41 and about to start either IUI or IVF

[Darkchoc]

Hi everyone

I am really new on here and have joined for support and honest answers if possible as I cannot find answers myself. I have one beautiful son, conceived quickly. He is now 3. However I am now single and going down the donor insemination route via a clinic in the north. I am healthy as far as I know and all fertility tests have come back great.

My question is this, am I wasting my time even thinking about trying to conceive via IUI or IVF at my age, 42, in summer? Are my chances really low at 13.9% as stated by the HFEA website or does it depend upon each individual woman and how healthy she is?

I am in a tizz as this is already an emotional rollercoaster and I don't want to waste upwards of thousands of pounds if my chances are just rubbish...I want to be as realistic as possible so advice from others would be appreciated.

Anyone my age ever succeeded?

Thanks x

[Persipan]

Hello! I'm single and currently on my two-week wait after IVF with donor sperm, though I'm a few years younger than you (38).

It will depend a bit from woman to woman - your clinic may be able to give you personal odds of success - but the average chances of success do start to decline quite significantly for women in their 40s.

Personally, I choose to go with IVF over IUI because, although IUI would have been much cheaper per cycle, I felt the chances of success per cycle weren't high enough to justify spending time on it. (If I were a few years younger, I'd probably have tried a few rounds of IUI first.)

I suppose the main question to ask yourself is which you think you'd regret more - not trying, or spending a substantial amount of money and not succeeding?

[Naty1]

I would think, you would have a higher chance than that as it includes, mainly people who have ttc for over 2yrs and failed, so 24* up to 20% and that hasnt worked.
So one of them likely has some issue(s)
I think though statistically the mc rate goes up as you get older, so it depends on whether you are looking at live births or not. Plus the increased DS risk.

i suspect donor sperm would be quite good quality so that should help.
For ivf they say people needing icsi for male factor or those with tube issues have higher than stated chances as the issue is worked around

[4030ludders]

I am 42, have a beautiful 3-year old, but after her I had 2 miscarriages. I have now conceived twins on second cycle ivf. However the more I look at the stats on the hfea website, the more I realise how fortunate we've been. I wouldn't ignore those stats. 10-16% chance per cycle. Bear in mind each cycle takes 3 plus months, then 2 months downtime min before next cycle. Look at those stats and think it through. 42 is basically your last chance using your own eggs. Hardly anyone conceives & carries to term at 43 plus.

[HawkeyeInChaos]

People do conceive with their own eggs at 43 and go on to carry to term.

Obviously the odds to go down with age, but there is no reason to assume that there is NO chance. If the fertility tests have come back great, then I'd say it is certainly worth giving it a go (if you think you would look back with regret if you didn't)

[Guin1]

Hi Darkchoc. I had my first round of IVF at age 39 and was lucky to have success with DS first try. Two years later and the frosty from that round didn't stick, so had a second EC (just after 42nd birthday). I can't remember how many follicles I had, not many, but I did have one big one. They ended up collecting 2 eggs, and only 1 made it to blastocyst stage. But that one stuck and DD is now 1 week old!

Are you too old at 42? Well it worked for me! Not that that is a guarantee of anything, but you aren't ever going to be any younger than you are now, so there's no time like the present if it is what you really want. We didn't use donor sperm as the infertility was most likely due to my knackered tubes (one of which had been removed anyway after a naturally conceived ectopic), as all other fertility tests for DH and myself came back OK. The low success rates are scary at our age, but they are an average. I made sure I was fit/healthy and that, along with having no other obvious fertility probs, gave me hope that my personal odds were better than average. If you have no problems with your uterus, like endometriosis, etc, then I would say yes, there is a fair chance. Be positive, but be realistic too.

There have been other threads on here in the past couple of months about chances of IVF working at 40+, so you could look for those too.

[zoemaguire]

I know very little about this, but presumably the ivf stats are made up predominantly of women who have suffered infertility. That is not your situation, which id have thought might well up the chances of success considerably. After all, the chances of an averagely fertile woman conceiving in her early 40s are still relatively good. But I know nothing about ivf, so this is just musing!

Good luck with whatever you decide.

[4030ludders]

Hi Zoe. National birth rates for women aged 43-44 are 5% ish. That correlates with medical advice - you have a 5% chance per month of conceiving aged 42 +. However miscarriage rates are 45-50%. If you look at IVF clinic stats on the HFEA website for live births for women in the 43-44 age group, you will see that they are generally 0, occasionally 1 per 20 or 1 for 30. So yes it can happen - but you'd be delusional if you thought the odds were good. I think it's better to be realistic when assessing treatment, because it is so demanding and so expensive.

[4030ludders]

This is the link. www.hfea.gov.uk/ivf-success-rate.html

[Persipan]

Certainly the advice I received when I first sought treatment as a single woman wasn't 'you'll be fine, you don't have a history of problems with infertility'; it was, basically, the odds aren't brilliant and will get worse as I get older.

Ultimately, sadly, it probably comes down to money. Treatment is incredibly expensive - and more so for single women, because you have the cost of donor sperm to factor in. (That stuff is expensive!) The cheaper treatment options have lower success rates, so you get into this mental balancing act of how much you're prepared to spend and what that might achieve. It might be possible to achieve a pregnancy with one round of unmedicated IUI for under £2000 - but it's very, very unlikely (like, a less than 5% chance for a woman in her 40s). IVF has a higher success rate, but is much more expensive. Clinics outside the UK are significantly cheaper, but the travel involved is logistically more complicated. And so on.

For anyone, really, but especially for someone who has one child to take into account already, I'd say money is the key question. It will be very expensive, and there are no guarantees of success. I know that's a pretty depressing response, and certainly there's always a chance, but it comes down to how you want to spend that money, and ultimately that's quite a personal choice. I definitely wouldn't recommend the OP taking any financial risks to fund treatment, and I guess largely it's about her considering her financial and family circumstances and deciding what's the best thing to do.

[Persipan]

Incidentally, I don't at all mean that in the sense of 'she has one child and should just be satisfied with that, dammit', but in terms of, I can see that the financial priorities of someone who's a parent may be very different to those of someone who isn't.

[zoemaguire]

4030 but I note that the percentage of ivf success for women aged 40-42 is 13.6% - so still low, but again I wonder what the stats would look like if only fertile women were included. There isn't actually much agreement about how likely it is for women in their early 40s to conceive naturally - the wikipedia page on female fertility by age quotes studies that say that of women starting to conceive at age 40, between 25 and 40% will have no live birth - so that is still between 75 and 60%, depending on who you believe, who will. Obviously that isn't comparable to ivf, as natural conception means you can try repeatedly every month in a way you can't with ivf, but it is still very different to the picture of fertility in your 40s that we are used to hearing in the media.

None of this is meant to give false hope, but in the sense that ivf is always a rollercoaster, you are always going to be looking down the barrel of some scary odds. More so at age 42, but who knows what your individual odds look like, compared to say a 31yo who has had 10 years of unexplained infertility. Can you go through some of these questions with the fertility docs? I know the clinics are not totally unbiased,but you'd hope they could lay at least some cards on the table for you.

[4030ludders]

OK, my last post. There is perfectly good factual data available from the ONS. Their recent data set is Live Births in England and Wales by Characteristic of Mother (2013) and includes live births regardless of conception method.

If you look at table 7 this shows that 3.8% of all live births in England and Wales in 2013 were for women aged 40-44. 0.27% were for women aged 45 and over. Granted, this is limited to women trying to conceive, but it's still a good data set! I think the Wiki entry is a misleading. 60-75%? That's just not born out in UK data.

See www.ons.gov.uk/ons/datasets-and-tables/index.html?pageSize=50&sortBy=none&sortDirection=none&newquery=childbearing

[Naty1]

4030 i just cant agree with you.
It is a big factor that op isnt trying naturally so doesnt know how fertile they are
Assume nothing wrong with sperm
Has carried previous child to term.

I would not nevessarily think the same for a couple trying unsuccessfully for years with an older women as
The issue could be either of them


It would be difficult to estimate how fertile women are at any age as they use contraception/fertility issue may be with other partner. And by 40s the majority of women will have the number of children they want leaving possibly those with most complex issues.
Also if because of low success rates and demand clinics have less practise on older women, also nhs doesnt necessarily fund it.

Individual success rates can vary dramatically from the clinic general ones.
I have 2 pg from 3 cycles (40% per cycle) and think if they hadnt screwed up it would have been 2/2
Dsis has 2/2 (35% chance per cycle)
Others have 0 pg from say 5 Ec.
Just as although you have 20% chance of conceiving tryibg naturally every month, some people have 100% as are really fertile others 0%.
And some doing ivf will get loads of great blasts that would all implant, others only get 0/1.

Though i do agree in general the chances as you get older do decline a lot and 'customers' who are older have to be prepared to pay for several cycles and possibly MC, which is why a lot do opt for donor eggs/embryos. Its often worth a go as some people will be a lot more fertile than their age suggests.
Dmum got pg naturally at about 50.

I was told i was likely to get lots of eggs/ i would only be allowed to put 1 embryo back and may get lots of blasts. I only had 13/9/7 eggs and never blasts as only 1/2 ever fertilised like 25% so much below the 75%. But 2/5 are now babies. Despite my theoretical mc rate of 40% due to pcos and now higher due to that plus hypothyroidism. So much of it is luck.

[zoemaguire]

4030, I'm afraid you are awakening the statistician in me! The % of overall births happening to women in their 40s tells you precisely nothing about how fertile women are at that age, as loads of women will have completed their families by that age, and so won't be trying. It isn't a meaningful dataset at all, as it isn't at all limited to women trying to conceive - it actually includes all those who ARENT trying to conceive. Meaningful studies are exactly those quoted in the Wikipedia article, which look only at women trying to conceive.

[Darkchoc]

Thanks for all the responses and replies. All fertility tests have returned normal and my first child at 37 was conceived the second month of trying, admittedly that was a few years ago now, but certainly nothing has been flagged in terms of adverse fertility. I am also fit and healthy. However, I will be 42 during the summer so the age factor is definitely real and most pressing.

The low success rate of IUI means that it is not worth trying for me. It will definitely be IVF. I have actually learned more from the posts on this thread than I did from my "crap" consultation last week. Now awaiting for a further consultation before getting the ball rolling. Beginning to lose faith in my clinic.

4030ludders, one thing I did not realise was that it takes approx 3 months for one cycle of IVF and then 2 months downtime between attempts. Something as basic as this factor ought to have been explained to me!!

Thanks again everyone, you have really helped me. If anyone has anything else to offer or to ask, I'd be great to here from you.

[BatteryPoweredHen]

It doesn't take 3 months for one cycle of ivf, neither do you have to wait between cycles.

I know I was very lucky, but I had only a 6 week timeframe from ivf being first suggested as an option by my gyne and getting a BFP (had to find a clinic, have initial appointment etc in that timescale too)

My consultant (lister) said that there is no reason to wait between cycles, unless you feel the need to do so for psychological reasons. He has patients who are clearly wealthier than us who come from overseas, rent an apartment round the corner from the clinic and do back to back cycles until they conceive.

Also, the HFEA stats cover all clinics, good and bad. You are better off looking at the individual stats for your clinic as they may well offer better odds than average. For example, the HFEA stats gave odds of 23% per cycle for a couple wit our profile, while the Lister's stats gave nearer to 60%. Well worth checking.

The only thing I would say is that at 42, you really need to be looking at live birth rate, not rates of conception as such a high % of you eggs will be aneuploid. I completely ignored this stat, and once pg really panicked about mc and chromosome problems. If I were to do ivf in my 40s, I would probably opt for pgd or similar...

[resipsa]

This isn't hugely helpful as my memory is like a sieve but there is a website with a calculator which gives you a more individualised success rate based on your history. Maybe try a search for it? For example, if you've previously carried to term, your chances are deemed to be higher because they can rule out any issues related to the competency of the uterine environment. I had IVF at 42 and think my chance was calculated at 29%.

[resipsa]

Think it is www.ivfpredict.com...

[4030ludders]

Dark choc, you're right in timings. 5 months min. If you go to a clinic and they tell you otherwise (ie that there's no need to wait between cycles) don't go with them. Your body really needs that rest and recovery time between cycles.
Re: my previous posts. I err on the side of facts. That's because I think you need to assess your chances rationally rather than emotionally. But having laid it out, my own exp was very similar to yours (easy prior conception at 38) and we succeeded on our second cycle, aged 42. However we did so knowing we had about a 15% chance. I personally avoided any zany non-evidence based things, but did practice relaxation techniques daily, which helped with the mental strain it puts on you.

[Persipan]

There's relatively limited evidence around the optimal gap between cycles but from what I can see it appears to make no difference to the outcome of your subsequent cycle - so, effectively, you don't need to wait, but you may want to (or your clinic may prefer you to). Different clinics seem to view this in different ways, so I wouldn't regard a clinic prepared to treat you over consecutive cycles as inherently suspect.

[BatteryPoweredHen]

4030, so the two top clinics in the Uk (Lister and ARGC) both advise patients that there is no need to wait, yet you think they should be treated with mistrust?

[minibmw2010]

I think there's a difference between a consultant telling you there's no physical need to wait between cycles and a woman who has been through IVF advising it. My mental health would not have been helped by going straight into another cycle, so I personally think people should wait whether they need to physically or not.

[Naty1]

I got pg on oct with a back to back cycle, jul- aug lp then took the pill to induce bleed after cancelled cycle and started on day 19 of that cycle. Having said that id only had 3 follicles so that probably made a difference. Mentally i needed to start again straight away, as a delay would have meant a wait over xmas again and with pcos hand a failed cycle last jan no way did i want a jan cycle again.
The 3 months per cycle is i assume long protocol so short would be a lot less
Lp was
Day 19 pill 7 days
21 nasal spray for 2 weeks
Blood test
2+ weeks stimms
Ec
16 days till test

But with a fail i guess some peoples periods dont start straight away/ go back to normal
Plus possible delay for chemical pg or early mc of say up to 12w.
Sp seems a lot quicker. (And without the awful 4hrly nasal spray, that i kept forgetting

[zoemaguire]

I err on the side of facts too 4030. We just have a different interpretation of which facts are significant, and, it would seem, how to interpret statistics.

[zoemaguire]

Incidentally, that ivfpredict.com website is very interesting. For a 42 year old woman with a previous live birth and no infertility, using her own eggs, it comes up with a chance of a live birth per attempt of 17.2%. But hey, it's just a calculator developed by three internationally-renowned professors of epidemiology and gynaecology, so what would they know?