point where it sank in thag there is a problem.quite what thiugh is still unknown! that was the nhs funded one (im in scotland so age is major factor) we knew instinctively we were not 'done ' yet so were looking to self fund this spring, 2018 .To manage ivf side effects i started using acupuncture & am still going.really good for me, its become a wee sanctuary.and a source of knowledge & information.literally 2weeks ago had another chemical pg..this has emotionally knocked me sideways, but also brought to the fore the nagging feeling that full blown ivf might not be our best solution right *now *. Ive started reading and researching & my instinct is i want to rule out if thres any other issues (ie aside from age or chromosonal flaws).its like the nhs can only do basic tests.private ivf is now more likely route, hell we r going to paying either way...but all my reading shows me that other countries do more testing..( yes namely the states & friends in australia who have done lots ivf cycles). For us id prefer to spend some time now delving deeper than storm straight into another ivf cycle for it to fail & stil have same questions.its emotionally exhausting...more after than during i have found.the book 'it starts with the egg"has been interesting for me...ive started some changes -not all of them, id go mad if i had to do all of it- but its fliped a switch. equally i found a very intersting blog by an american who suffered lots of early miscarriages & researched & found solutions. As im new on this site i dont know if allowed to post a link.my acupuncturist is also part of a fertility clinic & i've learnt more through them than via our wellmeaning but overstretched nhs. So sorry this is an essay😯 just want to end by saying well done for coming out the other side.this stuff is hard.and it's lonely as you cant open up to everyone on what it does to you mentally , emotionally and physically. I wish you strength & good luck x

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cheers hun for reply..my goodness my messaget was over a year old and 3 failed cycles since..I am older but not necessarily wiser sadly and my arms are still empty. .you attitude makes sense however I have accepted now I am 40 time is a real issue and in this field sadly there are so many unknowns so I am sticking with unexplained infertility diagnosis still and hoping round 5 works 😯xx

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Oh lordy, newbie didn't spot the date you posted.im sorry😯 .

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no probs at all..I found loads of helpful posts that were older when I came on here at first. ..I am in Scotland too😁sorry for your losses but welcome on here..masses of support from amazing women xx

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