Third Transfer, Third Chemical Pregnancy. Any advice on next steps?

[anz07]

My third transfer (and first FET) has, unfortunately, turned out to be yet another chemical miscarriage. Here is a quick overview of my journey so far:

IVF1: Fresh transfer, 5 day blastocyst - Chemical pregnancy at 4 weeks (on two pessaries a day).

IVF2: Fresh transfer, 5 day blastocyst - Chemical pregnancy at 5 weeks (on two pessaries a day + 1 Lubion injection per day).

IVF3: FET transfer, 5 day blastocyst - Chemical pregnancy at 4 weeks (on two pessaries a day, 1 Clexane injection per day, 2 baby aspirin per day + one Prontogest intramuscular injection every other day).

I have two frozen embryos left, both of which are low gradings (both C's), one is a Day 5 and one is a Day 6. I've been told this should be a double transfer due to the low quality.

I just don't know what to ask anymore. I feel like we have exhausted all options in terms of the meds I have taken to date. I am a gay woman with no diagnosed fertility problems which makes things complicated. Our first cycle had a poor result due to the sperm not binding properly with my eggs (I was left with 1 embryo and nothing to freeze from 12 mature eggs). My second cycle went better thanks to ICSI (13 mature eggs and 4 embryos).

Has anyone been in a similar situation in terms of repeated chemicals? If so, are there any changes beyond what I've already stated that you can recommend?

IVF has definitely taken its toll on both myself and my partner now. Fortunately our relationship is stronger than ever but we know that we can't keep going through this. We're at almost £30,000 (including buying the donor sperm) and have had nothing but misery so far. We will see through our final transfer in the next couple of months but hold no hope for it to work.

Any advice would be greatly appreciated. Thanks all.

[Scarlett13]

Hi! So sorry to hear of your hard journey so far. I know only too well how you’re feeling. It seems that the clinic are increasing your progesterone each time which is good but are you having your progesterone levels tested to see if they’re at a good level or just having more progesterone thrown at it in the hope it is helping? Please see my previous post about progesterone- I bang on about it 😂 Great news you have 2 embryos left and I know plenty of women who have got pregnant with lower grade embryos, so don’t give up hope!!! Have you had any other tests done at all to rule things out? Fantastic that you have no known fertility issues! Unfortunately with ivf it does just sometimes takes a while before it works. I wish you all the best xxx

[Masief]

Hey anz07, so sorry for what you've had to go through so far it is so tough! Have you had any tests in conjunction with the changes to your protocol? You manage to implant which shows your uterus is receptive, which is great. Have you had your eggs tested and considered doing ERA? I know that is usually for implantation failure but I don't know if the window and timing is off and whether that would still impact the development of the embryo? It's tricky as I think sometimes too much progesterone prior to transfer can cause issues too, I think it did for me so I ended up doing a natural FET. Is that an option for you? Best of luck for your next transfer xxx

[Lisichka]

Hi Anz

Sorry to hear you keep going through chemicals- they’re devastating!

I would do ERA and test your progesterone levels before and a few days after transfer to ensure they’re adequate.

This is what made a difference to me after 2 chemicals in a row with good quality blasts. My body wasn’t absorbing pessaries well and having intramuscular progesterone every other day simply wasn’t enough. I ended up being on twice daily injections. After doing ERA it also turned out that I needed one extra day of progesterone.

You could also consider doing a pregnancy loss panel and testing for MTFHR gene which is associated with miscarriages (in this case, you’ll need folate instead of folic acid).

There are extra things you can do so don’t give up and lose hope xxz

[Jumpppy]

So sad to read this

Maybe I missed your age and whether you are using the same donor there were issues with 1st cycle? ICSI is a mixed bag and donor sperm shouldn't "require" ICSI. I can only assume there was some concern somewhere as multiple IUI are usually first step and highly successful where there aren't MF or FF issues.

It can be an especially tough road when there is an "unknown" because it just hasn't been possible to "try unassisted." I was in that boat my first cycle.

May be worth a virtual second opinion from a more specialized RE? There are some good ones out there who can help validate approach of give other ideas. You have implantation consistently so that narrows down a lot what the issue(s) may be. (Also at my clinic 5wks isn't considered a chemical as you can see a sac/fetal pole).

Most clinics say implantation rates for donor egg + donor sperm (with known pregnancy) where there are no FF implantation issues are 80%-90%, but live birth rates are 50%-65%. You are spot on for the implantation. May not be a progesterone issue, but something else...

Also keep in mind that most stats reported are per cycle NOT per transfer. Your first cycle sounds like a bit of a write off, so you may need to go through all embies from the 2nd cycle to say for sure what next steps are. It wouldn't be unusual to need 2 good cycles...I know we all hope to have that 1 cycle that will have all the embies we need to fully complete our family (size) aspersions.

It's long and tough journey Best of luck!

[Fertilityjourney]

I'm so sorry to hear of your chemical pregnancies. I haven't had repeated CP's but had one after my first fresh transfer in Dec and it was so upsetting. So I can't imagine what you are going through.

In preparation for my FET, my consultant has recommended we do Thyroid tests to make sure these are ok. I did have some taken last summer and they seemed normal but after reading 'Its starts with the egg' one result is not optimal and I was also showing antibodies which I'm going to push for further clarification on to see if I should do something different...

The book has also prompted me to check my vitamin D levels as again, Im not sure if they were optimal.

Like others have said, perhaps it would be a good idea to have a consultation with another clinic when you are ready - to see what they suggest?

Take care of yourself and I hope.you get some answers. Xx

[Poosa]

Hi @anz07. I am sorry to hear that. I had multiple miscarriages. I can totally understand your feelings.Have you done hysteroscopy? I would suggest to check with your Dr if you haven’t done. This will tell if there is any issues in the uterus and if there is any can be treated while they do the examination.

Also I am not 100% sure about the ERA test. I have done that and the result was I needed one more day of progesterone before transfer. But all ended up failed implantation or miscarriages.

This time I requested the Doctor to go with regular days of progesterone (5 days) and added few extra medications.

I took doxycycline (Antibiotic) prior to the transfer and continue taking baby aspirin. These were prescribed to me. Now I am 16weeks. I never came this far. Hope this will be a successful pregnancies.

Hope these information are helpful to you.

All the best for your next FET.