Advice needed IVF failed - 3 day implant - Frozen Eggs
joebob - Sep 2nd, 2005 9:45 AM
[ Original Post ]

Hi

My name is Jo I have had one Ectopic pregancy which ruptured lost my right tube. Have just had one cycle of IVF I am 27. I was very sick during the cycle and although I had my eggs harvested on the 28 July I am still suffering with enlarged breasts, ovaries larger than golf balls, weird womb lining and pains in my womb.

I had 13 eggs harvested only 6 made it. They implanted one 5 cell grade 1 (being best) and one 4 cell on day three they froze 3 eggs one 4 cell grade 2, one 3 cell grade 2 and a 2 cell somewhere between grade 2 -1. I asked them after why they implanted on day three they said they normally implant on day two however, it just happened and said it was best for the embroys to be inside me ... end of story.

Also meant to say I did not have blood test at day three to check hormone levels like some women do and I also did not have blood test to double check negative pregancy test ... had to go to my local gp to double check. Some women also had hormones to help them if there levels were low ... is this normal should this happen ... did I get left out of the loop??

I did the pregancy test on 12 Aug and it was negative. I called the clinic they said bad luck. They could not see me until 12 Sept however, I went back as felt so ill. They said I have just had bad reaction and have to sit it out. I go on the 12 Sept to talk about the future.

I need some help .... I feel as if they were not that interested in me and as this was a government paid cycle that contributed to it. I have three eggs that are frozen and I don't know what to do about it. I also have a damaged left tube that I could risk attempting naturally.

What questions should I ask on the 12 ... how long should these symptons I experience last and is it really a sitting and waiting game. What is the quality of my frozen embies and are they worth defrosting....

Any advice or help would be fantastic as very lost at the moment ...

kind regards
jo

Comment


 

Dr Smith - Sep 6th, 2005 9:31 AM

From the sounds of it, you received the bare minimum treatment for IVF. That's probably because the clinic received the bare minimum fee from the government for taking care of you. There's something in the old saying "You get what you pay for". O.k., so that's all behind you and the question is what to do now. All of the embryos frozen on Day 3 were behind in their developmental stage (they should have been 8-cell stage embryos). I think you should thaw the embryos, but I wouldn't hold out too much hope for a successful frozen embryo transfer. I wouldn't waste any time asking any question when you meet with the Doctor on the 12th. You're not going to get any satifactory answers.

If the frozen-thawed embryo transfer fails, I would immediately change to another program that is willing to provide treatment at a level above the bare minimum. You may have to pay some money out of your own pocket, but you will receive better care and have a better chance of success. Have the doctor at the new program review you medical and embryology lab records from the first cycle and give you an opinion about what went wrong and what he/she would do differently.

I cannot address the persistant symptoms you are expereincing, as I am not a physician. I think Dr. Jacobs may be able to help you there. Try posting you symptom-related question on Dr. Jacob's Infertility 101 message board.


joebob - Sep 6th, 2005 10:34 AM

Dear Dr Smith

Thank you so much for replying to my post ... I had a feeling that the treatment wasn't great however, the government did pay this clinic over seven thousand pound for one cycle and I saw the consultant three times if you count last week ... when he told me not to touch my breasts as that would cause them to grow more!!

I have found another IVF specialist however, this previous clinic the specialist was suppose to be well known and good. How does one find out if the guy is good ... I mean my clinic had a good report from the HEFA however, they have turned out to be uniterested and awful. Is there any books you would recommend that would help me gain an understanding of the care that is required to give a person the best possible chance ... I know that IVF is no guarentee but it would be nice to know what care one should have to give it a good shot.


So the frozen embryos are not up to scratch is that due to the fact they were frozen on day three or that they were slow developers as you mention that they should have been a much higher cell content? I was a little unsure of why ... again sorry I am no biologist and perhaps I went into this too naively (that is the IVF cycle) and trusted the so called professionals!

The other thing I would like to know if you have time to answer is that a number of other ladies I| know talk of things that I am unsure of and would like a professional opinion on ... its regarding implantation ....

Firstly, after implantation you should lie down for an hour .. I was told to leave ten minutes after.

Secondly, ladies went back to the clinic around about day three to have their hormones checked ... and given relevent medication to help if necessary ... again I saw nobody.

Thirdly, how do you view accupuncture in reference to implantation half an hour before and half an hour later and a course of three months before hand?

Thank you so much for taking the time to read this mail and the previous one. I just want to say that in reading your previous answers to other people that it is so refreshing to find a professional who can say it like it is and also actually give advice that is relevant and in everyday language. Thank you for your time it is very much appreciated.

kind regards


Dr Smith - Sep 6th, 2005 11:34 AM

I can't personally recommend any layperson books on the subject of IVF because I haven't read any. My reading time is consumed with technical journals and the odd novel for recreation (btw I'm a big fan of the English humourist Terry Pratchett). However, I didn't want to come up empty handed for your request, so I looked around a little on Amazon.com and came up with this one which may fit the bill:

The Couple's Guide to In Vitro Fertilization: Everything You Need to Know to Maximize Your Chances of Success -- by Liza Charlesworth (2004)

http://www.amazon.com/exec/obid
os/tg/detail/-/0738208973/ref=sib_rdr_dp/104-
9847278-5271148?%5Fencoding=UTF8&no=28315
5&me=ATVPDKIKX0DER&st=books

Th
e
main reason I'm skeptical of your chances of success from a frozen embryo transfer (FET) is because of the slow development of the embryos. People do get pregnant from Day 3 FETs, but personally, I prefer to freeze embryos are the blastocyst stage because, by that point, the embryos have clearly demonstrated their developmental potential by reaching the blastocyst stage (embryo development is still uncertain on the third day of development). It may be difficult to find a program that will be willing to thaw the embryos and continnue to culture them for another 2 days to dertermine if they are capable of development to the blastocyst stage, but, if you can find one, that is what I would suggest.

Different programs have different policies regarding bed rest after transfer and there is no clear-cut answer to this question. The embryos will not pop out of the uterus if you stand up immediately after transfer. Remember, people have sex, go about their active lifestyles and become pregnant. The reproductive process is not that sensistive to gravity. At our program we recommend bed rest for the day or transfer (Day 5) and the day following (Day 6), but its more for psychological reasons than physiological reasons. I don't think that played a critical role in your recent IVF cycle failure. You didn't do anything "wrong" by getting up and going home after the transfer. Relax.

The reason for the blood test a fews days after the embryo transfer is to determine if the estrogen and progesterone levels are adequate to support a pregnancy (assuming one has been initiated). At my program we believe this is important and will supplement with estrogen patches and increase the dose of progesterone as necessary. Some programs assume everthing is alright and do not request thier patients to return for the blood test.

There is no definitive scientific "proof" showing the effectiveness of acupunture in improving implantation. However, that being said, there's also no definitive proof that it doesn't help. I'd say that, if your willing to try it, acupunture can't do any harm and if it helps - great.

I'm glad you appreciate my honesty. I do try to cut through the crap. However, its just one man's opinion and, on occasion, my shoot-from-the-hip approach has ruffled a few feathers amongst my colleagues. I can't imagine why? LOL


sblanton2 - Sep 6th, 2005 12:32 PM

I hope you do not mind my opinion, but I have the book Dr. Smith recommended and it is AMAZING. I think b/c it was written by a woman who went through all of this herself. It is written so that the average person can understand, and it does give helpful steps on what to do if your cycle is not a success. I wish you all the best with your journey.

Sylvia



Dr Smith - Sep 6th, 2005 1:35 PM

Thanks for for your recomendation Sylvia. I'm glad to hear that the book turned out to be exactly what the title promises. The cover notes looked good, but you can't judge a book by its cover (notes). O.K., that was pretty bad. I'll stick to science instead of stand-up.


joebob - Sep 7th, 2005 7:46 AM

Hi Dr Smith

Well thank you for your time and your answers also the book recommendation. Have you ever considered writing a book as your cut the crap is an excellent approach and it would be a best seller with the public as for your peers someone has to ruffle their feathers sometimes :0)

I did leave a message for Dr Jacobs but think I phrased it wrong as he said see my Doctor ... so will I guess just sit this one out.

Anyway thank you so much for your advice and time and straight talk can't tell you how much I appreciate it and on the 12th I will sit back and see what they say I should imagine it will be ... "your opportunity is good if you pay us £8,000 we make it work".... and the reply will be ... not in this clinic you won't!! (lol).

kind regards
joebob


joebob - Sep 7th, 2005 7:51 AM

Hi Sylvia

Thank you for sharing with me that you have the book and have found it really good. I will get it and have a good read ... give my brain something to occupy itself on instead of mulling over everything.

thank you, kind regards
joebob