Another heartbreak BFN - confused on what to do next?

[Hopewhite]

hi lovely warriors, i hope you're all doing well in your journeys and managing to keep strong and hopeful xx

I had my 4th transfer and another BFN this Monday (previously 1 fresh = MMC, 1 FET BFN, 1 FET BFN). We have our review appointment booked for Monday but a bit confused on what can we do differently next time or what to ask to the doctors. Don't know where to go next from this!

This past cycle was a bit underwhelming since the beginning as they under stim vs previous cycle. Last year they did a step down antagonist, this time they tried normal antagonist (no boost on first days) to try to stim me for longer and get more eggs, but my body didn't do what they expected and ended up triggering after 8 days of stims again (exactly same than previous year but less stims). Ended up with 7 mature eggs, out of which only 4 fertilised on ICSI, we have MF (low count, low morphology- sperm has not been tested again since a year ago, but did DNA frag which came back OK) and had a big drop last year from 9 fertilised eggs to 3 blastocysts. This time we only got 1 blastocyst, we were supposed to do Pgta but decided to transfer our only blastocyst instead.

On the last 2 FETs I got borderline and low progesterone, only on the last FET they gave me lubion, so I asked for the lubion this time and they said I should not need it, that my body should be producing its own and 2 cyclogest a day should be enough. Then I started spotting at 8dp5dt which then became a full period, i tested 1 day before OTD and unsurprisingly it was a BFN.

I now have to do a fresh cycle again, what's the healthy wait in between egg collections? what would you recommend me to do differently this time, I just turned 40. I took Proceive and coq10, magnesium, etc and my husband took impryl for 3 months and proceive for at least another 4 months before that. and have made lifestyle changes to diet e.g. no red meat, sugar, no alcohol, do exercise etc.

I feel completely lost, we waited longer on this cycle to prepare the body and I feel it made no difference, is there any hope next cycle could be different?

many thanks! in advance for whatever ideas you may have , i wish you all the best of luck on this journey!!

[pink_lemon]

Hello. I am so sorry the last transfer did not work. Not sure about a lot of the factors you have at play. I can only offer our experience with spacing between retrievals. We did 3 cycles when I was approaching 40, so almost the same age as you. We did one cycle, then skipped one as were waiting for pgta results. Then did anothe one immediately after we got results, and because the second cycle gave us no embryos (all 4 arrested by day 3), we jumped into another one straight away as it just happened to be my day 1 (period). We got 10 eggs on the last cycle (most ever), only one blast but that was all we were after. So I don’t know if waiting between cycles helps. I was not willing to wait at our age with my fertility going down every month. I was on ubiquinol too plus just prenatal vitamins.

A lot of embryos at our age are not viable in the end which could be the simple reason why you did not get pregnant.

This is such a hard game. Hopefully your consultant can offer some suggestions.

[Hopewhite in reply to pink_lemon]

Hi , I hope you’re well, thank you very much for sharing your experience, I hope things have worked out well for you in the end xx

Yes you’re right time is always so precious, I feel I don’t have the luxury of time anymore, I just didn’t know whether I had to prepare again with the vitamins etc , I’m sure in any case it would take at least 2 months to get to egg collection again. We’d also like to test the embryos but we didn’t get enough to do that this time , I felt there was no much point in testing 1.

Thanks again for the advice , I hope the doctors have some ideas , did you do any testing apart from pgta ? I’ve been tempted to do the Warwick implantation clinic one but the consultant discouraged me from it twice, I just feel there must be something else they could test just in case.

[WillowPark]

Hi Hopewhite, I am so sorry for your BFN. It is heartbreaking especially when you have now had so many. It might not be a case of what yo do differently - It is a numbers game and you are getting to transfer and beyond so that's really positive. The lubion thing must feel so frustrating. I get that completely - I had the same, low progesterone/early bleed on my first cycle and then lubion on my next 4 FETs. I then went for a natural frozen cycle and they told me I didn't need lubion. I was terrified and fully expecting an early bleed. I didn't- I got a BFP. I also went straight from a devastating cycle where I didn't respond as they wanted and we had to cancel before transfer into my next cycle. I wasn't expecting it, was underprepared, and was just coming out of feeling completely broken and that is the one that worked. I am a big believer in looking after ourselves on this journey but maybe giving our bodies that physical break is over rated x

[Hopewhite in reply to WillowPark]

Hi lovely thank very much for taking the time to share this and huge congratulations on your pregnancy! I hope all is going well and you’ve managed to relax and enjoy xx , I know you also had to go through a lot so it’s lovely to read your good news and really encouraging , like you say it is a bit of a numbers game and all the stars aligning, this gives me hope xx

You raise a very good point on the natural frozen , I’ve wanted to try that before as my periods are very regular , how did that work , did you get only progesterone as support? It’s a mystery how it all works isn’t it , I had never bled before OTD before, so I’m a bit puzzled by it all !

I’m sorry that you also had to deal with a bad cycle, glad it has all worked out for you on the next one , just curious to know did you also do egg collection but freeze all before your natural FET? How did they end up recommending this for you ? Many thanks again for sharing xx

[WillowPark in reply to Hopewhite]

Thank you. I'm always cautious about posting good news on here but it is important to see and know that it is working for people - and so it could work for you next time! I didn't do a freeze all, I had additional blasts from a fresh cycle. At the time of my fifth transfer the consultant just said I had been identified as a candidate for a natural frozen cycle if I had to go again with my final blast, as I had no known issues with lining and a regular cycle. When number 5 failed, I asked about it and they gave me the option and I tried it. The first time they tried no drugs and no scans. The plan was at home ovulation testing up to transfer, and progesterone support after that. But I didn't get an LH spike and when they checked it looked like I had ovulated but they didn't know for sure or when. So it was cancelled. I thought that was my chance at a natural cycle over but they recommended I try again with extra scans, and they ended up giving me an ovulation trigger early as they could see I had a lead follicle but was having no LH surge, and then they timed the transfer. So I had ovulation trigger and then cyclogest for progesterone support only. And it worked. I only had to take the cyclogest to 8 weeks too. It was much less invasive, less stressful and I have felt physically much better on this cycle. But it definitely felt more risky! x

[Hopewhite in reply to WillowPark]

Hi lovely thank you for explaining this , it does sound ideal as I’m not a fan of the oestrogen 😂, glad your doctors were proactive and offered you to try something different, this is exactly what I had heard about it that it could be cancelled but glad it all worked for you in the end. I’ll ask for this on my clinic again although next one will have to be a fresh transfer as I have to do stims again , but it does sound much kinder to the body !

[WillowPark in reply to Hopewhite]

Fingers crossed the next one works for you and you don't need to consider another frozen cycle! x

[Hopewhite in reply to WillowPark]

Thank you for your kind wishes xx

[kattie22 in reply to WillowPark]

Hi WillowPark , I read your sharing. you mentioned about LH not spiking . May I ask if you know if medicated cycle is supposed to spike also for better success ? I had a recent transfer and was on estrogen , progesterone and they gave me a trigger shot also. I asked to do a blood test just a day before my transfer . I saw my LH test results was negative value. I was little concern but i was told to proceed with next day transfer. So as I was reading your post , I am curious to know if LH matters if you are on medicated cycle.

[WillowPark in reply to kattie22]

Hi Kattie22, I don't think so but it isn't something I have asked. I would say I don't think so as on my medicated cycles I haven't had a lead follicle (deliberately and that is what they are looking for) so I imagine I never had an LH spike either. They control the switch from estrogen to progesterone and time the transfer based on that in a medicated FET. I understand they give a trigger sometimes if they are worried you might ovulate naturally and interfere with the hormones they are controlling. Transfer is also timed for 5 days after ovulation which is 6-7 days after LH spike so I wouldn't expect an LH spike would show the day before transfer as it should be disappearing by then. I don't think you have anything to be concerned about. Good luck!

[Whooper]

Hi Hopewhite,

So sorry to hear that it didn’t work this time.

Last year I had my egg collection, only two blastocysts made to the last stage out of 9. Sadly both transfers were unsuccessful, because of very low progesterone. I was on a healthy diet then. I turned 40 last month and was preparing my body for the next egg collection which was scheduled in August. Was taking Ovum and ubiquinol for just over 3 months. Also relaxed my diet this time, was eating whatever I wanted and of course it’s summer days - some alcohol got involved too with BBQ evenings during weekends. Had a huge party 3 weeks ago on my 40th and few days later I found out that I’m pregnant. I had hysteroscopy two months ago, took biopsy of my lining. So maybe this triggered …Conceived naturally after 7 years, still can not believe it… it’s very early days still. Miracles can happen ❤️

Don’t be so strict on yourself as IVF is very harsh journey itself.

Wishing you best of luck!

[Hopewhite in reply to Whooper]

hi Whooper , huge congratulations!! What a lovely surprise that must have been after all the struggles ! I hope you have a smooth pregnancy and get to relax and enjoy it xx

Thank you for your kind words , you’re right we must not forget to have a bit of fun in the middle of all this, it can be so consuming!

[Tinkertinkerbell]

Hi,

I’m 43 and currently 18 weeks pregnant from my 3rd cycle - 5th transfer and ended up using donor eggs.

First cycle with my own eggs I only got a morula. They transferred- BFN.

Second cycle with my own eggs I got a morula again and an ‘average’ blastocyst. They transferred both together -BFN.

3rd cycle I used a set of donor eggs. This decision seemed straight forward to me but I know it’s not for everyone. I just wanted a baby. They made 3 ‘outstanding’ embryos. First transfer - BFN. Second transfer - BFN. Paused for the EMA, Alice and ERA biopsy - adjusted for that (it found I needed an extra 30 hours of progesterone and probiotics). Third transfer - BFP! ☺️ So that biopsy was a game changer for me and I wish I’d done it earlier because it turns out all my transfers had been 30 hours too early.

Good luck to you x

[Hopewhite in reply to Tinkertinkerbell]

thank you Tinkerbell for sharing your experience and huge congratulations on your pregnancy! Thanks for the recommendations on the tests, I’ve been tempted to do the Warwick implantation clinic ones which I think are similar to what you had, but have been discouraged by the consultants twice before , when you said you needed extra 30 hours of progesterone, does it mean you started this earlier ? How long did you take probiotics for and which ones did you use ? On the donor eggs, is something that has crossed my mind but I feel we need to try a bit longer with our own , I can imagine it being a hard decision to make but I’m sure the baby will give you equal joy than with own eggs xx

[Tinkertinkerbell in reply to Hopewhite]

My clinic transferred as standard on day 6 of progesterone. The thought being that the average woman is ‘receptive’ on day 6 of progesterone (but not all women are). So for instance when I did my mock cycle for the biopsy, I recreated a typical protocol as I had the previous 4 failed transfers - I took oestrogen for 12 days, scanned to check my lining was thick enough, started progesterone, took it for 5 days and on day 6 of progesterone I had the biopsy. It worked out I had taken progesterone for 120 hours before the biopsy. My result was that my lining was ‘pre-receptive’ and it said that women with the same result became ‘receptive’ after a further 30 hours of progesterone. So in my next real transfer I took the oestrogen for 12 days, started my progesterone and on day 7 when it was exactly 150 hours from starting progesterone they did the transfer and it worked! So I started progesterone at the same time but just took it for an extra day and a bit before my embryo transfer. I’m so glad I did it otherwise I would have had another standard day 6 transfer and my last embryo would have been wasted. I think it’s a shame they don’t recommend this test until you’ve had a few implantation failures and wasted a few embryos. I wish I had it at the start.

The EMA and Alice part of the biopsy showed I had no bad bacteria but also no good bacteria. My confusion was that I had been recommended probiotics before the biopsy and had used one box of Canesflor prior to my biopsy but the results of the biopsy said that I still had no good bacteria. Following the biopsy, my clinics advice was just to use a box of canesflor and as I already had and it obviously hadn’t worked, I was very frustrated! I had 3 weeks until my transfer so I bought 6 boxes of Canesflor and used 3 a day for a few weeks - way more than the instructions say but following the recommended dose didn’t work for me and i had read that it hadn’t worked for others. So as I only had 3 weeks before my next transfer I went all out and shoved LOADS up there. I also took oral ones just in case - 2 a day of a brand called happy mammoth - Venus vital. Anyway, it must have worked. Unfortunately I keep reading that Canesflor is now unavailable which is a shame as I couldn’t find another brand in the UK that was vaginal. I hope all this makes sense. Good luck x

[Hopewhite in reply to Tinkertinkerbell]

hi Tinkerbell many thanks for explaining all this , this is very interesting about the progesterone as I definitely know for FET my body doesn’t have enough, so I’ll raise this as our clinic only does 5 days of progesterone pre transfer as standard , do you know if this would apply for fresh transfers too ?

On the probiotics I’ve been tempted to do those as I read another lady in here was advised them without the tests, so might be a good idea to find which ones are people using now that canesflor is no longer available x

Thank you very much for sharing all of this , wishing you all the best of luck for a smooth pregnancy xx

[Tinkertinkerbell in reply to Hopewhite]

No worries 😉 I think the same counts for fresh and FET.

Good luck! x

[Hopewhite in reply to Tinkertinkerbell]

Thank you !

[kattie22]

Hi Hopewhite, sorry about the results. I feel you. I am currently in my 2ww and I had a failed FET transfer 2 months ago. When my last one failed, I felt there wasn’t a proper review given to me. My doctor merely said all good went smooth, it’s embryo issue. But deep in me, I felt that something went wrong during the treatment cycle because it’s just not the same body functioning back in 2021 when my results was positive . In my last failed transfer, I was given some jabs which I felt my hormones went down after those jab and I was told those are supposed to curb my fibroids but I had that feeling that the jabs is the cause and they probably gave too much. My estrogen level was so low but yet doctor said lining is good to proceed.

I am also keen to know how friends here conduct their review with their own doctors after a failed transfer implant. Any one can share?

[Hopewhite in reply to kattie22]

Hi Katie all the best of luck for your 2WW I hope you’re doing well so far and get the positive outcome you deserve. It is hard to get these reviews , in our case they are quite standard if HFEA doesn’t approve as green they don’t recommend, also it feels like they have a one size fits all approach and are happy to keep you doing the same again and again which is insane ! Although they do say it’s a numbers game.

I normally write a list of points of topics to discuss with them and take it from there ,I ask here as well to see what people recommend as some times some have had similar experiences and different solutions for it. I think others are good at doing a lot of research on their own too. Thanks for sharing your experience, wishing you all the best of luck !

[Fruitandflowers]

I did back to back egg collections first and second time, albeit with an early loss from the first fresh in between, and I got all to blast the second time. The next round was nearly two years later and I got one egg, possibly as they messed up the protocol. So I don't think there's a need to wait and it's more to do with your body's response to the protocol and natural variation in your response each cycle (the clinics say that they control the meds and both ovaries should respond equally but so many women still seem to have a dominant ovary and a 'lazy' ovary and a better number of eggs when the dominant one would have been the one naturally producing the lead follicle that month). When I had bleeding before OTD on my second fresh the consultant said you shouldn't bleed if progesterone is doing its job properly and even though I was on 3 cyclogest I've always been bad at absorbing synthetic progesterone so he agreed to change to utrogestan and add lubion for my FET, which worked. I've also been told by doctors that we should produce enough progesterone after fresh but because of the the follicle stimulation I suspect oestrogen levels are sky high and sometimes the progesterone just can't compete and there's an imbalance which maybe doesn't happen so much on FETs. I was due to do a natural FET next (with progesterone support) to avoid all the oestrogen side effects and let my lining thicken naturally as it was always much better than when fully medicated. Might be worth investigating. My egg quality has been good as far as I know (have just had a second baby from a surprise natural pregnancy as just turning 40) on unibiquinol, bioavailable b vits (including folate), omegas, vit c and a skin, hair and nails multivit (had same stuff in as conception multivits but cheaper). I add good stuff in to my diet in particular good fats, also non-homogenised full fat milk, and don't restrict anything although I hardly have any caffeine as it makes me ill. I am really not convinced though that diet has a measurable impact.

[Hopewhite in reply to Fruitandflowers]

hi MrsOrangejuice thank you very much for taking the time to share your experience, and congratulations on your new baby , what a lovely surprise that must have been after all the heartbreak and IVF struggle! Hope you’re both doing well xx

I had the review appointment yesterday, they agreed to do the step down protocol again and higher dose of stims hopefully that will give us better results next time , 8 days of stims on the lowest dose still gave 7 mature eggs , but we only achieved 1 top 5 day blastocyst out of that but hopefully next cycle can be different.

This was a fresh cycle , and will have to do another fresh next but I also wonder whether natural FET would work better, it’s interesting what you say about progesterone the doctor just said it was probably a chemical and the MC happened if the embryo didn’t have enough genetic material to keep it going. So hard to know what was it, in any case she’ll prescribe the Lubion before next fresh transfer on top of Cyclogest.

Thank you for sharing the supplements you took , I’ll try to add the omega I haven’t so far because I already eat a lot of salmon and walnuts etc but better to be on the safe side, I’ll have a look for skin , health and nail that’s a good tip.

Thank you very much for sharing xx

[Esb27]

so sorry to hear this lovely, wish it was better news hope you are taking care of yourself and you get some positive next steps in your appointment tomorrow xx

[Hopewhite in reply to Esb27]

Thank you for your kind wishes xx

[Millbanks]

Hi lovely,

I'm so sorry to read this - it's so heartbreaking to see that stark white test.

I just wanted to say that each cycle is so different - there is absolutely no reason that it won't work the next time for you. Its hard not to feel defeated, especially when you've prepared so well but I have found that there seems to be just no rhyme or reason to it really. Even when everything is "perfect" it can still not work, and that cycle that you think is a disaster is the one.

Don't give up hope - you can do this xx

[Hopewhite in reply to Millbanks]

Hi Millbanks thank you very much for your lovely message ! We’ll keep going 💪🏼hopefully next time will be our lucky one ❤️, I hope everything is well on your end and you have recovered from your last heartbreak, wishing you all the best for your next steps xx