Failed First Round ICSI - no blastocysts - NHS wants to put us back on the waiting list. 39years old. Want to try again next month

[Cuppppatea]

39, Just had a consultation with Dr after failed first NHS IVF round. No blastocysts.

We were contacted out of the blue and our IVF started earlier than we expected (We were given a start of March 2024 as a guide to start) Our appointment was brought forward due to our age and AMH.

First appointment after failed cycle - the consultant now said we will be going back on the waiting list? Surely not?!? This seems so unfair. She said she will get a second opinion but it seems so counter intuitive to the reasons we were brought forward. What they are debating I don’t know but I can’t possibly wait another 6-8 months, my mental health will be destroyed. Will find out next week. The strange thing was she wasn’t really clear - she spoke about my AMH results and the fact they were 3 in the last test as opposed to 2.2 before and she said that I hadn’t had the response she would have expected.

I’ve read various posts about it being fine to start on the cycle AFTER the bleed following egg collection.

And I don't think my medication was correct TBH! I feel so let down. I think I had NEARLY minimum response to warrent egg collection and not cancel the cycle. Two follicles reached 18 cm but I think one never caught up by the final scan.

Medication:

short protocol:

Evening - 300iu meriofert started (day 4 of cycle) for 26th august 10 DAYS (last dose 4sept day 13)

Morning 300 Frymadel 31st (day 9) (last dose 4 sept day 13)

50000iu Gonasai Trigger injection - 21.00 (4 sept day 13)

Egg collection 6th Sept 9.00am

Three eggs collected

2 eggs fertilised but on day 6  told neither made to Blastocyst.

Scans: on the 1st Sept I had a scan and two were a good size I asked if the meds could be increased and was told a senior dr could make that decision.

on 4th Sept the three follicles were just about at minimum requirements and was told by the nurse hopefully they would catch up by egg collection day.

NHS in our area allows three cycles under 40 but only one after 40!

Sorry - this is a long post! Advice or experiences gratefully received.

Thank you x

[IVFat40]

Hello hun, I started IVF at 40. You might find some of the advice in the book 'it starts with the egg' by Rebecca Fett helpful for improving egg quality/embryo development. I also found I had a better response to Menopur as a stimulation medication, so it might be helpful to ask them to look at a change of medication. Wishing you all the best of luck.

[Cuppppatea in reply to IVFat40]

Hey, thanks for your reply. How many cycles did you have? Did you experience different responses personally with medications?

[IVFat40 in reply to Cuppppatea]

I did 3 egg collections and 6 transfers (8 embryos) to get my son. My 3rd collection was much more successful (6 blastocysts) than my first (1 blastocyst), I did a number of things that I think helped (I wrote a post about it all at the time), but this included using Menopur, a range of supplements, and quite big diet changes.

[Spicycurry]

I’m sorry you’re going through this. There are several things strange with your protocol: your on lower dose stims; you started stims too late; Frymadel might have been started too early; and gonasi trigger should be 10000 iu gonasi. You should be on 450iu stims (225iu meriofert and 225iu fostimon) each day. Stims should start in cycle day 2 if you need more help with follicles. Frymadel Should be started depending on when larger follicles appear. 10000iu gonasi should be used or dusk trigger.

Are you able to go private? I have up my one free cycle of IVF at 38 as I thought the nhs were not treating me fairly and their results were terrible. I went straight to CRGH. Are you TTC your first? If so, I would try to go private. I did Access Fertility and saved money. I used CRGH via Access Fertility.

[Cuppppatea in reply to Spicycurry]

Hey! I have been told to start fryemedel tomorrow (day 6) …I thought back to your post. Should this be dependant on follicle size ? I feel like I’m starting this too early. I’ve called the clinic but getting no answer - feeling nervous. I can only find info of people starting day 6. left follicles of 13,12,11,11,10 and the right 11,7,5,3

[Spicycurry in reply to Cuppppatea]

If you didn’t get blastocysts, it might be a sperm issue. Icsi did not work well for us. We had to do IMSI which nhs does not offer.

All the supplements from the book it starts with the egg helped. Good luck

[Spicycurry]

Also you might need hgh like zomacton to aid follicle growth which they do at CRGH

[amydrummo]

Hi, it doesn’t seem right that they would put you back on a waiting list, usually once you’ve done one cycle you’re in the system so to speak and would be free to start again as soon as you’ve had a period, if you feel up to it. With age being against you it would be unfair of them to hold you back. I was referred to IVF and when I was 39 and due to waiting lists didn’t start until 40 and only got the one cycle. I would really push to get your other free cycles!

[mumma_in_the_making]

I'm 33 and also doing an NHS cycle. I'm surprised they put you on a short protocol. I was told I had to do a long protocol because my AMH and follicle count were fractionally low (14.1 and 13).

The collection was very successful in the end. I down regulated with Buserelin (Suprecur) then had Meriofert stims. The whole process, minus the failed fresh transfer, was faultless.

Good luck with your next cycle. I really hope they don't make you wait long. If they do maybe you could do a private round? I know it's expensive though and might not be an option.

[Me_and_Sparkle]

I’m sorry to hear about your experience. The NHS is really stretched at the moment and they can’t offer many of the treatments women like us after 35 need - PGT-A in my opinion would save you a lot of heartache for example. Aged 37 60% of my embryos were abnormal so I would have had 3 miscarriages if I hadn’t tested them as they appeared to be all of great quality.

I wish you all the best in your treatment x

[Cuppppatea in reply to Me_and_Sparkle]

Hey - thanks for your reply what is Pgt-a please ?

[Me_and_Sparkle in reply to Cuppppatea]

Pre Implantation genetic testing - most miscarriages happen due to missing chromosomes / abnormalities or extra chromosomes. These increase as we age unfortunately. If you test the embryos before transferring them you can choose which ones are most likely to implant based on their chromosomes. (Often the best grading embryos are abnormal). I suggest looking it up as you will probably find a better explanation online!

[Twiglet2]

nice oor treatment starts you dont go back on the waiting list! Unless you are y between types of treatment (like IUI to IVF) with a different list I’ve never heard of this! Phone up and ask to speak to the lead consultant about the next protocol and when you can start it, dont be afraid to ask for the complaints procedure If needed as sometimes, especially the nhs clinics, they are so busy we really need to advocate for ourselves at times 😢 good luck and there is defo things they can change and try in that protocol for sure!! Xx

[Cuppppatea]

28th September update

Had my appointment with the nurse following a failed IVF cycle, three eggs collected (Two fertilised) producing no day 6 Blastos. The whole time only 2/3 folicles ovaries respondeded with one getting significantly bigger - after egg collection was told I had a cyst. Cysts not uncommon for me. Was this cyst a follicle all along ? Who knows ?! I was also told my progesterone would be too high for fresh transfer ? (Didn’t matter in the end anyway)

I suspected but I know for certain my last medication was started too late now (day 4 of bleed after stoping Progynova) This meant also Frymadel was started too late (i STARTED day 9 and nurse confirmed day 6?!?) I am on different meds now and also max dose of Gonasi.

I feel much more confident in this cycle and am hoping for a better result. - just so confused as to how they could get it so wrong?!

I will have a baseline scan 10 October

I will also have a scan first day of my period

I will start taking Nothisterone 5g twice daily on day 18

Merifert 75 +Fostimon 225

Fymadel

Gonasi 10,000

I refuse to believe I am a poor responder !

Upped coq10 and other vits

Thoughts appreciated.

[Spicycurry]

If you are under 40, you could do a long protocol with maximum stims every day (ie 450iu total each day) and hgh every other day.

[Cuppppatea in reply to Spicycurry]

Sadly I’m 40 in may and just can’t see me getting that in before my birthday

[Spicycurry]

Are you near CRGH? You need a better protocol. That’s all. Even when I just turned 40 my levels were good. Things changed at 41. You still have time but I understand the urgency. I decided I didn’t want to waste precious time on nhs. I used Access Fertility with CRGH in London. It was a 4.5 hour journey each way but was still determined. Been trying for number 2 but things are different now. I only have frozen embryos from one good cycle at 40.