Tying up loose ends after failed treatment-any tips?

[neonpg]

Hi everyone, thank you so much for all your support on my post earlier this week. It helped so much. Today is my OTD and the clinic didn't ring me until 4pm to check the outcome of my pregnancy test (way to make me feel supported, clinic!). Anyway, the nurse asked if I wanted a follow-up consultation and I said yes for a bit of closure.

But there's something that's been bothering me about the whole experience, and that is the clinic's refusal to acknowledge that the treatment was unsuccessful. For example, when I spoke to the embryologist he was adamant that I had an "acceptable" outcome because I got one (poorly-graded) blast to transfer. Then today my conversation with the nurse (who I've known for nearly a year and confirmed my miscarriage in Dec) went a little like this:

Me: "it was the same outcome as in February. Lots of eggs, good fertilisation, but then it all went wrong at the end..."

Nurse: "Well, I wouldn't say it 'went wrong'..."

For the record, I'm not blaming the clinic at all for what's happened. But no one will ever say to me "I'm sorry it all went wrong". And when they refuse to acknowledge that the treatment failed, it seems to imply that it's me who failed.

So I guess what I'm trying to ask (in a very convoluted way) is does anyone have any tips for my WTF meeting with the consultant? I think at this point I just want some answers on why he thinks it didn't work, why I always bleed 6-8dpt, and just to affirm I'm doing the right thing by stopping treatment.

Any/all advice welcome!

[Memacha]

I can really empathise with your experience. It’s so sad when it doesn’t work and then really frustrating when you get this kind of response from the clinic. We ended up having our follow up appointment with the director of the clinic given how many failed cycles we’d had. Whilst he tried a bit more to explain than some others, I still wasn’t satisfied. They were blaming egg quality (as well as quantity) and didn’t believe a different protocol could have a different outcome. Maybe you could ado to meet with someone more senior? I also bled early on 2 cycles before I convinced them to add injectable progesterone. This did help stop the early bleeding and I’ll always wonder if that impacted those earlier cycles although the clinic refused to acknowledge that. Maybe you could ask about this if you didn’t already have this? Ultimately we decided we needed to try something different and went to a clinic abroad who took a completely different approach in terms of stims meds, double trigger, zymot, clexane. And we did have a different result. Everything that fertilised made it to blast. Sometimes a fresh start and different approach can help you feel like you’re in with more of a chance, if you feel like you’re not ready to stop trying. Not sure if this ramble helps and I hope you get some answers in your consultation

[neonpg in reply to Memacha]

Thank you so much for your thoughtful response. I always said this would be my last cycle. However, all three of my own failed IVFs have been with gonal-f (our first cycle was with my wife's eggs and she was on ovaleap), and a part of me is wondering what would happen if i switched up the protocol. I know my current clinic would never do that (they specialise in mild IVF and do a one-size-fits-all strategy). Right now we don't have the energy and I think my wife would kill me. But I can't say I'm not tempted. For now I'm gonna do my best to be prepared and advocate for myself during this appointment. The last time it failed my consultant put my outcome down to "bad luck" and I'm not quite sure that's an adequate explanation anymore.

[Wishinandahopin]

I’m so sorry lovely this sounds really frustrating and I’m so sorry you’ve gone through this.

Your clinic sound challenging- a one-size-fits-all approach is a red flag and mild ivf is not the best option unless you’re over 40 and with low reserve.

ivf clinics do tend to blame the patient- they never want to accept it could have been something they did or didn’t do. From my experience. That said they should at least try changing it up if it doesn’t work.

If you always get your period 6-8dpt then this is nearly always low progesterone. You will need to be on pessaries and injections for this.

If you’re getting lots of eggs and good fertilisation then it’s failing - are the embryos dropping of mostly day 1-3? (This is normally egg quality related) or 3-5 (this is often sperm related).

Are they checking your progesterone levels on day of transfer?

I think you need to ask them why twice now you’ve only had one poorly graded embryo from a good amount of fertilised eggs and what could be the different reasons for that.

At this point though I would def be looking at changing clinics. Good luck xxx

[neonpg in reply to Wishinandahopin]

Thank you for your thoughtful response. After my first failed transfer I asked the clinic if progesterone could be an issue and they just dismissed it saying "the embryo was probably abnormal." The only time I've ever had my progesterone level checked was for my FET in December and it came back normal so they've never tested it since.

The embryos drop off from days 3-5. In my most recent cycle 4 of my 7 embryos were top graded at Day 3, but by Day 5 I had only one 3BC blast and the rest were morulas. We changed sperm donor in the hope it was a sperm issue but sadly that didn't help so I think the clinic will say it's an egg quality problem.

I will ask them my questions but I'm already trying to accept that I'll never really get an answer. Sadly many IVFs fail and I'm just one of the unlucky ones.

[Wishinandahopin in reply to neonpg]

I’m so sorry lovely. It’s all very challenging. And yes it could be an egg quality problem. That said your clinic should be doing more. I have had many friends have similar results at some clinics and then switch clinics and it has worked really well. So if you do go ahead I would change clinics if I was you. Keeping everything crossed.

[neonpg in reply to Wishinandahopin]

thank you! Sadly we agreed this was our last attempt so no more treatment for us.

[Wishinandahopin in reply to neonpg]

Oh I’m so sorry to hear this lovely, I hadn’t realised. Take care xx

[WHeatherW]

I’m so so sorry this has happened. These simple things can really bother us going through ivf and it blows my mind that clinics don’t understand that!

I’ve recently had my second round. I got a call on day 3 saying my embryos hadn’t developed and someone would call in the next few days to discuss, book the follow up appt etc. it’s 4 weeks on and no one has rang. I’ve chased and been told “it’s holiday season so there are delays”. Still no call but I did get a letter to confirm it’s in another 3 weeks. It blows my mind that I’ve just been left after such a heartbreaking ordeal!

I hope you get some answers at your appointment but I would prepare that you might not so you’re not disappointed by their treatment again (as if we have to think like this). Lots of love x

[neonpg in reply to WHeatherW]

I'm so sorry to hear about your ordeal. As busy as they are it's really bad that they haven't been in touch to at least offer you counselling or any sort of aftercare. I'm not sure if you're in a position to do so, but I'd maybe consider changing clinics if your follow-up doesn't provide the answers you're hoping for.

I think you're right that I'll need to manage my expectations with this follow-up. As they know I'm not seeking further treatment I think they'll just rush through it as a formality which is disappointing after I've put so much trust (and money!) into them.

[WHeatherW in reply to neonpg]

It’s so hard isn’t it. It’s such a massssive thing for us but it’s just business for them.

I’ve started to look into other clinics here and abroad so we’re in a good position to move forward regardless of the outcome at this appointment. Are you able to try anywhere else? Xx

[neonpg in reply to WHeatherW]

I'm so glad you've got further options. This is the end of the road for us so our consultation is more for closure than anything else.

[Wellington22]

Hi neonpg,I am so sorry to hear of your experience - it's a horrible time anyway but even harder when it feels like your clinic aren't on your side.

With the follow-up appointments, I've always tried to be as pragmatic as possible by having questions ready to ask because I know I'll be lost in the moment and might chicken out of asking anything challenging unless I'm prepared. We've had three full rounds of IVF at a UK clinic and just had a failed DE round at a clinic in Spain and there are a few differences; our UK clinic were very nice but communication wasn't the best. Our clinic is Spain is arguably better at responding quickly to questions and queries. Saying that, both clinics have that 'front' that avoids placing any 'blame' on the clinic and I think that is just how they deal with failed cycles.

It doesn't sound like you are happy with your clinic so I would certainly consider trying somewhere new, even if it's just to feel like you are exploring all of your options.

Hope you get some answers xx

[neonpg in reply to Wellington22]

Thank you so much for sharing your experiences. It's a bit of a weird situation as I'm not exactly blaming them (and I want to be clear that I'm not-I just got unlucky). This was actually our last attempt, so I wanted some answers to questions that have bothered me through the 2-year journey, so I can move on knowing I've done everything I could. But now I'm wondering if any sort of response from the clinic will bring me peace.