4th failed cycle - where to go now?

[darkbuthappyplace]

Hello, I have just had another fail, this being my 4th IVF cycle and don't know where to go from here. Is it time to give up or is there still hope?

Cycle 1 [IVF, long protocol]

> 6 eggs, 5 mature, 2 fertilised, x1 early blast Day 5 = failed implantation

Cycle 2 [IVF, long protocol]

> 5 eggs, 4 mature, 1 fertilised, x1 6 cell Day 3 = failed implantation

Cycle 3 [ICSI, short protocol]

> 4 eggs, all mature, 1 fertilised, x1 8 cell Day 3 = miscarriage at 6 weeks

Cycle 4 [ICSI, short protocol]

> 3 eggs, all mature, 3 fertilised, x2 Day 5 transferred (5BB and 3BB) = failed implantation

The only thing that tempts me to try again is the fact, that i was able to get a BFP in cycle 3 and better quality embryos in cycle 4 although my egg numbers are going down with each round is worrying.

I'm 38 on Monday, low AMH. I'm private client at NHS clinic. Short protocol with x3 pessaries in cycle 3 and x1 lubion injection per day in cycle 4. Could the reason for the most recent fail be too low progesterone?

My clinic dont test progesterone and i dont think they do genetic testing. I live in the North East and don't know of any clinics that do up here.

Are we fighting a losing battle? Should we consider donor eggs? I don't know if can emotionally go through it all again?

[Redsequin]

Hi lovely. So sorry it’s not worked out for you so far. It’s so demanding physically and mentally going through cycles, so I can understand not wanting to go through it all again.

Seems you are getting embryos but could do with more of them to counter the fact they don’t always stick. Would your clinic consider trying you on long protocol with DHEA and/or growth hormones to try and increase your egg count? What about ICSI instead of IVF to try and get a higher fertilisation rate? Xx

[darkbuthappyplace in reply to Redsequin]

Thanks so much for the reply.

Sorry, i should have included that initially. Cycle 1 and 2 i was on long protocol and they shifted me to short. I did get more eggs on those cycles i suppose but was concerned about the quality.

Cycle 3 and 4 has been on short protocol and ICSI. I think ICSI definitely helped with fertilization. I've been taking DHEA supplements in the last two rounds myself?

[Redsequin in reply to darkbuthappyplace]

Ah I see! So you’ve already tried everything I suggested except growth hormones then. I’m currently on growth hormones now but haven’t had egg collection yet so couldn’t tell you if it’s had an effect! The only other thing I can think of is doing a few cycles of embryo banking and then getting them PGS tested, but like you say, you might have to travel for another clinic for that which would be a pain but could give you answers. I’m sorry this is all so difficult! What does your consultant think?

[darkbuthappyplace in reply to Redsequin]

I'm waiting for my follow up with the consultant but after the last failed round he said that we could still try with own eggs but donor would be a 'game changer' he refused to give any stats for chances. He'd just flagged to use lubion injections this last round, assuming these are better and i know more expensive, however, i bled during the tww on this and not on any other cycle.

[Redsequin in reply to darkbuthappyplace]

Hmm, it's so tough. Lots of ladies on here have gone for donor eggs and then had success quite quickly after struggling for a long time. However, you are getting embryos and you can get pregnant, so if you preserved, there's nothing to say you wouldn't come across that one viable embryo eventually! I guess it comes down to how many times you're willing to go through the financial, emotional, and physical demands of IVF, and how strongly you feel about using your own eggs. What does your OH think? Could a few counseling sessions help?

[darkbuthappyplace in reply to Redsequin]

Yep, this cycle is the first one i've considered whether i can go through it all again emotionally and physically but i know i'll pick myself up and not ready to give up. My OH is a bit undecided he's worried about the physical toll on me and is up for donor eggs but ATM he's just so upset about the last fail.

We definitely agreed some counselling will help for both of us.

[Redsequin in reply to darkbuthappyplace]

Wishing you so much luck going forward! I hope you find some solutions. xx

[Millbanks]

Hi lovely, sorry to hear about your cycles not being successful so far.

Are you keen to have any other tests done?

I would suggest looking in to immunology.

I had 5 failed FETs before looking at my natural killer cells (which showed as high) and on my 6th FET with steroids and intralipids I had my only ever BFP.

Currently 35 weeks.

I always think that if you are still able to create embryos you're still in with a shot.

xx

[darkbuthappyplace in reply to Millbanks]

Sure, i'm keen to find out as much as possible just not sure how to go about it. How would i look into immunology, how does it work where do i go? My clinic hasn't suggested it, nor do they offer it by the looks?

I do agree with you too, i think i've still got a chance with my own based on cycles 3 and 4, so don't feel ready to give up yet. xx

[Millbanks in reply to darkbuthappyplace]

It's definitely something to chat to your consultant about - what have they suggested for next steps anyway?

It's a blood panel, they check all the different aspects of your immune system.

xx

[darkbuthappyplace in reply to Millbanks]

Thanks, i'll look into it. I'm waiting for my follow up consultation at the moment. xx

[Millbanks in reply to darkbuthappyplace]

There's a great website called the Duff - theduff.co.uk/ it gives a lot of info about IVF. Might be worth a peruse before your follow up.I always like to go in with lots of questions in mind xx

[darkbuthappyplace in reply to Millbanks]

Me too! I'll be taking a look at that - thank you!! xx

[hope406]

Hi, I am so sorry you are going through this. I am only of course speaking from my own ex[erience but, I would find a place that tests progesterone. My clinic has the highest rates of success when progesterone is over 100 and they will change meds and check every 3-4 days until you are there. My last clinic did not. Also, after many failed implantations (7) my doctor did a test to see when my "window or receptivity" was, this is the ERA test. I also had the EMMA and ALICE test. I took a few more meds and my transfer time was changed to better fit my personal receptive window... next transfer, both stuck!

[darkbuthappyplace in reply to hope406]

Thanks for this, we've only ever had fresh transfers and ERA i guess has never come up. Do you mind me asking which clinic you used for this?

[Krystal_43]

My results are pretty much identical to yours. Round 4 I was diagnosed with high nk cells so did steroids but it didn’t take either. My doctors have suggested doing some rounds with PGT so we’re going to do that. My clinic is in Yorkshire.

[IVFat40]

Hello hun, I just wanted to suggest I've seen quite a lot of women with lower AMH talk really positively about their experiences with natural modified IVF, which I think essentially produces only a few eggs but high quality. If you were interested I expect if you put a post out some would respond with their experience/advice.

I also wondered if you'd looked in to the sperm side of things further, again I've seen people talk about good results from seeing an andrologist, getting sperm DNA fragmentation tests, and being prescribed supplements/approaches to improve sperm quality.

Great that you're taking DHEA, I feel that helped me. While you're on it it's also worth getting your levels checked every now and again to make sure they're about right. I also found a high protein fertility diet helped energise my eggs (saw a fertility nutritionist). The book 'it starts with the egg' may be helpful.

I also really agree with others about making sure you have good high Progesterone levels.

Sending lots of good wishes.

[PinkPanther1234]

Hi hun, sorry you are going through this. I have just had my 4th implantation failure this week, it is horrible and can relate to the feelings.

I have bled early on 3 out of 4 transfers, the last one started at 6dp5dt. I am keen to ask why this is, as I was on a lot of progesterone. I would suggest asking your clinic to add in pessaries next time, as well as injections.

Try to focus on your follow up and see what they suggest for next time. You are making good embryos, so it may just be a case of timing, the right conditions and hitting that lucky one. There are plenty of other tests if you feel up to trying them. But I know it feels so hard when you feel like you are trying everything. Sending you hugs xx