First FET Failed

LeFemmeViolette

Hi everyone,

Today we got news that our first FET failed. And since we only had one good PGS normal embryo, we'll be doing another IVF/FET cycle.

I'm curious to know- for others who've had an FET fail, what did your RE change for the second (or third) time around? Higher dose of stims? Transferring more than one embryo at a time?

My follow up appt isnt for another few weeks, so I'm just trying to get an idea of what to expect. Planning is the only thing that's making feel better about this right now...

Thank you!

sleepyrn

My medication protocol is changing for stims.  (No birth control this time.)  I'll be doing medrol, claritin, and lovenox along with my PIO and estrogen patches before the next transfer.  Also, before starting stims next month I'll be having a uterine scratch done.    I've had a fresh and frozen failure with 2 embryos each time.  We didn't do PGS so we'll be adding that this round too.

Joslynj11

When I get started again I will be working on my second fresh cycle after 2 BFN FETs. My Dr. did decide to change my protocol to cut the risk of OHSS since I had it pretty bad the first time around. So I am doing a Lupron trigger protocol and adding in Menupar. He thinks the Menupor will help with the quality and he even told me that it is the "go-to" protocol they use with their egg donors. So that helps I guess, but the only thing is that it will be a freeze all

Edited to add number of embabies transferred. 2 transferred both times.

derrian

I'm going on round 3 (plus one FET). lol

First time was pretty normal stim with 2 embryos transferred

Second time around we did a Uterus scratching to try and reset the uterus cycle with my monthly cycle. We also did a higher dose of stims. 2 embryos transferred

For the FET we changed to the injection Progestrone and were going to do Lovenox (but didn't get the change to proceed)

With the 3rd time coming up, I did a surgery to remove endometriosis cysts (and anything else the doctor thought be a prob). We are doing a different protocol for a longer stim cycle. We will also be doing a 3 embryo transferred.

Here is my calendar (that I know of right now)

Estrace 9/11 - 9/24
Birth Control 9/25 - 10/9

Lupron 10/5 - 10/14

Endo Scratching & Baseline US 10/12

GA 10/15

Estradiol Valerate 10/15 & 10/18
Injection Progestrone

Normal stims - 10/22 - ??

Retrieval 11/1
Lovenox at time of transfer

AandDM2014

@derrian you should be prepared for transferring 3!! **tw** My first three transfers of 2 failed, and with my three worst quality embryos all three took. 

Tusername

TW, mc mentioned. 
@LeFemmeViolette My first FET didn't technically fail, but it did end in mc at around 8 wks. For my 2nd FET, RE didn't change any of my meds. This time around my lining did respond better so I have been on 3 patches of estrogen instead of the 4 I was on last time. My RE still strongly recommended transferring only one embryo again for my 2nd FET. 
I hope your second round goes well for you!

derrian

@AandDM2014 Very much prepared. I have had my heart set on twins for too many years already and with the massive trouble getting prego. I'll take the multiples and be done with it lol

We don't make many eggs (3 then 7) and the only FET we did resulted in the egg dying during defrost. Stick them ALL in! lol. 

I get told I'm crazy alot, but that is okay  The heartache of that FET was worst than the first BFN that we got.

Triplets is exciting for you! I think we'll all agree that any amount of babies is exciting at this point lol.

mtpbadger

My first FET failed and my re completely changed up my protocol. For the first I was on bcps and then delestrogen injections every third night and estrace twice orally and then PIO. For the second we went with no BCPs, estrace vaginally three times a day, estrogen patches (started at two every other day and then increased up to 4 after two weeks and then back down to 2), lovenox injections, prednisone and PIO. Just had my first beta and it came back positive. Not sure what did the trick but my re basically threw the kitchen sink at my uterus this time around and it seemed to work. 

Hopefully your second will be the one that sticks!

bells52000

@LeFemmeViolette. Sorry again for the negative.  I just came back for my meeting with my RE.  I will do another frozen single embryo trans.  He said I could trans two but it increases twins by 50% but only increases pregnancy by 10%.  He thinks it is better to go one at a time and have a frostie for another cycle in case we need it.

We we are switching to a lupron protocol ...I did no lupron last time.  We are adding vitamin D, Accupuncture on the transfer day, and not switching to crinone after transfer. We will stick to pio for two weeks before switching.  Next blast is a 5AA boy.  In some ways I wish I didn't know the gender. Makes it tougher when it doesn't stick.

If I need a fresh, he said they would decrease my meds just a bit because I was overstimmed last time.  We would look closer into sperm quality as well.  But overall it would be close to the same thing.

JamieH2000

@LeFemmeViolette.- I was so sorry to see your negative on the aug/sept board. I can only imagine how hard this is and my thoughts are with you. I haven't gotten to ER yet (my first IVF was cancelled due to poor response), so I don't have any advice on FET, but did have a few ideas since you have to do another cycle.

Did your RE have any thoughts about why only 1 embryo made it to day 5 and was normal? It seems like a fluke, so hopefully wouldn't happen again, but just curious what your RE thought about it. You are young at 31, so egg quality shouldn't really be an issue, however it wouldn't hurt to do everything possible to try to improve it just in case...

Based on my research and conversations with my RE, here are a few things you could consider or ask your RE about. If you haven't read it, I would recommend reading the book "it starts with the egg". I found it a quick easy read, and a good way to learn what supplements can help and which ones don't. Maybe you are already on it, but CoQ10 is recommended and Vitamin D. DHEA is also discussed, and usually used when there is lower reserve, but it can also improve quality.

It will be interesting if your RE is going to switch up your protocol at all. After my cancellation in August, I did a lot of research on protocols, and I will be on a new protocol for low responders in October, but parts of my protocol are supposed to help ensure both quality and quantity. Specifically, estrogen priming before the stimming cycle can really help quality. I will also be on HGH (human growth hormone) for 8 days during stims to improve both quantity and quality. My RE has said she has seen it made the difference for some ladies getting pregnant or not.

Definitely not trying to imply you have an egg quality problem or anything , but just wanted to share in case it helps. I hope you get some answers from your RE when you meet and they come up with a good plan for you!

LeFemmeViolette

Thank you everyone for such detailed responses! This gives me a lot to think about. I'm legit going into that appointment with a bulletpoint list of things to discuss.

While I know its possible for my RE to say that we just keep everything the same for the next cycle, it just worries me a little. It's frustrating because literally all my numbers were great. I have an good AMH level, been told my uterus is "beautiful", my estrogen and progesterone levels were ideal.

Overall I feel like there were two major issues: 1- how did we end up with only one PGS normal embryo? And 2- why didn't that embryo stick?

Ugh. So much to think about.

mtpbadger

@LeFemmeviolette hopefully you have a good appointment with your RE and get some answers as to why they think it wasn't successful. Try not to beat yourself up, my RE said that even when everything looks "perfect" on paper, science can only do so much and sometimes it's just luck. I can't remember who mentioned it, but maybe also ask about the uterine lining receptivity test? Maybe you're one of those people that need an extra day of progesterone for the uterus to be prepared and the embryo to implant? Might be worth asking to see what your RE's thoughts are.

mandasd

I'm so sorry for your BFN. Hang in there! It does start with the egg, but I want to caution against DHEA, there is not enough studies to support effectiveness. Both of my REs do not recommend it. They do recommend healthy fertility lifestyle that includes vitamins and supplements (prenatal, fish oil, baby aspirin, coq10, I add vitamin c and vitamin d). There is also a list of good supplements for your partner. Also don't rule out your partners sperm in all this, even though it starts with the egg after fertilization, it takes two! If he has any issues with morphology it could equate to poor embryo quality. Some docs say it doesn't affect fertilization but I read in the paperwork I got that poor sperm quality can decrease embryo quality. His fertility health is also important so make sure he's taking his supplements as well! Just some more to think about for your next round! 

APM_SLP

@LeFemmeViolette since you are also in the September FET buddy board I won't write everything here... But I did want to point you in the direction of the post I just wrote on that board.  May be something you want to look into eventually.