# Poor Response and Implantation Failure - what next?



## VickiK (Aug 9, 2012)

I've now had three attempts at ISCI - 2 fresh and 1 frozen.  The first cycle was a short protocol and they collected 7 eggs, 5 of which were mature enough to try to fertilise.  This resulted in 2 embryos.  Being a funded cycle, I was only allowed to have one embryo transferred the first time round.  This resulted in a BFN.  I then had the remaining frozen embryo transferred and again this resulted in a BFN.

It was suggested that we try the long protocol the next cycle to see if I would produce more eggs.  This time round I produced 9 eggs, 5 of which were mature enough and three fertilised.  2 made it through to blastocyst stage - one very good quality the other not so good.

Unfortunately the clinic put the fear of God in me and managed to persuade me to just have the one embryo transferred.  I was also using embryo glue so there was a very high chance I could end up with twins.  At this point in time, I had a work colleague having complications with her naturally conceived twins - this therefore added weight to my decision.  Something unfortunately I now regret.

Again we had a BFN.

I have got my review with the clinic next week to see where we go next.  We are not overly hopeful about the frozen blastocyst as it is of poorer quality than the one that was transferred fresh.  We are therefore thinking to go through the whole process again.

Everytime we've met with the consultants we've been told that we have a very good chance.  I have no known problems and my husband has low sperm counts and poor sperm quality.  

My questions therefore are as follows:

I want to produce high numbers of eggs like a lot of other people so that I can really maximise my chances - this was the reason my treatment changed from the low protocol to the high protocol for the 2nd cycle but as you can see from my results it made little difference.  Has anyone else had this and what were they advised?

If I've tried embryo glue and had a high quality blastocyst put back and it's still not implanted - what could the issues be here?

I know I will get the opportunity to ask all these questions next week at my review - I've a list as long as your arm to take with me.  I just want to see what other people have been told in situations like this so that I can possibly ask more during my appointment.  I'd also like to research some other things that people have tried so that if it is what is suggested to me for the next attempt I know what the consultant is talking about.

Many thanks for all your help and support.  Good luck to everyone else.

Vicki


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## julia3620 (Dec 12, 2010)

Dear Vicki,

I didn't want to read and run. I am sorry that you are having such a hard time at the moment and trust that you will find some answers. I have had five failed DE cycles and am about to try again in the new year. This time an endo scratch has been suggested to me - has this been suggested to you. I haven't heard about the glue you mention - could you tell me more?

Good luck on your journey.

Best wishes

Julia


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## tina11 (Nov 29, 2012)

Hi Vicky

So sorry about your bfn. I know how heartbreaking it is, especially with a good quality blast being transferred.

Have you considered immunes? I have had my cytokines and natural killer cells measured. I will be having intralipids, steroids and blood thinners with my fet. 
Also you can consider an endometrial scratch!!

Good luck, with your next treatment xx


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## Bumble Bus (Apr 23, 2013)

Vicki,

Your experience has been v similar to mine.

First cycle I did standard IVF (we use donor sperm as my husband has none), 10 eggs, 5 mature, 2 embryos transferred at 3 days - BFN.

Second cycle they changed my mix of stims (from 450 gonal f to 300 gonal f + 150 menopur), they did ICSI, we got 8 eggs, 5 mature, 2 blasts. They said the best one had a 60% chance of implanting so we went with just the one but it was BFN. Other one was frozen.

I have low AMH (4.5 at 31) and so they are keen for me to do another fresh cycle rather than use the frosty which is also what we want to do.

I met the clinic this week and they are adding aspirin while stimming and then clexane after ET. They are happy to treat empirically without doing any tests for clotting issues. They are also going to do a scratch.

They said if next cycle is also negative they will do recurrent miscarriage tests as there are lots of the same causes for recurrent implantation failure.

I am going to pop a link in here to a question I asked on the immunes board before my follow up appointment too. http://www.fertilityfriends.co.uk/forum/index.php?topic=314139.0

I asked my GP to run some of the bloods but she said she couldn't really do it. Am going to try another cycle, keep everything crossed we get something to transfer again and then go from there. If negative again I think we will do proper immune investigations as I don't want to waste time and money if there's a good reason for it not working. It's a hard decision though as equally don't want to waste money on pointless tests!

Best of luck for your follow up and do pop back on here and let us know what they say.

x


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## Fx (Feb 28, 2012)

Hi
So sorry for your failed cycles. It is heart breaking and so hard to pick yourself up again.
These are thoughts I have also had - what exactly is the cause of the failure. 

I have had 3x fresh IVF failures. Each time I had good fertilisation rates and went to blastocyst, not top quality blasts but blasts none the less and I have also been pregnant naturally so have evidenced implantation ability.
My consultant said the problem is either embryo quality (the combination of me and DH) or endometrial receptivity or both! He said it is not an exact science to know. Not helpful is it! 

If I decide to go again I will have an endo scratch. I asked about this last time but my consultant said there is both positive and negative evidence for it. I feel it would definitely be worth a try now though. I will also have immunes looked into as feel anything is worth a try.
As for protocols, the long protocol does usually get more eggs, but not that doesn't always mean the best quality.(I actually had more eggs on my first short protocol). 

Sorry, haven't been much help. Just echoing what the other ladies have said- a scratch and immunes. This is the route I am going to go down when I have the strength.

Good luck and take care. Xx


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