Recurrent implantation failure

[Grey792]

Hi everyone, I'm new on here but TTC 5+ years. Already had 11 transfers. The first ender up in a very early miscarriage and second in an ectopic. After these 2 no other (good quality) embryo gave any sign. We had already 11 transfered from the 3 rounds. I am so frustrated. TWW for our first ever double transfer (#12&#13).I feel like I've done everything. Artificial cycles, natural cycles, changed clinic, 2 endometriosis operations, 2 histeroscopies. 2 Biopsies..one looked into NK cells. Came out I have a very high nk number. Took Prednisolone, made lipid infusions...take baby aspirin.

I don't know what to do anymore. I feel like crying and I'm fearing the end of this cycle if it fails too like all the others.

I'm also very frustrated because I don't understand why the first and second transfer ever got me BFPs...even if just got a short time. And then nothing again in 2 years.

Did someone else experienced something remotely similar?

[Star3129]

Hi Lovely, i totally understand your pain and frustration to have your little one. Been there done all of it but what helped was looking into donor eggs, may be you can look into it.

I had my little one and is all mine by all means and i am blessed that he chose me can't have it any other way.

All the best in whatever you decide

[Grey792 in reply to Star3129]

Thank you for your kind message. Congratulations for your little one. We will have to decide what we do after this round. If that's an answer that would work for us too. At the moment I'm feeling like I'm giving my best shot at what else could be wrong with my body and I start to see that I think I did it all possible. We started this journey with such good numbers and good hopes. But we may have to let go of it soon and look for alternatives.

My biggest fear up to now is what it my body would reject anyone else. Does it really work stronger with the donnor eggs? Is it something with my DNA rejecting my one..are they are just weaker? Then yes... donor would work. I'll have to look into it.

[Memacha]

I don’t have the answers but just wanted to share that I empathise. I just had my double transfer with embryos 10 and 11 fail. I haven’t had my nk cells tested but was on prednisolone, clexane and baby aspirin this last cycle and still nothing, like you, I’m so confused and frustrated about why it’s not working. They say it’s a numbers game and after so many attempts, you’d think something would work. Have you done pgta? We’re thinking about this to understand if the embryos are normal or not. We know our latest miscarriage was euploid which makes me think something else must be going on.

[Grey792 in reply to Memacha]

Hello dear, thank you for your message. It means so much to just not feel alone. Ivf is such a good thing and it mostly helps people. I'm so sad it is not something that helped us.We never did PGTA testing. In Germany where our current clinic is, it is not allowed . But everytime they tell us how good these embryos look and develop I think it too...: From this high number of embryos one should have made it over the 3 IVF years.

[Endofitall]

You’ve really been through the mill 😔.

Would you mind sharing your age? PGTA definitely sounds like an idea just so you can have that information. As now you don’t know if it’s because of the embryos or something to do with implantation in your womb. Has your partner had thorough male testing such as sperm DNA fragmentation?

If you’re making good quality euploid embryos with normal levels of dna fragmentation, I guess depending on your age, then donor eggs or sperm are less likely to be useful and actually maybe surrogacy may be something to look at. Have you seen a second opinion for looking at recurrent implantation failure? Would you consider seeing a proper reproductive immunologist if you havent already? Have you considered going abroad where PGTA allowed? Just throwing ideas out.

Wishing you best of luck with your transfer

[Grey792]

My age now is 39. Was 36 when we started ivf with high Amh value and the defragmentation was done too and was alright. Yes, souragacy is such a complicated thing in this part of Europe. I don't think I'll be able to do that and it's too expensive. We were in Belgium before where PGT was permitted. Will see if we do another cycle for that.

Endometriosis was removed but because maybe in case inflammation is still there I took Prednisolone..still wondering if something is wrong in my womb.

And still frustrated that the very first two tried to attach and I keep wondering what has changed after.

I should look for an immunologist. Let's see if that's a thing in Europe. This is why we chose the German Klinik cuz they were looking into the nk numbers. But then my doctor left and who is replacing her doesn't believe in this.

[Endofitall in reply to Grey792]

It is all so complicated and expensive. DH and I anyway have drawn a line that our choice is to have our biological baby carried by me or stop. I know that’s not everyone’s choice and I respect that but that’s our line in the sand.

Endometriosis is a cruel and enigmatic beast. I’ve had excision but as you say it’s still there at some microscopic level at least. It is certainly known that we have more immune issues related to this . Immune issues may explain why first two tried and then you’ve not had anything implant since.

Have you had any evidence of adenomyosis in your womb as lots of endometriosis patients have this too, as this can make things more complex for fertility too? My MRI pelvis showed adenomyosis pre planning for the excision surgery.

We’ve been keen to do PGTA to have that info on why we keep having top quality blasts not stick but then my AMH is rapidly dropping off a cliff as endo damaged my ovaries and I don’t make many eggs per cycle. If I had the option though PGTA seems to make sense at this point to at least know if the embryos you’re putting in are euploid.

[Grey792]

such a similar story, thank you for sharing <3 ! I had an MRI for adenomyosis that came back negative. So it just left me further in the dark even though it's good news.

"My" theory was also that the first two had a lighter game but then my immunity kicked in harder...

In Germany on our last cycle the first 2 transfers I was given Omegaven perfusions which are supposed to lower NK. But nobody would plug me on an infusion here in NL and I had to go to my klinik in Germany every time for one. After trying it twice I just think it is not worth doing it. (Now I just take a lot of Omega 3,6,9 supplements together with my prednisolone and baby aspirine.). Shouldn't the prednisolone (20mg) not fight down any immune issues?

Another thing we tried recently: My Dr. in Germany is not a fan of anything else than this "game of numbers". But I managed to persuade them to put me on some protocol such as the artificial menopause one (I heard it is done for adenomyosis too, but for 3 months). He made the protocol in a way I could not find any similar information online: One decapepthyl depot injection on CD 21 (shut down the hormanal activity). Then on CD 32 I started my new cycle and started my current artificiacial transfer cycle (progynova and then progesterone and trigger 1 week before the double FET). So this is one more thing we tried... that is supposed to bring down the inflamation/activity but not sure it did anything for me.

For pgta and easier access we tried to move the embryos but no clinic will take them and also they think that unthowing them in another lab would maybe damage them. So for now I will have to "finish" the untested ones. It sounds horrible: "to finish" them, "go trough them" like they are files or post-its ..but having so many fail before makes me think they will just go away too.

[Endofitall in reply to Grey792]

It’s gutting we have to think that way sometimes.

Have you had your Antiphospholipid antibodies checked? I’m on enoxaparin/clexane now because of this. My cycle with proper dose of this and pred from pre transfer is only one I had implantation in womb. It seems having APS antibodies are more common in some endo patients.

Finances are such a factor too. Reproductive immunology and PGTA are not cheap 🫠. I will go abroad if my current cycle in UK doesn’t work as at least PGTA cheaper.