# What now?



## cherries (Jan 14, 2014)

Dear All,

I'm wondering if anyone has any advice out there of what our next steps should be?

We recently underwent IVF treatment but unfortunately got a BFN on 3rd July, which was devastating. Aside from that, we have managed to conceive naturally (over 3 years ago) but it wasn't meant to be. I never actually skipped a period so I'm not sure if this is classed as a chemical pregnancy (I had quite a few early preg signs) or an early miscarriage (as the period I had 1 week before testing (due to preg symptoms) was possibly not a proper period?).... anyway, we've basically been on a bit of a journey TTC. I'm 36 and will be 37 by the end of the year, and DH is 38.

I've read up on stress being a factor in TTC, and have spent the best part of the last 12 months undergoing counselling, CBT, EMDR to increase my self-esteem back to "normal" (whatever that is) levels after it plummeted back in 2011 and continued to drop, because after our mc, my sister lost a baby full term. And then we struggled TTC. Whilst undergoing psychotherapy, we also had fertility investigations done (me: day 3 FSH and AMH and day 21 progesterone tests, a HCG x-ray, chlamydia tests; DH: several semen analysis done to check for motility, morphology etc) and were told that the results all came back within normal range. However, the diagnosis was unexplained infertility and we were told that our best chances of success now were IVF. I can't understand how you get an unexplained infertility diagnosis when your test results are "normal"?

So we got 1 cycle of IVF on the NHS; 8 eggs were collected, 4 of which over-fertilised, 1 died, 1 was immature, 2 fertilised properly but we only had 1 transferred back in (on day 2) after the 2nd one didn't develop. And the only thing that has been offered to us is access to the counsellor and/or to the scientists (although it's unlikely that they will be able to tell us anymore than we already know). Why don't we get a follow up with the consultant? Wouldn't there now be more information/evidence available for a different diagnosis?

DH would like us to just relax and get back to being "us" for a while (to be honest, he would have considered that anyway after hearing "results within normal range" but I wanted to give IVF a try) and then see if it happens again for us naturally. I've also heard from others that the docs don't tend to investigate further (immune tests for example) unless you have had 3 mc's. I'm concerned that time is not on our side and also with the knowledge of only 1 out of 8 eggs showing any signs of development it kind of hints that there could still be an issue but they just haven't found it via the basic tests. However, I don't want hubby to think that me and him is not enough. I love him with all my heart and I just want to be able to have a baby with him. But how do I get him to understand that when you've planned to have children in your life, and you haven't had them yet, it's like there is a void?

I'm feeling a little lost at the moment, so if there is anyone out there that has a similar background/diagnosis that could give me some advice or PMA, I would be grateful xx


----------



## Fx (Feb 28, 2012)

Hi
Not sure if I can help you with PMA, but what I would say is that results can completely differ depending on what clinic you are with.
My first 3 cycles of IVF  were very luckily provided by the NHS, and admittedly I did manage to get 1 or 2 embryos to day 5 each time, however, they were always graded as poor quality.

I then changed clinic and on that cycle got 7 top quality blastocysts on day 5. I don't have a happy ending yet, but what I'm saying is that if you can financially afford not to give up on IVF, then don't! And in the mean time keep trying naturally, as you just never know, especially if you are 'unexplained'. There is lots of info on this forum about how to improve chances of natural conception e.g supplements, acupuncture, diet etc. but try not to let it stress you out, it can become all consuming!

If you want another try at IVF (it does often take a few tries) I would definitely recommend trying a different clinic. They will be able to learn for your results of your first go, and maybe alter your protocol. Different protocols can affect egg quality. Have you read the guide by agate on this forum called 'learning from your failed ivf cycle'? If not, I'd recommend it.

You should have also had a follow up with your consultant after the failed cycle to discuss the results.

Having a BFN from an ivf cycle is always hard as so much effort and hope is put into it. So I'm not surprised you're still feeling devastated from it.

There is definitely still hope for you. Sending you a hug.
Xx


----------



## cherries (Jan 14, 2014)

Hi Fx,

Thank you so much for posting on my thread. Sorry I haven't responded until now but I have had a week by the seaside and just spent the last week catching up at work.

We have not had a follow up with the consultant and when I called the hospital with my result, I wasn't offered a follow up either! I was only offered counselling and/or a follow up with the scientists, which I think is pretty poor. Surely the consultant will have all information available to him, from different sources, and therefore it should be him who gives the follow up? Anyway, I will contact the hospital and ask/demand a follow up with him. It makes sense that they should look at all the info to see if there are further lessons that have been learned :-/

Also thank you for the information you have given, it certainly gives me a starting point! I didn't realise that different protocols can affect egg quality?!?! I'll certainly be having a look at the guide by agate 

I am actually feeling more positive than I was though as I just didn't realise how stressful IVF is, so a week away was definitely needed! xx



Fx said:


> Hi
> Not sure if I can help you with PMA, but what I would say is that results can completely differ depending on what clinic you are with.
> My first 3 cycles of IVF were very luckily provided by the NHS, and admittedly I did manage to get 1 or 2 embryos to day 5 each time, however, they were always graded as poor quality.
> 
> ...


----------



## Londonkitty (Feb 26, 2014)

Hi cherries

I'm in a similar boat to you with regards age and am also in the unexplained category with one failed ivf to my name. The only slight difference is I got 100% fertilisation with 4 making it to day 5 of which two are currently in the freezer. We had a follow up with the consultant and if I'm honest it was frustrating because basically they said nothing was wrong with the ivf and it is still 'unexplained' as to why the good quality embryo didn't stick. My DH took the positives from this (namely that we responded well to the drugs and made a good embryo) but I'm still frustrated that despite all that once the embryo was in me, something went wrong. We have got the option of adding in a couple of different meds this time but like you, in the absence of them really knowing why it didn't work, I'm about to start taking meds for cycle two feeling much less positive. 

Not sure I've given you any answers but hopefully it helps knowing your not alone

Xx


----------



## cherries (Jan 14, 2014)

Hi Londonkitty, yes it certainly does help to know am not alone.

I recently read a bit about the mind and body connection, and on how thoughts affect feelings which affect physical reactions in the body. And I found this site particularly interesting - so much so that I've ordered the CD:

http://www.natalhypnotherapy.co.uk/78.html

Having been through CBT, I am a big believer in that what you think affects how you feel which then affects the physical side of things. I also got to thinking about my own fears of pregnancy (following some painful experiences), labour, motherhood etc etc and wasn't surprised to think that I might be holding myself back. I learned about this on other levels during CBT, in particular that I am a perfectionist which means that I might spend a lot of time perfecting something at work, which then affects how many other tasks I can take on which then ultimately leads to stress and burnout. And it also means that sometimes I don't take on a particular task for fear of not being able to succeed (no faith in my own abilities); thus holding myself back!

So I'm going to give the hypnotherpay a go and I wanted to share it with you in case you also find it helpful  xx

/links


----------



## Londonkitty (Feb 26, 2014)

Sorry I'm slow to reply to this. Just wanted to say thanks for the link-it looks really interesting and certainly resonates with me. Hope the cd is helping you. I've taken it repeating positive mantras-taking out the word trying-when I'm walking home. Might make me look mad but heh ho!


----------



## cherries (Jan 14, 2014)

Hiya

Must admit I haven't actually got around to listening to the CD yet!!  

I will get around to it but I've been busy lately with various things - wedding, BBQ, shopping, training for a 5k run!!!!! I must be mental   but it's to raise money for Sands (the Stillbirth And Neonatal Deaths charity) in memory of my sisters Angel baby that she lost 3 years ago. I'm running on 24th August (2 days after another wedding do!) and sis is running it too. I know we could walk it and still raise money but it's a personal challenge for her to show her angel that she can achieve something she puts her mind to (with a little effort), bless.. and for me, I want to be able to run it (well, jog!) just because. I used to love sport in school but for the last 20 years I haven't really done regular exercise. But after going through counselling, CBT and EMDR for mental health issues over the last 12 months, am determined to keep up with self-care, which is quite easy to neglect when you're so busy looking after others, and one of those ways of employing self-care is exercise. And it certainly won't do me any harm getting fit and losing weight  

I've also got a holiday booked mid-October so I've certainly got other things to focus on which will help with reducing the obsession of TTC  

Just editing to add in that I finally got around to asking for follow-up appointments and apparently the hospital will arrange a follow-up with the scientists first and also the doctors - woohoo..... this wasn't anything to do with being lazy or busy though, it was a self-esteem thing, so I'm chuffed that I actually made the call


----------



## simone546 (Dec 25, 2011)

Hiya, just a quick one from me. I'm sorry about your failed cycle and mc, no one should have to go through this. I have a couple of suggestions:

Try getting as many level 1 tests out of your gp as possible. They're cheap tests and if you explain the situation they really should help. I think it would be reasonable to ask for: full blood count ( and glucose for insulin resistance), esr and crp for inflammation, thrombophillia screen (they prob won't do the genetic tests but others should be ok), thyroid check, antinuclear and antimitochonrial antibodies. 

Have you tried mindfulness? I've found it really helpful for stress

Supplements: I personally think omega 3, coq10 and a multivitamin are the most important esp for egg quality.

Sorry if you've tried all of these!

Jess xxx


----------



## cherries (Jan 14, 2014)

Hi Jess thanks for your input hun!! I haven't been to my GP yet nor tried those supplements, so you've defo given me some more info to take onboard. Do you think it's a good idea to get the level 1 tests now even though we haven't had feedback yet from the IVF docs?


----------



## simone546 (Dec 25, 2011)

Imo,  followups just involve saying what they would do next time. Personally I would go to gp first, it's not just about ivfbut your own health too. Also if something comes back dodgey it can take a while to get to the root of the matter...apt with specialist etc. I would getter ball rolling sooner. Xxx


----------



## Little Rie (Jun 27, 2014)

Mornign Cherries, and everyone else, I wondered if you would mind me joining this thread as I am looking for advice similar to Cherries. 


DH & I have unexplained IF, with suspected complications in my tubes due to surgical adhesion. Inventions to diagnose this are too risky so it's still only suspected. After 3yrs TTC we had our first round of ICSI in July, which was a BFN 23rd July. Our cycle was textbook, our embie was top grade and everything was so smooth. The BNF has hit us both incredibly hard, and I am only just beginning to get my head round it. 


We are lucky, and grateful, that our local NHS will (at the moment) fund one more fresh and two more frozen cycles. We currently have three snowbabies waiting for us. As we are NHS, we have to wait until Octobers AF to restart treatment. We have a follow up appt at the beginning of Sept, but not really sure what to expect. Our consultant so far has changed her working days to a day I can no longer attend so we are having to switch consultants. Bit unhappy at this as she was amazing, but who knows what other positive factors this other consultant can over.   


Cherries, you sound like a very busy lady! Good luck with for your run on the 24th August


----------



## Hopefulshell (Mar 14, 2013)

Hi little rie

Sorry you find yourself here with us but 
you've come to the right place for support
and understanding 

You will still be feeling pretty raw at the 
moment so give yourself time to grieve and
try not to think too far ahead until you've 
gotten your head round things. It's hard 
to think clearly when you feel so crushed 

You've done exceptionally well to get 3 frosties
and an fet is far gentler on your body so
keeping everything crossed next time will be your
time 

It's a shame you can't see the same dr if you have
established a rapport with her but it can be 
good to see someone different too who can offer
a different viewpoint. To be honest, there isn't a great
deal the docs can change for a fet as obviously the
embies are already formed but they can offer ways
to aid implantation if they think that's the possible 
cause for your last tx. My clinic offers the endo scratch
which yours may do too  sadly there often isn't an
explanation why tx fails even when it appears to be 
textbook. Ivf is a numbers game and so often just comes
down to good old fashioned luck  However you've done
really well and the dr will have lots of positives to comment
on so keep your chin up and keep positive that although it
wasn't meant to be this time next time it could happen 

X


----------



## Little Rie (Jun 27, 2014)

Thank you Hopefulshell


----------

