Failed first cycle- debrief.

[Nofie22]

Hello,

We have just had our first failed NHS ivf cycle. We had a debrief today with the doctor who basically said the following…

They think possibly a sperm issue could be a reason things didn’t work out. Everything went to plan up to day 3 (I responded really well to the protocol, 12 eggs collected, they all matured, 8 fertilised, they all did well initially) but the embryos didn’t grow as they should after that which might indicate sperm quality. We got one embryo that they transferred, described as “moderate” quality, 2BC. The rest were all discarded.

Next cycle, the doctor suggested upping Bemfola from 225 to 300ui. ICSI will be used this time in order to select the highest quality sperm possible. They also suggested for me me to try extra progesterone in addition to the pessaries which might help but isn’t funded, it would cost £180. I don’t have to have it but they said it “could” help with the uterus lining as I shouldn’t have had a bleed or period before the OTD, but that is what happened.

Any thoughts or experiences? Particularly on whether you think extra progesterone is beneficial?

Tia x

[AuroraXen]

I'm sorry your first round wasn't successful 😔 but good to see your clinic suggested things to address and change. If you bled before OTD that can definitely indicate low progesterone, so I'd definitely be asking for extra this time. I don't know if nhs clinics like testing your progesterone levels but it's worth trying to push for that, as you shouldn't be bleeding early (I also had problems with this). Did they mention supplements for your partner's sperm? Could be worth him taking something like proxeed before the next attempt, to see of you can get the best sample possible (guessing they haven't done any more advanced analysis on the sperm? But do you know if there are any morphology problems there etc?) Xx

[Nofie22 in reply to AuroraXen]

hello 👋,

Thank you so much for this! Yes they have suggested supplements for Husby so on this already. Will definitely ask about the progesterone testing too, but good to know you think the extra may be worth it.

Yes, I’m pleased they have made some suggestions for going forwards, let’s hope they might work. No advanced analysis of the sperm but all the basics looked okay. We shall see!

With the bleeding, the doctor sounded surprised and said it shouldn’t have happened… perhaps I wasn’t absorbing as much of the pessaries as I should have?

Thanks again so much for your reply, great time hear other people’s experiences. Xx

[AuroraXen in reply to Nofie22]

Even if they don't agree to test progesterone, might be worth trying to get it tested privately (my clinic was private and I had to pay for the test but was worth it). Because you're absolutely right, it might also be the KIND of progesterone that's the issue. For me, in ivf, my body doesn't seem to absorb the pessaries well, I need to inject progesterone too to get my levels high enough. Lubion worked much better for me (it's expensive but did the job in terms of raising progesterone levels!) Xx

[Nofie22 in reply to AuroraXen]

brilliant, thank you. Definitely want to give the little embies the best possible chance of success xx

[Boo718]

hello I am all for the extra progesterone. We were on pessaries and moved to injections it is an extra cost but I would do it again xxx

[Nofie22 in reply to Boo718]

brilliant, thank you for this 😊 xxx

[sj482]

I added injections to pessaries and had progesterone measured in the final round. My levels were nice and high the day after transfer, and in currently 14.5 weeks. X

[Nofie22 in reply to sj482]

Brilliant, this is good to know. Thank you! X

[Nofie22 in reply to sj482]

and many congratulations! Sending you all the best vibes x

[Jokiekin11]

Sorry to hear about your failed cycle. I would definitely recommend the extra progesterone, in the grand scheme of things it’s not that expensive and will ensure your levels are good. You can also have the progesterone level checked two days before transfer (for piece of mind) but if you’re on the injections as well as the pessaries you should be ok.

I’d recommend supplements for 3-4 months before your next cycle. Have you read the book, it starts with the egg?

[Nofie22 in reply to Jokiekin11]

Hello, thank you so much, that’s really useful. No I haven’t read yet although I have seen it very much recommended. Although the doctor said that egg quality seems to be good as everything looked great for the first 3 days following fertilisation? He said those first few days of development are very much driven by the egg and after that is when the sperm’s genes start playing their part which is why he suspects a sperm issue. Will definitely have a look though x

[Jokiekin11 in reply to Nofie22]

yes it certainly won’t do any harm. That book lists supplements for men too x

[Nofie22 in reply to Jokiekin11]

brilliant, that’s great to know 😊 appreciate it x

[Seren0119]

I would say a DNA sperm fragmentation test is very important (comet test). Ask for this - we wasted many cycles because a varicocele wasn’t fixed xx

[Nofie22 in reply to Seren0119]

Thanks for this, will definitely pursue xx

[xIVFWarriorx]

My first round also went great up until day 3 then our embryos slowed down (we had 8 excellent embryos at day 3) and resulted in only two morula embryos left by day 5 which they transferred and I did end up pregnant but had a missed miscarriage by our 7 week scan. Our embryologist told us the same thing, that sperm quality is usually the issue but that the first cycle is also like a trial run. We had done ICSI first time round.

We’ve since gone through a second cycle which resulted in 5 blastocysts. We transferred one at that time and it sadly ended in a chemical. We’re now just waiting for my next period in January to start the FET process. I’ve pushed for extra progesterone going forward as I think this is why my last two cycles have failed. They say once a positive test is received then the baby can produce it’s own to support the pregnancy but it’s not always the case.

I guess what I’m trying to say is don’t be too disheartened by what they’ve said today. My husband was absolutely gutted after our first meeting thinking we’d never get to blastocyst stage because of him but now we’re sitting with 4 embabies in the freezer. Just take some time to relax after this round and go into the next with a positive mindset. Anything is possible! Wishing you all the very best ❤️

[Nofie22 in reply to xIVFWarriorx]

brilliant, thank you so much for this lovely, positive reply. Has definitely put me in the can-do mood

Good luck with your next FET, so good to have 4 embabies xx

[xIVFWarriorx in reply to Nofie22]

Thank you 😘

[Closems]

Get your man properly checked by a urologist/andrologist prior to your next cycle, there could be an underlying issue that can be treated easily and quickly which could optimise your chance of success. Don't rely on ICSI alone, get your man checked for Sperm Oxidative Stress and/or DNA Fragmentation and get advice. Otherwise you may have another wasted cycle.

[Nofie22 in reply to Closems]

thank you so much! X

[Albs171]

hello, sorry it hasn’t worked so far. Hope you are doing okay.

I added the Lubion. Injections which you pay for to my second round and now 28 weeks. I think it made the difference and from what I’ve read there is some evidence for that.

Best of luck! Xx

[Nofie22]

thank you so much! Congratulations, it sounds like Lubion is definitely worth it xx