IVF failure - when emotional pain is stronger than physical pain !

" Thanx a lot manju...i just love to read your reply.
I am very lucky to have a very loving and understanding husband. Just finiahed my 3rd ivf. Same protocol with 450 iu fsh daily for 10 days fron day 2 and cetrotide. Collected 9 eggs. 4 mature and 3 immature, 1 dead. 4 eggs icsied and got 3, 6 celled and 1,8 celled day 3 embryos and 8 cell embyo was grade a with no fragments. and others with small fragments.they tranfred 4 embyos My dr was very hopeful for this cycle. But just got my bfn on day 14. And this cycle also was not succesful. My progestrone on day of hcg administration was 1.7ng/ml. I was reading that elevated progestrone on day of hcg admnstration have a negative impact on implantation. As endometrium is less receptive. I am not finding any comfort anywhere. I am so hopeless. Just want to have my bundle of joy, but it seems its not going to happen.
I feel good talking to you. Just someone with whome i can share everything.
Thanx a lot for being there. "

Dear S ,

" I understand your pain. I have gone through IVF failures many a time - we feel so hopeless , and future might appear very dark and bleak. All I would say is , cry , cry and cry. It will make you feel better. 

Remember , there are women who go through much horrible times due to infertility. I know women whose husbands took it as an opportunity to leave them. I know women who can't get the baby they want because they do not have the necessary money. And , there are women  who just can't have a baby because their ovaries don't work anymore. Being grateful for what we have helps a lot to feel better at these difficult times. It helps you to feel thankful in spite of the sorrow you feel now. Life is never easy , not for anyone. The battles we fight , the courage and strength we show , will define who we are. 

First , even if you do not succeed in having a baby that's not the end of the world. You are already a wonderful mother and your child will come to you in the appropriate time. Never lose hope.

Yes , progesterone rise at the time of hcg administration can make the lining not in sync with the embryos' developmental stage - this might lead to failed implantation. Why didn't you tell your concern to your doctor at that time ? You could have opted for a FET. Nevertheless , past is past. The good thing is , you produce eggs still. When are you planning to start the next cycle ? Can you write to me before starting it , perhaps a month before you start ?

Now , just take your time to recover - read good books ; grow your spirituality ; do something which makes you feel good about yourself. Life will not stay as such forever - nothing lasts longer. This difficult time will come to an end , too.

Find happiness , please ! You can , it's all within yourself. You just need to know how to experience it , enjoy it , in spite of all the troubles. Finding ways to be happy amidst these difficult IVF times can help you to reach your goal with ease . "

IVF failure is no joke. I have seen couples who became suicidal after an IVF failure. The pain can be excruciating - you feel as if  you are sucked out of energy from every cell of your body ; thoughts about future can be very fearful. You feel as if you can never function properly - doing everyday chores can feel like an Himalayan task ; your professional life can have a set back , for that time being.  But the good thing about an IVF failure is , after you cry your heart out , you feel cleansed inside out. For many , IVF failure can open the door to spirituality - they try to analyze their actions ( life ) spiritually - as a result ,  most couples will definitely become better humans. Your preferences in life will change for the better. Your ego gets tamed , and naturally you start to give importance to the most valuable things in life - you will fill yourself with love and gratitude , rather than hatred and fear. After all ,  that is what life is all about ; that's what a failure does to a mature human being. After a painful experience , you will always be left with two choices - to become bitter or better. The good news is , most humans turn out to be better beating the bitterness within them. The only wise words at such times is , " Stay strong , this too will pass "

Can a high white blood cell count prevent embryo implantation ?

Question # 1

Would a high white blood count of 13500 stop implantation.  No symptoms of being sick however my wbc has been high for months.  I have ulcerative colitis but take humira and have no current symptoms.  I have three failed ivf attempts and one failed donor egg cycle all bfn

Answer :

My very confident answer is 'No'. 

Uterus lining , where the embryo implants ( decidua ) , is an immunologically privileged site. It means , the immune system doesn't do the actual function what it is intended for , in those sites. Even though ,  the trophoblast cells and the placenta carry antigens ( foreign molecules ) which are disparate to mother's immune system they are not attacked by the mother's immune cells. Since decidua is an immunologically privileged site , the immune system's usual reaction ( to attack foreign antigens ) is turned off ( by the secretions of the embryo ) and hence the immune cells doesn't hurt the embryo. Even in healthy pregnancies , the WBC count increases in your circulatory system. In other words , pregnancy can lead to an increased WBC in blood without any negative consequences to the developing fetus.

The success rate of an IVF cycle is not 100% , even with donor embryos. Sixty percent of women who are within 35 years of age , and who have good ovarian reserve  get pregnant within 3 IVF cycles ( not within 3 IVF transfers ! ) It is very natural to think that something is wrong with your body ( especially , the uterus ) when an IVF cycle fails. But the truth is , in 99% of the cases nothing is wrong . Not every embryo have the potential to implant and give rise to a healthy baby ( because of genetic defects in the embryo ) . We are still faraway from having a foolproof ART technology which could pin point which embryo will become a healthy baby. 

You just have to repeat your IVF cycle with donor embryos until you find success. Make sure that you are with a good IVF clinic which has high success rate.

Good luck !

Manju

Please read the disclaimer at the top right corner of this blog !

If you need to talk to me , write to me to manjupadmasekar@yahoo.com

I have failed IVF repeatedly, what should I do ?

You can do five things :

• Change your IVF clinic
• Change the egg
• Change the uterus
• Change the sperm
• Change the embryo

Unfortunately, there are no clear answers for most failed IVFs. If you have undergone multiple failed IVFs , these are the options you have in front of you :

• If you are a woman of advanced maternal age or with premature ovarian failure, it would be reasonable to try IVF with donor eggs from a young woman. In most cases this will solve the problem.
• If you are young and have still encountered several failed IVFs, try changing the clinic. However, make sure the doctor does not mechanically repeat the same treatment
• If you are obese and have metabolic disorders like PCOD or diabetes, try reducing your weight and keep your insulin and glucose levels under control and try again.
• If the above solutions do not solve your problem , then you can consider surrogacy.
• If fertilisation is occurring, then using donor sperm is unlikely to help, because 90% of the genetic abnormalities which prevent embryo development and implantation are found to arise from the egg , and not from the sperm.
• If you are unsure whether there is problem with your egg or your husband’s sperm , you can opt for donor embryos.

There is no explanation why IVF does not work for some women. Be open to different treatment options (like donor eggs or surrogacy); and if not, then have a plan B (like adoption or child-free living). Never start an IVF cycle with the notion that I will succeed. It is wiser  to start with the question “What will I do if my IVF cycle does not succeed ?”. Having such a mind-set will help you to remain resilient and sane.

Read  more at : http://www.drmalpani.com/failedivf.htm

http://blog.drmalpani.com/2010/06/after-4-failed-ivf-cycles-what-should-i.html

http://blog.drmalpani.com/2011/02/i-have-failed-five-ivf-cycles-dr.html

How to prepare yourself emotionally for an IVFcycle ?

Emotional preparation for an IVF cycle is as important as preparing yourself physically. Our mental and physical health is intertwined and any adverse change in one can affect the other too. Actually an IVF cycle is much more emotionally draining when compared to the physical discomfort it can cause. There are so many fears and concerns before starting an IVF cycle – and you are likely to feel excited and terrified at the same time. For most people the first IVF cycle (and for some every cycle) will be a scary emotional roller-coaster ride , filled with lots of uncertainty and heart-breaks. Of course there are a fortunate few who go through their IVF cycle smoothly and achieve success in their first attempt. But remember , this is not true for everyone. While we all want our first IVF cycle to be our last as well, if you are not hardy enough , an IVF cycle can play havoc with your mental health, sometimes irreversibly. So how should you prepare yourself mentally to deal with such an emotionally challenging journey ? How can you through an IVF cycle and come out successfully with minimal heart-breaks and few emotional scars ?

Acquire knowledge about the process

 

This is the first and foremost requirement which will safe guard your emotional health when going through IVF. Being literate about the IVF process gives you lots of confidence and a sense of control over the entire treatment. If you are knowledgeable , you will able to deal with the uncertainty inherent in the process more effectively.  Many first time IVFers find it hard to go through an IVF cycle because most of them are naïve about the process. The only thought they have in their mind is a baby , and they believe that every IVF cycle ends in a baby. They believe that all the medical nitty gritty of their IVF cycle will be taken care of by their doctor , and that everything will be fine if they are optimistic and have faith, so why should they worry about the technical minutiae of the process ? When their cycle doesn’t progress as expected , or if it fails , they are very vulnerable and may suffer from an emotional breakdown. Their belief in the entire process disappears into thin air and they find it very hard to cope. The best way to prevent this is to learn as much as you can about the IVF process. This will help in preparing yourself emotionally , because you will know : what to believe; what to expect; what can go wrong; how far your doctor can help you; how to deal with the cycle if something goes wrong; and why your cycle is different than that of your friends. The knowledge you acquire will act as a shield in protecting your emotional well-being. It will also aid you in designing a plan B if plan A doesn’t work. 

  

Prepare your mind for the failure

Some readers may find this advise absurd. Others may even get angry and think that I am a very pessimistic person. After all , who wants to hear about failure before starting their IVF cycle ? Everyone loves to talk to a person who encourages them and fills them with tons of positive thought. Everyone loves to hear that their cycle will have a positive outcome and they will take home a baby. Many refuse to even consider the idea of failure , because they dread the very possibility. They are worried that negative thoughts reduce the chances of success – or that they will create an unlucky jinx if they think about failure. Remember, you do not need any emotional preparation to face success but you need lots of emotional groundwork to face failure. The scientific truth is that only about 40 % of perfect IVF cycles end in pregnancy ! This means that only 4 out of 10 women who undergo one IVF cycle find success. Everyone , including me , wants to be one of those 4 ! But what if you are one of the 6 who fails to conceive after an IVF cycle? If you always obsess about success and a baby, how will you be able to face failure ? Many women who go through IVF are constantly advised by their friends, kith and kin ( and even their IVF doctors ) to remain optimistic. As a result of this, many women will train their brain to visualize only a positive outcome. They believe that if they do so they will end up becoming pregnant. I don’t know whether it will help you in getting pregnant , but it will definitely shatter you totally if the cycle fails. The pain a failed IVF cycle creates is enormous , and if you are a weak-hearted person it can paralyze you completely. So take care to prepare yourself for the worst. Write down how you will cope in case your IVF cycle fails. This will help your mind to be prepared for failure and hence the pain becomes a lot easier to deal with. Preparing yourself for failure will speed up your emotional recovery and will help you to plan for the next IVF cycle. 

Build a good emotional support system

It’s easier to handle difficult situations if you have a good emotional support system and family and friends can play a pivotal role in decreasing the stress of an IVF cycle. However, it is not wise to tell everyone that you are going through IVF and you need to decide who should know about your IVF journey. You might have lots of friends and family members but you might feel close and comfortable only with a few of them. Select people who really understand what you are going through, who are empathetic and who can whole-heartedly take part in your happiness and sadness. Surrounding yourself with friends and relatives who understand you will make a positive difference in your emotional well-being. This in turn will make your IVF journey a lot easier. My friends took away the stress of my IVF cycle by chatting with me (I forget to obsess when I am with them), by their compassion and by their kind words and deeds. During my recent failed IVF , my friends and their comforting words helped me a lot in regaining my routine. They patiently allowed me to grieve; and when I started to feel better , they came home and spent some quality time with me. One of my friends brought me a plant which is full of blooms and gave me a hug and that is all I needed to feel better instantly. I understand that many of you may be reluctant to share your IVF journey with anyone. I was also like that when I did my first IVF cycle, but it’s only later on that I realized that it is impossible to bear the brunt of an IVF cycle alone.  Happiness shared is multiplied , while shared pain is divided – share your IVF journey with your loved ones so that you get more emotional protection.If you have busybodies and nosy-parkers  in your life, please stay away from them. They just add to your stress levels and make coping with the IVF cycle much harder.

 

Turn to online infertility support groups

The best way to feel good is to talk to women who are going through the same infertility struggle as you are. There are so many online support groups where you can meet women who are knowledgeable about the IVF process . Most importantly , they are ready to help you both intellectually and emotionally. Another advantage with such support groups is that you do not have to reveal your identity and so you feel more comfortable sharing your journey with them. When you express your fears and concerns , you feel better emotionally. You don’t have to worry whether you will be ridiculed for your silly doubts because the other women have gone through the same situation you are in . You can also help other women with the knowledge you have gained. This will make you feel appreciated ; and this increased self-esteem will improve your emotional competence and strengthen your ability to face the next IVF cycle.

 

Prepare yourself physically

It is a well-known fact that a healthy body harbors a healthy mind, so take time to prepare yourself physically.  Please see my post on ‘How to prepare yourself physically for an IVF cycle?’

Relax

An IVF cycle is emotionally very stressful.  The most difficult challenge is to relax amidst that emotional stress. But when you relax , you will feel definitely better. You need to use relaxation techniques, and the good news is that there are many available, such as like breathing exercises ( pranayama); meditation; yoga and so on. But will they help ? How can a woman undergoing IVF relax her mind and get relief from the worries and doubts which constantly assail you. While yoga and pranayama will help you to relax physically , how far will they help you deal with your emotional stress ? I have found that the best way to relax is to address what is bothering you directly, instead of trying to suppress your fears and concentrating on something else. The major worry for a woman who is going through IVF is - ‘What will happen if my cycle fails?’ This question is the starting point of all stress, so try answering this along with your partner. Design a plan B ! It can be anything depending on individual circumstances – it can be another IVF cycle, it can be adoption or it can be child-free living. Once you decide what you will do if the IVF cycle fails , then it will be several times easier to relax mentally – and having a healthy conversation with your partner about what is bothering you will help you to relax as well !

"This too will pass"

It's a negative again! At this moment so many different thoughts are running in my mind but "This too will pass". Thank you for each and every wonderful person who prayed for me and did their best to keep me happy. Only all your kindness, keeps me going. 

It is hard, I did cry but I did feel peaceful within me after knowing for sure this is what it is. I haven't told my mom yet. I am gathering courage so that I can tell her without crying. Obviously she will tolerate the negative but not my sadness. I have let so many people down. I might have also shattered many of your dreams.  I have a friend who is also going through this. She told me 'Manju, if you get success it will give me lots of confidence to carry on'. Sorry! I know many people like her would have looked at my posts in search of some inspiration. Please remember-our baby making machinery is not so effective! Even couples without any problems need few months to a year to conceive. Do not take me as an example. I can show so many people who conceive with IVF/FET. There are so many people who conceive with a thin endometrium. Might be, I am just an exception who needs to fight a bit hard. I am not going to give up and every failure makes me stronger! I have 5 more frozen embryos. So hopefully when we are ready we will start the process all over again. My DH is calm and composed as always. I sometimes wish he breaks down as I do  - so that he will not accumulate the stress inside.

I still think my blasties looked so good and competent.  I failed to provide them the best : ( I just wish I accumulate enough patience, perseverance and persistence to go on with this process. As Winston Churcill said :

                  Success is going from failure to failure without loss of enthusiasm.  

Take care everyone! How much I wished I could put a picture of postive HPT in this post!!!! : (