I didn't get pregnant with my first IVF. I was able to produce four viable eggs, of which three were very good and were implanted. I was on 72 hours if complete bedrest (only to go to the bathroom). On my third day, I noticed a brown, very sticky discharge. Why did they fall off? Did the doctor not implant them properly, or could there be any other reason? How many times can a couple try IVF? If I try again, would I have a better or worse chance of a successful pregnancy?

L.

I doubt that the brownish discharge was related to anything other than manipulation of your cervix at the transfer. The higher hormone levels associated with egg stimulation predispose the outside of your cervix to bleeding.

The most likely reason you did not conceive is poor embryo quality. Your age, the number of cells in the embryo, and the embryo quality all play a role in predicting implantation. Many factors influence what happens after the embryos are transferred. Studies have shown that pregnancy rates are lower if your cervix makes it more difficult for your physician to transfer the embryos or if uterine bleeding occurs at the time of transfer. In our clinic, we perform a trial transfer on all IVF patients before the actual IVF cycle. If the trial or mock transfer indicates we are likely to have problems transferring the embryos, we can address that situation before the actual cycle.

Bedrest is not a factor at predicting success. The embryos do not "fall out" if you are on your feet. Our patients are instructed that they should take it easy, but that they can be up and about 10 minutes after transfer. This policy has not affected our success rates at all. In fact, without bedrest, 11 of our last 15 patients returned to their obstetricians with ongoing pregnancies.

While I cannot predict the likelihood of your future success, I would be concerned that only four eggs were retrieved. On average, we retrieve more than 12 eggs. As such, this may indicate a problem with poor response to ovarian stimulation or poor egg quality, which may reduce your odds of success.