Has anyone had top graded embryos failing to implant? We were advised we didn’t need testings before transfer, now our cycle has failed!

[Leyla1989]

Has anyone had top embryos failing to implant? The doctors advised that me and partner did not need any further testing like hysterocopy or DNA fragmentation test due to our age (despite me being very proactive and adamant that we should have further testing before proceeding with our 2nd transfer) and told us to proceed with our 2nd transfer- both transfers failed and so our whole ivf cycle has failed. This was with mild ivf Create fertility St Pauls

[DianeArnold Partner Nurse Fertility Network UK]

Hi Leyla. So sorry to hear this. perhaps you should ask for full report from the embryologist to see what he/she thought about the condition of your embryos. Perhaps a different type of cycle is needed with more support e.g. heparin or soluble aspirin for the womb lining?? I do have a couple of lists of questions I could email you if you want. Most won't be appropriate, but there should be a few you can use when you go for a follow up consultation. My email address is: [e-mail] Good luck! Diane

[Leyla1989 in reply to DianeArnold]

Hi Diane, thanks for your reply, it’s my first question so feels nice for someone to care to reply

Yes today I called asking for all the notes and records and decisions held on our cycle. I have to sign consent form and wait 28 days. It may be that I am on the wrong cycle and mild ivf just isn’t for us maybe. I also don’t feel doctors are so proactive and actually look deeper. It could also be our age that somehow they feel we don’t need any Further testings when clearly there’s something wrong, we have unexplained infertility which doesn’t help! But really there clearly isn’t such a thing as unexplained, it’s either because they haven’t done enough to find the cause of infertility or something hasn’t been detected yet.

Yes your right, something needs to be tweaked - I asked for progesterone injections in addition to pessaries - my hormone level was fine. We even did embryoglue but clearly that didn’t help either

That would be so great, I will email you soon, our follow up consultation is this Thursday, I need to try and stop sounding too frustrating to them, I know I will be firing lots of questions

Thanks Diane xxxx

[Libsie3103]

So sorry to hear this it’s such a tough journey. I’ve had 2 cycles fail with top quality embryos, it’s so hard and sadly despite all the tests etc there is still an element of it that’s down to luck / nature. Have you had your embryos PGS tested? That might be an approach to consider? Although sadly there are still instances where “normal” embryos fail to implant as well. Are you using ICSI? We asked about DNA fragmentation tests but were told it wasn’t needed as we were using ICSI. Lots of things to consider and questions to ask for when you meet with your Consultant xx

[Leyla1989 in reply to Libsie3103]

Hi Libsie,

Thanks for your response

I am so sorry to hear that your also going through this, it is so hard and so frustrating!

Because the clinic thought we were “young” we didn’t need any add ons, so we didn’t do PGS testing - I wish we did this I am very frustrated with their advise, I feel they didn’t take us seriously or respected us! Because their lack of looking into things deeper, it feels like we just threw our money out of the window! Our consultation is this Thursday to discuss next steps, I am trying to keep myself diplomatic and professional but it’s hard because this is a very personal journey and I have been treating this journey as my 2nd job - calling in every other day checking on things, asking on certain things - making sure they actually take our personal circumstances into consideration. I have been so proactive that I don’t think there is anything more I could have done

Doctors again advised we didn’t need ICSI - they said there is no sperm problem. But sperm testing only sees how the sperm is on the outside, after reading so many articles and YouTube videos of doctors in the US they always advise that before embarking on ivf, dna fragmentation and hysterocopy is very important - because then your making sure everything is good from the get go!

We had 5 blastocysts all from a mild protocol so we are shocked they didn’t work. I put two embryos in this 2nd time :(, 1 had died from thawing and we have 1 more left but I don’t trust to do it in this clinic. I feel disheartened to go ahead with them.

I feel that if you don’t ask and don’t push doctors they won’t take you seriously, so going forward firstly we are thinking to leave the clinic and secondly I will look into asking to do DNA fragmentation, hysterocopy, ICSI and Embryo receptivity testing. Which means more money to save up because of our wasted first cycle But at least then we can rule out things.

What are your next steps Libsie? Xx

[Leyla1989 in reply to Libsie3103]

Also Libsie, I do respect doctors and their decisions and advise but after reading a lot from other more experienced doctors in the US, India and Canada, just doing ICSI isn’t enough apparently, DNA fragmentation is the most important - as it is in depth analysis of the chromosomes and DNA. It could be that they are becoming blastocysts but there is a chromosome missing in the DNA pattern which doesn’t let it stick or a combination of that and a woman’s uterus factors

[Libsie3103 in reply to Leyla1989]

Hi, sorry if you thought I was saying you didn't respect your Drs, I didn't mean that at all. I think the reality is that there are SO many tests and investigations we can have and not all the IVF clinics in the UK do them or consider them. Have you read the book "Is your body baby friendly"? I have been recommended it (but not read it) as it talks about some of the wider tests / investigations you can have done to help get answers. Most of these need to be done independently by specialists but the results can be taken into account by your clinic. It could be that your embryos are fine but there is an issue with them implanting (as Diane mentioned above) ERA is one thing to check but you can also look at NK Cells. There is a clinic in Coventry that can look into implantation failure and see if NK Cells are a factor.

I also believe that protocol can have an impact on egg / embryo quality as well. My first cycle ended up with 3 blastocysts - the double transfer failed and then the 3rd embryo didn't survive the thaw. I had a 2nd cycle with the same clinic and had zero fertilisation from it. At that point I decided it was worth looking at alternative clinics / protocol and seeing if they would be better suited to me and have better results. I had 3 blastocysts from my next cycle and 2 implanted with the twins I then later sadly miscarried. My next cycle I had 4 blastocysts, the 1st 2 failed and I got a BFP with the 3rd on Friday. (Excited but we have a long way to go!)

As I said earlier there are LOTS of things that can be looked into but ultimately it's not all within our control sadly and nature plays a part. Wishing you lots of luck on Thursday - fingers crossed you get some answers xx

[Leyla1989 in reply to Libsie3103]

Oh no I didn’t think you were saying it in that way lol I am just so frustrated that’s why I’m talking like this haha

Ooo the book sounds interesting, I will definetly look it up

Oooo, which clinic is that in Coventry? I tried googling but couldn’t find one that specialises or have an implantation failure package/testing. I have had a read of NK cells too. I didn’t know what they were

Yes your right, there are soooooo many tests out there! Lol by the time I push doctors to do them all, I won’t have money to do the actual process!

Can I ask what protocol it was? Standard or mild ivf that you were in? I do agree with you that it may be the type of ivf and the dosage of medication that can have an impact. I am still reading on the differences of mild and standard and whether I should switch.

Oh wow🤩 congratulations!!!!! Fingers crossed everything runs smoothly for you! Please do let me know how you are doing, it’s always so lovely to hear good news - it inspires me and gives me so much hope! All the best x

[Sas1101]

Hi Layla,

I've had two transfers of 5AA blastocysts that both ended in a chemical pregnancy. It absolutely sucks and I was told that the embryo development looked excellent in the embroyscope. We didn't do DNA fragmentation or PGS testing as we are funded on the NHS and this wasn't suggested. Given my low AMH and hubby being nearly 50 I'd have thought they might have suggested it and we would have been happy to pay. My hubby had some chromosomal blood tests done and everything was fine.

I'm in a similar situation as you at present and we have decided to transfer our last two frosties of similar quality and then in further cycles do some more more testing. I was told by the consultant that it could be a embryo abnormality causing the chemicals. I'm hoping I have my lucky one or two left in the freezer.

Will you consider moving clinic if you feel you're not getting the service you need? Xx

[Leyla1989 in reply to Sas1101]

Hi Sas so sorry to hear that, it really is so frustrating and upsetting when a transfer fails. I am wishing you all the luck for your next transfer, fingers crossed this works for you and your out of this distressing period!

I don’t know why they wouldn’t be okay with just doing further testing, it’s as though they are happy to go in blindly and then slowly decide to go ahead with further testing if it fails, I feel like a guinea pig. I hope this isn’t the case for you and hope you have your happy ever after soon!

We have to push doctors and raise concerns and be more proactive to get ourselves fully looked into, this is a lesson I have learnt the hard way unfortunately doctors aren’t always right!

Yes if a doctor had told you there may be an abnormality definitely do the dna testings but hopefully you won’t need it. Do let me know how it goes Good luck xxx

Oh and in response to your last question, yes because I don’t feel I am being looked into properly and taken seriously, and doctors are not showing to be pro active, I am thinking of leaving the clinic and before embarking on our next journey I will make sure I read up things first and go in with good knowledge, we have to be just as much aware as doctors are! Sometimes we think we don’t know anything and should leave it to them and of course they are professionals but sometimes I feel that it is a joint effort regardless if your paying or it’s on the NHS

[Lisichka]

Hi Leyla

Sorry to hear that both transfers failed, it’s a very low feeling! I know from my own experience unfortunately. We had 4 failed transfers with excellent quality blasts (6 embryos in total). They were all untested as the doctor advised against it because of my age. I was at my wits’ end as you can imagine. It also coincided with us moving countries so we changed clinics.

We did a new IVF cycle with ICSI and did PGS testing for peace of mind

Ran a whole lot of tests (karotype, recurring loss panel to see if there are any blood clotting issues)

ERA test to see if the timing of the transfer is correct and if there’s enough progesterone

We also made changes to the protocol to include a mild steroid and baby aspirin.

You have to be your own advocate and push for further testing and answers. Every cycle they have to try new things because otherwise you’ll get what you always got.

Wishing you the best of luck!!! Xxx

[Leyla1989 in reply to Lisichka]

Hi Lisichka

Thanks for your message

I spent all night last night googling all the different types of tests and what they all mean, there are so many! But best to get things ruled out from the get go before embarking on another cycle!

Clearly age doesn’t make a huge difference and I feel that doctors need to take everyone seriously disregarding age!

Can I ask what your ERA result was? There are so many mixed studies on this and whether it really helps but then I rather do it so that I can say we have tested that too!

What did the clotting testing come back with? Is this why you had to use steroid/aspirin? I do have clotting during my period so I do think I should get this tested too.

But I also have a fibroid outside my uterine wall, doctors have said this isn’t an issue but I think I should get my blood supply checked just in case it is changing it.

Yes totally agree that we all need to be our own advocate, at the end of the day it’s our body and our money and time!

Where are you now in your ivf journey? will be lovely to know Xxx

[Aussie83]

Hi Leyla, I have also had two good quality blastocysts not implant so I feel your pain. So shitty isnt it ☹️

I have been looking in to PGS testing and ERA tests, seem to be good ones to check when implantation isn’t happening.

I am also with Create/ABC IVF & interestingly, i am also quite disheartened with them. I feel the same as you, they don’t seem to be that interested in my case and I feel like another number. I had to really push them to allow me just a progesterone test with my FET and even tho it wasn’t successful, I had a chemical pregnancy & had never seen a positive test before, so I feel like maybe there’s something to the progesterone levels thing..

Long story short my last cycle ended with one egg collected which didn’t fertilise & they didn’t suggest the cycle should be cancelled..they seemed more than happy to take our money for such a minuscule chance of success. I felt that showed a lack of care for our emotional and financial state.

I am moving clinics now but also have to wait 28 days for my medical records. I’ve found a new clinic that are much more hands on and actually seemed interested in doing everything possible to get success for us.

I agree with you - the one thing I’ve learnt this year is that I need to do as much research as possible beforehand and know my stuff, even tho they’re the pros & we trust them to do their best for us.

I wish you all the best for whatever you decide going forward x

[Leyla1989 in reply to Aussie83]

Hi Aussie,

Yes it is just so frustrating, they are the professionals so we put our trust in them. Even though some people have said they aren’t that pushy with add ons, they need to explain why they are not.

Isn’t there some sort of rule that if a cycle achieves one egg or none, that you will get all or some of your money back? Maybe check this with them because I had read it somewhere but not sure where!

I can’t believe some clinics like CRGH have a refund policy! I didn’t even know this until seeing this cycle of ours failing. I regret going to this clinic.

So sorry this has happened to you too, I’m hoping the next clinic will be better and that you also have taken your time to research and know more before going ahead with another cycle. Can I ask which clinic you are looking to go with?

Can I also ask how you knew you had chemical pregnancy? Did you do a home pregnancy test before the blood test? I haven’t even done a pregnancy test so I don’t even know if I did have a CP. this is why I think we should do pregnancy tests so that at least we know if it did stick and then wasn’t able to continue to implant.

I wish you all the best too! Stay strong and be more guarded and more in control next time - that’s what I’m going to do, I’m going to have my guard up and will question many times before I agree on something! I also think it’s good to get second opinions now too!

Xxx

[Aussie83 in reply to Leyla1989]

Hi Leyla,

Yeah I agree, they need to be more transparent. I feel some clinics can inadvertently take advantage of emotional, naive patients that might not know what they should be asking at the beginning and during treatment.

Not with our clinic. I looked into it and they do say in terms and conditions if a cycle is cancelled before egg collection that some money is refundable but they sadly didn’t offer me that option and I was hopefully at the time I blindly followed them 🤷🏻‍♀️

I spoke to the HFEA and they don’t have specific rules on clinics having to cancel cycles if you get less than 3 eggs, however they should base it on patients results and emotional states.

I have put in a complaint about it but also takes 28 days and I’m sure it will just be a load of ‘lip service’.

Yes I looked into CRGH, great idea for under 35’s, you will get full refund which is great but hopefully you have success and it won’t apply of course!

I am 37 and decided against that program as the price doesn’t include meds (or ICSI if needed) and the new clinic I found are about £16000 for two cycles (with ICSI & meds) and you get the third cycle one free.

You pay per cycle though.

It seemed like a better option for us as we don’t have the money to pay out such a sum up front.

We’ve already done 3 cycles with Create so money getting tight.

I didn’t really understand mild ivf (stupidly) when we joined them & feel like conventional ivf is something I need to rule out as mild didn’t go well for me..

The clinic I’m looking to is called City Fertility in London. Was recommended to me by a lady on here actually.

I knew it was a chemical because I did two tests the same day I went to get bloods. They were both quite obvious positives and when I told the nurse she said it must’ve been a chemical. I always do a test after the bloods but before my results phone call, as I like to know what to expect.

Thank you 😚 yes 💯 I need to be more confident and direct as well. You sound like you know what you need to do so I’m sure you’ll be fine.

All the best for your research & follow up appt X

[Ivfgotadream]

I was with Create Birmingham and actually found them very good. That being said I think St Paul’s gets very different reviews. I found that they are very anti add ons - we pushed for PGS due to a history of recurrent miscarriages but they were a bit nonchalant about it. But actually looking back now they were right because PGS was downgraded By the HFEA and I wouldn’t do it again (and didn’t and got pregnant with twins!). We also asked about sperm fragmentation But because husband had been on high dose preconception vitamins for months - Proceive Max for men which contain what the treatment is for fragmentation anyway then they said it was a waste of money. So I’d say they are very conscious about selling additional tests and add ons which dont have any basis for success and we were grateful not to feel like walking cheque books.

Their ethos is less is more so if you are young and no obvious health conditions and you haven’t had several miscarriages then I imagine they have said no to the tests you’ve asked for because they genuinely feel there is no need?

But if you aren’t happy then push them for some more feedback?

[Leyla1989 in reply to Ivfgotadream]

Hi there, I understand what you mean and agree that they are very reluctant for add ons - not sure if this is a good thing or a bad thing but your right I didn’t feel like they necessarily wanted to make money from add ons but I do feel that they didn’t do the main testings - dna fragmentation and hystoroscopy before starting a long journey I put my body through so many emotions only to have a failed cycle.

But...Congratulations on your beautiful miracles! How far are you? Was your ivf journey just with create fertility or also another clinic? Would you mind telling me what dosages you were taking and whether it was mild or natural? All the best for you and your lovely family xxxxxxx

[Olivialinney]

Hi. I’m 6dp5dt. With a top 5aa hatching blast and I’ve been testing and it’s bfn. It’s my 9th transfer so I know my body and know that I am out

I had a hysteroscopy 2 years ago after recurrent implant failure and everything was fine. Done Another cycle became pregnant but my baby passed away at birth

It’s been 2 years since and another has failed 😔 I really don’t know what else to do. I have been pregnant 3 times but 6 great embryos didn’t stick also

[Leyla1989 in reply to Olivialinney]

Olivia, have you done a dna fragmentation test and immune testings?

[Olivialinney in reply to Leyla1989]

We haven’t but it’s something I’m may have to push for. I love my clinic and they have got me pregnant 3 times but it’s now the 6th failed transfer. (Although not in a row) but my protocol is always the same maybe it’s time to change it up I would love to get to the bottom of it but I just get told it’s just one of those things 😔xxx

[Leyla1989]

I am so sorry Olivia to hear about this, it is so upsetting

But what else can we do but to move on and continue this journey - so long as we are emotionally and financially able to.

I truly believe if you want something so badly in life, you have to pursue it and keep going, eventually there will be a light at the end of the tunnel and you will have your miracle baby with you!

Keep strong 💪🏼 My best wishes are with you xxx

Can I check what clinic you are at? And where you did your hystoroscopy?

[Cinderella5]

Hi Leyla, I've had a number of good embryos fail....a lot in fact! It turns out my implantation window is out. It's not a common thing but I need a day more of progesterone for my uterus to be receptive. Also the amount of progesterone I need requires to be higher than most. I didnt have PGS testing as we were using young screened donors. I'm so sorry, its soul destroying. Hope you get to the bottom of it!xxx

[Leyla1989 in reply to Cinderella5]

Thanks Cinderella for your message

Oooo ERA testing clearly is very helpful! But everything is adding up so much so I don’t know whether to do a hystersocopy or do an ERA and a scratch. We are also definetly doing a dna fragmentation testing because my husbands brother also is trying for a baby for over 5 years and no success! They don’t have sperm problem as we didn’t do ICSI but there may still be a dna problem which isn’t tested generally.

And.....I just read your profile, congratulations!!!!!!!! All the best wishes to you and your little miracles! You are an inspiration and hope to me!

[Cinderella5 in reply to Leyla1989]

Ive had all of the above done but yes its is expensive, the hysteroscopy could rule out if there is anything stopping implantation for example fibroids etc but I think its important to know whether they would treat anything that they do find. If your embryos are doing well and Im sure you said you are getting good quality embryos DNA fragmentation may not tell you much. The embryologists can generally tell how things look from embryos development.....day 1 to 3 embryo development is down to egg quality and from day 3 to 5 is sperm quality so if they are having problems in those time frames they can usually pinpoint things a bit. However its not an exact science of course. Good luck and thanks for your kind words.xx