WTF poor report

Jzyla

Hey guys,

I know I said I was going to stay away from this board after our 2nd (final) failed IVF, but I had my WTF appt yesterday and wondered if anyone has any insight/advice. Interestingly enough, my RE had been concerned with our results (prior to BFN) but obviously hadn't wanted to worry us. She said she and the other RE were 'shocked' at the result. I had 27 retrieved, and 21 fertilized as of day 3. Then it all went south. They started to arrest and quality went downhill. My best was a "really nice" B and I had one more B that made it to day 6, but still wasn't good enough to freeze. So, like my Chinese Medicine Practitioner has been hypothesizing, the RE agreed that it is either/both an egg quality issue and/or a genetic issue. I have great FSH and AMH and I'm young. She's going to do some blood screening for me to look for indicators of MTFHR and to rule out Factor V (runs in DH's family, not mine to my knowledge, but still isn't likely the cause). They're also going to do another SA for DH to check for fragmentation. But that's it. That's all there is. She said we could go the immunology route if we felt like it, but she didn't support it and said it doesn't seem likely anyways. She also said we could consider egg or sperm donors, but considering we don't know if it's one or both of us, it would be an expensive experiment. She even offered to do IVF again if we wanted, but said she wouldn't expect a different result. Then she started talking about adoption.

I feel so deflated. It's like grieving IF all over again. It feels like I was given a terminal diagnosis for my chances of conceiving. Yes there's always the spontaneous miracle statistic, but we all know the reality of that likelihood. I'm doing my natural/TCM supplements to work on egg quality but it really feels hopeless.

Any WWYD advice?

Sunny B

I'm so so sorry
I would probably go forward with the testing she spoke about and then have another talk with your RE.
I'd also get a second opinion.

mharnicker

I'm so sorry your going through this. I agree! Get a second opinion. There has got to be other options besides donors and adoption.

kristyn831

I am so sorry you're going through this. I don't have any advice other than to get another opinion.

emmuffy

I'm so sorry. I know how hard it is to digest this information. The grieving is awful.

I'm also young-ish (31), but my AMH is poor. My RE said something similar at my WTF appointment (not to expect anything different on a subsequent cycle, although it does happen from time to time).I went for a second opinion, and I'm getting some additional testing done. Another perspective may help you consider different options or at least accept what you've heard. I've been surprised by how differently my two REs have approached my situation, and I'm glad I went for the second opinion.

Has your RE mentioned using Saizen (HGH) for egg quality? This is a step I am considering for my next IVF cycle.

GL

Justone13

Hey sweets!! I'm sorry you had such a shitty wtf appt. I would def go ahead with the testing especially with your dh's testing. I believe that after the first 3 days when things go down hill it's normally an issue with the sperm. I can't find where I read that. I want to say it was iswte? I hope that you can get some better answers after the testing comes back. Sending big hugs. Xo

ronniesgirl1981

I'm getting two more opinions and traveling for both. It sucks and maybe they will have a similar opinion, but maybe not. I've seen fresh prespectives work miracles for others. And I don't want any regrets in 20 years. I absolutely think the immunology testing is worthwhile. If for nothing else, at least you would know.

Twinkie0612

I would get a second opinion, sometimes small changes can make a big difference in egg quality. Something simple like a protocol change could be all you need. Also with regards to reproductive immunology, there are some issues that can effect egg quality. I think it's worthwhile to look into if it's a path you might want to pursue. If your interested in learning about the issues around immunology and unexplained infertility, I recommend "Is Your Body Baby Friendly?" by Alan Beers. Yes, the title is hokey, but the info on the relationship between the immune system and infertility is good. I will warn you that it was written before Dr. Beer's death in 2006 maybe so the treatment section is a little out dated.

zeynsom

I agree with @Justone13. I do not remember where I read it but I am told that if there is an issue with the embryos after day 3 it is likely because of sperm issues. You want to research that a bit. And, do not forget that most REs are not immune-treatment friendly. However, there are hundreds of women out there who are seeing immunologists and doing IVFs with their immune systems under control and many success stories out there. Do whatever feels right for you, not what your RE thinks is right. I would get second or third opinions, and maybe arrange a free phone consult with a reproductive immunologist.

princessisadora

I am so sorry. I agree with PP seek a 2nd and perhaps 3rd opinion. Do the testing, the more info we have going into this the better chances of  tailoring a more effcient protocol.

IfMamaAintHappy

I have no advice but wanted to say how sorry I am. I just found out today that the only 2 embryos that fertilized stopped growing after day 3, so I've got nothing to show for this IVF. Defeated and deflated are the same feelings I have today. I'm so very sorry. I'll be following up on pp's comments about sperm issues possible causing failures after day 3.

Jzyla

Thanks everyone for your wonderful support and advice. I'm hesitant to even pursue a second opinion because due to our location, the next closest RE is 10+ hours away (my husband rarely gets any predictable time off). And all the additional testing is additional money... when really, I am 85% positive we won't do IVF again. I'm torn because I want to know, but then I wonder if knowing will do me any good if there aren't evidence-based treatments or affordable options.
 
@Justone13 I wondered if anyone else had heard about the after-day-3 thing being due to male factor genetics - I know up to day 3, the embryo development is egg-driven and after that, the sperm actively participates.

I guess I'm still questioning how much fight I have left in me...

runforcookies

Thus happened to me with our first IVF. I responded amazing and by day 5 i only had 1 embryo left. Not wanting to risk the 2nd round, and not wanting to say something was definetly wrong as it was only the first time - we froze all embryos except the 2 we transferred on day 3. We did this because i have amazing insurance. 3 failed frozen cycles later here we are. This next fresh cycle we are going to have karyotyping test done and going for day 5 again. If it all fails we are moving in to adoption. Knowing when the fights over is important. I'm sorry you're at this point.

emmuffy

You may be able to get a second opinion consultation by Skype. I would look into it.

Carol77B

I'm so sorry. I think you should go for a second opinion, definitely. It seems unbelievable that there isn't anything that can be done to improve your results, since you are young and have had such great numbers. I know that Dr. Sher out of Las Vegas will do Skype consults.

And I know that I'm like a broken record, but I highly recommend that everyone doing IVF read "It Starts with the Egg." My RE isn't giving credit to the supplements/lifestyle changes I adopted from the book, but I know that my dramatic improvement in my numbers is due to it.

CML11

I would definitely search for more answers as well as a second opinion. I wouldn't give up until I knew why, and if there's something to be done to fix it before I could move onto other options.
Good luck and big hugs

CRMhoney

SECOND OPINION! I would def. get all the tests possible done! If she's offering to do them and insurance is paying, you might find its something that can be corrected. Why didn't they transfer the 3 day embies? Some embies just don't like being in a lab setting and would do better inside you. If you can, try to get an appointment with one of the big clinics. CCRM (colorado) or Cornell or NYU or RMA here in NYC. I know it sucks starting the process again, but it might be worth a visit to ease your mind. I had a shitty RE at first who didn't know shit from shinola as I found out when I met with my current RE. I got sad, I got angry then I got informed. Big HUGS!!! I am at Cornell in NYC if you have any questions. 

KM721

@Jzyla--I have heard the same thing as @Justone13. We are MFI and our embryos start to go downhill after day 3. In RE's words, the egg pretty much determines the embryo's growth up to day 3, and it isn't until day 3 or 4 that the sperm starts to have its say. I can definitely relate to the results you guys got. Sorry to hear you're in this spot. Hope you can find peace with your decision either way. 

przemosbabe

I'm so sorry ! I have been told that if its after day 3/4 it can be the sperm that caused the problem. I was told that by two different REs at very reputable centers. I think you should get tested for more than fragmentation. I'm not sure what the tests are but there are many girls who have done this and found out that all along it was there husbands sperm. I know of a person in this very group that this has happened to. I will email her and ask her if its ok to tell you her username so she can email you. That way you can ask what tests she did.