Agate's guide to learning from your failed IVF cycle

[Teddytots]

Hi agate, we've just had our 1st ivf cycle fail. Still coming to term with it but looking to the future. We are both 34 and has unexplained secondary fertility.My amh is 15.7.Dh SA was fine.I was on the short antagonist protocol with 150 peurgon. Initially I had 8 follicles but only 5 were at a decent size by EC (15-22mm). I got 4 eggs and 2 fertilised. I had a day 3 transfer with a 8 cell and 4 cell. Both grade 2a quality. Transfer was a bit difficult as they realised that I have a tilted uterus so took them a while to do it. I started bleeding heavily 12 days after transfer, I was still on the progestrone gel . Where do I go from here? I had a couple of autoimmune tests done but they came  back normal. Also how long would you recomend between cycles (both physically and mentally)?

My summary of care arrived from the clinin today so just adding my test results. They said all look normal but could you let me know what you think please when you get a chance? Also is one of these tests for factor 5- turns out 2 of my cousins had/have it but we don't know which side of the family it's from yet.

Oestradiol (2 days before EC) 2765 pmol/l
ACA IgG 1.4 GPLU/ML
AGA Igm 1.9
Beta 2 glycoprotein IgG<20 u/ml
Beta 2 glycoprotein IgM <20 u/ml
Protein S 0.85 iu/ml
prothrombin G20210A mutation - Negative (G/G)

PT 10.8 secs
APTT 30.2 secs
Fibrinogen 1.93 g/l
Protein c activity 0.90 iu/ml
Antithrombin Activity 0.90 iu/ml
APCR (+FV def) 2.9 ratio
FVIIIc 0.82 iu/ml

FSH 8.3
AMH 15.77

[FertilityFriends]

[agate]

the protein c activity is a screen for factor v - so it looks unlikely that you have that
if they've told you the rest are in the normal range i'd have to believe them - because you really need to know the normal range for that particular lab which isn't given above.

[Shoegirl10]

Thanks for that agate,
my cycles are dead on at 30 days
all my blood results are fine and had no side effects from any of the IVF treatments
My doses of gonal f and menapur were low so maybe the short protocol is another option

X

[whigers]

My gut reaction would be a sperm problem that the ICSI isn't fixing - although its quite likely to be a combination of issues.  I think from your history I'd prioritise infection testing and sperm dna frag testing first before the immunes route.  In the meantime, I'd see if you can get your partner to take 1g vit C, 0.4g vit E and a good quality men's mulitvit plus 1g omega 3 fish oil.  If he goes to serum, I expect they might want to also try him on 30-45 days of antibiotics to see if they can get his sperm good enough for ivf.

Thanks Agate.  My partner already takes the Zita West Vitamen and Vitamen boost.  He also tried chinese herbs for the last 3 months, doesnt drink alcohol or coffee.  Would he take the vits you mention in addtion to these?
He has referred himself to a urologist to see what they can come up with, just waiting on the appointment. 

Thanks again.

Whigers x

[Shoegirl10]

Hi

Just got back from clinic and my consultant is pleased with how my cycle went and how I responded but I will be going in for tests on Natural Killer Cells and Cytokine next week with a 2 week turnaround on the results
I am also going to be on clexane and aspirin on my next cycle as a prevantion

Cross fingers xxx

[CharlieClarke]

Hi Agate

I feel very frustrated and need some advise.

I'm on a short protocol and today is day nine of my cycle and day 8 of Menopur and day 5 of Citrotide. Since yesterday I have been having symptoms of ovulation. Went for a scan this morning and I have 6 follicles ranging from 12 to 21, 4 of them were on the bigger side. Then took blood after I advised and have just called advising that they are bringing my collection forward to Fri ( trigger tonight at 10.20 ) and that 1 of the levels they checked was raised confirming the pending ovulation. I'm having a scan before they do the EC to ensure they are still there.
I normally ovulate on day 11 which will be Friday. What are the chances of them still being there?
I thought the Centrotide was meant to stop this!

Any advise would be appreciated

[agate]

usually cetrotide will block LH and prevent ovulation.   this is how it should work, but in rare cases its not effective.  It sounds like your clinic are trying to be on top of the situation though.

[CharlieClarke]

Thanks for replying Agate

Yes, they are good there. Im just praying now I hold on to them. They said it was only slightly over so....

Nothing I can do so im just trying to relax and see what happens. The same thing happened on my first round and I held on to them. Will the trigger shot effect it though? Will it just make them pop out even quicker!?

[agate]

if it keeps happening they might try a drug called indomecathin (spelling?) which makes the follicles resist ovulation.  I guess they might have reduced your trigger shot dose or they may be sure that your LH isn't high enough to make a big difference?

[CharlieClarke]

Agate, it's the opposite, they have increased the shot to 3 x 5000!
They are trying to get the 2 smaller ones to mature by Fri