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Dealing with a negative beta HCG result can be one of the hardest
things to cope with during IVF treatment - especially if it’s your first
IVF cycle.
Before starting IVF treatment , patients need a lot
of courage and conviction. They do IVF with high hopes and expectations
, because they have read so much about this exciting new technology ,
which is so full of promise, and has created so many miracles. They feel
that this is the solution for all their problems – after all, if the
doctor is actually making an embryo in the IVF lab how can it possibly
fail ? IVF promises new hope – especially when the cycle has gone well
and you have seen your own embryos for yourself. Also, IVF is the final
answer, which is why so much rides on the outcome of the IVF cycle.
After all, if IVF fails, then there’s nothing beyond IVF , is there ?
Every couple thinks in their heart of hearts that
it’s going to work this IVF cycle– otherwise they would never start an
IVF treatment cycle. This is why the news of a negative beta HCG results
can be so difficult to cope with – especially when the result comes
after the 2 week wait ( 2ww) from hell. Your hopes were so high – and
now they have been dashed into nothing !
A negative beta brings forth the outpouring of
numerous emotions, no matter how strong you are, and how brave a front
you put on for the rest of the world. The primary emotion is one of
despair and frustration. All that money, time and energy gone down the
drain – what a waste ! This is often tinged with a sense of guilt – did
I do something wrong which prevented the embryos from implanting ? You
often blame yourself, and feel you have let everyone around you down by
failing to conceive – your husband, your family and even the IVF doctors
! Sometimes you are ashamed of your body – it was not good enough to
hold on to my embryos.
A failed IVF cycle is like a double whammy – I
couldn’t get pregnant on my own, and now I can’t even get pregnant after
IVF – I am a loser ! This can be even more acute, if some of your IVF
cycle buddies have conceived , because now you are jealous and envious
of their success as well .
You need to pick yourself up and move on – you’ve
been through worse !
The first thing you need to do is to talk to your
doctor. It’s a good idea to have a list of questions for your doctor, so
you are better prepared for the future.
-
What was the quality of the eggs ? sperm ?
embryos ? uterus ( endometrium)?
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Why do you think the cycle failed ?
-
Should we try again ? If we try again, will you
change our protocol ? How ? Why ?
-
Are there any additional tests we should do to
troubleshoot for undiagnosed factors ? ( eg hysteroscopy ?)
-
Are there any special therapies we should
consider ?
( eg, laparoscopic tubal occlusion if you have a hydrosalpinx)
-
Should we do our next cycle now or wait ? Can we
wait for a year ?
Please make sure you ask
for a photocopy of your medical records – this is very valuable in case
you need a second opinion ! If the second opinion confirms your doctor
is doing a good job, that’s fine. If not, then maybe you should be
pursuing alternative options at another clinic !
Often your doctor may not be able to tell you why
the cycle failed – and this is fine. After all, IVF is not a perfect
science, and we are still a long way off from the holy grail where every
embryo we transfer becomes a baby. Nevertheless, it’s important to
analyse the cycle carefully. What did we learn from this cycle ? What
went right? What went wrong ?
Remember, that the quality of the doctor’s answer
depends upon the quality of your question. The question should NOT be –
“What went wrong ? “ or “Why didn’t I get pregnant ?”
or " Why didn't the embryos stick ? " After all, no one
cares about problems – we are only interested in solutions ! Rather, the
question should be – “What should we do the next time to improve our
chances ? “ Constructive questions get constructive answers ! The key
question to ask should be – What, if anything, should we do differently
the next time ?
There are usually three variables which you should
look at carefully:
-
the number and quality of embryos
-
the endometrial thickness and texture
-
the actual embryo transfer
If all these were fine,
often the best option is just to repeat the exact same cycle again. It’s
like buying a lottery ticket – the more often you buy one, the better
are your chances of winning !
Patients are often so disheartened with failure,
that they often lose hope and give up. This can be a big mistake. For
anyone making good embryos, often getting pregnant with IVF is just a
matter of time till they hit the jackpot ! Just because you did not
conceive in the first cycle does not reduce your chances of conceiving
in the second cycle. After all, chance has no memory !
There are many things a doctor can change. For
example, he may want to change the superovulation protocol; or use a
higher dose of drugs; he may want to consider doing ICSI rather than
IVF; or a ZIFT
( ZIFT Video ) rather than an embryo transfer. He may also suggest using
donor eggs; or doing assisted hatching or a blastocyst transfer or
embryo biopsy. This is why it is so important that you go to a
well-equipped full-service IVF clinic which has the facilities ,
expertise and experience to provide all these options.
For many patients, second cycles are often easier
than the first. Because you’ve “ been there, done that “ , you know
what to expect, and are familiar with the treatment details and the
doctor. You know there's no pain and no surgery. It seems less daunting because you know what you are facing –
and since you’ve been through the worst, there is little you have to
fear. You have already survived a baptism by fire. It's also
easier to keep perspective - after all, what's the worst thing which can
happen in your second IVF cycle ? You may not get pregnant again - but
you won't be any worse off than you are right now. However , for other patients,
repeating another cycle is much more difficult . They find they cannot
cope with the stress, and the uncertainty. They find it’s more
frightening, because they know more about all the things which can go
wrong; they know how demanding the treatment is; they know there are no
guarantees; and they know what’s at stake.
No matter what the final outcome, you should have
peace of mind you tried your best !
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