intro, first DE BFN, what to do now? (pg loss mentioned)

intro, first DE BFN, what to do now? (pg loss mentioned)

Joined: November 23rd, 2010, 6:20 pm

December 21st, 2010, 1:37 am #1

Hi all,
I've been lurking for a while, and reading other women's experiences has been so helpful while considering, then planning, then going through my first DE cycle. Unfortunately, BFN was confirmed today. I have a consult with the RE on Wednesday, but I'm at a loss. I wonder if anyone here might have some advice for me?

My history: now 40.5 years old, ttc since age 34, 4 IUIs at age 36, then on to IVF (15 transfers with own eggs between 2/2007 and 5/2010). Several cycles at local clinic: 1 chemical, 2 ectopic pgs (both tubes removed due to ectopics; first pg tested appeared to be chromosomally normal). Several cycles at top 2 NYC clinics, all BFN. Two of 3 REs believe bad eggs, most recent RE (Dr Davis at Cornell) is not sure, believes chances will be better with either DE or GC, but doesn't know which, he suggests trying DE.

Testing: everything tests normal. Normal uterine evaluations (SHG, HSG, 2 hysteroscopies); no STDs; normal thyroid; normal insulin/blood glucose; normal karotypes for me and DH; no immune issues (tested at Millenova); no blood clotting issues; FSH around 6, E2 and P4 appropriate levels through cycles. High response to low dose meds. Stage II endometriosis found at first lap (ectopic #1), mostly removed. Normal semen analyses and low (good) sperm fragmentation for DH. Only tests I can think of that I haven't done are beta-3 integrin and/or endometrial function tests (REs seem to think have little clinical value).

This DE cycle, frozen eggs at GIVF: 9 available from donor, all survived thaw, all fertilized, tranferred two textbook beautiful fully expanded grade A blasts on day 5, have some frozen (enough for one or possibly two FET attempts). I never asked if 27 year old donor was proven, but will find out.

I had an emotionally difficult time moving from my own eggs to DE, but once I embraced it, I really thought it might be the answer to my prayers. This BFN is so much worse, in part because I had such high hopes. In many of my own egg cycles, the embryos were only fair quality and sometimes lagged in development, so I was really hoping that my first two REs were right, and it's been an egg problem all along. Now, after going through this DE cycle, where everything went about as well as could be hoped up until today's BFN, I just don't know. I know that DE is not a 100% success proposition- far from it. But those blasts were just so beautiful, I can only think that somehow it's me, we just can't figure out what's wrong, and I let those blasts down.

I am guessing that the RE will just suggest moving ahead with a FET, and I'd like to ask about doing it unmedicated or at least with vaginal P4 instead of PIO (it probably makes no difference, but I did crinone at local clinic and got pg but did only PIO at top clinics and never a hint of a BFP). A small part of me thinks maybe I was just unlucky, and we picked the wrong embryos to transfer, but the bigger part of me thinks I will have the same outcome: failure, again and again. I am too upset to think about a gestational carrier; it's too hard for me to wrap my head around right now.

So, I guess at this point, I'm not looking so much for hope (although I know there must be women here who were unsuccessful with DE at first, but eventually were successful), but any advice. Where do I go from here? Any insight would be much appreciated, and thanks for reading this long post!
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Anonymous
Anonymous

December 21st, 2010, 3:21 am #2

I guess I would ask the clinic how much success they have had with their frozen egg program, in both the clinical trials and now in their $7500 promotion. They seem reluctant to give stats out. I wouldn't necessarily blame yourself, perfect blasts may not be so perfect and frozen eggs are still "new" technology for most places.

I'm sorry and agree 100% that DE BFNs or m/c feel worse than OE because of the increased expectation and hope.

I've been tempted to try a frozen egg cycle there because it is in my backyard and such a good price so I sympathize. I guess you could ask them to test the remaining frozens before tx, but even a normal chromosome report isn't a guarantee of something sticking.
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Joined: September 13th, 2008, 5:13 pm

December 21st, 2010, 3:33 am #3

Hi all,
I've been lurking for a while, and reading other women's experiences has been so helpful while considering, then planning, then going through my first DE cycle. Unfortunately, BFN was confirmed today. I have a consult with the RE on Wednesday, but I'm at a loss. I wonder if anyone here might have some advice for me?

My history: now 40.5 years old, ttc since age 34, 4 IUIs at age 36, then on to IVF (15 transfers with own eggs between 2/2007 and 5/2010). Several cycles at local clinic: 1 chemical, 2 ectopic pgs (both tubes removed due to ectopics; first pg tested appeared to be chromosomally normal). Several cycles at top 2 NYC clinics, all BFN. Two of 3 REs believe bad eggs, most recent RE (Dr Davis at Cornell) is not sure, believes chances will be better with either DE or GC, but doesn't know which, he suggests trying DE.

Testing: everything tests normal. Normal uterine evaluations (SHG, HSG, 2 hysteroscopies); no STDs; normal thyroid; normal insulin/blood glucose; normal karotypes for me and DH; no immune issues (tested at Millenova); no blood clotting issues; FSH around 6, E2 and P4 appropriate levels through cycles. High response to low dose meds. Stage II endometriosis found at first lap (ectopic #1), mostly removed. Normal semen analyses and low (good) sperm fragmentation for DH. Only tests I can think of that I haven't done are beta-3 integrin and/or endometrial function tests (REs seem to think have little clinical value).

This DE cycle, frozen eggs at GIVF: 9 available from donor, all survived thaw, all fertilized, tranferred two textbook beautiful fully expanded grade A blasts on day 5, have some frozen (enough for one or possibly two FET attempts). I never asked if 27 year old donor was proven, but will find out.

I had an emotionally difficult time moving from my own eggs to DE, but once I embraced it, I really thought it might be the answer to my prayers. This BFN is so much worse, in part because I had such high hopes. In many of my own egg cycles, the embryos were only fair quality and sometimes lagged in development, so I was really hoping that my first two REs were right, and it's been an egg problem all along. Now, after going through this DE cycle, where everything went about as well as could be hoped up until today's BFN, I just don't know. I know that DE is not a 100% success proposition- far from it. But those blasts were just so beautiful, I can only think that somehow it's me, we just can't figure out what's wrong, and I let those blasts down.

I am guessing that the RE will just suggest moving ahead with a FET, and I'd like to ask about doing it unmedicated or at least with vaginal P4 instead of PIO (it probably makes no difference, but I did crinone at local clinic and got pg but did only PIO at top clinics and never a hint of a BFP). A small part of me thinks maybe I was just unlucky, and we picked the wrong embryos to transfer, but the bigger part of me thinks I will have the same outcome: failure, again and again. I am too upset to think about a gestational carrier; it's too hard for me to wrap my head around right now.

So, I guess at this point, I'm not looking so much for hope (although I know there must be women here who were unsuccessful with DE at first, but eventually were successful), but any advice. Where do I go from here? Any insight would be much appreciated, and thanks for reading this long post!
Since I cycled in the Czech Republic, Crinone gel is the standard there, and the doctors there believe that having the P4 up near the uterus is better (whereas U.S. doctors prefer to have a more reliable measure of P4 in the blood). So, I'm biased (twins on 2d DE cycle), but if your intuition is that the Crinone contributed to your getting pg on your unsuccessful pregnancies, I'd be inclined to follow it, especially as it seems like a whole bunch o' doctors now haven't helped you out yet. But if GIVF doesn't confirm that your frozen egg donor was proven, I might put the money for the FET toward a fresh cycle -- if money's starting dwindle, perhaps at CNY or Shady Grove. That's one rough road you've been on! You'll probably get a lot more useful insight from the other ladies with more extensive histories of ttc.

Also, BBG has a really unsettling story about how doctors failed to detect scarring that would have prevented her from ever carrying a pregnancy, and she may have some suggestions for you before you spend any more money.

Good luck! You really deserve a break!

Maggie (in VA)
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Joined: June 2nd, 2007, 7:45 am

December 21st, 2010, 3:33 am #4

Hi all,
I've been lurking for a while, and reading other women's experiences has been so helpful while considering, then planning, then going through my first DE cycle. Unfortunately, BFN was confirmed today. I have a consult with the RE on Wednesday, but I'm at a loss. I wonder if anyone here might have some advice for me?

My history: now 40.5 years old, ttc since age 34, 4 IUIs at age 36, then on to IVF (15 transfers with own eggs between 2/2007 and 5/2010). Several cycles at local clinic: 1 chemical, 2 ectopic pgs (both tubes removed due to ectopics; first pg tested appeared to be chromosomally normal). Several cycles at top 2 NYC clinics, all BFN. Two of 3 REs believe bad eggs, most recent RE (Dr Davis at Cornell) is not sure, believes chances will be better with either DE or GC, but doesn't know which, he suggests trying DE.

Testing: everything tests normal. Normal uterine evaluations (SHG, HSG, 2 hysteroscopies); no STDs; normal thyroid; normal insulin/blood glucose; normal karotypes for me and DH; no immune issues (tested at Millenova); no blood clotting issues; FSH around 6, E2 and P4 appropriate levels through cycles. High response to low dose meds. Stage II endometriosis found at first lap (ectopic #1), mostly removed. Normal semen analyses and low (good) sperm fragmentation for DH. Only tests I can think of that I haven't done are beta-3 integrin and/or endometrial function tests (REs seem to think have little clinical value).

This DE cycle, frozen eggs at GIVF: 9 available from donor, all survived thaw, all fertilized, tranferred two textbook beautiful fully expanded grade A blasts on day 5, have some frozen (enough for one or possibly two FET attempts). I never asked if 27 year old donor was proven, but will find out.

I had an emotionally difficult time moving from my own eggs to DE, but once I embraced it, I really thought it might be the answer to my prayers. This BFN is so much worse, in part because I had such high hopes. In many of my own egg cycles, the embryos were only fair quality and sometimes lagged in development, so I was really hoping that my first two REs were right, and it's been an egg problem all along. Now, after going through this DE cycle, where everything went about as well as could be hoped up until today's BFN, I just don't know. I know that DE is not a 100% success proposition- far from it. But those blasts were just so beautiful, I can only think that somehow it's me, we just can't figure out what's wrong, and I let those blasts down.

I am guessing that the RE will just suggest moving ahead with a FET, and I'd like to ask about doing it unmedicated or at least with vaginal P4 instead of PIO (it probably makes no difference, but I did crinone at local clinic and got pg but did only PIO at top clinics and never a hint of a BFP). A small part of me thinks maybe I was just unlucky, and we picked the wrong embryos to transfer, but the bigger part of me thinks I will have the same outcome: failure, again and again. I am too upset to think about a gestational carrier; it's too hard for me to wrap my head around right now.

So, I guess at this point, I'm not looking so much for hope (although I know there must be women here who were unsuccessful with DE at first, but eventually were successful), but any advice. Where do I go from here? Any insight would be much appreciated, and thanks for reading this long post!
Hi there,
Firstly, I'm so sorry for your recent BFNs and the long road that has brought you here.
with your DE or OE cycles did you use antiobiotics, steroids, bloodthinner combo especially round transfer? I only had success when I did. Also, endo sets up its own wee toxic enviro (I have a loong Hx with endo), and can come back with no signs or symptoms; I took herbs to mitigate toxicity of endo on my successful try too.
HTH.
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Joined: November 23rd, 2010, 6:20 pm

December 21st, 2010, 3:49 am #5

Thanks, everyone. This can be a lonely road, so I really appreciate the support.

I'll definitely be asking whether this donor was proven or not. When I selected her, I didn't really care, because she was the closest match for me. And when I did my consult at GIVF, Dr Lincoln said they were seeing ~40% success rate with the new frozen egg program, though he did say that given my history, my odds were somewhat lower (actually, this was one of the deciding factors for me to cycle there: a doctor who had really gone through my file and was being realistic about my chances). I guess because the blasts were so good looking, I thought it'd be almost like doing a fresh cycle with them and really got my hopes up.

Maggie, I think you're right about having to go with my gut about the P4 supplementation. It seems like such a minor thing, but I keep wondering why I wasn't able to get pg at the top tier clinics, what was different, and I keep coming back to the crinone vs PIO.

Laura, could you share what herbs you took for your endo? I've always taken low dose aspirin while cycling, and always a regimen of antbiotics around transfer as well. This was actually my first cycle with no steroids (did methlyprednisolone on all my own egg cycles), because this RE felt that since my bloodwork showed no immune issues it wouldn't make a difference.

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margolis
margolis

December 21st, 2010, 4:58 am #6

Hi all,
I've been lurking for a while, and reading other women's experiences has been so helpful while considering, then planning, then going through my first DE cycle. Unfortunately, BFN was confirmed today. I have a consult with the RE on Wednesday, but I'm at a loss. I wonder if anyone here might have some advice for me?

My history: now 40.5 years old, ttc since age 34, 4 IUIs at age 36, then on to IVF (15 transfers with own eggs between 2/2007 and 5/2010). Several cycles at local clinic: 1 chemical, 2 ectopic pgs (both tubes removed due to ectopics; first pg tested appeared to be chromosomally normal). Several cycles at top 2 NYC clinics, all BFN. Two of 3 REs believe bad eggs, most recent RE (Dr Davis at Cornell) is not sure, believes chances will be better with either DE or GC, but doesn't know which, he suggests trying DE.

Testing: everything tests normal. Normal uterine evaluations (SHG, HSG, 2 hysteroscopies); no STDs; normal thyroid; normal insulin/blood glucose; normal karotypes for me and DH; no immune issues (tested at Millenova); no blood clotting issues; FSH around 6, E2 and P4 appropriate levels through cycles. High response to low dose meds. Stage II endometriosis found at first lap (ectopic #1), mostly removed. Normal semen analyses and low (good) sperm fragmentation for DH. Only tests I can think of that I haven't done are beta-3 integrin and/or endometrial function tests (REs seem to think have little clinical value).

This DE cycle, frozen eggs at GIVF: 9 available from donor, all survived thaw, all fertilized, tranferred two textbook beautiful fully expanded grade A blasts on day 5, have some frozen (enough for one or possibly two FET attempts). I never asked if 27 year old donor was proven, but will find out.

I had an emotionally difficult time moving from my own eggs to DE, but once I embraced it, I really thought it might be the answer to my prayers. This BFN is so much worse, in part because I had such high hopes. In many of my own egg cycles, the embryos were only fair quality and sometimes lagged in development, so I was really hoping that my first two REs were right, and it's been an egg problem all along. Now, after going through this DE cycle, where everything went about as well as could be hoped up until today's BFN, I just don't know. I know that DE is not a 100% success proposition- far from it. But those blasts were just so beautiful, I can only think that somehow it's me, we just can't figure out what's wrong, and I let those blasts down.

I am guessing that the RE will just suggest moving ahead with a FET, and I'd like to ask about doing it unmedicated or at least with vaginal P4 instead of PIO (it probably makes no difference, but I did crinone at local clinic and got pg but did only PIO at top clinics and never a hint of a BFP). A small part of me thinks maybe I was just unlucky, and we picked the wrong embryos to transfer, but the bigger part of me thinks I will have the same outcome: failure, again and again. I am too upset to think about a gestational carrier; it's too hard for me to wrap my head around right now.

So, I guess at this point, I'm not looking so much for hope (although I know there must be women here who were unsuccessful with DE at first, but eventually were successful), but any advice. Where do I go from here? Any insight would be much appreciated, and thanks for reading this long post!
It is so heartbreaking when we feel so hopeful that DE is the magic ticket.

FWIW, here is my experience re: crinone. I've used just crinone (cycle in the CR) on failed cycles, as well as just PIO. I don't think either one were the reasons, at least not sole reason of the failed cycles. However, my RE started to see success when he added crinone to the PIO protocol. HE thought that somehow helped the uterine enviroment. So, for the cycle that I did get pg on, I used both the crinone and the PIO. Maybe you could talk to your RE and try that.

And sadly, a lot of this is dumb luck. Even with a proven donor, not every embryo results in a baby. Not even the ones that "look" perfect and are hatching etc. You never truly know if the embryo is good unless you'v done the CGS (I think those are the initials) testing on this. Hopefully, Wilson, who knows a ton about this, will chime in about that. However, if you only have a few number of embryos (likely if using frozen eggs), then it might just pay to do the transfers and hope for the best. I'm not that versed in this area, I only know what I read here.

If you have frozens, I wouldn't necessarily give up on them so fast, but I would see and ask your RE what else you can do (add'l testing, change in protocol, etc.) to try to increase your odds with them. That was always my first question in my WTF consult: "What can we possibly do different that will increase my odds of this working on my next attempt".

Good Luck with whatever you decide, and come here whenever you need support. It's a great group of supportive ladies with a lot of collective knowledge. A fantastic resource!
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Joined: September 13th, 2008, 5:13 pm

December 21st, 2010, 5:44 am #7

Thanks, everyone. This can be a lonely road, so I really appreciate the support.

I'll definitely be asking whether this donor was proven or not. When I selected her, I didn't really care, because she was the closest match for me. And when I did my consult at GIVF, Dr Lincoln said they were seeing ~40% success rate with the new frozen egg program, though he did say that given my history, my odds were somewhat lower (actually, this was one of the deciding factors for me to cycle there: a doctor who had really gone through my file and was being realistic about my chances). I guess because the blasts were so good looking, I thought it'd be almost like doing a fresh cycle with them and really got my hopes up.

Maggie, I think you're right about having to go with my gut about the P4 supplementation. It seems like such a minor thing, but I keep wondering why I wasn't able to get pg at the top tier clinics, what was different, and I keep coming back to the crinone vs PIO.

Laura, could you share what herbs you took for your endo? I've always taken low dose aspirin while cycling, and always a regimen of antbiotics around transfer as well. This was actually my first cycle with no steroids (did methlyprednisolone on all my own egg cycles), because this RE felt that since my bloodwork showed no immune issues it wouldn't make a difference.
I started at GIVF before legal and financial circumstances forced me to go overseas, and Dr. Lincoln performed my Asherman's surgery. Maggie (in VA)
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Joined: June 2nd, 2007, 7:45 am

December 21st, 2010, 5:56 am #8

Thanks, everyone. This can be a lonely road, so I really appreciate the support.

I'll definitely be asking whether this donor was proven or not. When I selected her, I didn't really care, because she was the closest match for me. And when I did my consult at GIVF, Dr Lincoln said they were seeing ~40% success rate with the new frozen egg program, though he did say that given my history, my odds were somewhat lower (actually, this was one of the deciding factors for me to cycle there: a doctor who had really gone through my file and was being realistic about my chances). I guess because the blasts were so good looking, I thought it'd be almost like doing a fresh cycle with them and really got my hopes up.

Maggie, I think you're right about having to go with my gut about the P4 supplementation. It seems like such a minor thing, but I keep wondering why I wasn't able to get pg at the top tier clinics, what was different, and I keep coming back to the crinone vs PIO.

Laura, could you share what herbs you took for your endo? I've always taken low dose aspirin while cycling, and always a regimen of antbiotics around transfer as well. This was actually my first cycle with no steroids (did methlyprednisolone on all my own egg cycles), because this RE felt that since my bloodwork showed no immune issues it wouldn't make a difference.
I took a combination of high dose resveratrol and pycogenol for what I'd planned to be 3 months but ended up 5. oh, and high dose fish oil too...
There was some great research about how these strong antioxidants help lower the toxicity of the endo byproducts, but I can't find it or the doses I took, right now sorry.
HTH.
Last edited by phoebegrace on December 21st, 2010, 7:23 am, edited 1 time in total.
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Brenda
Brenda

December 21st, 2010, 12:54 pm #9

I guess I would ask the clinic how much success they have had with their frozen egg program, in both the clinical trials and now in their $7500 promotion. They seem reluctant to give stats out. I wouldn't necessarily blame yourself, perfect blasts may not be so perfect and frozen eggs are still "new" technology for most places.

I'm sorry and agree 100% that DE BFNs or m/c feel worse than OE because of the increased expectation and hope.

I've been tempted to try a frozen egg cycle there because it is in my backyard and such a good price so I sympathize. I guess you could ask them to test the remaining frozens before tx, but even a normal chromosome report isn't a guarantee of something sticking.
I just spoke to a lovely lady there and I am thinking about doing frozen eggs next year, but their fee will be doubled to 14,000...but if you book the consultation now, you will get the old price of 7500
good luck
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Joined: May 15th, 2010, 12:08 pm

December 21st, 2010, 3:12 pm #10

I took a combination of high dose resveratrol and pycogenol for what I'd planned to be 3 months but ended up 5. oh, and high dose fish oil too...
There was some great research about how these strong antioxidants help lower the toxicity of the endo byproducts, but I can't find it or the doses I took, right now sorry.
HTH.
Did you take the resveratrol and pycnogel before or during cycling? I haven't heard of this.
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