| 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.
1. What was the quality
of the eggs ? sperm ? embryos ? uterus ( endometrium)?
Why do you think the cycle failed ?
2. Should we try again
? If we try again, will you change our protocol ? How
? Why ?
3. Are there any additional
tests we should do to troubleshoot for undiagnosed factors
? ( eg hysteroscopy ?)
4. Are there any special
therapies we should consider ?
(eg, laparoscopic tubal occlusion if you have a hydrosalpinx)
5. Should we do our next
cycle now or wait ? Can we wait for a year ?
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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 ?
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There are usually three variables
which you should look at carefully:
1. the number and
quality of embryos
2. the endometrial thickness
and texture
3. 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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