((little fighter)) (pg, kids, losses, sorry really LONG)

I'm so sorry for your losses. Like you, my DE history is long and checkered. My RE said that in my case, he didn't feel it was possible my losses could all be chalked up to just bad luck (and you've had more DE losses than I have - I've had 3 w/ proven DE/DS plus 4 with my own eggs). Here's my history:

1st fresh - young proven donor, transferred 3 on day 3, none frozen, BFN
2nd fresh - young unproven donor, transferred 3 on day 3, none frozen, chem pg
3rd fresh - young proven donor, transferred 2 on day 5, BFP twins, 4 blasts frozen
1st FET (from 3rd donor) - 1 blast transferred, mc
2nd FET (from 3rd donor) - 2 blasts transferred, chem pg
4th fresh - young VERY proven donor, transferred 1 on day 5, BFP (35w pg), tons frozen

Here's some of the testing/results we had:
-Before the 1st fresh, we learned DH had high sperm DNA fragmentation, so we used donor sperm for all attempts; it became much easier for me to get pg once we did that, but I still lost the DE pgs.
- In between the 2nd and 3rd fresh, we found out I was hetero for MTHFR, but RE didn't change anything in protocol (I used BA anyway). We did have a live birth from the 3rd fresh attempt.

- When we started ttc a sib we had trouble again. This RE thought we needed to add folgard for MTHFR so we did. After the 1st FET failure I did a hysteroscopy and lap to check out uterus and abdomen, even though HSG showed clear tubes when we were ttc w/ own eggs. Much to our surprise, one tube was totally blocked (hydrosalpinx) and the other was "questionable" (open but not in great shape) and could have been leaking toxic fluid into the uterus during implantation, leading to chem pgs/ implantation failure/ mc. Theory was, infection following c-section (or HSG original results could have been wrong - apparently HSG is only accurate 80% of the time - which NO ONE TELLS YOU!) We took out the totally blocked tube and tried again, FET #2. I also did further immune testing and found I was positive for lupus anticoagulant (a blood clotting factor), so we added lovenox and prednisone on advice of a rheumatologist, and just for the heck of it added intralipids (IL) before transfer. But again, a loss.

- Before our 4th fresh, we did yet another lap and took out the second tube, plus repeated all of the above we'd added before the last FET. My DH and RE both refused to consider IVIg or Enbrel, which rheumatologist recommended even in the absence of blood tests confirming NK or other immune activity, as rheum said all of my DE/DS losses with proven donors and my sky-high anti-thyroid antibodies were "highly suspicious" of an immune reaction to pg, even if we couldn't prove it. The 4th fresh attempt worked and we're currently 35w pg.

Given your history (how many DE losses you've had) I don't believe it's possible you've had luck THAT bad. I would be looking for answers before cycling again. I would:
- Have a lap and hysteroscopy with a very competent surgeon, explore EVERYTHING surgically to make sure you don't have an undiagnosed structural problem. Could be blocked or scarred tubes creating toxic fluid (this is well-documented cause of the issues you are experiencing), could be a bicornuate uterus, or something else that hasn't been spotted with less invasive investigation. My RE was very insistent that he commonly finds things that should have been visible on saline sono or HSG, but just weren't. And as I said, HSG is apparently only 80% effective at diagnosing tubal problems, as there is some sort of path the dye can take that looks like it's in the tubes but isn't (sorry, I totally forget the more technical explanation LOL, but my RE said he saw this a lot, which I found shocking).

- Have DH take the sperm DNA frag test (SCSA) if he has not already. Even if it comes back normal... consider using donor sperm. If you've been checked out for immune issues and treated what you found, plus you rule out structural issues, the problem just may not be you. Just as we haven't quantified every egg issue, I really believe the same to be true for sperm. There are several women on the board who only after multiple failures with DE replaced their DH's "normal" sperm with donor sperm for a final try, and finally had success. I don't believe that's a coincidence. At all. REs are very reluctant to do this, perhaps it's a "guy thing" or perhaps they figure, we carry and bf the baby but DHs dont' get those bonding opportunities so the genes are somehow more important? In any case, I can tell you my DH doesn't give a puff at all - we are just so glad we did both DE/DS and have the kids we have. If you use donor sperm, also use a VERY PROVEN donor there too (I looked on the donor sibling registry once I found a handful of donors I liked, so confirm there had been live births - only way I could think of confirming, as most sperm banks will only confirm there's been a resulting pg).

- I'd use only a really proven egg donor for next attempt, and make it a high producer - so you have embryos for a fresh cycle, and to save for a GC if that's ever something you'd consider and can afford. Or try a shared risk if they would accept you, so that you will get money back for adoption if that's preferable for you/DH. I always had three more plans in the works as living child-free was NOT an option for me, and I knew I wouldn't stop until I dropped or became a mom however that happened. If you feel the same, always leave yourself options. I know you must feel at the end of your rope now (I sure did) but there is ALWAYS one more thing to try.

Those are the things that come immediately to mind. I really dont' think with the number of losses you've had that it could be bad luck. I hate saying that to you, b/c I assumed for a long time that mine was, and when my wonderful RE gently told me he really didn't think it could be bad luck a the point we were at, I left his office in tears and cried for days, thinking, "OMG we've surrendered, we've given up our genes, we've given up all of our savings, we've given up everything we thought was important to have a child and even ALL OF THAT wasn't enough." It was the final straw of my sanity nearly, knowing that there was yet something ELSE wrong with my body when we had tinkered with it already beyond belief. The surgeries to explore and remove tubes nearly broke me, honestly, and I kept feeling like we'd never stop discovering things that were wrong me, that I was just a total failure reproductively. But in the end... we did get very, very lucky twice. Luck, with a lot of hard work, far too much money, a great RE who insisted on investigating and changing things up instead of just taking our money for another fresh cycle, the support of the women here, and KNOWLEDGE of what others had done before me after multiple failures. Keep going, honey, but leave NO stone unturned, and always leave yourself a plan B (DH and I joke that it was Plan Y that worked finally!)

Huge hugs and good luck to you,
Kenny