Multiple FET Failures - Need Advice

richmondtxmom

I will try not to make this too long. I have a 3.5 year old daughter from IVF. I decided to try for our second child. We had to do another egg retrieval, but I thought it would be be easy. I was wrong!! Since I am older (36) I decided to have the embryos go through PGS testing. It resulted in four normal and one low mosaic that the doctor said I should keep and implant if needed. 

On two separate occasions I have implanted two 5AA PGS normal embryos and implantation has failed. My lining for the first was 8.3 ad for the second 9.2 (both triple layer). Before the second transfer, I did a ERA test. It came back saying I was post receptive....we moved the transfer up one day. I thought that was it! 

Everyone from my acupuncturist to the nurses is completely shocked. Everyone thought this one would stick for sure. I have three embryos left, but they are not nearly as good of a grade (4bc, 3bb and 3ab). 

I don't know what to do. They have ran every test imaginable.  Also, I don't want to change doctors; my doctor is one of the best. People drive hours and hours just to see him. 

Any shared advice or experiences would be greatly appreciated. I have given up hope and that so unlike me, but I feel like I've been defeated. I go in to meet with my doctor next week. Help! 

rachelbeth130

Did you do another era to get a receptive result? I ended up doing 4 eras before I finally got a receptive result, my second one said we could do the transfer by adjusting the time 12 hours, but even then we wouldn’t have been in the window. Glad I did 2 more. It was a pain, but I would have been heartbroken to waste all those embryos.  I also did a natural fet instead of medicated. My body responded much better to the natural cycle.

richmondtxmom

No, we just did one. Maybe I will ask him about doing another. 

JamieH2000

Hi- I also had multiple failed transfers and I was post receptive too- it’s a very rare result and I think you are they first on these boards besides me that I have seen this. The test recommended 24 hours less but the confidence range wasn’t super high, and my initial test was 116 hours I think? My RE likes thought it best that we do a second ERA to confirm since I think the post receptive results are so rare the test may not be as predictive. We did 96 hours instead of 92 and I got receptive at 96. I was so relieved. We transferred two and they both stuck, tho one stopped growing at 7 weeks. Before that transfer I had never seen two lines ever- so the ERA is literally the unlock we needed to get pregnant and I wouldn’t be pregnant without it since we never had an embryos there when I was actually receptive before. Anyways, best wishes and I really really hope this next cycle is the one for you!

beachbunnyxo123

@richmondtxmom what is your FET med protocol? A part of it could be other factors impacting not just based off an ERA. Have you done a endo biopsy to check for endometritis?

richmondtxmom

@JamieH2000 It sounds like I may need to do a retest. Luckily, I was able to book an appointment with him for next Tuesday. I am so desperately searching for an answer to this! 

@beachbunnyxo123 I'm on progesterone (four days due to ERA), estrace, six days of steroids, baby aspirin and I take extra vitamin D, folic acid, etc. I know I have PCOS, but haven't done an endo test. That's something im going to add to my discussion list. Thank you. 

funkykey

@richmondtxmom  - I'm sorry, that sounds really tough. I've had a couple of failed transfers, and it was devastating.

Are your three remaining embryos PGS tested, or were these left over from a previous cycle? (Ie. the cycle you did to have your daughter). Did you get pregnant with your daughter with your first transfer last time? If so, chances are that a leftover embryo from that cycle will do the trick.

Honestly, I wouldn't pay too much attention to the embryo grades. Lots of 3BB embryos implant & lots of 5AA embryos fail. 

What does your doctor say? Is he telling you to just keep trying? Statistically, it's pretty common for a 36 year old woman to have to do 2-3 rounds of IVF (complete rounds, transferring all embryos) to have a live birth, so what you're dealing with is not unheard of, as devastating as it is.

That said, it's definitely important to trust your gut. If you think something is going on with your lining, ask & have it checked out.

Good luck!

richmondtxmom

@funkykey I had one embryo left from the cycle with my daughter. I implanted it last year, but it didn't work. This is a new cycle, and all embryos were PGS tested. I'm wondering if I have something autoimmune too. I actually had two implantations with my daughter's group. One just ended in a miscarriage. None of those were PGS tested, but my body was much younger too.

funkykey

Hm, I see... I think? I read these sentences:

It resulted in four normal and one low mosaic that the doctor said I should keep and implant if needed. 

On two separate occasions I have implanted two 5AA PGS normal embryos and implantation has failed.
I have three embryos left, but they are not nearly as good of a grade (4bc, 3bb and 3ab). 

To mean that:
1) You have 5 embryos from this cycle
2) You have transferred 4 embryos so far with these FETs (2x 2)
3) You have another three embryos left.

So I assumed that you must have leftover embryos from a previous cycle. I realize now that I read the second sentence differently than you intended it, and that you must have only transferred 2 embryos (2X1).

This does make me really optimistic for you, though. If from the cycle with your daughter, you had 3 embryos and one resulted in a live birth, that's 1/3. Odds are, one of your other two PGS-normal embryos will be the one!

I've had three failed transfers from my IVF round. I was 32 when I started the cycle, so we didn't do PGS testing. We have unexplained infertility and we were told that for women my age, about 60% of the FETs resulted in pregnancy. Our first failed FET, I almost expected. I mean, I was hopeful, but I kind of thought: "There's a pretty good chance that one of these embryos is not going to stick." Our second failed FET, I was devastated. Our third failed FET, I was a mess. I can't bring myself to do another transfer without doing another round of IVF with PGS testing. Our RE says, statistically, the last embryo we have frozen is going to be the winner, but I'm not ready to find out. Between our 2nd and 3rd transfers, I did an ERA and had a receptive result.

My RE and I have spoken at length about autoimmune conditions/the possibility of one. In the absence of a clear diagnosis, I've spent some time grasping at straws. He says right now, what is most likely is that the embryos are just not going to take - even with a PGS normal embryo, for a 36 year old woman, the odds of implantation are only about 60%. But, if we produce PGS normal embryos, and find that my next transfer fails as well, he is open to putting me on prednisone or something, some of the autoimmune treatments. That said, I'm pretty sure my issue is just embryo quality, not my immune system. If 50-60% is the average for embryos to stick in my age group, I think my percentage is hovering somewhere around 20% (at least, I hope!). I think I'm just a bit below average.

Anyway, I don't know if that helps you at all. IF is brutal, and IVF is extra brutal - the success rates, while improved, are still so low. You work so, so hard to get those little embryos, to transfer them, to medicate - getting a BFN call is like being stabbed in the heart. Even on these boards, sometimes, it seems like so many women get KU-ed on their 1st or 2nd transfer. Having 2 failed transfers, with PGS normal embryos? That would SUCK. But you're not alone, and I think you have another baby in one of those frosties.  

sungirl39

*Lurking* I am currently trying the autoimmune protocol, happy to answer any questions! Like you, I had a successful fresh cycle (many years ago, but it worked on the first try). In May we started trying using frozen embryos from the same batch.  So far, I have had two failed FETs..this is our third try, but my first try with the autoimmune meds...figure its worth a shot.

katie35

Hello.  Jumping in as well!  @sungirl39 I would be interested in your immune protocol if you don't mind!  We have had 5 failed transfers.  Other than a slightly off ERA we don't know what is going on.  How did your RE decide to put you on the immune protocol and what does it entail?

richmondtxmom

@funkykey Your words are encouraging. I felt like I  was the only person going through this craziness! I hope your last one is the winner for you! Our struggles are definitely real. I'll let you know how my doctor's appointment goes in Tuesday. 

@sungirl39 When is your fet? I hope this is your answer! 

sungirl39

@richmondtxmom transfer was Sunday, so 4dp5dt.  I have no idea if it worked, I have zero symptoms...feel completely normal.

@katie35 No prob!  My RE has used this protocol before with success, so we figured it couldn't hurt.  See below, it's definitely a lot of meds...sort of overwhelming at first but doable.

A wk before transfer: Intralipid IV Infusion, takes a couple of hours
A few days before transfer start the following meds:
Aspirin 1x per day
Prednisone 2x per day
Lovenox shots 1x per day These SUCK.  The shot doesn't hurt anymore than other fertility shots, but its like a game of Russian roulette on your stomach...you pick the wrong spot and you end up with a purple bruise the size of a baseball!  Google it, I have one now...it looks worse than it feels though. I now try to be very careful to avoid even the smallest vein! Least favorite shot I've ever had, and I've had them all lol.

Day before transfer: start antibiotics, take 2x per day for the next 5 days.

Two days after transfer: add the following meds:
Pepcid 2x per day
Claritin 1x per day.

I'm also on the standard PIO.

Sooo, ya its a lot of pills per day and two shots.  I think if i get a positive beta I go back for a second intralipid infusion. Fx this all works! 

katie35

Thanks @sungirl39!  Fingers crossed that this does the trick for you!

@richmondtxmom Sorry you are going through this.  Getting that negative result is so hard.  If this helps at all, I have read a few articles now which talk about how the fact that an embryo tests PGS normal is way more telling than embryo grade.  I have a feeling that one of your three waiting for you is the one! Good luck to you!

richmondtxmom

Thank you all for the support. Truly, because if you all, I (cautiously) now have hope. 

richmondtxmom

I wanted to update everyone. My doctor wants me do a second ERA, so once I get my period, I am going to go straight into that. He also wants me to start my estrace dosage by taking two orally and one vaginally instead of just two orally.

sungirl39

Good luck with everything @richmondtxmom!

NicWalker10

@richmondtxmom I feel your pain, frustration, anxiety and all the rest.  I have an almost 2 year old son from IVF.  My son was our second ivf attempt but first transfer from a batch of embryos creased from a pretty successful stimulation cycle  we did PGD on all embryos.  I went to my RE when my son turned 2 in hopes of getting started on a sibling for him.  My RE made it sound like it would be a piece of case since we had success right out of the gate with that group of embryos.  HE did the US and I did the saline sono.  Both clear.   Note I had a C section with my son.   I did THREE FETs....one chemical and 2 BFN.   So frustrated I just lost my mind by the third one.  NO answer from RE other than, keep trying.  So I consulted another RE at same clinic.  He ran the full panel of tests for autoimmune and leaky gut and everything in between.  All clear.   Then I did the endo biopsy.  Came back with traces of a polyp by no endometriosis.   He say no need to do anything.  My nurse suggested I do the hysteroscopy and I agree ---if something is in there I want it found.  I'm so conflicted and I feel really netative because my doctor doesn't thing there's anything in there preventing implantation.   So i'm at a total loss.....
Sorry for the long story,  but my suggestion would be maybe try the biopsy? I have read that the estrogen from  repeated cycling can cause polyps which could interfere with implantation. have you done the saline sono?  My RE did say for my next cycle he was going to add a benedryl into the protocol for any inflammation.
I wish you and everyone else here struggling the best of luck!!! keep us posted.  

richmondtxmom

@NicWalker10 Our stories are so similar! Yes, after my first ERA I had a sonohystergram done. They discovered fibroids, but they are not in the uterus and will not impact implantation or pregnancy (so they say). I'm glad you mentioned benadryl. I talked to my doctor about it and he jokingly covered her ears and said, "It won't hurt anything to take one Claritin or Benadryl, as long as it's not the D kind." Did your doc give you any details about dosage, type of antihistamine, etc? Does it need to be benadryl? I only ask because it makes me so sleepy. How many more embryos do you have? I'll keep you in my prayers!

allycoghlin

@sungirl39 I am doing a FET next month with similar protocol? Curious to hear if you got your BFP if you are willing to share.

sungirl39

@allycoghlin I did! This is my third FET and first success...first FET was a BFN, second was a CP.  I am currently on the August FET board, so I have some updates on there and my betas are in the August spreadsheet.  Still on all the the meds and I think I go for another intralipid infusion next wk.

NicWalker10

@richmondtxmom I didn't get details yet on the dosage, but my nurse did say it would be benedryl or it's generic equivalent.   I think it's only once a day so you an probably take it at night.  it also makes me tired so I think night time is the only way to go. 
Keep me posted on what happens next for you.  I will be going my hysteroscopy 9/21 and i'll give you a shout if they find anything they didn't see before...worth knowing if that's a possibility I think!
I just didn't know it would be SO hard a second time around.  I really 100% thought if it worked once it would work again.  I feel even more defeated that it's not working the second time around.  Which I feel super guilty about because I feel like I sound greedy.  But I really just want to be able for my son to have a sib.  Thinking good thoughts for you!!  

richmondtxmom

@NicWalker10 Today was an emotional day. I just have this fear that nothing else is going to work for me, but l'm trying to get out of my funk. I also feel greedy. I was want #2 so badly, but I know how blessed I am to have my (obvious) miracle child. 

I'm trying to do research on when I need to start taking the benadryl/claritin for the fet. It's hard to find specifics in this. 

NicWalker10

@richmondtxmom i'm so sorry you're going through this.  I really don't wish this on anyone.  it's so hard to do this when there seem to be no  real answers  especially after you've been successful once before.   I 've always been appreciative that the IVF worked the first time and gave us our son but I have to say now I really do look at him like a miracle and at the same time I get really sad that I might not be able to give him a sibling because I think he would love it.  Like you, i'm trying to stay un funked so that my negative mindset doesn't make matters worse (because honestly at this point i'm terrified anything can have a negative impact on this process) 
On the benedryl,  I don't think it comes into play until a few days before the transfer...but I have asked my nurse to see if she can send me the suggested protocol for my next cycle and if I get deets I will definitely share with you.  

richmondtxmom

Thanks @NicWalker10! It's funny, I didn't know you, but I feel like I do at the same time. I was just telling my friend that I was blessed to have my daughter from IVF, but now I know she was really a true miracle! A miracle that I may never experience again.

Yes, please keep me updated and I will do the same! 

richmondtxmom

I met with my acupuncturist yesterday and she is familiar with the antihistamine protocol, but doesn't believe in it, neither does my doctor. I've started on the following supplements to assist with inflammation, blood flow, etc.: OPC3, Methyl Folate and NAC, also known as N-ACETYL L-CYSTEINE. I was amazed with the benefits for just the OPC3. I should have been taking this all along! By the way,  I am taking the liquid form of OPC3. I also restarted my daily tablespoon of apple cider vinegar. Just wanted to update! Praying that this next one sticks (5bb).

NicWalker10

hi @richmondtxmom   hope you had a good labor day weekend!   I am on methylfolate too!   I am not user what OPC3 is but I will have to take a look!   I take an omega 3, I also take an all natural Prenatal vitamin, a pre biotic and a probiotic (vsl3 specifically is what my dr recommended--it's expensive, but supposed to be one of the best because of the amount of bacteria....)  I asked about the antihistamine protocol and she said it's benedryl 3 x per day.   They seem to have had some success with it (whether it's the antihistamine or everything else, who knows!!)  but i'm going to be exhausted with benedryl 3 times a day!!!   I suppose at this point i'll do anything!!!  I  am on the bcp now, counting down to my hysteroscopy on 9/21 and then I go in 10/1 for monitoring to start the FET cycle....I feel like it's been so much waiting and delay to try again with honestly no sure fire answers for what will get us to the positive result...I know there are no guarantees but it's so frustrating..... it will be seven months since my last transfer by the time we do this one and i'm not getting any younger so i'm so frustrated...I just don't know what my next move will be if this one doesn't stick....which I know I shouldn't even been thinking about because it's negative, but I feel like with this process, you cant help but have that thought...
sorry for my rambling but I do feel like I know you too!! our paths are so similar it is comforting to have a friend...I was definitely feeling very alone and  weird about where i'm at with all of this now.... so thank you for being a friendly, similarly situation kind shoulder to lean on.   praying  for sticky embaby for you!!!  

richmondtxmom

@NicWalker10 I'm keeping you in my prayers! I wish I know why this was happening to us, but you're right, positivity is the key. It can be so hard though! I have my second ERA on Monday and will try another transfer right after that. I'll keep you updated! 

NicWalker10

@richmondtxmom oh soo soon! that's great.  I will be thinking all the good baby thoughts I can for you!!  

richmondtxmom

@NicWalker10 If it wasn't for my husband's insurance covering $15k worth of procedures, I would not be able to move so quickly! 

richmondtxmom

Had my scratch done. It was easy breasy! I have also started acupuncture twice a week instead of every other week. 

NicWalker10

@richmondtxmom I hear you!  we are lucky that my husbands insurance has  provided good coverage.  Glad your scratch was a breeze!!   Hopefully acupuncture helps!  I loved it when I went with my first...I haven't been able to get back to my same girl for these last three failed transfer but i'm thinking I need to try and find a way!   When is your transfer date!?   

richmondtxmom

@NicWalker10 It's tentatively set for Oct.1. It's sad though, I'm doing my best to not get excited about it. 

NicWalker10

@richmondtxmom sorry I was dark--I wasn't getting notifications for some reason so I just saw your note---I TOTALLY get what you're saying about not getting excited.   it's so hard to  have you're hopes crushed when you go in positive and excited....at this point, I always feel like I need to be prepared for the worst news and pleasantly surprised/relieved if there's a positive.   I will think good thoughts for you!!
I had my hysterscopy Friday and they removed at least one polyp and the beginnings of 2 others.  I'm trying to stay hopeful that maybe things will head in a positive direction from here.  Fingers crossed for Oct1 for you!!!   

richmondtxmom

@NicWalker10 Hi! I wanted to update you about my fet. My transfer Oct. 1 failed. In addition to that, one of my embryos didn't make it through the thaw. On October 30 I transferred my last embryo, a low-level mosaic. Crazy.... It implanted and I'm currently pregnant. My first beta was yesterday and it was 350. I have another beta on Monday, so I have a looooong way to go, but I got past the first hurdle. The only difference? I used the antihistamine protocol this time! 

NicWalker10

HI @richmondtxmom I have been thinking about you!!!   I'm so sorry to hear about the negative results, but am SUPER happy for you to hear about your great beta!!! that's an amazing first beta--so great!!   I cant believe the only diff was the antihistamine protocol! 
I did a transfer on October 24, first beta was 270, second was 731.  I have had two ultrasounds,  most recently saw the heartbeat! as you know all too well,  it's exciting but nervewracking.  I am scared to be too excited or optimistic because it's so early and who knows what can happen.   So i'm in that waiting place of waiting form ultrasound to ultrasound holding my breath everytime I get on the table!
Can you believe my Dr still has me taking benedryl 3 times a day?? it's KILLING me.  It makes me so tired. I've officially been on it a month and I don't really understand why I still have to be on it! it's brutal! 
Good luck and keep me posted.  I am thinking the very best thoughts for you!!!!  
(Sorry it took me so long to respond; I haven't been on for awhile--sleeping through the beneryl!) 

ninami

Hi @richmondtxmom- I had one chemical on my own and then dropped a pgs normal embies after a super positive pregnancy test. Then a failed FET and a failed fresh with 2 5 day perfect blasts. Prepping for another FET now , just finished ocp after 6 long weeks with tons of bleeding and on lupron. Started prednisone and will do aspirin/lovenox combo, which I also did second failed FET. Wondering if need ERA. Never had a problem with lining, always thick and trilaminar. So crazy how some stuff just randomly works. 

MamaK225

@ninami - We're in another thread together and I'm so sorry to hear about your losses. It never gets easier and I hope this upcoming FET is the successful cycle. Even after nearly 5 years of working with an RE, I'm still convinced that conception is 80% science and 20% MAGIC.

In 2018, we had 3 failed cycles (total of 4 embryos) and had developed a sensitivity to sesame oil during that time, so we switched to prometrium-only (ewwwww!). So then I did an ERA with this protocol and it shifted my window out by a day (i.e. I started Progesterone a day later), had 3 more failures (totaling 6 embryos) during 2018. Finally, I just said SCREW IT and have gone back to PIO - but this time the ethyl oleate instead of sesame oil. It's $300 for 3 vials, instead of $30. We're doing the original protocol that I had success with, so I'm hoping the PIO was the missing link and that the ERA was just a fluke (I was under a LOT of stress at the time, work and having had the 3 failed FETs). I had such high hopes, given my really efficient and productive "haul," and am trying to maintain them, but it's hard. Tomorrow, we're transferring the last two embryos from my 8/2015 retrieval so I'm really nervous, as I don't want to go through a whole cycle all over again - but it looks like it's not really up to me.

@richmondtxmom - How is everything now? I actually added benadryl to this cycle - mostly because my allergies have been killing me - but have done it per the protocols I've seen (and discussed with my RE). Hoping with the PIO + antihistamine that THIS is the one!  

@NicWalker10 - How is your journey going?

ninami

@MamaK225, sounds like you’ve been through a lot as well. I feel like it’s 50/50 science magic at this point, but hey what ever works! I really hope this one is bullseye for you. I did 2 retrievals, we did pgs on my embryos, aside from the fresh transfer. My RE doesn’t seem to think I need ERA with a medicated cycle, my prior FET were timed to natural ovulation since I’m pretty regular but I am 41! Did you test your embies? Any other work up? This “unexplained” stuff is the worst. I was hoping they find something.
Stress is a big role in this and is the hardest thing to control.
Will keep you in my thoughts and prayers for the transfer!  

MamaK225

Thank you. @ninami. Definitely a larger portion can be attributed to magic than I originally suspected I wish I could do unmedicated, my main issue is being anovulatory due to PCOS ... so here we are. I'm hoping the PIO ethyl oleate is the key, so FX! No, we didn't test our embies because we had such a high yield (13) and they were all so highly - visually - graded (the lowest were BB) ... it didn't seem like that would have told us much. Hopefully, this transfer will be the key and I won't have to think about this anymore. Should we continue to beat the odds and go through it again, we will consider testing. I've had every kind of blood testing, scoping, etc and everything keeps coming back normal. But - knowing what we all know - results for one person may fall onto the "standard" normal range, but be "abnormal" for them. So who knows. Unexplained is the worst kind of response, for sure. Thank you for the thoughts and prayers, they're very much appreciated and I'll do the same for you ... I'm ready to graduate out of this "club" and be normal again  

ninami

@MamaK225 sorry for late reply. I hear you, been through same. All seems to come back ok, even laparoscopy. Doing full immune protocol this time, planning transfer on the 17th so have to decide by next week about IVIG and it’s driving me nuts. Just have to keep trying. I have very high amh for my age and hyperstimulate, E2 goes over 7000. Conventional docs don’t think I have pcos since my labs are normal and I’ve always ovulated on the dot, but the off main stream ones say it is. My last 2 FET were timed to my natural ovulation, got pregnant first one but miscarried with pgs normal. Second didn’t take . It’s seems your entire life revolves around this while people are enjoying careers and families. I really hope you get there this time! Sending all the best and positive thoughts!