When A Cycle Gets Cancelled…What Next?

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After getting only 5 eggs, out of which only three fertilised, with very low grading quality, the doctor and embryologist knew the likelihood that they would implant was very slim.

Still not wanting to take any chances, they laid the cards down before Bimpe and her husband, Deniyi, reiterating that the likelihood they would have a successful cycle was very slim, in fact they expected it to fail. The question now became, did they still want to go ahead with the cycle or cancel it? They asked.

The clinic then went on to suggest that they could either stimulate Bimpe, to get more eggs, or they could try a donor cycle. Bimple visibly blanched at the latter option.

Yes, she was on the wrong side of 30, but to use donor eggs was far from the ideal scenario for her. She still wanted to try with her eggs, but not immediately, so officially that cycle was cancelled.

Even though she had time to process the news, and knew that there was a possibility of her cycle being cancelled, she also felt weird at a loss at not being able to complete the process she started and had been looking forward to.

When the day that would have been her transfer day came along, she felt the difference, when she should have been in the two week wait, she didn’t know what to do or how to feel. Work was the only thing that took her mind off her cancelled cycle.

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For Toyosi, the daily injections had little or no effect on her ovaries, which simply refused to show forth any glorious eggs. The dosage of her meds was increased to see if it would work, but no, there was nothing for it.

By day 13 of daily injections and three scans,  Toyosi and her doctor had to sit down and face reality; her body just wasn’t responding. And if her ovaries did not cooperate in the next few days, they would have to cancel the cycle. There would be no egg-retrieval, as there weren’t any eggs to retrieve.

It was a dicey one, everything was working as it should; her uterine lining was perfect, her husband was ready, but her ovaries just were not ready for an IVF cycle.

Two more days of injections and a scan, and it was official. The cycle had to be cancelled. She went through all sorts of emotions, some of which she shared below;

“The waiting absolutely killed me and almost pushed me over the edge. A cancelled cycle and waiting so long to start another one is something I hadn’t even thought off. So for it to now happen, was just too much for me to handle.

For the money side of things, the drugs I had used were used. Even though they didn’t work on me, there was no getting a refund. And then there was the fee for cancelling the cycle. It was just too many details to deal with in my emotionally fragile state.

As for discomfort – as I didn’t respond much at all to the meds, I didn’t feel too uncomfortable physically. The scans sucked, but the cancelled cycle was even more so…the emotional pain of being cancelled, of being part of the cancelled statistics was the biggest killer of all, and really unravelled me…

I guess, it turned out  just like many people have told me – the first cycle is the cycle where the doctor is trying your body out to see how it will respond, so second time around they will know how to tweak it…I know, but this trying out hurts a lot…and what an expensive trial.”

Toyosi has scheduled another IVF cycle and we are keeping our fingers crossed that everything will work out well this new cycle for her; ovaries, uterine lining and all.

It should be noted that it is possible to predict fairly well the ability of the woman’s ovaries to respond adequately to ovarian stimulation, with 3 simple and inexpensive tests:

  1. Antral follicle counts – ultrasound test
  2. Anti-mullerian hormone level – blood test
  3. Day 3 FSH level – blood test

Other general indicators of the risk of cancellation include a previous response to injectable gonadotropin stimulation, and female age.

Apart from inadequate response to ovarian stimulations, it also happens on the other end of the spectrum. Occasionally, an IVF may be cycled due to overstimulation. In these cases, the ovaries are making too many follicles, and too much estrogen, and other hormones and growth factors.

There can be some potentially serious health risks for the woman, from severe ovarian hyperstimulation syndrome (OHSS), if the HCG injection is given and the cycle completed when the ovarian response to stimulation is very high.

What Next?

Get an honest estimate from your IVF doctor on your chances for success rates with a second IVF try

Most doctors would advise you to wait for a month before starting a new cycle. Take it. While it is medically possible to do the next cycle immediately, most patients need a break to marshal themselves, especially their emotional strength, before starting again. 

Your doctor may need to modify your treatment, depending upon an assessment of your previous cycle. For example, if the ovarian response was poor, the doctor may advise you to increase the dose of drugs.

If there were significant egg and/or embryo quality issues, it is most likely due to an egg problem or an IVF lab quality control problem. Consider solutions.

Overall, IVF success rates are only slightly lower for second attempts as compared to first IVF tries.

Couples with the best egg quality are more likely to get pregnant on their first try, but this is balanced out to some extent by potentially learning from the first failed cycle and making adjustments to maximize success for the second in vitro fertilization attempt.

So, all hope isn’t lost after a cancelled IVF cycle. You can always try again, utilising the experience from the last cycle.

Godspeed mamas!

 

 

Join the conversation with any of our TTC and Pregnancy Groups here

Photo credits:

1. http://gcmsk12.org/

2. http://reproductivemedicinewagga.com.au

3. https://cdn.shutterstock.com/

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