# Failed cycles - what questions to ask



## Laura11 (Apr 18, 2015)

Hi everyone, I wonder if anyone can help me. I've had one fresh IVF cycle which was BFN and have just this morning got a BFN for our first FET. I know that doesn't sound like many cycles but I'm finding it really hard to have hope as everything looked so positive both times. I'm 31 and have PCOS but no other identified problems, and nothing identified on my husband's side. I responded well to stimulation on my fresh cycle, got 10 eggs collected and 6 fertilised and all made it to blast. Transferred 1 x 5 day blast then 2 x 5 day blasts on my FET but BFN both times. 

I just don't really know where to go from here. After my first failed cycle my clinic didn't seem to have any ideas about why it didn't work, it was very much "you're young, better luck next time". I asked about immune system and blood clotting meds but was told "we don't do those here". I'm an nhs patient but am lucky enough to get a further fresh and frozen cycle funded so can't really afford to go privately before doing that.

I wondered if anyone had any ideas what I should press my clinic for this time? I've had my thyroid checked. Had a HyCoSy which showed clear tubes. I have one small fibroid but it's on the outside wall of the uterus so was told that wouldn't cause any problems. Other uterus looks fine.

I did have a bad reaction to cyclogest pessaries on my fresh cycle so when I had some cramping after transfer put it down to that, especially as I didn't get it on my FET. Since switching to gestone I haven't had any symptoms of progesterone like I did on the cyclogest (sore bbs) so have wondered whether I'm not absorbing it as well, but everything I've read says that gestone is the most reliable method so that seems unlikely.

Although we ended up with 5 frozen blasts, when it came to thawing the first 3 didn't survive the thawing process, so I wonder if they weren't as strong as they looked? Our clinic didn't tell us the actual grading but just said they were excellent quality.

Sorry for the long rambling message but I would so appreciate any advice. We are devastated and finding it hard to have hope without anything to look into. Thank you xx


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## Angedelight (Aug 17, 2012)

Hi
Sorry to hear about your failed cycle.
I used this thread for my follow up questions.
http://www.fertilityfriends.co.uk/forum/index.php?topic=261901.0
I've come to the conclusion that although it's science, it's definitely not an exact science and sometimes the 'experts' can't even answer the questions!!.
Good luck for your follow up- hopefully this thread will help. 
X


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## Carrie88 (Aug 2, 2015)

I'm so sorry  I'm in the same position....two failed FET transfers! I have a list of questions, I'll try and find them for you.

I got told the same, it's just bad luck and is probably due to the embryos having from chromosome abnormalities!

We have one more embryo to transfer from this cycle but we are paying for private testing now for all sorts of immune issues. I've ummed and aaahed but I need the peace of mind that there's nothing wrong with me.


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## Franny80 (Apr 10, 2016)

Hi Laura,

Sorry to hear about your failed cycles. I know they are really tough and my heart goes out to you - I've had a similar experience with one fresh and two frozen SET transfers all ending in BFN. I don't have any answers for you I'm afraid as to why it hasn't worked. I'm not sure why it hasn't worked for myself either. I have friends who did IVF and all got pregnant from their first fresh or first frozen transfers. My three failed ones seemed like a massive failure. But I don't think you should give up hope. I saw the consultant today and he said it can take multiple attempts. The NICE guidelines say that women should be prepared for three fresh cycles before they get pregnant. When you think of your frozen transfers as still being part of your first cycle, then really your odds are still really good.  

I'm now between cycles, and have been doing loads of research into vitamins and supplements that can help my PCOS. I've also changed my diet too. It's really helped me to feel like I'm doing something positive instead of waiting and getting frustrated. I'm not sure yet if it's made any difference, but I do rattle like a pill bottle when I walk! 

Best of luck

x


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## Laura11 (Apr 18, 2015)

Thank you so much for your replies ladies. It is a comfort to know I'm not alone as it certainly feels that way a lot of the time. We have an appointment with the consultant on 17th May so DH is busying himself researching things to ask about - he's talking about pre-genetic screening of embryos and all sorts but I keep telling him not to get his hopes up that we'd be able to have any of that stuff while we're NHS patients, even if we can pay for it I'm not sure it'll be possible, and the consultant will most likely say it can take 3 cycles, as you say Franny. I keep thinking that we've now had two cycles but maybe FET doesn't count as it's the same batch of embryos.

Franny are you able to point me towards any info on diet/supplements to help with PCOS? That might make me feel like I'm doing something constructive. I might try to lose some weight as well - my BMI is in the healthy range (just!) but I carry all my weight round my tummy and can't help thinking that might be a bad thing too.

Thank you again for replying to me, it means a lot xx


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## Angedelight (Aug 17, 2012)

Hi Laura

I have PCOS too- maybe once a year I have a longer cycle but apparently my ovaries are PCOS looking. When they first diagnosed it I'd had absent periods for 3 months which I put down to stress at the time. I have a normal BMI and no other symptoms. I've read 'It Starts With The Egg' by Rebecca Fett which lots of ladies have read on here. It's scientific and evidence based and recommends loads of supplements for ladies with PCOS. We got all ours from Amazon. 

I bought a PCOS diet book. Some of what that says conflicts with what I read online but Google PCOS diets and lots comes up to give you an idea.  I'm just trying to eat well, limit carbs and stay away from sugar.

I've done all of this as each time whilst my eggs have looked fine when retrieved and  I've responded well, once they become embryos they are not good quality and that's down to the quality of my eggs. If you're getting to blast and being told they're good quality and they're good enough to freeze it sounds like you're both doing ok.

i honestly think fertility treatment is a lottery of sorts. It's a horrible process and can drive you mad. I hope your appointment comes quickly as its so much better when you have a plan to work towards.

X


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## marty123 (Dec 26, 2015)

Hi, hun, Laura11! I'm so sorry for your failed cycles. I've also had one with donor eggs. 
Our situations are different, people describing more and more positions they are in. Here's a nice link for ex. I've come across while looking for the same answer - http://www.bubblesandbumps.com/whats-going-wrong-with-ivf-questions-we-asked-the-doctor-after-3-failed-rounds-of-ivf/.
There are also some interesting facts taken from the article: 
"The first person patients turn to when their IVF cycle fails is their doctor. He is the person who performed everything from the ovarian stimulation to the embryo transfer. He is the one who advised them to do IVF; and reassured them that they had a good chance of succeeding. Patients naturally think that their doctor should have an answer for the most important question that haunts them - 'Why did my cycle fail?' There are patients who are naive about the IVF process, and who get angry with their doctor when he cannot offer a satisfactory answer for the failure. They start imagining the worst - that their doctor did not perform the procedure well, or that the clinic is not competent, which is why the cycle failed. Some might blame themselves, because they start thinking that their body is not conducive for achieving a pregnancy; that their uterus is not good enough to accept the embryo; and that they are not fit to carry a baby. Some believe that their body is defective or that it "rejected" the embryo. Many start obsessing about all the 'mistakes' they did during the 2ww - from not taking enough rest to eating certain 'forbidden' foods..."
"What causes an IVF cycle to fail?
No one knows the answer! There are some explanations, for example - poor quality of the embryo; genetic defects in the embryos ( which we cannot always diagnose); or the presence of an unreceptive endometrium. But the problem with existing IVF technology is that there are no sure ways to find out which embryo is genetically normal and which endometrium is receptive. Hence giving an exact reason for the IVF failure to an individual patient is not always feasible, because of the limitations inherent in today's ART. Let us consider a fertile couple that is trying to have a baby in their bedroom. Do their attempts at baby making sex result in a baby every month they have intercourse during their fertile time? Of course not! A young fertile couple may take up to one year to achieve a pregnancy - and they have just a 15 - 25 % chance of conceiving in a particular menstrual cycle. This clearly shows that human reproduction is remarkably inefficient. During IVF the chance of achieving a pregnancy in a single attempt is significantly higher- most clinics around the world have a success rate of 40-50 %. But it is impossible to pinpoint why 6 out of 10 women who undergo IVF fail to achieve a pregnancy and why the other 4 are successful in their attempt."
The article is really worth of reading. Have a look for more: http://www.inviafertility.com/blog/blog/infertility/draniruddhamalpani/causes-of-ivf-failure/.
Be brave, hun! Storms never last forever!! 

/links


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## Franny80 (Apr 10, 2016)

Hi Laura,

The theory is that PCOS is linked to insulin resistant, so PCOS women can't manage their blood sugar properly and this causes a hormone imbalance. This insulin resistance / problem with sugar is in slim PCOS women too. I have lean PCOS and a BMI of 21, and like you have a bit of fat around my tummy, which is also apparently a sign of insulin resistant. 

So the main thing to do is cut out sugar, and cut down your carb intake (but don't cut our carbs). When you eat carb it should be wholegrain only - so wholemeal pasta and brown bread etc.. If you follow a low GI diet you are in a good place as it is all about slow energy release from food and avoiding sugar spikes. Alternatively you can follow a diet for insulin resistance. Google both diets and you'll start see they are pretty similar and what they involve. Another good tip is when you eat wholemeal /unrefined carb always try and eat protein too as this will slow the energy release from the carb down. Or if you have fruit try and eat a handful of nuts as this will do the same.

I read about the general principles in Natural Solutions to PCOS by Marilyn Glenville, which is good at explaining it all. A PCOS friend who managed to restart her periods using it recommended it to me. She also recommends cutting out dairy (which I haven't done). She recommends A LOT of supplements so I'm not taking all of them. I'm doing the ones I have also read about on the internet.

The main supplement for PCOS is inositol (which was also recommended to me by my IVF consultant) which helps to improve our body's sensitivity to insulin. The dose is 4g so I got mine from Amazon as the stuff they sell in Holland and Barratt isn't strong enough. I started on this, but have now added these into the mix too:

Omega 3 fish oil which is supposed to help lower testosterone. (take enough to get 700mg of EPA)

30 mg Co-Q10. This is an anti oxidant which helps improve egg quality, but is also good for women with PCOS.

100 mg Alpha-Lipoic acid - this is good for PCOS and egg quality. 

Women with PCOS are also mean to be lacking in vitamin D so make sure you are getting enough of that. There is vitamin D in my conception vitamins so I'm using those to cover that. 

Sorry, there is a lot there. I hope it helps and doesn't confuse. I've found it useful to feel like I'm doing something and also taking back some of the control. I've only been doing it for a couple of weeks so I can't say it'll work yet. But worth a shot.



x


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## Laura11 (Apr 18, 2015)

Thank you so much ladies. I've downloaded all those books and started reading It Starts With The Egg. I'm still not sure whether egg quality is a factor for me as all our embryos made it to good quality blasts, but figure it can only help and makes me feel like I'm doing something positive at least. Thanks again xxx


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## KDJay (Sep 21, 2015)

Maybe ask about the scratch if you haven't done already, it picked up an unseen infection in my dp so that could be treated which was an extra bonus also what about acupuncture


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## Charlottots (Mar 30, 2016)

Hi All, 

Hi Laura - I think we were on the 2ww together and both got a BFN on the same OTD. Seems like a lifetime ago now but I have already been looking into boosting egg quality with PCOS. My consultant is putting me on metformin starting next week, which I have pushed for to help with insulin resistance. I am also getting vitamin D blood test and a full thyroid profile - PCOS ladies are more likely to have both of these deficiencies and thyroid especially can prevent implantation. You mentioned you had already got a thyroid test but if on the NHS they probably only tested TSH. If you have PCOS you also need to get T3, T4 and thyroid antibodies tested for, most GPs will not test for this, you can have a normal TSH but have problems with T3 T4 or antibodies. It may not be an issue for you but I think always best to rule it out if you can. I am paying privately for the tests as my GP wouldn't test me for it either.
Other supplements to look at for PCOS are myo-inositol and d-chiro inositol (google ovasitol) and also melatonin (but not if you take thyroid meds) (google inofolic plus)
Not sure what vitamins you take but my nutritionist recommends NHP fertility support. This contains coQ10 but research suggests a higher level of coQ10 needed for PCOS so I also take a supplement. Also recommended additional vitamin D and C, and omega 3 as Franny80 suggested.
I didn't actually realise how much PCOS can affect egg quality until I looked into it but everyone's different - I am fat with PCOS but others are lean so may have different requirements. I am also going to start acupuncture next week to see if it helps - willing to try anything!
I hope some of this is useful to you xx


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## Laura11 (Apr 18, 2015)

Hi Charlotte! Thank you that is really helpful, have looked back through my blood results and yes I was only tested for TSH. I'm also going to ask the consultant about metformin when I go on the 17th (feels like ages away!), since I responded well to clomid no one's ever really mentioned my PCOS, but it's the only identified problem we have so it makes sense to really work on it. The vitamin info is really helpful too, at the moment I just take a pregnacare conception and extra vitamins c and d, so will look into that. I'm also going to give acupuncture a try - it can't hurt! Really helpful thank you, and all the best to you too xx


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