34 Responses to “My IVF Cycle Failed – What Went Wrong? Question #16: Why did my hCG levels stop rising properly?”

1. Lauren says:

   August 23, 2011 at 3:50 pm

   Dr. Sher,
   I tried to post a question on the SIRM discussion board but was unable to. I'm hoping you have some advice for me. We are doing IVF/PGD for a single gene defect as well as 24 chromosome testing with GSN. I just finished my first IVF cycle which we froze in order to batch with the next cycle, because we only had 5 embryos make it to blast. I am 31, fertile (2 previous successful pregnancies), and had 11 eggs retrieved, 8 mature, 6 fertilized and 5 made it to day 5. Given all the testing the embryos will be subjected to, we were hoping to get more embryos to work with. I was on long Lupron protocol, BCPs for 5 weeks, then overlapped with Lupron for 4 days, then started Gonal F on CD12 and Luveris on CD14, and I stimmed for 9 days. Any advice for my next cycle to get more mature eggs to work with? Thanks.

   Reply
2. Geoffrey Sher, MD says:

   August 26, 2011 at 11:15 am

   In fact..tis sounds like a good and expected response. To get 5 blastocysts from 11 eggs is good. Possibly slightly increasing the dosage of Gonal F could increase the egg yield, but not necessarily. I agree with the protocol used.

   Good luck!

   Geoff Sher

   Reply
3. Jade1982 says:

   September 26, 2011 at 12:02 pm

   Dr. Sher,

   I just transferred 2 blasts at day 5 transfer and got a positive HPT. My first beta was 363, then 48 hours later it had only gone up to 400. 72 hours later is had gone up to 1081 (50.9 hr doubling time). What do you think the chances of this being viable are? Thanks so much

   Reply
4. Geoffrey Sher, MD says:

   September 26, 2011 at 12:47 pm

   It could still be fine but have your doctor keep an eye out for a tubal (ectopic) pregnancy…just in case! For more details on Ectopic Pregnancy read elsewhere on this site.

   Geoff Sher

   Reply
5. Mishell says:

   July 19, 2012 at 11:23 am

   I had my ET Day 3 and Day 12 had a beta of 7
   Day 14 – beta 11.1
   Day 16 – beta 11.5
   Day 18 – beta 10.1

   I had my period as well so I am assuming the hcg is still going to be on the decline. Should I take the advice and walk away from this ivf cycle or is there a possible chance? This is my first time and I am wanting to be sure I am not making the wrong choice, I won’t forgive myself. I think from all that I have read that its probably time to let go. I just didn’t know if a large fibroid replacing the uterine wall could just stall things and maybe once the bleeding is done it could regain itself again? I’m probably way off in that being a possibility but after 4 betas I’m not feeling like I have closure to this. thanks.

   Reply
   • Geoffrey Sher says:

     July 19, 2012 at 4:26 pm

     I think this cycle is probably not going to work out. The extent to which the fibroid in your uterus, may or may not be playing a role, would require much more information to evaluate.

     Feel free to call 800-780-7437 to set up a free telephone consultation if you wish to discuss further.

     Geoff Sher

     Reply
6. Soha says:

   July 29, 2012 at 4:05 pm

   I had my 1st IVF cycle with egg retrieval done 14/7/2012 after OHSS , I experienced severe abdominal pain,dyspnea ,difficulty leaning forward….,my E2 level was 3072 ,Dr decreased my injections ( LH + FSH ) combination to 2 instead of 3 daily plus triptorline SC 0.1 ( decapeptyl) ,then on day 18/7/2012 I ad my HCG trigger 6 am & E2 4 hours later which was 24000 ,Next day Dr examined me by U/S & decided taht I will have my embryo transfer now (day 5 blastocyst stage ) My pregnancy test is supposed to be 31/7/2012 , but yesterday I had uterine contractions that I’m used to feel before my menstrual cycle.I’m so depressed & I’m waiting for it .Also I sometimes experience some back Pain & pelvic pain ,all are the same like those preceding menses.Could these be my period?

   Reply
   • Geoffrey Sher says:

     July 30, 2012 at 2:12 pm

     The symptoms you are experiencing can also occur with an early pregnancy. They do not of necessity mean that you are about to menstruate.

     Keep me in the loop.

     Good luck and G-d bless!

     Geoff Sher

     Reply
7. Soha says:

   July 31, 2012 at 3:12 pm

   Thanks for replay Dr. Sher.
   Well, my beta HCG came negative( 2.5) . I’m so frustrated although I know.
   The centre where I did my ICSI( In Cairo, Egypt) didn’t tell me anything about my frozen embryos, how many , what grade …., so I feel lost. I’m afraid I would never be pregnant.
   I’m 27 , have PCOs, married for 4 years.I hope one day I’ll be a mother

   Reply
8. Soha says:

   August 1, 2012 at 6:44 am

   Dr, may I ask you if it was a wrong decision to go on with my embryo transfer despite OHSS that I had with my E2 level rising from 3000 on day 9 to 24000 on day 13 4 hours after HCG trigger or they were right to continue !!!

   Reply
   • Geoffrey Sher says:

     August 1, 2012 at 3:23 pm

     I personally would not have done the ET. The development of OHSS would be almost inevitable here….especially if your estradiol was measured in pg/ml.

     Call 800-780-7437 if you would like to discuss.

     Geoff Sher

     Reply
9. Soha says:

   August 2, 2012 at 6:06 pm

   Thanks Dr. Sher for your reply.
   Yes it wasin picogram/ ml.Then they are partly responsble as they didn’t give attention to my previous history of OHSS wih clomiphene citrate & then because they didn’t coast despite severe hyperstimulation & lastly due to going on with procedure neglecting all facts.

   Reply
   • Geoffrey Sher says:

     August 3, 2012 at 5:37 pm

     I am a little shocked!

     Geoff Sher

     Reply
10. Eileen says:

    August 6, 2012 at 9:32 am

    Dr. Sher, May I ask your opinion on an HCG result of 7.9 drawn yesterday (8/5/12). Here is my IVF history…I triggered 7/21/12 w/10,000u of Ovidrel at 945pm, ER was on 7/23/12, and my ET was on 7/26/12 (3dt). The embryo implanted was less than optimal (nurses words) as it was only 7 cells. My Beta HCG was drawn yestersday and it was 7.9. The nurse said it was pretty much negative but “just in case” would like me back this Tuesday for another draw. Should I hold any hope? Thoughts…??..

    Reply
    • Geoffrey Sher says:

      August 7, 2012 at 2:49 pm

      Not so fast! I would definitely repeat it in 2 days. If it fails to double, then yes…all hope would be gone. However if it doubles or better, it could still be a viable pregnancy.

      Keep me in the loop please!

      Geoff Sher

      Reply
11. Jill says:

    August 23, 2012 at 8:50 am

    I did IVF and got an initial Beta of 98 on 8/17, 4 days later on 8/21 my numbers had only increased to 189. Rechecked today and they only rose to 196. Does this mean this pregnancy is over or is there still a little hope?

    Reply
    • Geoffrey Sher says:

      August 24, 2012 at 10:03 am

      Sadly I am afraid this does not bode well.

      Geoff Sher

      Reply
12. Jill says:

    August 23, 2012 at 8:53 am

    Forgot to say that 2 embryos were placed.

    Reply
13. Janice says:

    December 17, 2012 at 2:34 pm

    Dear Dr. Sher,

    In 2009, upon my first ivf transfer I became pregant with my son and delivered in Dec 2009. Since this time (about since 2011) I have been trying to use the frozen embryos and when that didn’t work, used a new donor. I have had 2 miscarriages (one with frozen and one with the fresh transfer). There was one frozen embryo from the lot of my sons and that embryo was thawed and insterted within a half hour.

    I just had my hcg test and it came back at 10. i am to repeat on Wed. but could the fact this was a frozen embryo, I just found slight implant bleeding today as well (day 14) have something to do with the low number. I am just sick over this and want to try to find hope. I take 100mg of progesterone in oil 3xday, 2mg of estrace 2x day and then one vaginally and one shot of fragmin a day, plus one baby asprin and prenatal. I am 52

    Reply
    • Geoffrey Sher says:

      December 17, 2012 at 4:07 pm

      I think you just have to follow the blood hCG levels every 2 days to see if they go up appropriately.

      Good luck!

      Geoff Sher

      Reply
14. Sarah says:

    March 10, 2013 at 8:00 am

    Dear Dr. Sher,

    It is the second time I am experiencing a chemical pregnancy after a day 5 blasto transfer. First HCG was 15, 3 days later, second HCG was 4. I am scared that this may happen again; what are the reasons for chemical pregnancies, is it just bad luck that it happens twice within 5 months ? We still have 4 fertilized ovocysts but before we go ahead, I would like to make sure we have all our chances. thanks a lot

    Reply
    • Geoffrey Sher says:

      March 10, 2013 at 3:29 pm

      Hi Sarah, it sounds as if you might have an implantation issue. This should be evaluated before you proceed any further. Clearly this has something to do with the protocol for ovarian stimulation. I might be able to help here. I suggest that you to the home page of this blog at http://www.IVFauthority.com . When you get to home page, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.

      1. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.

      5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)

      6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)

      7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)

      8. “IVF success: Factors that influence outcome”

      Consider calling 800-780-7437 or 702-699-7437 to arrange Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.

      Geoff Sher

      Reply
15. Kelly says:

    March 20, 2013 at 6:22 am

    Hi Doctor, I just had a failed IVF. My first beta HCG test showed 5.9iu/l so I supposed it was considered as chemical pregnancy. My period came after I stopped progesterone tablet. Now my period has finished, I just did another test on the beta HCG and the result is 143iu/l! Do you know why? Also, I suspect I have immunological problem. I try to read your article but it’s a bit hard for me to understand. Could you please tell me the basic tests / things I need to do to find out whether I have immunological problem? Thank you.

    Reply
    • Geoffrey Sher says:

      March 20, 2013 at 8:12 am

      It is possible that you might be pregnant, in spite of the bleed. I suggest you repeat the beta hCG test to see if it is rising.

      Good luck!

      Geoff Sher

      Reply
16. Kelly says:

    March 20, 2013 at 6:53 pm

    Hi Doctor, thanks for your reply. Although I wish what you said is right. However, it doesn’t seem to make sense. I supposed to get approx 100IU/L last week, but I didn’t. Then, I got period. I thought it’s over, but a week later it turns out to be 143IU/L. How can a pregnancy postpone a week? And How can I have period (It was not light spotting, it was like a normal period to me) if I am pregnant?
    Thank you so much.

    Reply
    • Geoffrey Sher says:

      March 20, 2013 at 8:47 pm

      I apologize. I seem to have misread your post. This must be a chemical pregnancy.

      Geoff Sher

      Reply
17. Kelly says:

    March 20, 2013 at 11:45 pm

    Hi Doctor, thanks again for your kind reply. Since I am not pregnant, how come my Beta HCG raised after my period? Shall I check again few days later hoping that it will back to normal? If it stays high, means I have other health problem? Thanks a lot.

    Reply
    • Geoffrey Sher says:

      March 21, 2013 at 6:00 am

      I do not think that this is related to a different problem. Indeed repeat it in a few days time.

      Geoff Sher

      Reply
18. Karen says:

    April 21, 2013 at 12:49 pm

    Hello Dr. Sher:
    My first IVF has just failed and I am devasteed.
    I’ll give you some stats here so maybe you can offer some advise.

    I had an AMH of .78 but produced 10 eggs. They said the sperm failed the centerfuge test. It was used w/no ICSI and only 3 fertilized.

    Those 3 three-day embroyos were implanted. 2 had 4 cells and 1 had 7, but all had 25% fragmentation!

    I will go with another bank/donor(s) next time. Anything else besides that and ICSI that could be done?

    My period came 8 days after transfer and one day early from original schedule. I have never been so angry at my own body.

    Is it the quality of my eggs too? I’m 37…I’m going to have the lab investigate more. I need to know if there are things that I need to do for the second attempt.

    Thank you for your assistance.

    Reply
    • Geoffrey Sher says:

      April 21, 2013 at 12:55 pm

      Hi Karen,

      I am so sorry for you. However, (not through lack of trying on your part) there is simply not enough information available here for me to be helpful to you. Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail

      In the meanwhile, how about going to the home page of this blog, http://www.IVFauthority.com . When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.

      1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)

      2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”

      3. “Agonist/Antagonist Conversion Protocol”

      4. “Immunologic Implantation Dysfunction” (posted on May, 10th and on May 16th respectively.

      5. “Embryo Implantation………” (Part-1 and Part- 2—-Posted August 2012)

      6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)

      7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)

      Best wishes,

      Geoff Sher

      Reply
19. Michelle says:

    April 22, 2013 at 4:46 am

    I had a 3 day transfer of two embryos. My official testing day was Saturday and Beta was 17, was 17 24hrs later and another 24hrs later 18. Now I know my levels fell as I took a digital hpt on Friday that said pregnant 1-2 weeks and again on Sunday morning that said not pregnant. Despite my immune assay being ok, my ivf clinic are now suggesting an infusion of IVIG at a cost of £1500 – saying it may work, it may not but not really giving much justification. I no longer feel pregnant, symptoms have gone. Surely this is a waste of time and money??
    Thanks

    Reply
    • Geoffrey Sher says:

      April 22, 2013 at 1:40 pm

      Michelle,

      Respectfully, I do not believe it to be ideal to empirically treat for immunologic implantation dysfunction without a diagnosis. I would discuss alloimmune/autoimmune testing with your RE in advance of undergoing IVIG treatment.

      Geoff Sher

      Reply
20. Ollanis says:

    April 26, 2013 at 10:29 am

    Hi Dr, I am 39 years old, I got my retreival on 4/11/13 5 eggs, 3 on good condition by day 5, I put 2 backs on 4/16/2013, today is my day 9, my only symptoms is that my temperature is higher 98.4, and I am urinating a lot mainly at night, when they did my blood work on Tuesday, the Dr ask me to start with progesterone 100 mg every 6 hours and start with the estradiol patches and continuos with progesterone injection and estradiol pills,but they did not tell me my HCG result, tomorrow is my second blood work but this morning I did a pregnancy test at home and was negative, do I still have any chance to be pregnant?

    Reply
    • Geoffrey Sher says:

      April 26, 2013 at 4:49 pm

      The pregnancy urine test is not nearly as sensitive as the blood test.I have seen numerous cases where the former was negative and the latter turned out positive.

      Good luck!

      Geoff Sher

      Reply