3 failed IVF transfer, what is next?

knottie772f8483cf18be1e

My name is Sahar, and this is my story. My husband and I have been married for 5 years, and we have been trying to conceive for the past 3 years. I suffer from Polycystic Ovary Syndrome (PCOS), and my husband has a low sperm count. We have undergone infertility treatments for some time. After three failed Intrauterine Insemination (IUI) attempts, we were referred to an In Vitro Fertilization (IVF) clinic.
After my eggs were retrieved, I suffered from Ovarian Hyperstimulation Syndrome (OHSS) and was hospitalized for 4 days. I underwent multiple fluid extractions, and the doctor decided not to perform a fresh transfer. Instead, we had to wait two cycles before attempting a transfer.
My first transfer took place in September 2021, but the result was negative as the embryo failed to implant. I then waited 4 months and attempted the second transfer in February 2022. The result of this transfer was positive, and the HCG beta count was 25. The doctor asked me to repeat the HCG test every 48 hours to see if it increases. The HCG count increased every 48 hours, which was a good sign. In mid-March, I went for the 6-week scan, but the doctor couldn’t detect a fetal heartbeat. I was told to come back after 2 weeks for another scan.
In early April 2022, I went for another scan, which concluded that it was a miscarriage. I did not do a Dilation and Curettage (D&C) and waited for the sac to expel naturally. At that time, I was devastated, depressed, and started having hair loss. I lost quite a bit of hair and often saw a dermatologist. I was also communicating with the doctor about the steps we should follow before attempting a third transfer.
We did a Preimplantation Genetic Testing (PGT) test on the embryos, which showed that 2 out of 4 embryos were normal. I also went through a comprehensive blood test, genetic test, and insulin-resistant test. All of these were normal, except for a few things that the doctor said he would adjust during the third transfer. I waited a year and attempted my third transfer in February 2023.
The doctor added two adjustments: a blood thinning injection and a steroid. He also approached this transfer using the natural way, such as using Gonal F, Organterell, and Ovatrell to prepare the lining. The embryo used was normal PGT tested. However, after the transfer, when I went home, I developed a 37.6°C fever. I immediately informed the doctor, to which he replied to take paracetamol or a cold shower if the fever does not go away. The fever went away a day after.
I had my pregnancy test on February 26th, 2023, and the result was positive with an HCG beta count of 306. The doctor said that this was a fantastic number, and there was no reason to repeat the blood test. He asked me to come back after 3 weeks for a scan. Anxiety took over me, and I did a blood test in another lab on March 5th, 2023. At that time, the HCG beta count showed 726. This made me even more nervous as I was told that the count should double every 48 hours. I messaged the doctor, and he said not to worry and just come for a scan in 3 weeks.
The scan was scheduled for March 16th, but I asked the doctor if I could come sooner because I couldn't handle my anxiety. The doctor asked me to come today, March 14th, 2023. When he scanned me, he did not see the fetal heart, but he did see the fetal pole. He also said that the size of the sac was smaller than it should be. He told me to come back in 10 days for another scan.

I had a déjà vu of what happened last year, and I feel like I am heading towards the same thing this year. I am torn, in shambles, and have completely lost faith. I don’t know what to do. If the embryo was normal, all protocols were followed correctly, the medication was administered on time, and the HCG test was 306, why didn't the embryo develop?

00kim00

This happens a lot, unfortunately. Most likely it was something wrong with the embryo; there's a lot the genetic tests can't test for. There could also be something about your uterus or blood that wasn't receptive, or the PCOS could be a factor.. IVF doesn't always work even if you do everything right and it looks on paper like it should work. 

Next, you should talk to your doctor about what he'll change with your protocol for the next transfer. (You still have one embryo left, right?). You didn't mention progressive and estrogen, but I assume you were on those for the transfer? See what else he recommends. After that, you could try another egg retrieval (though that might not be a good idea due to the OHSS), try donor eggs or donor embryos, look into foster care or adoption, or decide to be complete as two.

knottie772f8483cf18be1e

> @00kim00 said:
> This happens a lot, unfortunately. Most likely it was something wrong with the embryo; there's a lot the genetic tests can't test for. There could also be something about your uterus or blood that wasn't receptive, or the PCOS could be a factor.. IVF doesn't always work even if you do everything right and it looks on paper like it should work. 
>
> Next, you should talk to your doctor about what he'll change with your protocol for the next transfer. (You still have one embryo left, right?). You didn't mention progressive and estrogen, but I assume you were on those for the transfer? See what else he recommends. After that, you could try another egg retrieval (though that might not be a good idea due to the OHSS), try donor eggs or donor embryos, look into foster care or adoption, or decide to be complete as two.

I am on progesterone injection as well as pessaries. I will try another transfer using the last embryo that I have and maybe do another egg retrieval.

ivfmeerut

I am sorry to hear about the difficult journey you have been on with infertility and miscarriage. It can be very challenging to cope with infertility and pregnancy loss, and it is important to take care of yourself during this time.

Regarding your question about why the embryo did not develop, it is unfortunately not always possible to determine the exact reason for a pregnancy loss. In some cases, genetic abnormalities in the embryo can be a contributing factor, but there are many other factors that can come into play, including hormonal imbalances, uterine abnormalities, immune system issues, and more. 

It is important to remember that pregnancy loss is not your fault and that you did everything you could to promote a healthy pregnancy. It is also important to remember that every pregnancy is unique and that there is still hope for future successful pregnancies. If you are struggling with anxiety and depression related to your experiences, it may be helpful to seek support from a mental health professional. There are also many support groups available for individuals and couples who have experienced infertility and pregnancy loss, which can provide a sense of community and understanding.

I wish you all the best as you navigate this difficult time, and I hope that you are able to find the support and care you need.