If you have a failed cycle the first question you are likely to ask yourself is “why?” The answers to that are varied and sometimes there just isn’t one. If something can be pinpointed as the reason for it not working it is usually very clinical, and does not give the emotional comfort that you are seeking. Knowing what went wrong, though, can help you and your doctor in subsequent cycles. Anyone who endures IVF knows that you are often on pins and needles waiting for the results of the Egg Retrieval, and unfortunately for some this is where the failure takes place.
When you go in for monitoring the nurse or technician or doctor is often using ultrasound to count follicles. Sometimes the treatment protocol does not result in mature eggs in those follicles – which is for sure devastating but not wholly bad news because often medications are one of the more simple things to tweak and hone to help urge your body to create eggs. This can affect the number of eggs that are able to be recovered, as can prior scarring or biological problems that make retrieval difficult. Nobody wants to hear a low number when the doctor tells how many eggs were retrieved but there is truth in the saying that it only takes one and if normal eggs are recovered then there is still hope at this point.
Beyond the stage of recovery of eggs there are unfortunately quite a few other things that can also derail the cycle. There could be a problem with the semen sample, fertilization may not occur even if both the eggs and sperm are normal, the embryos may not develop normally or at all, there may be difficulty with the transfer, implantation may not occur, or the embryos may cease to develop after implantation. Doctors may not be able to identify a reason why some of these things happen – if is is technical difficulties or human error they will usually let you know – and sometimes the only answer is that this time just wasn’t meant to be.
If you are like me, that is not an answer that will ever provide the comfort that I need. I want to know what can be fixed or done differently the next time. Fortunately, there are a number of different protocols and a lot really is learned from each cycle and typically a doctor can do something different the next time to try to maximize your chance of conception. There is something very important that I feel as though every doctor should do the first time, though and that is a trial transfer. There are a lot of things that are out of your hands and even those of the doctor, but learning of technical difficulties on the day of the transfer should not be one of them.
Your doctor or nurse should do a trial transfer prior to your transfer day. They will make sure there is not scarring or blockage that will impede the tools used to transfer the embryos. They should walk you through it and get a feel for how your body is designed and what they need to do on the all important day. Trial transfers by no means guarantee success and if you find that there are issues you may not be able to rectify it in time for the transfer – but it is definitely something that your doctor should be aware of and I truly believe that a trial run gives you a better chance at success. There are already so many things that can go wrong – why would a physician add to that by not doing his “homework,” aka trial transfer.
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