No idea what next....

[Georgina81]

Hi all, just looking for any advice now really as I have no idea what to do next. I just had my 6th transfer with double donor which has ended with a chemical max hcg reached 225. The previous 5 transfer were all donor eggs, all failed except the 3rd which was double blighted ovum. Era, Emma, alice done, hysteroscopy in 2023 clear, basic immune testing clear. I'm 43 and don't know whether to keep trying or whether this journey will just keep giving more heartache , if anyone has any advice on something to try or your own experiences please do share, I'd be really grateful!! Many thanks.

[CyclingAddict]

Sorry to hear this. Were the embryos PGT-A tested at all? That could be the next step. I had 4 implantation failures and 1 chemical before finally PGT-A testing the embryos and having success X

[Georgina81 in reply to CyclingAddict]

Thanks for your reply, no none were tested my clinic said because of the young donors it was not necessary. I actually asked for the double donor embryo to be tested but again they said its not necessary, I think its definitely is the next step. At the moment my husband has had enough and I don't think he wants to keep going, despite all of the medicine, injections, pain etc over the last couple of years I can't honestly think about giving up but im 44 in a couple of months and all this cant be good on the body. I had an mri done in Dec to check what they thought was fibroids on ultrasound, that found fibroids outside the uterus, possible pelvic congestion syndrome and possible adenomyosis, I did down regulation before this fet for this reason. It just never seems to end. Xx thank you again for your reply xx

[CyclingAddict in reply to Georgina81]

That sounds very stressful! I was 32 when we did PGT-A testing. 4 out of 11 of my embryos came back as abnormal - and one of those was a 4AA, so it can still be worth checking.

Have you also looked into embryo donation? It might be worth considering if you haven't already. We have 6 PGT-A tested embryos in the freezer and once we have finished expanding our family, we plan to donate any embryos that are left over (hopefully we do have some left to donate!). I know many couples who have had successful cycles end up donating embryos that are high quality and already tested. I believe it's cheaper too as the embryos already exist and it saves the stress of waiting to see how many fertilise. Just a thought! X

[Georgina81 in reply to CyclingAddict]

Yes this last one was a double donor embryo donation. I did 2 full cycles of ivf with my own eggs 4 years ago and only ended up with 1 embryo so moved to donor. After the first 5 donor eggs failed we thought we would try this full embryo donation. Thanks for your replies, it means a lot and I'm grateful!! Xx

[Endofitall]

I’m sorry you’re facing this. PGTA sounds sensible at this point. I hope you and hubby can have a chat and air it out and find a way forward through this. I do think it’s hard for them to see the impact on us and there was definitely a period of time I wasn’t myself at all which must have been a real challenge for my husband. Sending love and strength xx

[Georgina81 in reply to Endofitall]

Thanks so much for your reply, yes need to decide how to move forward now. Xx

[Boo718]

I’m so sorry I hope you’re doing ok. I’m not sure when you had the era but I know that if you have an implantation after the era it can change the window for the next rounds. Have you have a look at natural killer cells? Or immune illness that was our next steps xxx

Also pgt the embryos even though they are donor. We went down the donor path and a number of the embryos were abnormal. Just because the donor is young doesn’t mean that it will be normal embryos that’s what we were told xxx

[Georgina81 in reply to Boo718]

Yes I'm quite upset with myself i didn't push for a tested embryo this time, I was just advised it wasn't needed as it was a double donor. I did an immune panel but it didn't flag anything untoward, they added in intralipids and clexane anyways for the last 2 tries. If we go again will definitely go with a tested so at least I know more where the issue is with me or the embryo!! Many thanks for your reply xxx

[SushiTilly]

hey Georgina81

I am sharing your birth year, on my fourth FET transfer but several IVF cycles since 2019 and never once pregnant. I can completely understand the emotional and physical strain. It is hard to make decision on the next step.

IVF doctors will keep saying it’s a numbers game. Eshre guidelines and HFEA guidelines never really is easy read because many add ons don’t prove themselves, that depends how personalise each protocol can become. I’m sure if clinic advise it’s not required it’s down to not enough evidence. Trying something you strongly want to try so your future self is thankful you did what you felt best to do at the time is important.

I find after failed cycle the time out is important and counselling. Give yourself a breather then heart to heart with partner and yourself on what means best for you and him.

I don’t think there is definitive option a b c it’s down to what you both want, and I can understand difference directions when two people are involved. My DH and I have slightly different view. We respect each others needs.

Take sometime to give your body to regulate itself off medicines. GP told me it takes a few months. I hope your ivf clinic can advise you both on options depends on which you want to go.

amongst my friends they’ve taken different avenues to have family. I find older I get the tired I feel so I can empathise being on IVF is massive toll. I refrain from advising which way to go based on my experience. I’m now in 2ww it’s hard, I’m walking in the dark. At least we both can thank ourselves for doing all we can, all we can do is our best, you’ve done it. Embrace yourself with love and peace.

All the best with chat with ivf clinic and always get second opinion. Meanwhile bless you, and sending my love and kindness.

💐🫂💚

[Georgina81 in reply to SushiTilly]

Thank you so much for your lovely words, and I'm wishing you all the luck in the world for this 2ww. My sister wants me to get some consultations at other clinics to see what they might do different, I have a clinic where we live which I use for scans etc before we fly for transfers and they also do things very differently!!Thank you again and sending positive thoughts for your test day xxx

[Wuhu85]

Find a good reproimunologist and test yourself on KIR AA-HLA-C mismatch. Maybe there is a problem. I have the issue as well and waiting for my HLA results right now.

[Georgina81 in reply to Wuhu85]

Thank you for your reply, they suggested testing for my husband only as we were using a donor and for the donor embryo no testing for this as they don't do it for their donors unfortunately!! Xx

[Wuhu85 in reply to Georgina81]

If you are KIR-AA and your partner is HLC2 than donor does not help because not the egg is the problem but your uterine. SND your uterine attack an embryo with C2 heritated from the father.

[soccerkt6]

Hi lovely, I agree with the others that pgt-a testing should probably be the next step. And a few other suggestions that came to mind.

1) Have a hycosy done (or re-done, if it's been a while since you had one) to ensure your tubes are clear and there are no problems there that could be affecting implantation.

2) Have a laparoscopy done to check for endometriosis. Silent endo (meaning you don't have any symptoms) is an underdiagnosed reason for recurrent implantation failure. There's a woman on here - I can't remember her name - who had success on like her 10th transfer after having her endo excised.

3) Consider the Female Microbiome test from Fertilysis (fertilysis.com/tests/female... ). I know you said you've had the emma and alice tests and all was clear, but Fertilysis tests for a wider range of infections so I'd prob do it just to be sure.

xx

[Georgina81 in reply to soccerkt6]

Thanks for your reply, weirdly enough i have never had a hycosy done, it was never mentioned to me. I did down regulation before the last two transfer to settle anything down in case but yes a lap might have better results. I have looked into the fertilysis before so maybe I should revisit that again. Unfortunately it's tricky where I'm living as they have said sometimes they don't allow the packages to go so would need to organise another way!! Many thanks for your reply and suggestions definitely some things to think about adding in next. Xxxx

[soccerkt6 in reply to Georgina81]

I'm no expert on endo but I think it some cases excision is necessary as opposed to just down regulating. I've heard the Nancy's Nook facebook page has loads of valuable information in case you want to research further. In any case though, an exploratory lap should at least give you some more information! xx

[Doodlebug23]

It took me 7 transfers with 10 embryos (3 doubles) to get my daughter. 3 BFN with first donors. Then chemical on transfer 4 with new donors. Transfers 6 we added clexane and prednisolone. Transfer 7 had a natural modified transfer with clexane and prednisolone. I’ve no known issues so fell into RIF category. Embryos were not tested - my clinic also said not needed as donors are young. I was on a refund guarantee programme and I think they do go with the numbers game theory that if you put enough back eventually one will stick. I’m 48.

[Georgina81 in reply to Doodlebug23]

Ahhh congratulations on your daughter, that's amazing news. I think thats what is keeping me going, I keep thinking maybe the next one will work!! Thank you for sharing your journey and congratulations again xx

[Babyjour12]

hi so sorry to hear this. Are you getting treatment in the UK or abroad? It seems like a lot of transfers and I would expect them to have agreed to test the embryos before now.

[Georgina81 in reply to Babyjour12]

I'm from the UK, living in dxb and all my transfers were done in brno. I did 2 cycles of my own 3 years ago but we didn't get any blasts so moved to donor. I do think we need to change clinics to be honest, I just think we need some other options rather than just putting them back in and not getting anywhere, not to mention the cost xxx

[Forevertrying2]

Morning, I had over 20 years of infertility and so much treatment. Fresh IVF own eggs, frozen transfers own eggs and a donor transfer and a frozen and nothing worked for me. All my immune basic tests came back ok but with my last donor egg FET I insisted on prednisone and I got my first ever positive test. Sadly we lost the baby at 12 weeks with a missed miscarriage. Most likely due to chromosomes but I really feel that the prednisone helped with my implantation issues, it was just the wrong embryo. I’m 42 now and we decided after that heartbreak to quit treatment. It might be worth talking about steroids if you want to carry on xx

[Georgina81 in reply to Forevertrying2]

I am so so sorry for your loss, that is absolutely heartbreaking for you. With my job I can't actually take prednisone, but maybe I should try and see if there is anyway around this!! I am truly sorry again for your loss and thank you for sharing your journey and advice with me xxxxx

[Spicycurry]

You could do biopsy to test nk cells in endometrium. If low, you can have treatment for transfer such as neupogen infusion first day of progesterone and hcg wash day of transfer.

[Georgina81 in reply to Spicycurry]

Thank you for your reply, i actually did the nk cell biopsy but came back normal. I was trying to see if I could get neupogen as that does seem to help some people, could be worth looking into! Thanks again Xxx

[Spicycurry in reply to Georgina81]

HCG wash on day of transfer also increases implantation chances. Another thing is having more progesterone. Mine was 127 on transfer day. My clinic always like it above 100 on transfer day and that was a natural transfer.

[Nes1005]

hello

Sorry for all that you are going/have gone through. Have you been blood tested for sticky blood (blood clotting disorder), common cause of miscarriage or repeated implantation failure. I was diagnosed with APS at the beginning of this year and a new protocol to treat it has made all the difference.

Wishing you all the best for your next steps, sending strength and love.xxx

[Georgina81 in reply to Nes1005]

I haven't done the testing for this but they did add in the blood thinner injections just in case the last 2 times. Might be worth actually getting the testing done to check Xx

[Nes1005 in reply to Georgina81]

I would get the test done, the haemotologist who diagnosed me, wrote the protocol for my fertility clinic in Cyprus, and this cycle worked- the last 3 hadn’t (my 1st one did work back in 2022 but ended very sadly). It was very specific protocol in that blood thinners had to be started at the same time as as stims along with Hydroxychloroquine 8 weeks before starting the stims. Then predislone on positive test. I posted a copy of the protocol on one of my previous reply’s to someone else if you want to see it. Hopefully you don’t have sticky blood but I only wish I had been diagnosed sooner.x

[OnRoundEleven]

Hi there. Firstly my heart goes out to you. I'm so sorry to hear it has worked yet for you. My one question is what tests has your husband had? I ask as we had 4 failed rounds before changing clinic at the age of 40. They told us to PGT-A test, but also did a DNA fragmentation test on my husband's sperm. Previously my husband had passed all the sperm tests with flying colours (the microscope tests looking at number, shape, mobility). When the DNA test came back we found he had very high fragmentation. He had to go on Impryl vitamin tablets, avoid caffeine for 3 months, change diet and exercise (no cycling for example). They operated to take the sperm from the testicle rather than using ejaculate.

It resulted in my beautiful son on the 7th round.

Like another commentator said, ivf is a numbers game, but if it isn't working, it may be worth seeing if you can do more tests, or maybe change clinic to see if they can give a fresh perspective.

Good luck.

I wish you all the best.

[Christianbaby]

What one commenter mentioned above about PGT-A testing might be worth looking into if you haven’t already. It can help identify embryos with the best chance of success, which might give you a clearer picture moving forward.

I know it’s so hard to figure out what to do next, especially after everything you’ve been through. Maybe having a chat with your doctor or even getting a second opinion could help you explore all the options out there.

Rooting for you. xxx