# 2 failed ivfs and unexplained infertility - where to now?



## Amber80 (Oct 28, 2015)

Hi, this is my first ever forum post so please be gentle! 

We (me 35, DH 37) found out last week that our 2nd ivf had failed and was hoping some of you knowledgeable ladies might be able to offer some advice and thoughts as it feels pretty bleak right now and I can't see a way forward.

We have been ttc for 3 1/2 years now and have the helpful diagnosis of "unexplained infertility". All tests normal (husbands SA borderline ok, count good but morphology around 4%, me AMH around 20, fsh 7 - this was all over a year ago). On our first go at ivf we had a bit of a nightmare. First they found a polyp when doing stims right where the embryo was going to be placed so had to get that out then start stimming again. We  were on long protocol got 13 eggs, 10 fertilised and at day 3 had about 8 embryos, about 5 top quality. Unfortunately by day 5 we only had one blastocyst which was 4AA, not sure what happened to the rest, I think we had 2 early morulas. The blastocyst was transferred and got a very faint bfp which continued to be faint (which when I voiced my concerns to the nurses was met with "a positive is a positive" -ha!  ) When we went for the 7 week scan there was nothing in my womb - it was a "pregnancy of unknown location" and was never found. I had methotrexate to resolve it.

On our second ivf we changed clinic and were put on short protocol, all quite straightforward we got 14 eggs, 8 fertilised then 5 good embryos at day 3. By day 5 we had 2 rubbish blastocysts and a slow embryo which was a 3bb blastocyst by the time we went in for transfer so the 3bb was transferred. I started bleeding 5 days before OTD. 

So, now I'm not sure what to do. Since things seem to go downhill after day 3 I was wondering if getting a look at sperm dna fragmentation might be a good idea? And/or immune testing? I feel like I haven't got many more rounds of ivf in me so feel under pressure to make the right decisions (also aware I'm not getting any younger).

If anyone has any advice or insights I would be so grateful. Thanks x


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## angelica_wales (Oct 10, 2012)

Sorry you find yourself here Amber  

I would agree that losing your embryos after 3 days would suggest a sperm problem.  It might be worth checking for dna fragmentation. When I asked my clinic (although we made perfect blasts everytime) they simply suggested using IMSI without testing as that would be the suggested solution of dna fragmentation.  They also recommended vitamin c and fish oil to improve sperm quality. 

Your CP and early bleeding could be down to immunes,  but as you can't really rely on embryo quality right now,  it's difficult to say. 

I would suggest asking your clinic all of these questions and if they're not open to these possibilities,  maybe go for an initial consultation with a different clinic. If cost is an issue,  maybe look at getting some tests done abroad. Immunes testing isn't cheap here ... 

At 35, you've still got some youth on your side   I would take a few months to regroup and plan what you're going to do. I think you'll feel better in making some changes rather than doing exactly the same again. 

Good luck 

Angelica 
xx


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## Carrie88 (Aug 2, 2015)

So sorry Hun  

I'm in the same position. 2 failed transfers of a 4AA and a 5BC embryo. No fertility issues and doing pgd for a genetic condition so very frustrating.

Sounds like you've had a bumpy journey too! What have your clinic suggested? Mine suggested a hysteroscopy which I had last week to see if there was anything that was stopping implantation. And we have a private appointment tomorrow evening at a clinic local to us who specialise in immune testing. My clinic are just putting it down to the embryo having chromosome abnormalities (I'm not convinced) 

I feel the same, we are almost on our last pgd cycle so I wanna check everything out as much as possible.


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## Amber80 (Oct 28, 2015)

Hi Angelica thanks for your thoughts it's really helpful to 'chat' to someone who gets it! Next step is to arrange the review appointment I guess but I think you're right since we aren't generally getting decent embryos immune testing might be a moot point anyway (and ££££). I always imagined Ivf would at least thow some light on why it's not happening so I think I'm finding it difficult that it hasnt really, just more questions.

Anyeays thanks very much for replying and all the best with your pregnancy! Xx


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## Loulou4- (Sep 18, 2014)

Hi

Your AMH and FSH look good and your getting decent number of eggs, from what I understand the sperm tends to takes over with embryos from day 3, as you know you will always lose some embryos when taking them to day 5 but if there is a big drop in quality and quantity then it's good chance it could be sperm issue. 

MY OH had issues with really low sperm count but the other parameters were ok, they did suggest some more tests, he had DNA fragmentation, blood karyotyping test and they also mentioned the FISH test for sperm. He didn't have this one in the end and can't remember what it's for! But it's maybe something you could look into. 

If it is a sperm issue there are things that he can take to improve it but think  it needs 3 months to see impact. Like other ladies have said sometimes it's good to take a bit of time to re group., I'm not sure which clinic your with or if NHS but if your clinic are reluctant to do the testing don't be afraid to go elsewhere for tests private., be proactive in research and get second opinion. I think a lot of clinics tell you it's just a numbers game and while that can be the case if your not in a position to do countless cycles it's better to look into things now than ploughing ahead doing same thing if you've got a feeling something's not right., 

Re immunes, ive had all immunes testing and it can get really expensive so I wouldn't advise it unless you've ruled everything out as it is a bit of a Pandora's box, you'd prob come out with more Q's than before! 

Sorry your going through this, we are 2 years in and it's been a nightmare at times with various things going wrong, so frustrating.  I'm no expert in all this by any stretch but hope it's helped a little bit 

Xx


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## marty123 (Dec 26, 2015)

Hi, Amber! Just dropped in to give you a strong hug. This is so very tough to face! I've also had one failed round IVF with donor eggs. This is our shot#2 in Ukrainian clinic. And I'm so sorry for your "helpful diagnosis "infertility"  This must be harder for both sides you and your docs to struggle with no vivid reason. This is so weird!! 
As for your age, you're still young brave lady. (I'm 40 yo but don't feel like that !!) So I guess there is the reserve which gives us strength and belief in a happy future with our own tinies.


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## monkeyface1856 (Jul 16, 2014)

Hi, 

I wanted to tell you my story too as it may help. I have had 2 fresh and 2 frozen cycles on the NHS and not one of them ever implanted. My AMH was low but FSH was fine for my age. (I was 32). On the max meds I only ever got 4-8 eggs and out of them all fertilised and 50% made it to blast but I kept getting BFN. DH sperm looked fantastic on paper so we didn't know what was happening. I then went to Barcelona to pay private and they suggested testing his sperm and we found out that 47% of his sperm was fragmented which they believed was the reason for the failure. He also did the FISH test to check chromosomes but it was fine. All he had to do was take anti oxidants for 60 days and he got it down to 12% which is in normal range. I did decide to use donor eggs in the end as I didn't want to pay all that money for a few eggs of my own.  We had one fresh go which failed and we have just got our ever BFP with our frozen cycle. I used two embryos as I didn't want to leave any behind. 

My point is, check the sperm before giving up. If the NHS would have checked I'm sure we would have saved them money in the long run. I'm 36 now and I don't know how many more cycles I could have gone before I had to give up. 

I wish you luck with the future.


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## Amber80 (Oct 28, 2015)

Hi everyone, thanks so much for taking the time to reply - I know this is how forums work but I'm a bit touched! We've arranged a couple of little holidays away to try to regroup a bit (good advice, nice to have something to plan) and a have made a review appt date and am getting DH to book a spermcomet (dna fragmentation test). We are at Leeds so I don't think they are particularly into immunes etc but maybe that is something for a bit further down the line. I had in my head we would only do 3 rounds of ivf but maybe I need to consider that we might have to try more and try to make other things in my life a bit better for the long haul! It just feels so much like we're in limbo and I just want that feeling to stop, loads of stuff like we both don't like our jobs but need to be earning what we are to fund ivf and it feels like everyone is moving on in every aspect of life except us. All of this plus only just really realising this might just not happen for us is just a bit much at the moment. Hoping the holidays sort me out!

monkeyface - thanks for telling me about your situation I def want DH to get checked out, even if it's just to give us an idea of how long it's worth continuing. Congrats on the bfp!

marty - hug much appreciated thank you 

loulou - thanks for the advice I'll see what they say at review and look at getting a 2nd opinion. 

carrie - your situation does sound similar  . I have never had a bfp ever except on my first round of ivf when I had the polypectomy, which obviously got rid of the polyp and also injures the endometrium (so I'll prob ask Leeds about an endometrial scratch). Obv I don't know if the polyp was hindering things as well but it was fairly large and scans didn't pick it up, so I guess a hysteroscopy might be worth a try. But who knows?! How did your appointment go? 

Good luck to you all, so rubbish that we are all here but I'm grateful for the support!


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## ~Sapphire~ (Apr 14, 2008)

So sorry your cycle wasn't successful.    I just wanted to comment because you said it appears your embryos go downhill after day 3.  Every time we tried to go to blastocyst we lost a large number of embryos between days 3 and 5 and the ones that made it to blast were not great quality.  Our embryos were all top grade at day 3 and what worked for us was having the embryos put back earlier. I had two successful cycles and one chemical from day 2/3 transfers and no success at all with blasts.  By all means if you want to rule sperms problems out get the tests but I think in our case our embryos just preferred the uterine environment to the lab.

I wish you success in the future. Take care xx


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## Amber80 (Oct 28, 2015)

Hi Sapphire thanks very much for your post that is interesting, I did wonder about asking them to try day 3 embryos last time as I was worried that we might not end up with anything considering what happened the 1st time. However as there were 5 that were top grade at day 3 the embryologist said there was nothing to tell them apart so it would be a bit pot luck with which they transferred so we went to day 5 to weed out the better ones (also used the embryoscope which I think is supposed to give a more stable environment). But looks like you were in the same kind of situation so will put it on my list to bring up at the review! Thank you
xx


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