Change clinics after failed first attempt?

[Ses9]

Hi all!

I’ve just completed my first ivf cycle and I’m looking for some advice from more experienced ivf ladies.

in a nutshell, I’m wondering if I should change clinics or question them further.

I am 40 and had previous successful pregnancy and miscarriages (12 years ago) good amh, afc and retrieved 16 eggs out of 22 follicles.

They said all eggs looked healthy quality but only 4 fertilised ( they said ICSI plus calcium might be tried next time, no male factor, I think they think it’s my stubborn eggs)😏

Out of the 4 that fertilised, we got 4 day 5 embryos ( 3 became blasts).

However, one was 1CC (they discarded it), two were 1bb.

They transferred a 1bb midday day 5 ( I’d wanted a freeze all cycle but on day 5 morning, the embryologist suggested a fresh too. By the afternoon, the other 1bb had become a 2bb and they froze it.

11 days after transfer I’ve started to bleed heavily and tested negative.

My concerns are :

Would a slow growing 1bb midway through day 5 ever be likely to implant in time for the implantation window?

Could they have grown them to day 6 to see if they would expand, then freeze them. I feel like I’ve paid to freeze an underdeveloped blast.

During my first scan, they picked up suspected Adenomyosis and said don’t worry about it and did nothing.

I was told at an unrelated scan in A&E 6 years ago that I’d need ‘help conceiving again’. They didn’t explain. Very odd!

my clinic seem to not investigate anything and just brush off my questions.

We never saw the same nurse, had concerns about ohss on day of transfer, I was swollen and in pain ( was high risk). Nurse said I didn’t look unwell so transfer would be ok.

I understand this is the first cycle and it’s a game of chance and trial but I don’t want to throw money away, if other clinics are better without me knowing.

thank you for your answers and support

Ses xx

[Keepondreaming]

hello, I am sorry to hear about your unsuccessful cycle and your experience. My advice would be if your gut is telling you to change clinics then change.

We were fortunate enough to have a NHS cycle and whilst we were really grateful we weren’t very impressed with the care and the lack of patient choice. You could pay the NHS clinic for private treatment but we chose to go elsewhere.

I’m not going to lie we have now done three private cycles and not had success and we have considered other clinics. However we feel we have come so far with them unsure what another clinic would offer and also unsure another clinic would understand/read the notes of/ look into the full complicated back story.

Like you say unfortunately it’s down to chance. But that chance has so much riding on it and costs such a lot of money you don’t want to get it wrong.

I too have Adenomyosis which was mention on nhs cycle when I raised this they brushed it off. Private clinic advised down regulation before transfer, unfortunately this was not successful but I felt they were acknowledging the fact I have Adenomyosis. I also have really low AMH despite my young age and we usually only get 2 eggs on one occasion we got 3!

Wishing u the best of luck with your journey. But honestly follow your gut/heart if you feel this clinic isn’t right for u xxx

[Ses9 in reply to Keepondreaming]

Hello, thank you for such a thoughtful reply🙂

I completely understand your concerns about a new clinic not reading notes or understanding your backstory. Also the fact that is a very expensive way to just ‘try and see’ over and over again. Have they changed your protocol/tests much each time or are they saying they are searching for that good embryo that will stick? They told me why worry about something that can’t be changed - re Adenomyosis, and to just go ahead with ivf. Apparently, it’s not in a place where it would affect anything but it’s only been noticed not investigated so they really don’t know. All they say is ‘it’s age’ but I’ve had fertility issues since I was 26!

I fully accept that at my age and given my history , the odds are not great but I’d still like them to do their best and exhaust all possibilities.

We have gone private and even then the communication between the nurses and consultants has been poor. I had to tell them that the dr had prescribed me fragmin and progesterone after my ET. They’d have sent me home without it because they never check the notes. I saw my designated nurse once - even though I was assured I’d see her all the way through. It’s just these little mistakes and inconsistencies, that make me unsure.

I don’t know about your experiences with drs but mine, although very experienced, doesn’t seem to offer any further investigations or blood work, despite my history. I’ve read about different treatments and drugs that can be tried but my clinic doesn’t seem to know about them or offer them. I had a friend at my clinic, whose Adenomyosis wasn’t diagnosed until she went abroad - after 8 years of ivf . There she had an internal investigation and had some of her lining removed, now her baby is 6 months old.

It seems that in places like America, it’s a more tailored service and protocol with a bit more determination to find the issue - lots of tests and bloods . I’d love to find a clinic near me that did that. I feel it’s quite a limited and set process where I am. Lots of nurses doing all of the scans and processes not the consultants. Yet we have to trust that they know what they are doing, as the experts. I’ve even thought about getting a fertility coach to help me to navigate this complicated rollercoaster!

I wish you so much luck and really do hope you get your baby soon! Thank you again for getting in touch, it’s so helpful and supportive to share experiences in an otherwise lonely, often secretive situation! Xxx

[Keepondreaming in reply to Ses9]

Hello you’re welcome yes you’re right it can be a really lonely experience. Happy for you to message me if you want clinic info.

We are consultant\Dr lead due to low AMH. So each scan I see a Dr. Each time we haven’t had success we are discussed at MDT and they then come up with a plan and we get a follow up appointment to discuss. To be fair last time I asked lots of questions and they could answer them all and they didn’t know what I was going to ask.

I have made some suggestions and tests. We paid for a biopsy after asking if they would follow any advice from it and they said they would and be happy to look at the results and recommendations from it. They have suggested blood tests and further tests and options and treatment and some of the tests we have paid for we have asked regarding and made the suggestion. I do feel like they do consider us each time individually.

At my initial scan the clinic advised I had symptoms of Adenomyosis on the scan and advised it can only be diagnosed by mri we didn’t have to have the mri but we chose to and they referred us for the mri. We don’t have a named nurse but we do have a patient co ordinator. But in all honesty I’ve been going that long now most the nurses know me.

I fully appreciate your concerns but you have to do what’s best for you. My advice would be so your research, but bare in mind I do feel people give negative reviews if they haven’t had success and positive if hey have (understandably)

Thank you I hope you get your baby soon too!

If you ever want to message me please reach out happy to chat xx

[Ses9 in reply to Keepondreaming]

Thank you so much. Likewise - I’m always open to and happy to chat! Feel free to message. Two heads are better than one ☺️

[Hope823]

Dear Ses9, I am sorry you had a failed embryo transfer! My whole 1st cycle had failed so I know how you feel. In terms of your message, first of all I saw that you mentioned your age (40), unrelated to your question I wanted to recommend you a book that has helped so many couples. Especially those who don't have a male factor. It is called 'it starts with an egg' someone recommended it to me in past, it is very good and helpful!

I would change the clinic. My situation was opposite to yours, after the egg collection and 5 days fertilisation I felt I felt ok for fresh transfer and really wanted a fresh transfer. My clinic was concerned I was still little bit swollen and were trying to talk me out...as I was at risk of OHSS. I didn't want to listen and said I still wanted a fresh transfer. But once I researched more about OHSS, I agreed to freeze all embryos and prepare my body physically (mainly physically) and mentally for the transfer. My personal opinion, based on how my clinic tried to talk me out of the fresh transfer, yours should had never transferred that embryo as you are saying you was in pain and swollen. Your body was not ready for it. And by the sound of it mentally you would of been better with a frozen embryo transfer too.

Seems like they were rushing things. This is such an expensive procedure and last thing you want to do is gambling.

[Ses9 in reply to Hope823]

Hi 👋

Thank you 😊

I’ve heard of that book but not read it yet, just seen a few quotes from it posted online. Might download it!

How long did they say to wait before your frozen transfer ? Did you have any symptoms of shortness of breath etc?

I was told that I was at high risk and given an info sheet about it. It said breathing issues, reduced urine output and pain under ribs. I had really bad pain ( couldn’t walk any faster than pigeon steps), my diaphragm felt swollen and painful, I looked 5 months pregnant and put it down to the retrieval and constipation because I didn’t have the shortness of breath or urination problems. Looking back now, I think it was OHSS as the level of pain and swelling was causing me physical stress and therefore not good for a transfer at all.

[Hope823 in reply to Ses9]

They told me to wait until my next period. So basically 1 month later I had a frozen embryo transfer. I felt exactly like you did and I didnt have a urination problems or shortness of breath. Because it was your 1st cycle you had nothing to compare it to. For me it was my 2nd cycle (egg retriaval) after my first one I felt totally normal. Had a fresh blastocyst transfer and it did not implant. Then we started all over again, injections etc...and I think the dose was bigger or something but I felt so bad after the second egg retrieval. Bloated, constipated, in pain...wanted to poop but couldn't...so different to the 1st time. Clinic said I might have OHSS....the rest of the story you know....