I am 37 years old and will be 38 in Jan of 2009.  Our two IVF cycyles were failed.  We have a male factor.  The first protocol is too aggressive so it was cancelled before the egg retrieval.  225 Gonal F and 1 powder of menopur for 8 days.  day 9, no med but start Ganierelix.  day 10 half powder of menopur and Ganierelix.  By day 11, the estradial level drop significantly.  The doctor still want to try to increase it with 3 powder of menopur and Ganierelix but by Day 12, it is too late.  They called to cancel it on day 12.

The second cycle, I am on Lupron protocol.  .1 CC for eleven days.  Day 12-Day 19, I use two powder of Menopur AM and 150 Gonal F PM plus .05 CC of lupron.  Bloodwork and ultrasound looks good.  Day 20, the doctor reduces to just 150 Gonal F pm.  Day 21, no med and take the trigger shot.  Day 23 is retrieval.  9 follicles total but 1 too matured and 1 under matured.  7 were subject to ICSI.  4 fertilized.  By day 3, only 3 left.  But 2 with 8 cells and 1 with 10 cells.  So the doctor did the day 3 transfer.  My bloodwork pregnancy test came back negative.

I need to make an appointment and not sure what to ask my doctor.  I just do not understand what can help the implantation.  It looks like I have good quality eggs and embryos.  I started progesterone in oil for 1 ml a day since the day of the retrieval.  I avoid heavy lifting and aerobic activities. 

Please advise.  This is a very expensive procedure and I want to make sure I do everything correctly on my part to make the next one become successful.

Hello there,

I am sorry to hear that your IVF cycle was not successful.  Obviously the first one without an embryo transfer had no chance of working but the second cycle did appear to be much more promising.  Certainly you need to have a follow up visit with your RE to go over the details of your IVF cycle as he or she would know much more about your medical history.  Even with IVF we have many failures that cannot be explained.  Usually it takes several attempts at IVF before we can say it is not going to result in a live birth.  Depending on your clinic live birth rates range from 20 to 30% per cycle meaning that most of the time an IVF cycle fails!  It sounds like you had good embryos go back and they just did not continue to grow and this does happen more often than not.  Ask your RE based on your age and day 3 FSH level what they expect your chances of a live birth per cycle start to be.  This percentage may give you a better idea of what your overall chances are going to be before you decide to attempt another cycle.  I hope this helps and good luck!

R,
Dr. Miller