Failed IVF Cycle 6

My IVF journey in Vietnam started with choosing a doctor, banking sperm, handling paperwork, and eventually undergoing Cycle 6. No matter how much you prepare, life has a way of throwing surprises at you, and this journey was no exception—it was filled with ongoing obstacles.

Chosing IVF doctor

The first doctor I met was a specialist I found online, known for his credibility and success with celebrity patients. However, during my first visit, I didn’t feel a connection with him, and that was important to me. I decided to see another doctor—an associate professor and a highly regarded expert in the field my sister recommended. I felt much more comfortable talking with him, and he took the time to review my medical records and give thoughtful feedback on the medications and protocols I had previously used.

I need a doctor I can communicate with—someone who listens, makes time for their patients, and doesn’t make me feel like I’m rushing or taking up too much of their time. This doctor gave me the impression that he truly cared and left me feeling hopeful that he could help make my journey a success.

His office was inside an IVF hospital, which I hadn’t realized at first. I met him in the evening, and it didn’t seem unusual since many doctors there work extra hours after their regular 9-to-5 shifts. Initially, I thought he worked for the hospital, but it turned out he owned the clinic and collaborated with the hospital. The setup had its drawbacks. Unlike at a hospital, where multiple doctors might be involved in your treatment, here you only have one primary doctor. While it’s possible to seek second opinions elsewhere, it’s harder to receive the same level of care as a direct patient. At a hospital, however, since all the doctors work within the same system, you will likely receive similar care from each one. Despite this, I had no plans to switch doctors because, as I mentioned, he’s one of the top IVF experts.

Banking sperm

In the second half of November, S was in Vietnam to go with me to the hospital and bank his sperm. As part of the process, he had several blood tests and a general health check. His samples were then analyzed to ensure they met the requirements for freezing and storage.

Given my repeated failures in the past, I anticipated needing several IVF cycles, so we decided to store six tubes of sperm. Initially, we planned for just four, but on two occasions, they collected more than one tube, and since all were qualified for freezing, we chose to store them all.

S received an FTA card for both his blood and sperm identification each time they were collected. The total cost for banking six tubes and four FTA cards was VND 17 million ($670)

Although his specimens were qualified for freezing, they were honestly of the poorest quality compared to the previous ones. Still, they were all we had, and I knew I would be relying on them throughout the IVF journey.

My doctor knew about my husband’s sperm quality, but he didn’t seem too concerned. In IVF, as long as men have sperm, doctors tend to focus more on the woman’s issues. I was told that women contribute to about 80% of the success rate in IVF.

Paperwork legalization

While we were doing the preliminary health checks and blood tests, we met with the administration department to make sure we didn’t miss any documents. This was really important to us because I didn’t want any delays due to a missing signature or paperwork that didn’t meet their requirements. Since my husband was still there, I wanted to ensure we had everything we needed.

Since we got married in the US and my husband is non-Vietnamese, we had to notarize his passport and get our marriage license verified by a local American authority to confirm it was legitimate. After that, the legalization and translation were processed by a Vietnamese consulate. The whole process was time-consuming, especially at the consulate. We ended up paying around $300 just for the legalization and translation of our marriage certificate, along with four copies.

I prepared the documents in 2020, as we had planned to do IVF in VN. However, right after that, the COVID pandemic hit and lasted for two years, putting everything on hold. Honestly, I felt a sense of relief as we prepared for the IVF journey in VN, as I didn’t have to worry about the documents anymore.

In addition to those documents, we had to prepare authorization papers for sperm use and embryo transfer, which had to be notarized since S wouldn’t be there during the IVF process. The authorization forms were provided by the hospital, and each hospital has its own policy on this. The one where I received treatment only allowed the authorization to be used three times before a new one would be required. However, in practice, this can be flexible. Instead of getting a new one, you can write an application letter (using the hospital’s form) explaining the situation and confirming that you and your husband are still married, with the understanding that the hospital won’t face any legal issues.

I was hopeful about doing IVF in Vietnam for several reasons. First, I had great support and care from my family there. Second, a change in environment and atmosphere would positively impact my mood. Additionally, there were many reputable hospitals and doctors to choose from, IVF support services were available and affordable, and treatments were quick and flexible. On a more spiritual note, as a Vietnamese, I felt I might have better luck in the country where I was born and raised. But above all, what mattered most to me was that I thought doctors in Vietnam would offer a more personalized treatment plan, rather than the one-size-fits-all approach I had experienced at my clinic in the US. At that clinic, you’d start with birth control pills no matter what, and while I understand the reasoning behind it, there was little flexibility or alternatives if you didn’t want to go that route again. I was confident that there were no issues with the quality or quantity of my eggs; I just needed a better protocol.

Cycle 6

On November 30, 2023, I had an appointment on day 2 of my period. The ultrasound showed I only had 6 eggs on the right and 2 on the left, a significantly reduced number. My AMH had dropped from 2.69 to 1.49 in just two months, which was a huge shock. I hadn’t expected such a rapid decline. But then I realized that for women undergoing IVF, egg count can decrease much faster compared to those who aren’t. Considering my age, the new circumstances, and the fact that I was getting treatment outside the US, time was more critical than ever. I really wanted to start my treatment as soon as possible to make the most of my time there.

However, my FSH improved a bit to 12.25, down from 15.1, which was a positive sign. But, IVF doctors generally consider FSH levels as high once they are elevated, even if the current reading is normal at the time of treatment.

I remember that my IVF doctor in the US mentioned my FSH was a bit high, but she wasn’t overly concerned about it. She focused much more on my AMH levels and follicle count during baseline ultrasounds. However, when I consulted with an IVF doctor in Vietnam, he said outright that I would never be successful with such a high FSH and recommended waiting at least three months. That was really discouraging. But when I raised the concern with my doctor in the US, she reassured me that she wasn’t too worried about that level. At the time, since I was undergoing treatment in the US, I chose to trust her judgment.

Back to Cycle 6, I started stimulation on 11/30/2023, for eight days, beginning with Pergoveris 300 IU and adding Orgalutran on day 6, 12/05/2023. The process was simple and quick. The ultrasound showed good results, and my blood tests were normal. On Day 8, 12/07/2023, I had six follicles measured at 19, 17, 16, 15 and 14 mm before the trigger shot that night. Then, the retrieval day arrived, and the doctor retrieved four eggs. Three of them were degraded, and the last one was abnormal. My doctor said my eggs looked like those of a 48-year-old woman. I felt completely emotionless hearing that. Maybe it was because I already knew how tough this journey had been for me, though I hadn’t prepared for zero fertilization in this cycle. That comment only reminded me that the obstacles had become tougher, and I needed to try harder rather than give up.

He recommended using donor eggs, but I declined. He suggested taking a break and starting treatment again after the Lunar New Year, which made sense. The festival was approaching, and people were already slowing down their activities to prepared for the New Year. Plus, normal routines wouldn’t fully resume until a month after the Lunar New Year, as everyone would still be caught up in the festive atmosphere with plenty of gatherings and celebrations.

Above all, I truly felt I needed a break, something I hadn’t had in almost two years of continuous treatments. The challenges kept piling up, and the dark days of November 2023 really knocked me down. I was drained. Taking time off to focus on improving my health became essential, and I had a plan in mind for it.

I forgot to mention one more thing. After the fertilization failed, I spoke with the embryologist, in charge of the fertilization. She was quite pessimistic about our chances of success, given the quality of both. She said that after thawing, none of the sperm were mobile. She told me that if our eggs and sperm didn’t improve, it would be difficult to expect a better outcome.

I told my doctor that I wanted to use my husband’s sperm, which had been stored at a different hospital since 2020, for the next cycle. His sperm quality back then was much better than the one stored at the hospital where I was currently being treated. Unfortunately, the hospital didn’t accept his sperm from a different facility, and that really bothered me. Given what the embryologist had told me about the poor quality of both his sperm after thawing and my eggs, I started to wonder if I should change my doctor and do IVF at the hospital where my husband’s better sperm was being stored.

I had done an IUI once at that hospital, and honestly, when S stored his sperm there, we hadn’t really thought through a solid plan. It was a public hospital, so it’s no surprise that it was always crowded, with hours of waiting just to have a few minutes with the doctors (there were no appointment bookings available). S didn’t have a positive experience there, mainly due to concerns about hygiene and clinical practices. His worry about hospitals in VN, in general, was that the overcrowding could lead to mistakes, infections, or cross-contamination. It wasn’t that the doctors weren’t good, but there were just too many patients, and the rules of practice weren’t as strict as they were in the US. When I did IUI there, a staff member actually mistook my medical records for someone else’s, and my doctor reviewed the ultrasound image with the wrong date. They didn’t realize the mistakes until I pointed them out. This experience only added to S’s concerns about doing IVF in VN.

I’m not sure why I’m bringing this up, probably it helps explain why I had chosen a different hospital, instead of the one, where my husband’s better sperm was stored. Considering the failure of Cycle 6 due to the poor quality of both my eggs and my husband’s sperm, I didn’t know what the right move was for the next cycle. Should I switch doctors? Switch hospitals? I couldn’t make up my mind at the time, so I decided to sleep on it and focus on improving my health.