Ivf. Doctor seemed overly negative.

[mikkyr]

So husband and I have had 3 failed ivf cycles in the last 2 years. I am 41 and husband has had a vasectomy (previously married). Given the time constraints we decided that a testes biopsy was the best route to go instead of a vasectomy reversal which may not be successful and then still need to do a sperm extraction via biopsy at a later stage.

My last cycle failed completely whereas before I have had two early miscarriages. Without going into all the medical jargon I retrieved a fair amount of eggs for my age, they were reasonable quality, the embryos were not A grade but also not the worst. Everything seemed pretty average.

My appt with doc yesterday was terrible. I went in feeling so full of hope that we would be able to do another egg retrieval, ICSI and transfer before Christmas. But the doctor was so negative. He didn’t have anything hopeful to say. Basically I’m old my eggs have aged. My husbands sperm is less than great because it’s been extracted via biopsy and a vasectomy after 10 years rescues the quality. Our embryos are poor. The chances of genetic abnormalities are high. Our track record of 3 failed cycles leaves such a small percentage of success in the future. It’s costly.

We told him that money was not an issue (that sounds pretentious but we have enough to do another few cycles)

I’m just so disappointed in his atttitude. It’s like he doesn’t want me to do another cycle. I thought this whole process was about hope and that these doctors would be able to try and try. 3 cycles seems very little compared to what I’ve read and I’m surely not the only 41 year old who is seeking fertility help when there are 41 year olds falling pregnant naturally?

I don’t know what to do.

@rorosemary

If you had one cycle with multiple transfers then I would try again. I had 2 cycles with a total of 5 transfers, all great quality and 2 stuck (one ended in tfmr). The doctor is probably correct statiscally but I'd give it two more full cycles before you give up. You don't know which statistic you are. I'd get a quick move on though, don't wait at your age. I was 38 during my first egg retrieval which ended in 4 embryo's and 40 during the second and only ended with 1 embryo.

You could try reasearching other clinics in your country. I chose to travel further and go to the clinic with the highest success rate. Really happy that I did.

Can I just be a little bit envious of all the women who get anesthetics for the egg retrieval? I hit the roof with the pain of it. It was awful. Also not UK.

Are there places you don’t get anesthesia for egg retrieval. Geez. Glad I don’t live there. Although here everything comes at a cost!

It does sound like the doctor was trying to be balanced and give you all the info objectively. At 41 and 45 and after failed IVF cycles and a vasectomy... well there are a lot of complications as the doctor said - he was just being truthful but it is hard to hear :( So sorry you are going through this.

Anyway I have now spent a good hour in my car reading and replying while parked in a shopping center parking lot. Best I get on with life. This ivf thing is crazy how it stalls all sense of reason. I’ve been living off hope and any thing that dashes that hope means that the process consumes me again.... googling researching asking opinions. And the next thing hours have gone by again.

Thank you!

Nothing to add but sympathy.

It's horrible.

He also told me there is nothing you can do to improve egg quality... is this true?
Sadly this is correct and as said before you can go from a decent quality of eggs to bad ones in less than a year.

You haven't responded about your AMH levels. This is the best indication of the quality of you eggs. I can't remember the value but u der a certain level, you need more if a miracle for a successful outcome.

How old were you when you had your eggs collected @mikkyr? How many embryos did you get? If it wasn't that long ago then it's probably worth trying again with PGS.

I'm 41 and have given up now, as even though I have lots of eggs left, I don't respond well to the drugs so can't harvest enough to do PGS on them. At 41 I wouldn't want to proceed unless I could do genetic screening on them as the chances of them being genetically normal are so low.

You've gone through one of most challenging life experience, especially with two positive results that ended in miscarriages so do take care of yourself.

@dontdisturbmenow

He also told me there is nothing you can do to improve egg quality... is this true? Sadly this is correct and as said before you can go from a decent quality of eggs to bad ones in less than a year.

You haven't responded about your AMH levels. This is the best indication of the quality of you eggs. I can't remember the value but u der a certain level, you need more if a miracle for a successful outcome.

Just had my bloods done an hour ago. So waiting for results so I can compare to two years ago.

Hello OP. I have gone through 4 rounds of IVF myself, and 3 miscarriages, so I feel your pain. It is possible to fall pregnant naturally at your age, many people do, my mum had me at 46 naturally, so of course it is possible. But it is unusual, especially with your first baby. With fertility treatment, there are so many hurdles and risks and just ongoing pain and frustration. We spoke to our clinic about donor eggs. It took us a long time to get our head around. However we had success first time, both times, and now are so totally and utterly in love with our children. They even look like me! It is my husband's sperm and the wonderful donor's egg. She was what they call an altruistic donor - she donated her eggs because she wanted to help others. Can you imagine kinder genes for my children to have? When people gave me a little stick for not sending my kids to nursery, or for leaving work with no intention of returning, I was always honest and said 'I've been to hell and back to have these children, I'm spending every second I can with them'. I hope you get to feel that too OP. Sometimes our families come together in unusual and unexpected ways, don't discount other ways of achieving your goal. X

It's really hard. I do think the Dr was being honest but if it was me, I wouldn't give up now.

You talk about being at a crossroads and a life without children vs a life with them. In my own head I would have to examine whether one of the other options is one I could live with - and that is to revisit the idea of having a child that isn't biologically yours or DHs.

I know that personally I would rather have a child with donor eggs and/or sperm than no child at all. So yes, I would revisit this option. You haven't really said why you won't consider this?

If money is no object and mentally you can handle it, I would give it one more go with your own sperm and eggs and if this doesn't work I'd give it one go with donor sperm/eggs.

Then you have explored everything and if it still hasn't worked there are no what ifs.

But this is me and it's not my decision, but I think discounting donor eggs/sperm at the outset and never reevaluating that decision could be a mistake.

Just to add OP, are you taking projesterone suppositories? After my miscarriages, i took these and the pregnancies stayed with me. The clinic should be giving these to you for at least 3 months x

Hi, I have looked through the OP posts and wanted to say good luck.

We were in a similar position in a way- I went to see the IVF specialist after 3 miscarriages when I was 42. He said there was no point trying IVF, that I should "face it" and reconcile myself to not having any kids and offered me counselling, which I refused. I felt the game wasn't over yet.

He did offer to see me again, by which time I had fallen pregnant naturally . That pregnancy and the next one went relatively and I have 2 healthy children now, doing well at school.

Just posting as people were discussing the importance of hope.

Medical science is wonderful in many ways, but doctors still don't know everything and do not always have the final say.

The consultant did prescribe us loads of vitamins (which we both took) as there was evidence they might help, I had also cut out caffeine, as there was some discussion in the literature that eliminating caffeine might help with recurrent miscarriages, and was drinking very little alcohol anyway. And I chose a less stressful workplace, partly because of the miscarriages.

We also got a very early scan when I was pregnant as there was evidence that this helped avoid a miscarriage (again possibly because of improved confidence). I hope it's ok to mention that, in case any of it is helpful .

I'm 42 and I've not had IVF, I think at our age the chance of conceiving naturally or by IVF is lowish. And of course all your eggs won't be great and there will be some chromosomal issues.
I had a miscarriage and then conceived at 38 and had a baby at 39. Conceived at 39 and had termination at 40 due to poorly baby at 13.5 week (chromosomal) then conceived at age 40 (chemical) then again at 40 and had baby at 41.
So I guess doing it by IVF would lower your chances a bit too? I'm not sure how it works. I decided I would keep trying and we got there in the end, but I know my egg quality can't have been brilliant.

I think the IVF Dr was being brutally honest.
As was mine, during my rounds of ICSI IVF.
Better that than a Dr / clinic that will keep selling you hope (& tx)
Its a big business industry after all.
But that doesn't mean you cannot keep going if you wish.
What does your heart tell you?

OP I wouldn’t give up hope. I think the dr was just trying to manage your expectations.
I had a hell of a journey with ‘unexplained infertility’.
Tried ICI and it failed.
Tried IVF and didn’t have enough or big enough eggs.
Abandoned next round as they found fibroids on a scan.
Had an op to remove fibroids and during the op they couldn’t find any fibroids...!
This all in all took 3 yrs and cost £6000.
Had a break from the process and conceived naturally.

In your shoes I’d give it another go using what was remaining of your DH’s specimen.

I would get a second opinion. Ask for all your records and take them to another clinic.

@ClaireP20

Just to add OP, are you taking projesterone suppositories? After my miscarriages, i took these and the pregnancies stayed with me. The clinic should be giving these to you for at least 3 months x

Yup. Everytime. And even progesterone injections which are hellishly expensive compared to the suppositories. Obviously not taking them now.

If you want to have a few more cycles that's a valid decision, but cost aside is it something you can go through emotionally? Especially since it sounds like your odds are low. Sorry you're dealing with this OP.

@PurBal

If you want to have a few more cycles that's a valid decision, but cost aside is it something you can go through emotionally? Especially since it sounds like your odds are low. Sorry you're dealing with this OP.

I think I could do another cycle. I have heard all the comments about drawing a line as our limit and in my heart this next round would have been it. Just didn’t expect to get such a unenthusiastic response from the RE.

Is this someone you're paying to see privately? In that case, I think it's very ethical of him to suggest that paying for it mightn't be worth your while, rather than just taking your money.

Also, saying it might mean a client is less likely to blame him/put it down to him if it doesn't work out.

I know quite a few doctors are of the opinion that IVF has such a low success rate overall that it shouldnt be pushed. Also a lot of people overestimate the success rate of vasectomy reversal. It is after all, a permanent sterilisation. You are likely peri-menopausal too.
I am not sure if your doctor was overly negative, or appropriately negative and trying to manage your expectations. After all, having a lot of money doesnt mean it will work

I have been there. I am now early 40s and after 4 rounds of own egg IVF without a whiff of pregnancy the clinic were clear that they considered future success v unlikely with my own eggs. Horrible to hear but true. Am now on round two of DE (first ended in miscarriage). If this doesn’t work I know I’ll have tried everything possible (within your realm of comfort, you may have v good reasons for not using donor eggs but definitely don’t write it off without thinking about it). It feels like a massive hurdle to start on another process but it’s actually a lot more straightforward than traditional ivf. All the best.

I can imagine it must be absolutely awful so you do have my sympathy OP. I would also say if you can afford it then keep going, it’s no ones business as such. You’re 41 not 51!

I suppose the doctor is being realistic though. I would say it’s better than a doctor promising the earth and taking your money when the reality is it’s Mother Nature that decides whether it’s going to end successfully.

The sad reality is some women will never fall pregnant through IVF and as we know, the quality of the eggs diminishes with age. That’s not to say it won’t work, hopefully it will for you, but I don’t think it’s unreasonable of him to be cautious.

I hope it works OP

I just refer back to your post about your dhs “precious jewels”. Whatever procedure he has pails in comparison to anything, which happens to a woman actually doing ivf and the procedures, which can be performed on you. Not time for either of you to get precious about the pain / discomfort he may go through.

Hope your blood work comes back ok.

@52andblue

I think the IVF Dr was being brutally honest. As was mine, during my rounds of ICSI IVF. Better that than a Dr / clinic that will keep selling you hope (& tx) Its a big business industry after all. But that doesn't mean you cannot keep going if you wish. What does your heart tell you?

My heart is sad. Just been shopping and pushing a trolley and thinking about why I’m sad. This process itself is such a heart wrenching one. You most want the end result which is a healthy child but each step in the process is such a pain in the arse. I spend each drive to the clinic feeling angry that I have to pursue this route to motherhood and almost having to convince myself to walk into the clinic because it’s such a shitty way to have a child!