implantation failure

[ToffeeLou]

Hi everyone,

looking for some feedback on implantation failure and whether there’s anything I can do or if the failure is more likely from Embryo quality.

I’ve had two double embryo transfers with my own eggs (collected at age 37/38- two batches of 4 and 5 a month either side of my 38th birthday) and collected at 39). Both times I had a BFN on test day. I then changed clínics and to double embryos. Egg donor was 28. We got 16 eggs, fertilised 12 and from those 12 got a 3BB, 4BB, 5BC and 3BC). Before the transfer I had a hysteroscopy which showed a polyp which was removed. They then transferred the 3BB which also ended with a BFN. I’ve since done some blood tests to test for clotting and autoimmune conditions and all have come back normal. All of my transfers have been controlled. I’ve spoken to the doctor about doing natural but as I live overseas he prefers controlled as it’s easier to manage. I’m about to do my next transfer in a few weeks.

Seeking your wealth of experience incase there’s anything I am missing here or if there are other investigations I can ask for. I’ve never tested positive so worries that there’s an implantation problem given I’ve used both my own eggs but also younger donor eggs now too.

Thankyou 🙏

[DianeArnold Partner Nurse Fertility Network UK]

Hi ToffeeLou. Sorry to hear you have had another failure. Have you had your Fallopian Tubes checked. They can sometimes be responsible for failure if blocked or scarred, as excess lubrication can seep into the womb. Many specialists now believe it can cause implantation failure. Also, have you had a hysteroscopy? Can have a biopsy of the lining at the same time and check for any possible problems. I’m sure the others here will offer ideas too. All the best with whatever you have done next. Diane

[ToffeeLou in reply to DianeArnold]

Thanks Diane, I’ve had a hysteroscopy, that showed the polyp but not the fallopian tubes so that’s a helpful suggestion thankyou

[Pintu88 in reply to DianeArnold]

When you say implantation failure does that mean receiving a straight BFN or could it also be responsible for a chemical?

[ToffeeLou in reply to Pintu88]

I’ve had no chemical pregnancies just negative test result each time

[Crie1983]

Hi, I’m sorry to hear about your implantation failures. I wanted to second what Diane said, I went ahead and had 3 transfers. I then saw a gynaecologist who discovered I had badly damaged tubes and had to have both removed. It’s definitely worth while getting them checked, it’s one more thing to rule out if all ok. Best of luck. Xx

[Pintu88 in reply to Crie1983]

May I ask how you got diagnosed with badly damaged tubes? Was this via a scan or MRI?

[Crie1983 in reply to Pintu88]

The gynaecologist suspected it from a scan and then it was confirmed by an MRI, which resulted in a laparoscopy. The consultant said she’d make every effort to keep my tubes but they were too severely damaged that they were both removed.

It’s a challenging one as hydrosalpinx isn’t always visible on a scan. I’d had multiple scans as part of my first three ICSI cycles and it wasn’t picked up! I ended up paying to see a brilliant gynaecologist who specialises in fertility who first mentioned it could be my tubes. I had to travel from London to Birmingham but was well worth it. I was fortunate enough to have private medical through my work which then allowed me to see a consultant and have the MRI and laparoscopy nearer home. X

[Pintu88 in reply to Crie1983]

Thanks so much for the detailed response, really appreciate it. I’ve had a hycosy done where they diagnosed a blocked right tube and after my two chemicals, I’m starting to think this may be worth looking in to. Did they remove tubes via Lap?

[Crie1983 in reply to Pintu88]

You’re most welcome. Yes both tubes removed at same time during laparoscopy. X

[ToffeeLou in reply to Crie1983]

Thanks Crie1983. Do blocked fallopian tubes affect transfer? I thought with transfers it bipassed the fallopian tubes but definitely worth me looking into. Thankyou x

[Crie1983 in reply to ToffeeLou]

The issue is the fluid from the fallopian tubes leaks in to uterus which can affect implanatation or the embryo developing. I’m no medical expert. just speaking from experience and what I was told.

Also here is what is said on the NICE guidelines regarding hydrosalpinx nice.org.uk/guidance/cg156/....

If your fallopian tubes are blocked and swollen (a condition known as hydrosalpinx), you should be offered the choice of having your tubes removed through laparoscopy before IVF. This increases your chances of a successful pregnancy through IVF, but it means you will never be able to conceive naturally in the future.

Xx

[ToffeeLou in reply to Crie1983]

Oh wow, that’s super helpful, thankyou. If it doesn’t work next time I will definitely ask them to check. I think at 42 natural conception is past anyway so definitely worth investigating! Thankyou x

[ToffeeLou in reply to Crie1983]

Hi Crie1983, I just wanted to say thankyou so much for what you told me about the fallopian tubes. In September I had a transfer cancelled because they found liquid by my left ovary. My doctor suggested a laproscopy for exactly the reason you said . Although I was gutted to cancel the cycle had my laparoscopy instead and they found my left tube was blocked. They removed it and I’ve just got a positive for my latest transfer. It’s early days, my clinic has me do a blood test on 7dp5t so I must test again on Thursday, but if you hadn’t shared with me your experience I might have pushed ahead with the transfer in September rather than laproscopy. I know t there are a lot of hurdles for me to still get through but to finally know I can implant is such a relief. I know you also have had a painful journey so I do hope my message isn’t triggering for you, but I really wanted to thankyou 🙏

[Crie1983 in reply to ToffeeLou]

Hello, firstly a massive congratulations on your positive result, what amazing news. All sounding very positive for Thursday so I’ll have everything crossed for you. Your message has made me so happy. As tough as it is to go through what you have been through, I’m glad that it was picked up before going through the cycle in September.

I’m a couple of days away from finding out if latest transfer has been successful. This 2WW never gets any easier 😫. Xx

[Spicycurry]

Hi. I would try to do a natural modified FET with progesterone added. I would also do Emma, era, Alice and nk cells. I did and era was spot on with a day 5 transfer, Emma was clear but I had dysbiotic bacteria which I knew about. I also had slightly high nk cells in blood but very low nk cells in endometrium. The low nk cells in endometrium affect implantation. I had neupogen infusion on first day of confirmed ovulation and hcg infusion on transfer day. It worked. I did get pregnant. I didn’t go on steroids as I was getting recurring infections. I unfortunately lost my baby at 8w but implantation did occur. I had produced the embryos for my second at 40 when levels were good.

[Spicycurry]

Another thing high progesterone can also help with implantation. I was on 3 cyclogest a day and 2 lubion.

[ToffeeLou in reply to Spicycurry]

Thanks Spicycurry, they’ve done NK tests and tested for clotting but the results all came back as normal. I’ve taken injections and progesterone pesseries plus the estrogen so think that’s covered. I guess ERA is the next thing but wasn’t sure if that’s necessary for a controlled cycle 🤷‍♀️ the doctors always say my lining and progesterone levels are perfect on transfer day and it must be the embryos. Unfortunately my clinic doesn’t do PGTA testing. Anyway next transfer is in a few weeks so hopefully this is the one 🤞xx

[Spicycurry]

Are you able to do a natural modified FET transfer as I believe it’s easier to hit the implantation window? With medicated FET, sometimes the implantation window is narrower. I had implantation success with natural modified but didn’t with medicated. I also had neupogen infusion for low nk cells in endometrium and hcg infusion on transfer to boost implantation chances.

[ToffeeLou]

thanks spicycurry, will ask about that. I did mention a natural cycle to my doctor before starting this round but he said because my lining and everything had looked so good he didn’t want to change that side of things. But I will literally try anything that gives me a better chance of a BFP!

[ToffeeLou]

hello Crie1983 just wanted to share with you that I just had a laproscopy. My doctor spotted a cyst last week at my day 10 scan so we cancelled the transfer and did lap instead. Turns out my left tube had a hydrosalpinx so they removed the left tube. Hopefully this is what was needed and if next one doesn’t work I can do the ERA, EMMA and Ana 🤞 thanks so much for your advice xx

[HedgehogMad]

Hi lovely, sorry to hear about your failed transfers. The most common cause of implantation failure is chromosomal problems with the embryos so they often recommend PGT-A testing. The stats show that with transfer of 3 PGTA normal embryos the implantation rate is 95%, so the vast majority of failures are not to do with the womb environment.I unfortunately have a history of recurrent implantation failure and found the European guidelines a good place to start. A lot of private clinics offer various expensive tests and treatments but a lot of them have no evidence of benefit. Our thoughts were that it is better to spend the money on PGTA testing to ensure we are transferring embryos with a good chance each time. Here are the guidelines in case you wanted to take a look: academic.oup.com/hropen/art...