Help & Advice needed please, feeling desperate after another failed cycle (8th transfer but first with donor egg)

[TTCs]

Hello. Sorry for the lengthy post. I'm looking for advice to move forward after yet another failed round. I feel so numb, I haven't even cried that much this time which is very unlike me. I do have an awful headache and can feel the stress running through my body.

8dp5dt and 9dp5dt pregnancy tests are negative. Got bloods taken today so I'm expecting the call tomorrow will confirm a failed cycle.

We have been on this journey for 7 years with the last few years being with a clinic in Spain. 3 cancelled cycles due to lining issues plus 8 transfers. This was first transfer using donor egg and partner's sperm. I was disappointed with the quality of 4BC and have had better quality ones using my own eggs but was reassured on transfer day that the embryo had started to hatch.

We threw everything at this one. I've been taking most of medication for 4 months, had 2 mock cycles, X2 procedures to determine window of implantation however, these were inconclusive I was pre receptive after 4.5 days and after 5 days. It was too expensive to repeat a third time at 5.5 days so they decided to settle on this being the most likely option as in 2020 when I had ERMAP I was post receptive at 5.5 days.

I had PRP treatment this time again as I suffer from poor lining. It helped and lining was 8mm for transfer which is good for me. I intralipids the day before transfer and accupuncture on the day of transfer (both before and after procedure).

We have drained every resource and have poured tens of thousands of pounds into trying to have a baby and I feel empty and depressed that we have nothing to show for it.

At the moment I am compiling a list of where to go from here and wanted to seek your advice and expertise on any suggestions or things we haven't yet tried. We have had the HLA KIR testing too. We paid for a package of up to 5 blastocysts so still have another 4 to generate.

This cycle I was on intralipids, steroids, progynova vaginal and oral, clexane, aspirin, X2 Lubion daily, 400mg utrogestan, G-CSF (granocyte protocol), folic acid 5mg, levothyroxine. I had Ovitrelle 8 clicks day before transfer and then 8 clicks every other day x 2.

Thank you in advance for any advice you can give.

How are you??

Xxx

[DianeArnold Partner Nurse Fertility Network UK]

Hi TTCs. You have cetanly been through so much, and I hope you have plenty of support too. The only things I can think of is having a hysteroscopy to check out your womb, a sperm DNA fragmentation test prior to ICSI and perhaps using low dose aspirin or heparin to help with blood flow and to help prevent clot formation. Apologies if these have already been tried. I shall be thinking of you and hope that next time will be your time. Diane

[TTCs in reply to DianeArnold]

Thanks Diane. I have had hysteroscopy 3 times and had scar tissue removed on one of the procedure. Nothing else really remarkable from them. We have had sperm DNA fragmentation too though I thought results weren't great in part, clinic still said sperm quality was good. I've taken 100mg aspirin and 40 of clexane on my last few cycles. Thanks for thinking of me. I was going to ask if we should try donor sperm but I think clinic will say no need xx

[Zahra72]

Any reason why clinic did not put you on estrogen before transfer to build and thicken your uterus. Also the utrogestan (progesterone) seams low, as standard most clinics recommend 800mg per day. For my frozen transfer I was put on 1200mg progesterone and prednisone (mainly for anti inflammatory purposes) with aspirin. After 8 years of ivf only time we got pregnant, sadly miscarried at 10 weeks.

[TTCs in reply to Zahra72]

Hi Zahra72. Thank you for your reply. I was on 10mg of progynova (6mg progynova orally + 4mg progynova vaginally) in terms of estrogen. Do you think this is not enough? In terms of progesterone I was on the max dose Lubion according to my clinic (2 daily injections of Lubion (50) and they also added in 400mg utrogestan the night before transfer to continue through 2ww as it was low in blood test day before transfer. Progesterone was around 25 day of transfer, not sure what others is? I googled and that seemed ok. I'm so sorry to hear of your miscarriage, absolutely devastating for you 💔 I have only got pregnant once in 7.5 years and it was a chemical pregnancy, seems we are both having no luck. This journey is brutal xx

[Zahra72]

Thank you, which one of the medication they put you on other than aspirin was to reduce inflammation in uterus. Reason for asking for last round I asked about steroids but clinic I was with do not believe in killer cells in uterus. They advised that they help to reduce inflammation which is key and why for frozen transfer only time they recommend prednisone for 5 days from day of transfer. This and high level of hormones was only difference between last round of ivf and previous failed rounds. Like you have always had good quality embryos put back in.

[TTCs in reply to Zahra72]

As far as I know the Clexane, aspirin and steroids were related to this. I was on 10mg of prednisolone steroids prior to transfer and then 20mg from day of transfer onwards. xx

[Marisa32]

Just going to brainstorm here...not sure if you had the embryos tested before transfer. You mentioned quality seemed worse with DE than your own. Was everything checked on the sperm? DNA fragmentation test or whatever else that may impact quality on his end?

[TTCs in reply to Marisa32]

Thank you for your reply. We did not have the embryos tested, we paid nearly £20,000 for this round as paid over £10k for the donor package of up to 5 embryo's plus 2 ERA plus PRP treatment, biopsies and medication. We figured we would take the risk with it being donor egg and less likely to have issues with the egg. We have had the DNA fragmentation test done and there were some issues but clinic are saying quality is good which confuses me. I'm going to ask about this again.

How are you gtn on in your journey? X

[Marisa32 in reply to TTCs]

I see. It's hard to know if the embryo was even viable or not. Although not all viable embryos implant, at least you would know you are going into it with a good embryo so to speak. I would do the embryo testing next time, especially since they did see some issues with the sperm. When I pursued DE treatment, we got 6 top grade blasts out of 7 eggs collected and I still got them tested because I was so paranoid. 5 out of 6 came back good, which seems in line with using a 23 year old donor I suppose. Did you get only 1 blast from this entire cycle?

[TTCs in reply to Marisa32]

Thank you for this info. The way my clinic works is the package is up to 5 embryos but they only generate 1 embryo at a time. I did question it but because we have been going to the clinic for a few years we didn't want to switch clinics when they know our history etc. I know other clinics you get all the eggs the donor generates but this clinic doesn't do it that way :/ I did think it was a strange system. So we have 4 more goes but none in the freezer if that makes sense. It's good to hear that 5 of 6 of your embryo's came back as normal ❣️ our clinic don't give any info at all about donor so I don't know what age she was. The quality was 4BC which isn't awful but isn't good either xx

[IVFat40]

I am so sorry for all you have been through. There is a clinic/research project run at Coventry hospital with Warwick University, supported by the charity Tommy's, that specialises in repeat implantation failure (as well as miscarriage). You can self refer, and in IVF terms it's very cheap for what you get (about £500 from memory). I thought they were wonderful, I hope they might be able to offer you some further insight. From what I understand the Dr's are experts in their field, I saw Prof Brosens. After transferring 7 embryos that failed, first transfer after seeing the clinic is now my little boy.

[TTCs in reply to IVFat40]

Thank you for your reply, I will definitely look into this, it's very helpful info. Amazing news that you now have a little boy, congratulations ❣️ I'm sure he is everything you dreamed of and more xx

[IVFat40 in reply to TTCs]

Thank you for your lovely reply. Wishing you all the success you so deeply deserve.

[TTCs in reply to IVFat40]

Thank you ❣️