2 Fresh ICSI, 2 FET, 6 top quality blasto’s, 4 transfers... and all BFN. Anyone else had recurrent implantation failure? Losing all hope!

[Halli23]

Where do I even start... this is my first ever post on something like this so apologies if I ramble on.

As the title suggests I’ve had 2 fresh ICSI and 2 FET with 6 top quality blastos and today I got my fourth BFN. I’m literally heartbroken. Not even a sniff of an implanter from 6 top quality blastos, this just doesn’t sit right with me. I’m 32 with a high AMH of 33.7.

I had a miscarriage from a natural pregnancy just over 2 years ago and from that I had to have 2 x D&C’s which sadly caused me to develop severe Asherman’s Syndrome (uterine scarring). This was thankfully corrected after 2 x hysteroscopy’s and a stent balloon fitted for a month. My endometrial lining can be a little thin since but is sufficient enough at over 7mm - 9mm average in a natural cycle.

DH and I tried for a year after the corrective surgery but it just wasn’t happening for us so we turned to IVF. Hubby got testicular cancer shortly after this too so ICSI was recommended following his remission. (Our reproductive organs really did take a big hit!!)

I respond really well to stimming and my lining reached up to 12.7mm in the first ICSI, only gets to around 6/7 in a FET but consultant says this is fine. He does not think that Ashermans is the reason I now cannot seem to conceive again as there is no more scarring and my lining grows...

But after 4 transfers of top quality blastos, I can’t shake that this MUST have something to do with it despite everything inside apparently looking ‘completely normal’. I’m losing hope incredibly fast that I’ll ever be able to carry my own child again. Has the scarring altered the receptivity of my lining? Is that even a thing?

Has anybody had anything similar? Or had any investigations to look in to recurrent implantation failure? I’m not sure I can listen to another...”you’re just unlucky” speech. I would like to do the ERA test although consultant isn’t convinced of it at all.

Any experiences or PMA kicks would be greatly appreciated...

Thanks

[Halli23]

I Should have also added that I have also been treated with immunes (clexane, prednisolone and Intralipids) during last fresh as a precaution if this was the issue as haven’t been tested... and still nothing sticks!!

[HopeTTC18 in reply to Halli23]

Sorry to hear about your repeated failures. The only thing thing to add after Cinderella’s reply is to ask if you have had the embryos PGS tested? Even though they are top quality it’s possible they were abnormal and that’s why they wouldn’t implant?

[Halli23 in reply to HopeTTC18]

Hi HopeTTC18,

Yes, have been thinking this may have to be the next step too... consultant says with my age and AMH that he’s not convinced it would help much and that it’s not always that accurate. Having read in to it a little now, I see what he means but surely if it can save me some of the heartache of fail upon fail it has to be of benefit?!

They don’t actually do PGS at my clinic so they would have to be outsourced after collection if that is even a thing probably making it ten times harder. 😩

[Cinderella5]

I've had quite a few transfers with 4 bfns and 2 pregnancies. Found out I had subclinical underactive thyroid so on meds for that. I also have a little trouble with my lining but like you get sufficient enough for transfer. We have been changing our methods after each failure including hysteroscopy so now do baby aspirin to aid lining which gets changed to clexane blood thinners just before transfer. Intralipid infusion. For our first BFP we added in an extra day of progesterone pessaries before transfer incase I had a later implantation window & Prednisolone. We have miscarried for the 2nd time sadly but have now found out my progesterone after transfer isn't high enough. I think all of the things above are worth discussing you your clinic. Ask anything, I'd be happy to help. We seem to have managed to find our recipe to get pregnant now, just struggling to keep it!!xx

[Halli23 in reply to Cinderella5]

Hi Cinderella5,

Thank you for response. I’m so sorry for your losses and negatives as well.

We’ve changed the protocol each time and tried the Intralipids, clexane and prednisolone and still nothing wants to implant. I’ve been on baby aspirin since my miscarriage 2 years ago and am also on Lubion injections for extra suppport.

I am looking in to the ERA test to see if my implantation window is displaced, and maybe potentially now thinking of PGS too. I don’t know what else can be done / offered over and above what I’ve already tried. Do I really have to just persevere?

Clinic hasn’t monitored my hormones during and after stimming so maybe this could also be done?!

[Cinderella5 in reply to Halli23]

Have you had your progesterone levels checked? One of the other girls recently was on lubion and her levels were low. We considered the ERA too but our consultant decided to try me on progesterone for a little longer and that along with all the other stuff seems to have helped. PGS may be worth considering. We didnt do this but we were fairly confident in th fact that my husband had karyotyping done and we're now using donor eggs (so she has been screened too) and she has proven success of donating. It's really hard to keep going, I completely understand your frustration. I know someone that had the ERA test and it turns out her window was later too and she had success first time using this info. Good luck.xx

[Halli23 in reply to Cinderella5]

Had my progesterone checked in a natural cycle before we started IVF and it was in the normal range. I’m not sure if it changes much month to month but will be asking them to monitor it next time.

When you say you did an an extra day of progesterone before transfer... when does that mean you started it? I am started on Progesterone the day of egg collection in a fresh go and day of ovulation in a natural FET (as don’t respond to medicated so can’t do it)

Haven’t had the karotyping or NKC tests but may be worth considering now? And so glad to hear of a good story coming from the ERA test. X

[Cinderella5 in reply to Halli23]

I was given progesterone for 6 full days before transfer instead of the 5. My progesterone levels are normal in a natural cycle, I ovulate naturally etc. However clearly not when I'm doing medicated stuff and my FETs are semi medicated. It's all so expensive to do all the extra stuff. Karyotyping is less expensive than PGS however this would t completely discount a couple of faulty embryos in there but you're young so it shouldnt be so much of an issue. ERA may well be something to consider.xx

[Halli23 in reply to Cinderella5]

Ahhh ok, good to know. I’ll definitely ask for hormone monitoring this time despite the bloody extra it’ll cost for all the blood tests 🙈

Yes all the extra tests are so expensive aren’t they, it’s ridiculous. That’s why my consultant treated me for immunes with the lipids etc as if I had tested positive for them as treating them is more cost effective than paying for the result. Was worried that having stuff that may not be needed would be an issue but I was quickly reassured it wouldn’t be.

Feel like I should be doing the actual tests now though so I know for sure or can at least try and identify what’s going wrong.

Definitely luck in there too as you say, game of numbers and some are luckier than others. It’s a miracle anyone can even get pregnant in the first place when there are no issues!

I feel slightly less alone than I did this morning... so thank you for the responses x

[Cinderella5 in reply to Halli23]

To be fair that's good for your consultant to let you try the immune treatment....a lot won't. I asked for prednisolone and our consultant wasnt too fussed but said there was mo evidence it worked but could try if I wanted to. We had all the bloods etc done and probably wasnt worth the money when you can just throw drugs in! Best of luck, it is tough but hang in there!!xx

[Halli23 in reply to Cinderella5]

Also, can I ask why you are now using donor eggs? Was it because of the recurrent failures? X

[Cinderella5 in reply to Halli23]

I have had 2 OE failures but was older, 38 so likely my eggs weren't great quality. I've since had 3 failed DE transfers with the best grades embryos and even our consultant was shocked we havent gotten anywhere as she has donated to another couple who got a baby! I think there is a massive amount of luck involved too though....some ladies are super lucky and others aren't unfortunately. At least your clinic have tried to change something each time.xx

[Boo718]

Hello have you done the pgs tests? We had top quality embryos aa ab ab and then a cd the cd was the only one that was normal. The rest were all abnormal so we’re discarded. Hope you get some answers xxx

[Halli23 in reply to Boo718]

Hi Boo,

No we haven’t done any PGS yet because of age and AMH, dr thought it wasn’t worth it. Whether now he changes his mind after 4 failed with 6 top graded with no likely cause known. Surely 1 out of the 6 should have worked?! I appreciate not every one would have been genetically normal... but 1 little one out of the 6?!

It’s so disheartening.

My clinic don’t actually offer PGS though and I’m stuck with them as I’m part of the Access Fertility multi cycle deal. They won’t let me switch clinics so not sure if they would be willing to send them off somewhere and if this would affect the blastos even more if they have to be transported elsewhere?!

Did your normal tested ones work for you? X

[Hidden]

Hi Halli,I'm so sorry to about your BFN's I know it can be soul destroying,I'm currently on day 8 of 2ww, 2nd cycle and 4th transfer with DE, my first cycle with own eggs was abandoned and as I was 40 moved straight to DE's and 1st natural transfer sadly ended in miscarriage. I suffer with allergic reactions to shellfish and have a strange exercise related allergy to wheat so was convinced it was my immune system,last cycle I had baby aspirin,clexane,prednisone and intralipids as extras but it still failed so.I had a chicago blood test done which was very expensive but showed I had high levels of toxic cells and was TH1 dominant so consultant upped my dosage to 20mg and have been on it for several weeks now, along with intralipids to try and calm down my immune system so stop it attacking, I also changed my diet,completely cutting out gluten amongst other things and exercising more regularly as its meant to help with the immune system, after talking to Cinderella I also spoke to my consultant and they agreed to let me start progesterone (just 4 tablets in the evening) before originally planned, if this fails then next time we will try a new donor as consultant says that we may be incompatible.

There is so much information out there and tests its really difficult knowing what to do for the best x

[Bexta6060]

Hi, I dont have any advice for you more than whats been said above but maybe I can give you a little hope. Ive just had 4 failed implantations, but number 5 stuck with immune protocol and im currently 11 weeks pregnant.

[Belle2019 in reply to Bexta6060]

Hi Bexta6060 please can you tell me what is meant by immune protocol? Congratulations on your BFP.

[Bexta6060 in reply to Belle2019]

Just Clexane and Prednisolone, I havent had the NK cells test but I do have autoimmune thyroid issues which is why i asked for the immune protocol this time.

[Belle2019 in reply to Bexta6060]

Thank u xx

[RockPig]

I can’t really add any suggestions to what’s already been said but just wanted to let you know you’re definitely not alone. I’ve had 3 failed transfers with 2 different donors and nothing. Like Cinderella says, if you keep changing things round each time eventually you’ll hit on your magic recipe. Don’t give up, it’ll happen one day. XX

[Sprinkles86]

Hi Halli I’m so sorry to hear what you’ve been through. I had recurrent early miscarriages (some natural, some IVF), and all investigations came back as ‘normal’. So frustrating when you know something is clearly wrong!! So I booked myself in to Siobhan Quenby’s clinic at Warwick where they look at natural killer cell levels in the lining of your womb. It’s aboyt £500 and they take a sample of your womb lining about a week after ovulation and see what your levels are. This is then repeated a month or two later to avoid a ‘fluke’ low or high result. One of mine was normal, one was high so for our last frostie I was on steroids from transfer day and cyclogest pessaries 400mg twice a day. Worked for us and we now have our beautiful boy. It also worked for another lady on here I recommended it to. It’s well worth looking into if you can get there xx

[Halli23 in reply to Sprinkles86]

Hi Sprinkles,

I’ll have a look at the clinic, thanks. I’ve been on steroids and cyclogest for all 4 transfers as well as a lot of other stuff for immunes (clexane, aspirin and Intralipids).

I had the scratch twice too... and have had acupuncture once a week for nearly 18 months now and nothing!! It’s baffling. 😢

So happy that you got your happy ending... x

[Sprinkles86]

Just to add, the ‘scratch’ they do to get the sample has shown to sometimes be enough to regenerate the lining of the womb to make it more receptive to embryos trying to implant. I also spent some time reading the book ‘is your body baby friendly?’ Which is an interesting read. I had regular reflexology with a reproductive reflexologist, adapted my diet to reduce inflammation in my body (as I have bad endometriosis) and also had a few sessions of acupuncture xx