Disappointing IVF retrieval

lylf

So I started my stims on Feb 27. Everything looked promising. I had 15 follicles of the right size and tons of smaller follicles. My estradiol was nearly 6k pg/ml. The doctor and I were expecting to retrieve 20+ eggs. 

On the actual retrieval, she suctioned each follicle she could find. She was only able to retrieve 8 eggs. The rest were empty. The next day I got the call. Of the 8 only one was mature. They inseminated it but it didn’t divide by the next day. 

My doctor seems very stunned about the outcome. She wants us to try again but there are several variables to our decision. I can’t seem to find why this happened. She says she learned alot about my ovaries and thinks I have a severe form of PCOS. But other than that can’t offer an explanation. She says she would try a different medication plan but isn’t sure what that would look like yet?

anyone ever have or heard of similar results?

I’m so crushed right now, so hopeless. I feel like a freak experiment she wants to practice on. Something she hasn’t seen but wants to cure at the cost of my mental and financial well-being. DH wants to try again, but he respects that it’s ultimately my decision. To make matters worse, my ovaries feel bruised and every time I move, I’m just reminded of the grief. 

andreamm31

Im so sorry you had such a terrible retrieval.  I know how that feels, as does a lot of other women on this site.  Things never seem to go as we hope them too.  This is such a loss that you will need to grieve.   I had 3 IVFs and the most they ever got was 2 eggs out of me.  I was devastated.  And to make matters worse, the eggs fell apart the minute they left my body and were deemed terrible quality.  I even had one round that got canceled because I had a lead follicle.  IVF is definetly not for the faint of heart and it is a grueling, difficult, and often times disappointing journey.  However, your doctor is right...she is just learning about your body and how you respond to medications so once she analyzes your case a little more, she will come up with a new plan to see if your next cycle will have better results.  My doctor tried 3 different protocols with my 3 IVF rounds.  Many other women on this site have had success with changing up protocols and going again for the next retrieval.  Women who do one retrieval and have all the success are really just unicorns in this infertility world.  It typically takes repeated tries with multiple rounds of IVF to bank enough normal embryos to have the families we dream of with a few extra for failed transfers.  I know that is something you probably didnt want to hear, but having the expectation that all you need is one IVF round can cause you to have a big let down when it doesn't go that way.  So mentally preparing yourself for a heavy financial toll, emotional toll, and multiple rounds helps to move through these tough times and prepare for the next step.  I am using donor eggs, and we are on our 2nd donor and just had our 3rd donor egg embryos transfer.  We have spent $80k.  Its been really really hard and 2 years in the making, with 6 miscarriages along the way.  Hoping that your next try is the one that gets you the embryos you need to make your little family.  For now, take the time to grieve, be gentle with yourself, and feel everything you need to feel.  And when you are ready, you pick yourself up the best you can and you try again.  Sending you love

mbradfo2

What @andreamm31 says is very accurate -- each cycle, even failed, is a chance to learn more about your unique system. I've heard of some variations of PCOS where the eggs don't mature properly, so maybe that's what your doctor is talking about? I've heard of having increased success when retrieval is done after ovarian drilling (with a laser, don't know much about the procedure itself though). 

It is very very normal for a couple to take several IVF cycles before they have success -- it's those of us, who by some stroke of dumb luck, get that golden embryo on the first cycle that are aberration! Even with success, the whole process is draining and emotionally rough -- I was so over the whole thing by the time I got to my first transfer that I didn't want anyone to accompany me, not my husband, not my mom. It was just like, "Let's get this over with". 

lylf

Thanks ladies. I’m so scared to hope because hope isn’t cheap. But this helps me realign my expectations. I think my doctor is too hopeful. 

cashewchicken

I’m so sorry. I had a similar experience. I have polycystic ovaries (PCO) but not PCOS. My periods were regular, lab results looked normal, I just had ovaries with follicles that  looked like string of pearls. The REs were confident that I would be able to bank all my embryos from one, if not two retrievals given my high ovarian reserve and my past response to stim meds for IUI.  

That was not the case. 

The first and second cycles I did a modified antagonist protocol that is supposed to be great for someone with PCOS as the risk of getting OHSS after the retrieval is very low. The first cycle I retrieved 22 eggs but only 10 were mature. Of the 10, 8 fertilized but due to the bacterial contamination, I lost all the embryos. The second cycle was even worse. I retrieved 15 but only 3 were mature. They were able to mature more eggs in vitro and I ended up with 8 fertilized eggs. I was able to get 5 blasts but after the PGS testing I found out they were all aneuploid. That was the low point of my infertility journey. After a discussion with my RE, he recommended the long agonist protocol (“the gold standard”). Egg maturation seemed to be the problem with me and I was explained that the HCG trigger should work better than lupron for egg maturation. 

The third cycle wasn’t trouble free either. We started with a dose of stim med that we quickly realized was too high, decreased the meds but ended up coasting (stop stim med) for several days before the trigger as my estrogen level was high and that’s a huge risk for OHSS. I triggered with only 3300 U of HCG instead of the typical dose of 10000 U because my estradiol was still high (though it was coming down). I thought this cycle failed, too but I was wrong. I retrieved 15 eggs and 10 were mature. All 10 fertilized and I wound up with 7 blasts. Out of 7, 4 were PGS normal which shocked the RE and myself! I was turning 39 in two months so that was totally unexpected. I was hoping to bank 4 PGS normal embryos for the goal of having 2 kids, so that third cycle provided all the embryo I needed. 

***TW*** Out of 4 embryos, I transferred the second best quality embryo in July 2017 and I had my son in March 2018. I transferred the best embryo in November 2019 and I had my baby girl in August 2020. ***end TW***

Just wanted to chime in as your story sounded like mine (my second IVF cycle). Hope your next cycle is the one. 

[Deleted User]

You have heard from some very experienced ladies so far, and each story is different.  Your story too, is your own.  And none of it is easy. ❤️ I'm sorry you had such a disappointing run out of the gate.

Ours is a little different, but hopefully it may help from some perspective.  We have complete MFI, so our only hope at biological children was finding sperm from DH by surgical retrieval.  Which by luck, we did!  But then moving onto my half of the show was supposed to be the straightforward part.

While mine didn't go quite as awfully (and strictly speaking was, "successful"), I have to wonder if my doctor wasn't a little surprised.  The first time we went from 18 eggs collected to 3 blasts, and the second time from 21 eggs retrieved down to 4 frozen.  We did not do PGS / CCS.  I will be transferring all, regardless of outcome.  I was hoping for 5 kids from our 7 embryos. Lol

**TW**
<div class=" Spoiler">We have been lucky enough so far to have two healthy baby girls from the five embryos we've transferred thus far.</div>
Without PGS / CCS, I don't know how many of those had been euploid, or even if the ones we've lost so far could have tested pgs normal.  <b>For the sake of argument, let's call it 37-39 eggs retrieved... Only to yield two PGS normal blasts<i> </i></b><i>(that we know of).  </i>It seems insane to think about.  But then I try to put it into perspective and say that if a couple were trying normally, after three and a half years' worth of monthly ovulations to have possibly two living children?  Then it seems to me like more of a "normal" outcome.  Granted that's not exactly how it works, but hopefully ykwim.
<div>
It's hard because we always had dreams of a big family, but now here we are in fertility treatment.  Success in this world is one live birth.  Maybe we have to check our expectations - Still.  I am bracing myself.  We may have two more losses and be done here.  Time will tell.

I could sit here and wonder, if we had done PGS or somehow could have known of the seven frozen, only two were normal, would we have done another retrieval?  Would we have tried a different protocol?  Could there have been more babies waiting for us if we had pushed my doctor to think outside the box a little?  We will never have answers to those types of questions.

But you have an exciting chance right now, like your doctor said, to learn from this experience.  I'm sure it doesn't feel that way, but she's right.  We did not do PGS, (partially for religious reasons you could say, because I didn't want to run the risk of a potentially viable embryo being damaged or discarded due to testing, and rather just give them all an equal shot), but I understand why people do.  There is so much unpredictable about this whole process, and the fact is on both the patient side and the doctor's side, we are all just taking our best shot with the incomplete information we have, and hoping for the best.  We learn as we go.  Try not to be too discouraged. ❤️ People have success every day, sometimes you just have to work through the process to discover what your path to success is going to look like.  Hang in there. ((((Huge Hugs))))</div>

mbradfo2

@BusinessWife
I think part of the issue that I, at least, often ran into in the beginning was an overpopulation of super-ovulation among the major media voices surrounding IVF -- most of the stories I read about IVF seemed to be from women who got 20+ eggs each cycle with 10+ blasts from them --- obviously an exaggeration, but when I went into my first cycle I was expecting tons and tons of eggs because of the stories I had read...and then we got 9 mature ones...which I'm learning is a pretty decent response! I was surprised after joining this board to find that my overall IVF experience was actually among the more positive outcomes -- I was pretty convinced I was out when I had only 2 day 6 blasts...only to learn later that it's fairly normal to only get 2-3 healthy blasts a cycle. 

And really, it only takes 1.  You just need to go through a ton of crap sometimes to get that 1. 

[Deleted User]

@mbradfo2  Yes.  I think that's probably the biggest general misconception about IVF, that would never get debunked for most people, unless they have to go through it.  It does happen?  But I think that's more the rare exception than the other way around.  And even when they do get a lot to freeze, it doesn't mean they are mostly viable, either.

dukie001

@BusinessWife I agree with you. Quantity doesn’t mean quality, which also leads to a lot of heart break. I had 21 retrieved, 18 mature, 17 fertilized and 7 made to blast. Oh boy, I thought we would have 7 kids. How naive I was 🤦🏻‍♀️. Out of 5 transferred (all not tested) only 1 led to life birth. Other transfers resulted in a lot of disappointment, tears, frustration, and depression. IVF is a bumpy road and it shows how fragile or strong, I'm on the weak side, we may be. But there is definitely a possibility of success in the future, it just no one ever know how long the road may be. 

Edit: I hate autocorrect....

[Deleted User]

@dukie001 ❤️❤️❤️
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