# Failed DEIVF, now confused



## jch182001 (May 9, 2011)

Hi all

Not really sure what help & advice I'm looking for but here goes...

Following unsuccessful OEIVF, and treatment when I didn't respond to meds, my DH & I were advised our best option would be donor eggs.  Following counselling and meetings withe the donor egg specialist, we agreed to join the waiting list.  
I have low amh, (unsure of level) and having miscarried twice using own eggs we decided to give it a go, especially as I hadn't responded to meds on the last round.  On the 2nd round of IVF i had 10 eggs collected, 5 fertilised, 2 transferred, BNP with subsequent miscarriage, on the 3rd round i had 6 eggs collected, 2 fertilised & transferred, BNP & subsequent miscarriage of twins, with an horrendous hospital experience (1 foetus tested and all ok)

Having been assured by our clinic that a donor would produce better egg collection results and most likely better quality eggs, we agreed in March 14 to accept an egg share donor, but it would have to be a FET due to my cycle not matching the donor, I wasn't particularly happy but was advised that being fresh or frozen didn't really make much difference.  The ED produced 5 eggs, of which only 2 were mature enough for ICSI (a last minute decision made via telephone after a conversation with the embryologist, just to help fertilisation along!), luckily both fertilised and survived thawing, unfortunately BNP.

The clinic want to do a follow up appointment in about 6 weeks, however Ive been lucky enough to persuade them to do the follow up this week, I have so many unanswered questions its unreal, but if anyone can offer advice on experiences they have had it would be appreciated:
Were we right to transfer to DEIVF or should we have given it another go using OE?  We felt quite rushed into making a decision, and weren't given any other options.
Should we have stuck with preferring a fresh cycle to frozen?
Did the donor produce sufficient eggs?  In the end they produced less than I had when I responded to meds, should we have tried using OE again before moving onto DEIVF?  I suppose this is my main concern.
Why was such an important decision discussed over the phone?  ICSI had never been previously mentioned, and we had no significant knowledge of what it involved, i.e. only eggs that were mature enough could be inseminated
Would more eggs had fertilised naturally rather that via ISCI?
Various documents weren't signed in advance for the thawing & transfer of the embryos, why weren't the clinic organised, it all seems so unprofessional, we had to attend clinic the day before the FET to sign  
There was no advice regarding semen, as my DH says there was no prep advice (when to avoid intercourse to ensure healthiest sperm etc.)
We were only informed when the DEC would be less than 48hrs before hand, is that normal?
+ loads more concerns

I know there are no guarantees with any IVF, I just feel really let down my clinic, thoughout the entire process of DEIVF there has been very little help, advice or information, whereas with OEIVF we were given information leaflets & advice etc.

I think for me my biggest issue is I don't know which way to go first, do we seriously consider changing clinics (we are visiting one this week for advice) for either OEIVF or DEIVF, stop trying and accept that i have one biological child but my DH doesn't, consider adoption etc.  I feel pulled in so many directions, my DH wants to try again, the in-laws want answers (they understand there are no guarantees but are concerned about the number of DE's in comparison to my own  (they also help fund any treatment)), my family know nothing about the latest rounds of treatment (my mum wasn't supportive last year), my friends that do know don't understand, and meanwhile I feel like a failure with no one to turn to 

I (and no doubt many others undertaking fertility treatment), do wonder if its worth all the stress to my body and how it effects the family I already have.  The strange thing is I seem to be finding it much harder to accept that the treatment has failed this time around, even more so than when I miscarried


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## Tincancat (Mar 19, 2012)

Hello JCH
I was wondering if you have had the standard Miscarriage Clinic tests? The following are what are normally done if you attend a recurrent Miscarriage Clinic.

DVV Test Ratio (Lupus Anticoagulant test)
Coagulation screen (Prothrombin, APTT, APTT Normal, 20/80 APTT)
G20210A Prothrombin Gene mutation
Anticardiolipin antibodies
ANA
Antithrombin Activity
Protein C Amidolytic Actvity
Free Protein S Antigen
APC Resistance Ratio
APC (V modified) Resistance Ratio
Vitamin D
Prolactin,
LH 
FSH
AMH
Thyroid (TSH needs to be below 2.5 for fertility patients)
Fasting blood glucose

You have possibility had some of these so you will only need those you have not had. More expensive tests often done are Factor V Gene mutation and MTHFR Gene Mutation but these are quite expensive and I am not sure they are worth it as the treatment is probably cheaper than the test - so often it is just as well using Clexane treatment.

Male Miscarriage factor testing which are useful include:
Sperm DNA Fragmentation (SCSA)
Sperm Aneuploidy (FISH)
Infection Screen (DL12)

If you take a look at https://www.tdlpathology.com/home most of these tests can be done at this Laboratory if you get a doctor to sign your form then you can pay for these tests above yourself. In some cases you do not even need to attend the London testing lab you can have blood taken locally and post it or drop it off at the Manchester Clinic.

I do think if you are considering DE again you should look at going abroad. Success rates are much higher than UK more than 80% at the Clinic I went to. However communication is not brilliant but as I was warned of this before hand so I was prepared: I went because of recommendation and the success rates not the communication. I knew how many eggs had been collected but did not know how many embryos had developed until I arrive in Cyprus as they leave them alone and don't keep looking at them every day. Also take a look at doing a Tandem Cycle abroad as this would give you another chance with own eggs and a donor as back up.

Good Luck
TC x

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## jch182001 (May 9, 2011)

Hi TC

I was fortunate enough to get the miscarriage testing completed on the NHS, my ivf consultant also advised on miscarriages and was able to get me tested fairly quickly, all the results came back showing there was no reason for the miscarriages.  I have thought of trying a clinic abroad but was abit wary, I haven't mentioned it to DH but may be worth it.

Do u mind me asking roughly how much treatment is abroad? And why you chose Cyprus?  &  what was  involved in going abroad?

Many thanks for your reply

J


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## dillydolly (Mar 11, 2005)

Jch

Tinacancat has mentioned some good things to try and some good points 

I would just say that if it was me I would get a second opinion. Also we all have to be grateful that ladies share their eggs but sometimes when it's a share scheme then the lady could have her own egg issues although it's all usually fine. I think it's better to get eggs from someone who is young and donating their eggs to help someone but not through an egg share scheme. I think it's called alturistic ?  Or like tincancat said abroad where eggs are from young donors and have a proven history if possible

Donor egg cycles do fail, mine did and I just out that down to bad luck and possibly dodgy sperm so get sperm checked for sure if it hasn't been already. Also you thyroid

You are probably finding it harder this time as donor eggs are mo re successful but it hasn't been for you this time. I wouldn't give up though just yet! And you're not a failure!


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## Tincancat (Mar 19, 2012)

Hello JCH
Pleased you have had all the miscarriage testing. That's one thing you can discount.

It cost me 5600 euros for double donor. I had a gonapeptyl injection on day 21 which shut down my own hormone cycle and then waited for my AF to arrive. No particular side effects unlike long down reg with buserelin. Booked my flights on day one of AF, started oestrogen tablets on day 2, had lining scan in UK on day 9, after which I needed to increase my oestrogen dose. I started progesterone and prednisolone on day 10 with 5 day course of doxycycline. Flight to Cyprus on day 13 and had embryos transferred on day 15. I returned to south of Cyprus and stayed a further 7 nights in Larnaca as it was very cheap out of season and I had my BFP the morning I left Cyprus. You can fly straight back after staying the 3 nights if you wish but I wanted a bit of a holiday.

I chose Cyprus as I knew someone who had been there and who also had had DE treatment in Spain plus the UK. I had been all set for Spain but switched to Cyprus when I found it was much cheaper with equally good success rates plus I had some say over the choice of both male and female donor which I would not have had in Spain. Flights to Cyprus were cheap out of season with EasyJet from my local airport and so was accommodation: I would recommend going in October to March as you will get the best deal for both flights and accommodation then.

Have a look at http://www.dogusivfcentre.com/ which is where I went with Dr F or http://www.dogusfertilityclinic.co.uk/ which is the website of the other doctor working out of Dogus who has a lovely UK Coordinator called Ayse who is a Londoner or http://www.adaivf.com/ which is a new clinic set up with an embryologist who used to work at Dogus, plus the former UK coordinator from Dogus. I understand Ada are getting some great results according to what I learned whilst out in Cyprus. The only thing I will say about Dogus is that communication can be relaxed so be prepared for that and also don't get your medications from them as they can be bought from a great Pharmacist Erol on Kyrenia harbour at a much more competitive price. Dogus used to use Erol until they realised they could make more money by supplying the medications themselves! If you use Dogus for your accommodation then you are are given 200 euros towards accommodation and transfers to and from Larnaca plus the clinic are included. However accommodation worked out expensive via Dogus at 67.50 euros per night B&B where as in Larnaca I found a lovely apartment out of season for just 30 euros a night. I therefore stayed only 3 nights in Kyrenia before using the free transfer back to Larnaca.

I would never cycle in the UK again and only wish I had been brave enough to go abroad before now. I wasted so much money and so many years in the UK where success rates are so poor.
Good Luck
TC x

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