Q: I just had IVF done and it didn’t work. They implanted two grade 8b eggs. I thought that was good; I guess not. I am so upset. I want to try again but am afraid it will not work again. My question is does it seem to work better the second time around?
A: I am sorry IVF didn’t work for you in the first cycle. I know how devastated you must feel. Do not despair. Remember IVF is great technology. It gives us the best pregnancy rates of all the infertility treatments available to date. But still, not everyone gets pregnant in their very first cycle, so don’t give up.
I think couples going into IVF treatment do better emotionally if they regard their IVF cycle as a little bit of a gamble and a fact finding mission. No one can know going in how they will do in terms of egg production and quality, how well the eggs will fertilize, how many embryos they will have, and whether or not they will have embryos to freeze.
Pregnancy rates in any IVF cycle are dependent on the age of the egg (you are born with all the eggs you will ever have, so your eggs are as old as you are.), how good your ovarian reserve is (this is determined by testing blood on your day of cycle two or three for the hormones FSH, LH, and estradiol), and the quality of the sperm. Your chances of a pregnancy are about the same in the second cycle of IVF as they are in the first, not better. Most of the pregnancies that occur from IVF do occur within three cycles of treatment, so to continue treatment indefinitely without making some changes is probably not a good plan.
You didn’t give me many details about your cycle. From what you did say, it seems that you had two embryos (fertilized eggs are called embryos) transferred to your uterus at the eight (?) cell stage (that would be very good if the embryos were transferred on the third day after the egg retrieval. Perfect embryo development on day three is eight cells). The embryos were graded as grade B (?) at that point. We (at Reproductive Biology Associates in Atlanta) grade our embryos on a scale of A to D on day three. (I’m assuming that the IVF center you used uses a similar grading system although these grading systems do vary from laboratory to laboratory.)
Grade B embryos on day three are very good quality embryos (they should have given you a good chance to get pregnant) although perhaps not perfect or they would have been graded A. They may have had a minor degree of fragmentation which is common and has very little negative impact on the outcome. I think you should have had a good chance to get pregnant in your IVF cycle if the assumptions I have made are correct. If you are under thirty-five years of age, you should have had about a 50–60 percent chance of a pregnancy with two embryos like that transferred on day three after egg retrieval.
You didn’t say if you had additional embryos that were good enough in quality to freeze. If you did, you have another good opportunity to get pregnant at a much lower cost if you do a frozen embryo replacement cycle. The pregnancy rates from frozen cycles can be as high as 40 percent (check with your individual center, the success rates may vary from one center to another) and they are usually a fraction of the cost of a fresh IVF stimulation.
The important point here is that frozen cycles are almost as good as the fresh at a fraction of the cost. Discuss with your doctor how you did in your cycle and by all means try again; it sounds like you are a good candidate to be successful! Good luck!
