# what next?



## pnutbutter (Jun 7, 2018)

Hi 

Myself and my partner have just had our first failed IVF with ICSI cycle. I had 6 eggs collected, 5 fertilised and only 1 that made it to blast at day 5, had two others which were growing but were just too slow to keep observing, so unfortunately have no frosties. 

I was wondering what people did during their next cycle? Do we go straight into PGS or do we have another cycle (hopefully up the meds to produce more eggs) with some added extras such as scratch or glue? I have seen on multiple forums that people have had perfectly graded embryos with no chromosomal abnormalities and still experienced no implantation.

any personal experiences or thoughts appreciated


----------



## Molly87 (Jan 29, 2018)

The first cycle is always trial and error. It may be that your consultant just recommends upping the medication to get more eggs and hopefully more embryos. The fact you got to the stage you did in the first round is great, it just doesn’t always work unfortunately! Success rates from one cycle alone are not that high. I know it’s devastating (I’ve had 3 failed transfers) but you have to try and pick yourself back up and try again. I obviously don’t know your background etc but follow your consultants advice - ask lots of questions. I find after the follow up appointment I can get closure on one cycle and feel really positive about the next.

My meds have just been upped each time and I went from 4 eggs in my 1st cycle to 16 in my second. I’m about to start my 3rd cycles with the meds upped again - it seems it’s very much a numbers game! xx


----------



## bombsh3ll (Apr 19, 2012)

Sorry for your disappointment this time, it's always hard to pick yourself back up again. 

Firstly, even if everything is on your side; egg/sperm quality, age, uterine environment etc, each IVF embryo transferred statistically only has about a 16% chance of successful implantation and continued development. I used to employ this statistic during my treatments to argue against enforced SET - I transferred 3 each time and the chance of triplets was like 0.16 x 0.16 x 0.16 ie vanishingly small. This means that there probably really wasn't anything you could've done differently or should have any regrets about. 

Regarding PGS, given you only had one decent blast to transfer, and have only had one unsuccessful transfer, I think this is an expensive avenue that may not be the best one for you to pursue. It tends to be of higher yield in people producing several good looking blasts that are repeatedly not taking. If you only have one or two to transfer, it is not as if you are looking for the good amongst the bad, more you've got what you've got. 

There may be other issues to consider - 6 eggs can either be a sign of a responsible and progressive clinic using gentle stimulation to minimize OHSS risk, or it can reflect poor reserve, particularly if you were on high dose stimms or are in the older age group. These are things to discuss at your follow up appointment. 

Having said that, the main things that jump out are 1/. a very low proportion of your fertilized eggs making it to blast. There is a school of thought that when eggs initially fertilize but the embryos deteriorate between day 3 and 5 ie don't make it to blast, it can be an indicator of poor sperm quality rather than egg factors. 2/. the use of ICSI  (unless used for everyone as standard at your clinic) also suggests a possible sperm quality issue. If applicable, you need to get an honest idea of how significant this is. It may not be an issue or they may have really struggled to find any useable sperm.

I think these are the areas to bring up with your consultant and see what they suggest. At this time, there isn't much evidence to support the use of glue or the scratch. The latter can also be an infection risk, and also a risk factor for placenta accreta which trust me you do not want to have.

I too had banked on frosties from my first cycle but found out too late the Cypriot clinic didn't do vitrification, & it was gutting feeling we were right back to square one, but hopefully some valuable information may be gleaned from your first cycle that can help increase the success of subsequent goes. For example we learned I OHSSed very easily and developed stimulation-induced hydrosalpinx, which ultimately led me to choosing the right course of action for me that led to success. 

Best wishes, I hope next time is your time.

B x


----------



## Rumplestiltskin (Mar 11, 2014)

Hi Pnutbutter, so sorry it didn't work this time. However, I'd agree with Bombsh3ll, that PGS may not be the way to go right now.  

Sadly, most IVF cycles (70%) are unsuccessful. Nothing really prepares you for how it feels when it fails, but it's entirely possible that you'll be successful next time. Being in your 20s means time is on your side,  so maybe the first thing to focus on might be to try to produce more eggs, so that you've got more choice of embryos, and the possibility of frosties. If it's a sperm issue, then there are lots of lifestyle changes your partner could do to improve his sperm, including cutting out alcohol/smoking, and taking supplements. Check out the male factor boards for lots of advice and success stories. 

Good luck.


----------



## noelle80 (Mar 23, 2014)

Hi pnut, I was in the same cycle buddies thread as you, so sorry you had a bfn. We too had bfn this time. We are in a different situation to you, in that we have had a cycle before which was successful (we were really fortunate to get lucky on our first try) We are now almost 5 years on and just started trying for a sibling. This cycle has been very similar to our first... different clinic but similar doses of meds, same numbers of eggs collected, similar numbers fertilised, better embies as we actually had frosties this time compared to none last time, and yet we still got bfn this time compared to bfp last time.

I think what I’m trying to say is that even when things work and you replicate them best you can, there are no guarantees. It all comes down to luck at the end of the day, and unfortunately most people are not lucky enough to be successful 1st time. 

I think you should talk to your clinic. I imagine they will tweak your meds to try and increase your number of eggs, and it may be worth talking about whether there is anything your hubby can do to improve sperm quality. I don’t think you need to look at genetic testing yet. You will hate to hear this but you are young, time is on your side (I am 38... I wish I started trying in my 20s) Give it another cycle or two, most people take at least 3-4 cycles before they get lucky. If after a few cycles you still have no hint of a bfp then it is worth asking more questions... for now I think unfortunately it is just a numbers game xxx


----------



## pnutbutter (Jun 7, 2018)

Hi Molly, bombshell, Noelle and rumple  Thanks for taking the time to reply. 

Noelle - thanks, I've been keeping up with the thread as intrigued to know how the other ladies are doing. You feel like you know each other after a while and feel each others pain! I think the more people I speak to the more I realise.. like you say it sounds more of a numbers game! 

That's a relief that everyone thinks PGS is not needed yet as we worrying about the added cost. It is a shame that your first round is pretty much a trial run, despite the amount of money we paid. 

We have MFI so my OH is doing all the right things as his count has improved from 0.8mill/ml to the one we used to IVF which was 11 mill/ml but great improvement. However we could both improve our diets. I think in the meantime we are going to make an appointment to see Dr Jonathan Ramsay to see if he can suggest anything. We are yet to have a follow up with clinic, do you know how long they would prefer you to wait between cycles?

Thanks


----------



## Molly87 (Jan 29, 2018)

My clinic lets you start again straight away if you feel ready. So previously I’ve had my bleed post BFN then started on the next cycle. I have heard some clinics like a wait though.

Dr R is really good and may be able to suggest something for your OH. The improvement he has made himself sounds great though! We went to see him last year - unfortunately he couldn’t help us as my husband doesn’t produce sperm but he is clearly very passionate about what he does and I felt we needed to go and see him. 

Good luck with your next steps. xx


----------



## noelle80 (Mar 23, 2014)

Pnut yes even though it is only a few weeks you do become very involved in your cycle buddies lives! After my last cycle one of our bunch started a f b group and there are about 15 of us who are still in touch. It is great, some who got bfn when we first cycled got bfp later (only one lady never did unfortunately) and many of our group have had siblings now. Some of us have even met up when we can.

Sounds like your hubby is doing what he can. We have mfi too But as long as there is some sperm there that they can use then you are in a good position. I think you just have to try again and see what happens. I guess it is up to your clinic what they recommend about how soon you can try again, I’ve heard some say they’ve been told to wait 3 cycles, and others can go again on their next one. I’m hoping to try again ASAP, although with Xmas coming up that will mean the new year for us as we will be in Northern Ireland at my parents’ in the middle of my next cycle. Silver linings though, at least I will be able to have a Christmas tipple or two before getting back on the ivf bandwagon in January!

I really hope you have a better result on your next try, feel free to message me if you need to xxx


----------



## pnutbutter (Jun 7, 2018)

Thank you Molly 

Noelle - Yeah I think we are going to start again in January too. No more holiday for work and plus gives us some time to digest, improve on a couple of things and enjoy a drink over Xmas! So maybe we will be cycling together again soon  Good luck to you too on your next one!


----------



## miamiamo (Aug 9, 2015)

I am sorry it did not work for you. I fully agree with what Rumplestiltskin has posted x


----------

