Strange (failed) IVF cycle- your thoughts?


#1

Well I had a very strange first IVF cycle which was a total bust. All numbers looked fine. Blood work was fine. I had an antagonist protocol with menopur, Gonal f and ganirelix. Ultrasounds showed good response to the injections. Come retrieval my RE only got 6 eggs. Of the 6, 2 fertilized. On day 3 they were grade 1, and on day 4 they stopped growing. Day 5 transfer was cancelled.
What in your opinion/experience could be a reason for such a poor retrieval rate? My Dr has a very very high retrieval rate. He wants to try a different protocol next cycle but I am just baffled as to what went so wrong. Have any of you heard of this?


#2

So sorry to hear about this devastating news. Yo said all of your levels were good? You were on antagonist protocol though? What was your AMH level and your age? At age 35 only 2/4 eggs are viable at 40 it drops to 1/4. Also could it have been clinic error by the doctor or embryologist? Hope you get some answers.


#3

I’m sorry about your cycle. How did your E2 look throughout? How much stims were you on? Were the doses high and the E2 low? That would indicate a poor response and egg quality could be compromised. If that was all fine and the embryos took a downward turn after day 3, that could indicate an issue with the sperm DNA, as that comes into play on day 3. High counts alone dont negate the possibility if fragmentation. How was his morphology?


#4

See my siggy but I had a terrible response to the antagonist protocol.

More details pls what are you and you so if? Levels? Doses?

For me the protocols made huge differences!


#5

Thanks for responding

Ugh I had a heck of a time finding this thread! I don’t know what my AMH was. All along my Dr kept saying my numbers looked great. They only tell you if they see a problem. (I will be asking for more info next cycle)
I was on 112.5 Gonal F and one amp of menopur for 4 or 5 days. Then added in one syringe ganirelix and one amp of menopur until trigger. At trigger I used 450 Gonal F. My RE expected 11-15 follicles per the ultrasounds. I will be 35 in sept and its going to be a very rough birthday. I am angry at myself for putting this off, but all alon my RE kept saying with my age there would be no issues. So I took that for granted and blew off IVF for a year. Because i was scares of it. Stupid. So so stupid!!!


#6

I’m a rookie by the way

I don’t even know what E2 is…all this info you’re giving me is so helpful because I know almost nothing. I just got my protocol and went with it. I hope the next cycle will yield better results. I am going to the best Dr in the area and he has the highest retrieval rate in the practice. So my cycle left everyone scratching their heads. I thought it was strange that I was the only person in my IVF class who did not have lupron in the protocol.


#7

Oh one more thing

I also used letrozole for 5 days.


#8

Usually antagonist protocols are used when a regular long lupron cycle fails. If they put you on this protocol I would ask why. Also ask for copies of your blood work and ask for an explanation of your levels. Good luck. I hope you get answers soon.


#9

Really!!??

Wait…they use this type of cycle AFTER something else fails?! Why would they use antagonist vs Lupron anyway?? They never told me any of this. Most likely because they did not want to stress me out. Now I am stressed out!!!


#10

I agree that it is very odd to use the antagonist protocol first. The standard is long Lupron and then if that doesn’t work (you don’t respond) then other protocols are considered. Given the very low doses of stims it seems like using more meds may have given you more eggs. I would consider changing clinics completely.


#11

Yes, it’s normal to do the long lupron first. If you have low Amh or there is a reason they think you won’t respond well they will do antagonist.

I had the same thing on antagonist with the letrozole. I had 8 follis on us but I ovulated them early and ended up with only 3. I would ask why they did that protocol on you. Also find out as much as you can from them.

I would ask them for help on next cycle. Just because their numbers are good, if they are much higher than others around they could be screening out theses that don’t respond we’ll!

Best of luck on your next cycle.

Also, our first cycle is a learning experience and its normal for you to have 2-3 cycles before a successful pregnancy.

:grouphug: you’ll get your healthy take home baby! Hang in there


#12

Ugh

The more I learn the more upset I get. Ignorance really is bliss.


#13

Low AMH…

I don’t think I have this. Wouldn’t they have told me? No one has told me anything. All along it was you’re fine, you’ll do great, this will work. I’m absolutely floored right now.


#14

It is not always the case that they use Long Lupron first. I have had 3 IVF cycles which resulted in pregnancy (One a chemical though) and never took a single dose of Lupron. My clinic prefers to use the antagonist cycle predominantly. I know a friend of mine who is much younger they also used antagonist on and she became pregnant both times.


#15

Hmm…

That’s interesting. Well in my IVF class there were 5 couples including me and I was the only one with antagonist protocol. I was never offered an explanation as to why I had this specific protocol I just accepted it for what it was. My RE was extremely confident that this cycle would be successful at least in terms of egg production. Of the 6 eggs I got 4 were mature. But my dose of FSH was relatively low at 112.5, I’ve met women who have used 150, 250, etc. I think he was cautious about overstimming but that doesn’t explain why such a low # of eggs. Or why only 2 fertilized…or why they arrested on day 4. RE thinks they werent good quality. :frowning: I have been diagnosed “unexplained infertility” so I think if something was off they would have called it out. No idea what the next cycle has in store. I am just shocked at how badly this one turned out, I hope the next one is better because it definitely can’t be worse :"( I cried so much today my poor husband feels helpless.


#16

So, so sorry that your cycle ended this way. As others have pointed out, a lot is learned from the first cycle which will surely improve your next attempt.

Definitely don’t be afraid to ask questions of your RE and collect as much information as possible. It might be worth requesting an AMH test, or something similar, to get a better sense of your ovarian reserve. Some conclusions can also be drawn about egg quality from these tests, too.

I do not think it is always standard protocol to begin treatment with a lupron cycle. At my clinic I believe the standard is the antagonist.

My :pray: for you!


#17

I was also the only person on an antagonist protocol in my teaching class. When I asked why they said that it was because I had plenty of antral follicles. It’s also the protocol used for most egg donors, who are presumably young and healthy. Do you know how many antral follicles you usually have?


#18

@onemoore- fingers crossed

Onemoore I see you had a transfer today!! I wish you lots of baby dust for a BFP!!!

@Anna I don’t know any of my numbers but my RE was always saying how everything looked great, IVF would be a piece of cake for me because I’m young and my numbers look good. I don’t know the issues of the other couples in my IVF class I just figured my protocol was tailored toward my needs. My Gonal F dose was only 112 which is a lot lower than a lot of others I’ve seen. This cycle definitely has all of the REs at my practice scratching their heads in disbelief and I hope whatever they learned from it will help with my next cycle. I both love and hate these boards. It’s great to be able to compare protocols and get support but all of the contradictory information makes my head spin. Especially since I am not very well versed as many others appear to be. This was a really rough day :frowning:


#19

I think that you have come to the right place to get support and information. The thing that I have learned through this process is that you have to be on your own advocate to some extent. If you don’t ask, they will usually not say. I agree with other posters that suggested that you ask what your baseline numbers were and why they decided to put you on that particular protocol. After you get some answers, I would also look into what supplements you can take and maybe acupuncture. I think when REs give assurances like they give you that it isn’t fair because it leads people not to ask questions. Good luck. I am hopeful that your next cycle will be a success.


#20

Aha, I just remembered the details of why I did the antagonist protocol! It’s been a year so I forgot before, but if you have lots of follicles and use an HCG trigger you’re at higher risk for OHSS. If you suppress with Ganirelix instead of Lupron, though, you can use Lupron as the trigger and avoid OHSS. I remember now, at the time I was so grateful for that because my E2 was over 5000 at trigger and that would be a major risk factor for hyperstimulation. That seems to be different than your doctor’s motivation, though, since you didn’t do a Lupron trigger? Also, I only did 75 units of FSH, but that was because my eggs were getting big too quick. I only stimmed for 7 and a half days.
So you said you had a good response to the stims initially but when you went in they only got 6 eggs. Do they have an idea of what happened to the missing ones? Did you ovulate, or were they just empty follicles? I hope your doctor will be forthcoming with all this info. Keep us posted when you hear back from him!