IVF or not (at 40) - opinions please

[Harrjenk]

Hi all, would like honest opinions please. We are TTC #2. We have a 2 yr old son (conceived first time trying) and fell pregnant last year (after 2 months trying) but had to have a TFMR in Dec due to a chromosomal abnormality. We have been TTC again since Jan with no success. Have tried acupuncture, have a good diet, lifestyle etc and take all the supplements. We visited a fertility clinic and there are no obvious reasons why we aren’t getting pregnant again, except that I am nearly 40 and so the odds decrease and my AMH is quite low.

We are thinking of trying IVF with this clinic but part of me wants to wait in case we can get pregnant naturally again. But I also know that time is of the essence and don’t want to leave it too long. And we will do the screening to make sure no abnormalities again. It’s obviously all very expensive, but we have the money in our “rainy day” account so we are fine with spending it on that.

What should we do? Would like opinions from people who have had successes and failures from IVF in our situation (unexplained fertility, in 40s), maybe people who wish they’d done it or those who wished they hadn’t tried. How many blastocysts people got with low AMH Etc etc. Any opinions appreciated and valued! Go! Thanks x

Have a look at IVF clinics in Europe, a quarter of the price including travel. I would go for the IVF if you can find it unless you set yourself a time scale of say 6 months, but every month counts for egg quality at this stage.

I'm now on 2nd.cycle of donor egg IVF. I have one child (naturally conceived) at 33, then struggled with second. I have done 2 rounds of IVF (own eggs) at age 41 and 42 - I wish I had done it much sooner but I kept thinking it could still happen. In both cycles I got 8 or 9 eggs, but only 2 embryos were viable by day 3 (double transfers both cycles, both negative). Now on our second donor egg cycle...we have 3 very good day 5 blasts frozen and hopefully doing a transfer next month. From my experience I would say do not waste any more time - just go for it. Really wish I'd gone straight to IVF as soon as we were struggling to concieve! Good luck!

Sorry, should have said, mine was also 'unexplained' and I did have a low AMH.

@12RedRoses thank you for the suggestion. I don’t think it will be practical for us to go abroad as my partner is in the military and is working away for the next 5 months so I’ll be doing most of the process by myself, and needing to look after our toddler and we don’t have any family childcare support. So I think it will be too complicated to travel for it.

@Hopeful2024 thanks for sharing your experience. How low is your AMH? Friends who I have spoken to who have been through successful IVF have all said the same thing as you- that they wish they had just gone for it. Did you put a limit on how many rounds you would do before you started? Also have you done the screening on the embryos to check for chromosomal abnormalities?

I started ivf at 40 with amh of 4.2. At 41 my levels had dropped to 2.3. Don't wait. Amh can drop a lot very quickly and it can't be improved.

I would also suggest pgta if you can afford it. We managed to get 3 embryos through pgta but it took three collections to get there.

Hi, I can't remember what my AMH was - about 11 I think. We paid for 2 rounds (at a slight discounted rate). We talked about testing the embryos but at day 3, we only had 2 left and the clinics view was 'better out than in' so they were put back in. Pretty much the same with my second cycle - similar number of eggs (which they said was good for my age), but only 2 embryos on day 3. So, didn't have any blasts with my own eggs. We went for an information evening at the clinic years ago - I spoke to the consultant aftewards who said as I'd conceived a child naturally, there was a very good chance IVF would work, and not to wait too long. By the time we got round to doing it, it must have been 2 or 3 years later - and I regret that. I also tried acupuncture, and had a cycle of clomid. Nothing successful. So now we're on our last chance with 3 donor egg blasts frozen. They are all excellent grades (not tested but donor is young) so I've got everything crossed. I'm under a Spanish clinic who have diagnosed adenomyosis - so having injections to control tha, and they are trying 2 new things to try and help with implantion on this cycle . As part of my UK IVF journey the consultant noticed a goitre in my throat - I was then diagnosed with Graves disease/over active thyroid. I've been on and off meds for that over the last few years. Thyroid function is very important in fertility so if you've not already, ask for bloods to test that. Happy to answer any other questions you have. It's daunting and a big step (and crushing when of doesn't work) but as the saying goes, I felt it was better to regret something I had done than hadn't, and I didn't want any 'what ifs'. So if I were you, I really would crack on with it asap!

I wonder whether it would be worth waiting 6 months to see if you get pregnant naturally. You have had a tough time and I wonder whether it would be worth seeing how it goes. The IVF process is tough on your body as well so you could always see the time as a way to get ready for IVF if natural pregnancy doesn't occur.

@CR7 thanks for sharing. Where are you at now on your journey? Have you had the embryos implanted?

@Hopeful2024 thanks for all the info. I have had my thyroid tested with a blood test and everything normal. I’m a little confused about AMH numbers as they seem to be very different when I google- mine are 3.5 which the doctor told me was on the low side of normal for my age but not awful. Not sure how that compares to your AMH of 11?

also, have you found the IVF rounds hard on your body? Im conscious that im at home on my own a lot with my toddler with my partner being away and dreading feeling absolutely awful!

I think I feel the same as you that it is better to try as much as possible now rather than regret not trying later.

When your eggs are almost at maturation string IVF you don't get much notice on when egg collection is supposed to happen.... Would your partner be back in time to provide his sample for fertilization ? Or maybe you'll wait until he has returned to start...

Maybe it depends on the clinic but you could have to be in the clinic at 6-7am for internal scans to check how things are going during the injections - not easy if your partner is away and you have a toddler.

I did IVF at 42/43 and had amh of 11/12 from what I recall - high for my age. We did 2 rounds. Failure on round 1, failure on round 2 (,but has one left over to freeze - which resulted in a successful pregnancy).

Your partner being away for 5 mouths while you ttc is not great - as well as looking at fertility treatment regular sex that's fun and not.focused on TTC would be useful. I know it's so hard to relax and not focus on it !!!

14+2 incredibly. Can't actually believe it x

@Harrjenk yours is very low. Not trying to be rude. Mine was 2.2 so even lower xx

@CR7 oh wow!!! Congratulations. Wishing you all the very best. How many rounds have you done to get to this point? And yes we are doing the PGTA.

@Pippielk partner being away is not ideal, but he’s not abroad but just working away 4 days/nights a week. But he can come back for appointments and for TTC if we continue to try naturally. Not ideal, but the process shouldn’t be delayed by him being away, I’ll just be on my own at home with a toddler when he’s away and not required for appointments

One with nhs. Absolutely shocking from start to finish.

Duo stim with care. Private. Three euploids. First one didn't work.

Lots of investigations. Discovered I have a displaced implantation window.

Change of drugs. Progesterone test. Transfer worked x

@Harrjenk forgot to tag you c

Hi, I think I was about 37 when I had to AMH test. I can't remember all the details but it was definitely classed as 'low'. Some clinics seem to be more concerned about AMH than others I think. I did find it hard...headaches, bloating etc. but the emotional aspect was much harder. The waiting - how many eggs/how many fertilised then the dreaded calls every 24 hours to say how many were left. Then the dreaded wait before testing (although I started bleeding both times and knew it hadn't worked). I feel like I've spent the last 10 years of my life trying to get pregnant...it has sort of taken over, but I've felt like a part of me is missing without that 2nd child, and it's made me keep going. I tried everything before resorting to IVF - supplements, certain food, the acupuncture and clomid, listening to the Zita West visualisation meditation every night. I honestly would not wait....my friend was 38 and had (successful after 2 cycles) IVF. She had tried for 6 years before. She only got 1 embryo on her 2nd cycle...but it worked. I think it's harder when it's 'unexplained' because there is nothing obvious to treat. Go into it as positive as you can, but I would say hope for the best and prepare for the worst as the chances of it working with own eggs post 40 is fairly low x

@CR7 brill thank you. Having done some
research myself I think my issue might be to do with progesterone and implantation.

@Hopeful2024 good advice thank you so much x

@atotalshambles this is a really valid point and something we have been wondering about. Also been wondering whether to start small- maybe by taking progesterone and seeing if that helps. Hard to push away the panic feeling though of timing running out and not wanting to waste time

Hi @CR7 I hope you don’t mind me reaching out. Firstly congratulations 👏🏻 xx

I wondered what clinic you went to? I’m turning 40 in Feb, I’ve an AMH of 4.5 and had 2 rounds on the NHS but both failed. We have since found issue with my husbands morphology and wondering our next steps.

thanks x

Of course I don’t. Glad you have and sorry for the delay. I went with care in Manchester.

no sperm issues our side. hopefully yours can be sorted with icsi? My amh was way lower than yours and I was also older so I have lots of hope for you. Xx

Hi @CR7
I’m so pleased it’s worked out for you!

How did your clinic know to check for displaced implantation?

I’m 42, low AMH, had 2 fresh rounds plus 1 FET fail to implant (not enough blasts worth testing), so could be quality (but all high morphological grade).

We have started 3rd fresh round with steroids and intralipids to suppress my immune system (not based on any tests or evidence) so I wonder if they missed testing for displaced implantation. Is that the the uterine lining biopsy test they do to diagnose?

I also really regret not starting this earlier… our little girl will be 4 in the summer and we really want a sibling for her

I had the full endemetrio testing so it was discovered x @RF81