Failed 1st IVF cycle... now what?

[jbird30]

Hello everyone, I'm pretty new to this- figured it would be helpful to find some support because I don't really have any friends going through IVF. I just had my first failed attempt (found out yesterday), and I am wondering what I should do next. My clinic said that I can arrange a consult with my doc. I am wondering, for anyone who has tried and failed before, what kind of questions I should be asking him. Throughout the cycle, everything seemed to be going really well. I produced 12 eggs, 10 retrieved, 8 fertilized, and got two really good embryos (both transferred) and two others were viable and frozen. My hormone levels were high and stable throughout the cycle. Naturally, I am really, really bummed that this didn't work out, and I'm guessing that's normal... sigh.

[angeinhull]

Hi

So sorry that you are going through this. I know it is heartbreaking.

The kind of things I asked were around egg and embryo quality, what could be done differently next tim to improve our chances etc.

I hope your meeting goes well and you will be able to heal and move on to your next chance. Will it be FET?

Angela

[jbird30]

Thanks Angela, I really appreciate the feedback. Yeah, going through this really stinks! I will definitely ask about those things. I'm hoping to move forward with FET, but I have yet to know their quality (I have two of them.) Have you gone through a cycle yet?

Thanks again!

p.s. - new to this - just noticed that that you have gone through IVF and had success! Congrats to you!!

[Ghost]

Do the FET. It's cheap and easy compared to another fresh cycle.

They usually don't freeze embryos unless they are pretty good.

[jbird30]

Question for you both: when did you first find out the quality of your embryos? I wasn't told anything about them (except that I had 8 eggs fertilized) until about 10 minutes before my transfer, while I was lying down, waiting to go. When the doctor told me I only had 2 good ones, and wasn't sure yet as to whether or not any of them could have been frozen, I completely panicked, thinking this was a 1-shot deal and if it didn't work, it was back to the drawing board all over again! (Luckily, we ended up with the two frozen.) I know it would be unreasonable to blame the heightened stress right before the transfer for the failure... but I can't help but feeling that the timing of giving me that info was a little inappropriate. Shouldn't they have called me the night before perhaps? Just curious on what your experiences were.

Thanks!! Jeannine

[Ghost]

Question for you both: when did you first find out the quality of your embryos? I wasn't told anything about them (except that I had 8 eggs fertilized) until about 10 minutes before my transfer, while I was lying down, waiting to go. When the doctor told me I only had 2 good ones, and wasn't sure yet as to whether or not any of them could have been frozen, I completely panicked, thinking this was a 1-shot deal and if it didn't work, it was back to the drawing board all over again! (Luckily, we ended up with the two frozen.) I know it would be unreasonable to blame the heightened stress right before the transfer for the failure... but I can't help but feeling that the timing of giving me that info was a little inappropriate. Shouldn't they have called me the night before perhaps? Just curious on what your experiences were.

Thanks!! Jeannine

We tell patients how their embryos are developing from day to day, and we tell them the quality of their embryos before transfer. We give them photos of the embryos if they wish. If they want photos and assessments of those we froze, no problem.

Your clinic should have photos of your frozen embryos and at least be able to print/photocopy them for you (perhaps they can email the photos to you). Even better, find out their success rates with frozen embryos from SART:

http://www.sart.org/find_frm.html

[jbird30]

Thawed Embryos From Non-Donor Oocytes <35 35-37 38-40 41-42
Number of transfers 142 86 69 16
Percentage of transfers resulting in live births 24.6 17.4 13.0 2 / 16
Average number of embryos transferred 1.8 1.8 1.7 1.9

Ghost - first off, I just wanted to thank you for all of this information. I had no idea that this database existed.
These are the stats from my clinic - what are your thoughts on this? Looking at this, I am a little concerned. Keep in mind that changing clinics is totally on the table.

I read some of your posts from a couple of years back on frozen vs. fresh. Given your previous info, I'm thinking that these stats should be higher???

Thank you again so much - I hope you have at least an inkling of an idea of how helpful this is!

Jeannine

p.s. I totally spaced the data out, but when it submitted it jumbled it all together! Sorry - I've sure you can figure this out but to save you time, the % of live births from FET is 24.6%.

[angeinhull]

Hi

We were told the quality on the 2nd day after retrieval. It didn't mean much to us as novices so more was explained at the meeting after the failed cycle. We didn't freeze on that cycle.

We froze on this cycle, we have 5 blasts frozen, 2 very good quality 3 not so good but who knows right? We intended to do FET if this cycle failed but we were lucky ad have our son.

Ask away I am always happy to help if I can, this is a horrible journey for us all.

Ange

[jbird30]

5 frozen sounds like a great number! When it's time again, would you opt to put the two good quality ones in at once, or one at a time?

I guess in hindsight I'm just going over everything in my head, and trying to figure out where my concerns lie so when we have our consult, I am prepared with the right questions. We're lucky to have awesome insurance, but even that will run out and I just feel like this time around, we should be more educated and if that means finding another clinic, then so be it. I really like my doctor (LOL - he's also extremely attractive, but that's besides the point!), but I'm also an hour out of NYC, where some really good clinics are. Just don't want to waste my time - going through this and failing once was painful enough!

Have a great day!
jeannine

[blairwh58]

jbird-I saw this board and thought I should contribute. We did our first IVF cycle in June and I thought for sure it would work (as did the MD and NP). We had 13/13 eggs fertilize and 10 left the day of the transfer. We transfered 2 and ended up with 6 good quality ones to freeze. Since the 2 we transferred were 10 cell I thought it was def going to work for us. And I guess technically it did, since I ended up with a Positive HPT and Beta. But the beta was low and didnt go up so I ended up with a chemical pregnancy. We are in the middle of our frozen transfer cycle now, and are hoping to transfer on Aug 24 if everything works out like it should. Best of luck to you!! I have heard that some people and some clinics have better luck with frozen...so thats what I keep telling myself.

[angeinhull]

I think the 1st cycle is almost like a learning cycle in some ways and as a result things may be done differently. For instance on my second cycle I was stimulated with a much lower dose and longer to ensure we got more mature eggs. So maybe changing RE is not the answer straight away if you are comfortable with them

1st cylce - 21 eggs, 8 mature, 8 fertilised, 3 blasts. 1 transferred, none frozen, BFN

2nd cycle - 12 eggs,11 mature, 11 fertilised,6 blasts. 1 transferred, 5 frozen, BFP and our lovely son. So you can see this was an improved cycle

I never had the chance to transfer 2 on either cycle to UK guidelines.

If we do FET we are allowed to transfer 2. I wouldn't do this now because we have our son and all the risks of multiples seem too much, plus how hard they must be to look after. BUT I would have taken the risk I think before we had Freddie because I would have done anything to have my baby and it would have been our last free cycle. So really a battle of the practical vs emotional and usually my heart wins.

[jbird30]

Blair - there's a contributor above (Ghost) who is a wealth of info - I looked at some of her posts back a couple of years ago and he/she had some very interesting things to say about the success of frozen embryo transfers, as this was also a concern of mine. If you click on his/her name and search through her previous topics of postings, you may be able to find it. It really lifted my spirits about transferring frosties, since that's the route we will be going! Not sure when though. Good Luck to you!

Ange - I couldn't agree more. It absolutely was a learning cycle. Thanks for your info - we'll see if my doc follows a similar protocol. Speaking of which - did your doctor or the office call you personally after your BFN, or did you not hear from them again until your follow up appointment? Just curious -

Thanks ladies! The best to both of you -

Jeannine

[angeinhull]

Hi

I didn't hear until the follow up appointment but bear in mind mine was a NHS cycle and not private so after care may be different

Angela

[Wondercat]

The first cycle is definitely the most difficult, and for me the follow-up meeting was one of the hardest parts. You want answers, clear-cut answers as to WHY it didn't work when you and they had every reason to believe it would. Many times there just isn't an answer, but I found it frustrating and upsetting that the upshot of what my RE had to say was "we don't know, better luck next time." Looking back now, they did do many things differently the next 2 cycles. But at the time I left feeling really deflated. I think failing on the first try is so hard because even though you have told yourself that it might not work and you think you're prepared for that possibility, really you go into it thinking about how excited you're going to be when it works. Suddenly you've had your feet knocked out from under you and you're thinking in terms of "if it works" and "what if it NEVER works?"

As others have said here, the first time is like a learning cycle for the RE as much as us. They have to figure out what is and isn't going to work for us. Unless your clinic's numbers are really below average, I wouldn't worry too much about statistics on other women. One thing I have learned on this board is that pretty much every woman on here has completely different reasons for their infertility and has a slightly unique experience with IVF. I think it's also easy for some clinics to pad their numbers by screening patients to weed out ones that might negatively effect their stats. With your follow-up meeting focus on what they think may have gone wrong and what they are going to do differently next time around - keeping in mind not to be surprised if the answer you get is "sometimes, even though everything seemed perfect, it just doesn't work." Also don't be afraid to tell them that they upset you by the timing with when they gave you the information about the eggs, or anything else that bothers you. It is definitely helpful to feel comfortable and (relatively) stress-free at your clinic.

[jbird30]

Thanks Wondercat - that pretty much sums up my feelings at this point! Glad I'm not the only one who "fears the worst" about it never happening. After joining this baord and seeing so many women succeed after 2, 3 tries and more, I feel a little better about jumping on the wagon again. Perhaps I will call today to make my follow-up appt.

Thank you!