We were disappointed for our recipients that the first embryo transfer did not work. Originally they told us they wanted three children, all full genetic siblings. That was a long shot to begin with since we only had three embryos to offer them. With only a one in three change of success per embryo (assuming all the embryos thawed) it was likely that our recipients would end up with one, or possibly two children.
On the other hand, there was also a possibility that they would have either zero or three children from the three embryos. But now that the first transfer had failed, it was almost impossible that their dream of having three genetic siblings would come true with our embryos (identical twins are much more common with IVF so there is a slight chance they could still have three genetic siblings).
We knew these wonderful women wanted to be mothers with all their hearts. We wanted to help them. Since my eggs had been used to create the embryos, I felt like I was at fault for the failure of their first attempt.
WHY IT DIDN'T TAKE
It is impossible to know exactly why the embryo did not implant. We know that embryos of the size this one had achieved have at least a one in 3 chance of becoming a baby. But they have a two in 3 chance of failing to implant, just as they do when conceived the old fashioned way.
There were several factors that probably contributed to the lack of a pregnancy:
1) The embryo was only grade C. I had never before produced a grade C embryo, all my previous embryos being higher grades, but it's not surprising that this embryo was of lower quality. I was 37 when these embryos were created. That's not super-old for successful reproduction, but it's not considered young. Most clinics won't even accept egg donors in their mid to late 30's.
2) This cycle had been rather stressful for the recipients. There was the mix-up with the prescription, first-time jitters, meeting us for the first time, traveling to a new area, and so on. Stress is known to have a significantly adverse affect on IVF outcomes.
3) We later learned that both women had a common bacterial infection known to cause miscarriage and failure to implant. The clinic requires these infections to be treated before a cycle can begin. I am not sure how the infection was overlooked, but it could certainly have had an affect on their chances for success.
Well, at least they had two embryos left. The recipients looked into ways to increase their odds of success for the next attempt. One thing they did was treat the infection. Another thing involved me, and shortly after the failed transfer they wrote to me to see what I thought about it.
More on that next time.