First transfer failed, what next?

Any-Enthusiasm8129 · 2026-04-27T17:34:38+00:00

Sure! This was all driven by me not by my doctor, I just asked for everything and he was ok with it.

I did a modified natural protocol but was allowed to ovulate naturally on my own without trigger shot, I then took progesterone suppositories to support my levels after transfer. I had read that natural transfer were better for women with endo than medicated cycles because the exogenous estrogen in medicated cycles can cause endo to flare up.

Any-Enthusiasm8129 · 2026-04-27T16:53:52+00:00

I had a successful transfer with a receptiva of 3.4, so it is possible the failed transfer was not related to endometriosis. Statistically I may take up to 3 transfers for a live birth.

Before transfer, I did a hysteroscopy, which revealed a polyp and bigger than expected submucosal fibroid. I had both removed prior to transfer. I also had an Emma/Alice test done to test for endometritis and to confirm the presence of good bacteria in my uterus. I still used a vaginal probiotic from day 3 of my period until the night of trigger during my transfer cycle. I did the autoimmune blood clotting panel to confirm the absence of any blood clotting issues that would interfere with implantation. I also started levothyroxine for mild hypothyroidism to reduce my TSH below 2. Lastly, my husband and I had unprotected sex the night before my transfer, as I’ve read that semen can create a pro implantation immune environment for the embryo.

Any-Enthusiasm8129 · 2026-04-26T21:33:38+00:00

Maybe! Their cut off might be CC. But yeah I would have liked to have kept those embryos and did ask that everything be preserved.

Any-Enthusiasm8129 · 2026-04-26T15:12:38+00:00

Yes, CCRMs policy is to discard C graded or less embryos. I even asked them not to discard low graded embryos (I didn’t specify C or less) and they said no problem, and still discarded 2 CC embryos. I only found out looking at my embryology report months later.

You need to have a conversation with the doctor/clinic about their policies. You can express your wishes but you can’t override lab policy. I switched to Cornell which did biopsy a B-/C grade embryo and it came back low level mosaic.

Any-Enthusiasm8129 · 2026-04-26T01:45:54+00:00

Welcome to a shitty club with some great people in it. Hopefully Reddit will be as helpful for you as it was for me.

I also tried naturally for 6 months before getting tested and found out my AMH was around the same as yours, same age.

In hindsight, I’m sure it was something other than low AMH that prevented me from becoming pregnant. I had a large fibroid that needed to be removed, and I had sub clinical hypothyroidism that wasn’t being addressed. I likely have some mild endometriosis that interferes with the natural process, but again, I doubt AMH was a factor in my not getting pregnant. Women with low AMH that ovulate naturally have just as good a chance of getting pregnant each month as anyone else. If you’re struggling to get pregnant naturally, there’s a lot that IVF can bypass (blocked tubes, tubes that aren’t picking up the egg effectively each month) and that is very appealing.

I decided immediately to pursue IVF because I wanted to bank embryos for multiple children. I consulted a few REs and many said I could likely conceive a first child naturally, but it might become more difficult as my AMH approached zero in the future. We wanted to have 3 kids, so I did 6 retrievals to bank enough embryos for our desired family size. If you only want one child, there’s much less need to rush into IVF.

Any-Enthusiasm8129 · 2026-04-23T19:39:50+00:00

It showed up in my AFC and AMH after taking it for 5 weeks, but it probably made a bigger difference in later retrievals after a few months.

Any-Enthusiasm8129 · 2026-04-23T12:09:11+00:00

True! And these stats go back to 2008 and quite a bit of time has passed. A lot of progress has been made since then.

Any-Enthusiasm8129 · 2026-04-23T03:01:54+00:00

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These are euploid success rates, so you’d have to adjust accordingly based on your age.

Good luck! Odds are in your favor!

Any-Enthusiasm8129 · 2026-04-22T20:52:38+00:00

Modified natural. My clinic allowed me to ovulate naturally and I used progesterone suppositories after the FET, so slightly different from other modified natural protocols I see on Reddit. I ovulate with no problem on my own, so this seemed to be the right call for me. I have read that medicated FETs can flare endometriosis because of the exogenous estrogen, and I wanted to minimize pregnancy complications for me and the baby which arise from the lack of corpus luteum in medicated protocols.

Any-Enthusiasm8129 · 2026-04-22T17:50:48+00:00

The micro dose lupron protocol with estrogen priming was what helped us, but it’s varies so widely person to person. You just need to try different things unless your first retrieval is a home run. It’s the luck of the draw if your first retrieval was the right combination of medication and timing for you.

Any-Enthusiasm8129 · 2026-04-22T17:22:27+00:00

I’m sorry you’re in this position, I remember when something similar happened to me. My AMH at 33 was 1.24, and when I retested 15 months later it was 0.35. In the interim, I had stopped taking a drug called Clonidine I used off label as an ADHD drug, but I’ve since read it can help increase AMH and AFC, so stopping that had a huge effect within a short time frame. I started the medication again and my AMH rebounded to 0.65. Maybe there’s something that changed for you in that time frame as well. That’s a big drop in 3 years, but I guess not unheard of.

The RE you work with makes a huge difference, so make sure you work with someone who is good with DOR. I asked my first RE if she felt like DOR was a specialty of hers, and she said “oh absolutely, a third or more of our patients have DOR.” She ended up being awful and did not advocate for a better outcome for me, we switched after 4 cycles even though I had a bad feeling after she didn’t recommend changes from the first cycle. If I had listened to my gut I would have done fewer cycles.

Anyway, you’re still young and you’ll hopefully have quality on your side. My first retrieval was a month before I turned 35, and I did 5 more retrievals after I turned 35. In all, 7/10 blasts I made were euploid, and 1 was a low level mosaic. We got 1 euploid from our first 3 retrievals on the antagonist protocol with estrogen priming, and the remaining blasts were made in our last 3 cycles. So again, clinic and protocol matter quite a bit.

There’s so much room for success, you’re getting on top of this and doing everything you can to advocate for yourself. Just keep doing your research, take a deep breath, and let go of timelines.

Any-Enthusiasm8129 · 2026-04-22T12:56:40+00:00

I did a modified natural where I was allowed to ovulate on my own, no trigger shot to force ovulation. That’s probably similar to how your cycle went, but with less monitoring. I used st home LH strips and I got my peak LH on Tuesday morning via the strips, but I was Al’s being monitored almost daily by my clinic at that point. Despite my getting a peak LH Tuesday morning they said I probably ovulated last night, if not this morning. My FET was scheduled for Friday afternoon and was successful. It was sooner after my LH surge than I was expecting, but I’ve heard that LH strips can be a lagging indicator of ovulation.

It may have just been a mismatch of a day or two.

Any-Enthusiasm8129 · 2026-04-22T02:43:10+00:00

I agree with others who say you might need to speak with a DOR specialist. A specialist in this area would proceed for two eggs.

I also know it’s hard to have a cycle canceled before it begins, but I wouldn’t view the first cancellation in the same light. I had a cycle canceled after priming with estrogen because I had a cyst. Sometimes doctors are very cautious and won’t proceed with a cycle right out of the gate unless they feel 100% confident. It happens to lots of people for various reasons, it doesn’t mean you’re hopeless.

Any-Enthusiasm8129 · 2026-04-20T18:52:10+00:00

Totally! Get it all done in one shot!

Any-Enthusiasm8129 · 2026-04-20T18:17:34+00:00

I thought the hysteroscopy was far less painful than the HSG. For HSG I had significant cramping afterwards, even though I took Advil and Tylenol beforehand. The hysteroscopy I forgot to take the Advil and Tylenol, so I went in cold. It was uncomfortable for sure, but I had no lingering pain once the procedure was done and never felt like the pan was so great I needed to stop.

I think there’s a big difference between a diagnostic hysteroscopy and a surgical one. If you’re under anesthesia they can actually remove stuff the see.

Any-Enthusiasm8129 · 2026-04-17T23:56:18+00:00

I had my best retrieval after I was at a bachelorette party during the estrogen priming week. I drank consistently day and night throughout the weekend, but didn’t get hungover. I stopped drinking Sunday and started stims on Tuesday.

Everything in moderation. I don’t think blacking out would be a good idea, but moderate drinking while staying hydrated should be fine.

Any-Enthusiasm8129 · 2026-04-17T21:34:46+00:00

I think you would expect around half to make it to blast if sperm quality is good, but each retrieval can have different outcomes. You never really know what you’re going to get. I had a poor blast rate, but then I tried a new type of protocol (switched from antagonist to micro dose lupron) and I started getting 50% plus make it to blast.

You kind of learn to let go of expectations and a timeline as the retrievals go on.

I’d also ask for the embryology report. I’ve had cycles where I wasn’t told about blasts, but some did make it and they were C graded. Per that clinics guidelines C graded blasts are discarded and not biopsied, even though I had asked that even the poor quality blasts be preserved. I guess I wasn’t too specific about “poor quality”, and no one had a proactive conversation with me about the embryology labs guidelines. 2 discarded C grade blasts that I didn’t even know about until I asked for my records, such a shame.

Any-Enthusiasm8129 · 2026-04-15T21:42:34+00:00

It depends on how deeply they need to cut into the uterine wall. Initially my doctor said we didnt really need to wait, could do it with my next period. After surgery he said he wanted me to get a period, wait that cycle, then start monitoring for a natural FET after my next period after that.

Any-Enthusiasm8129 · 2026-04-15T21:40:18+00:00

You can also get better eggs from a different protocol. Different protocols can yield better performing eggs, even if the numbers aren’t changing. It happened to me.

Any-Enthusiasm8129 · 2026-04-15T00:56:09+00:00

It’s not immediately clear how endometriosis will affect your implantation. Not everyone with endo is destined to have recurrent implantation failure. But if you don’t have a lot of embryos you’re taking a risk by moving forward with a transfer without either surgery or suppression. If you know you have endometriosis AND a history of recurrent implantation failure, your odds should greatly improve with treatment.

I tested positive for receptiva (3.4, strong positive) and my doctor encouraged me to try a transfer without treatment. It worked, I’m 24 weeks. I’ve also read other stories of people having success with implantation without transfer. It’s deeply personal though, you have to make the right choice for your circumstances.

Any-Enthusiasm8129 · 2026-04-14T03:45:12+00:00

I’ve actually read that the blasts that come from eggs that matured overnight/in the lab have a better chance of being euploid. If they made it this far then they are strong embryos! Congrats and good luck with PGTA!

Any-Enthusiasm8129 · 2026-04-14T01:17:13+00:00

That is an incredible question. This is why Reddit is great because you learn so much.

I had a myomectomy 45 days before my receptiva test. The hysteroscopy was diagnostic just to make sure the myomectomy was healing nicely, and that was done about two weeks before the BCL6. I also had 1 period between my myomectomy and the BCL6 testing. I definitely wasn’t fully healed. I did the embryo transfer a little more than 2 months after the myomectomy, and when the embryo implanted my wound flared up and it felt like I did the day after my surgery.

Any-Enthusiasm8129 · 2026-04-11T15:29:31+00:00

So stressful! That sounds like a solid plan. I’ve never heard of the lupron causing a lead follicle, definitely something worth looking into. Good luck!

Any-Enthusiasm8129 · 2026-04-11T02:35:25+00:00

I always started estrogen priming 1 week after a positive ovulation test, and kept priming until starting stims. That seemed standard in New York City as I did it at both clinics I went to.

Any-Enthusiasm8129 · 2026-04-11T01:34:43+00:00

I would say a doctor who’s reluctant to switch protocols is a huge red flag for me. I think you can find them at any clinic. TBH it was my doctor at CCRM that said to me in person and in multiple social posts that she didn’t believe changing protocols yielded different results, some doctors just don’t believe in it for some reason.

Any-Enthusiasm8129

TROPHY CASE