how many rounds of ivf?

[montague]

Hi I would be grateful for some advice or thoughts from any ladies in their 40s who have had a number of unsuccessful rounds of Ivf. My situation is that I have just had my third round of ivf with embryo transfer today. We had a day 5 transfer of the two embryos that had developed out of 10 eggs collected. Neither embryo had made it to blastocyst at the time of transfer, they were morulas. I don't feel tremendously optimistic given that the two we have had transferred seem to be a bit behind optimal development.

I find the whole thing easier to cope with if I don't get my hopes up too much so am starting to try and think through what we might do if this round is unsuccessful. My question is are there any ladies on here who have persisted beyond three rounds of Ivf? If you did what was the outcome? What advice did you get about likelihood of success in light of previous failed attempts? I hadsort of assumed that, at my age (40) the chances of success in any given round of Ivf were such that we would need to be prepared to have two or three goes, but now I'm wonderng if we have reached a point where if we have failed three times the chances are so low we should just call a halt.

I will obviously discuss this with the consultant if / when it comes to it but the result of previous discussions following past failed rounds hasn't been terribly illuminating in that they seemed to think that there was nothing to be done differently (save for increasing the dose of gonal F) and that it was just a matter of having another go

If anyone has any experience or thoughts to share I would be grateful

What does the consultant think increasing the dose of Gonal F will do to help? Where are you hitting barriers? Are you getting plenty of eggs that look okay? (Ten seems a reasonable number to me but I'm not an expert.) Have you tried ICSI or just IVF? Did all 10 eggs fertilise and some just not make it or do you have a low fertilisation rate?

If there is no obvious reason for the failure then it's just down to luck and percentages. I was 39 for my third round, but we'd learnt a lot from the previous two rounds, enough to get 4 eggs to blastocyst to give me the best chance.

It sounds like your response has been really good. A double blastocyst transfer from 10 eggs is an excellent result.

I'm only 33 and I've only managed 12 and 11 mature eggs on each of my IVF cycles, and my clinic said that was optimal. Sadly, I think IVF is often a simple matter of persistence and luck.

There's a support thread for ladies undergoing multiple IVF / ICSI / FET attempts over on the conception boards. Perhaps pop over and join us here for some support and to read about our experiences?

Thank you both for your replies - the pattern has tended to be 9/10 eggs collected of which 6/7 fertilise (I understand that this isn't a bad rate) and then we the eggs gradually stall in the period between fertilisation and transfer so that we end up with 1 or two lead contenders to transfer but never really more than that

Ist time we had one blastocyst transferred on day 6 (it had been a bit slow developing but we were told it looked good on day 6) - we waited until day 6 to avoid transferring a double transfer because there were two morulas which we couldn't distinguish between on day 5 and because i was (it now appears foolishly) concerned about twin risk from a double transfer

2nd time we had three embryos transferred on day 3, one of which looked really good and the other two less so but by this point we thought might as well shove em all in!

3rd time a morula and a not quite a morula on day 5 - again our sense was that these two were regarded as having been a bit slow in developing which made me feel not v optimistic and that we may as well put two back.

The only change in protocol was increasing the gonal F from 225 to 300 (which they did with this last cycle) in the hope of getting a few more eggs and possibly having something over to freeze but that hasn't worked out with this cycle. The impression that I have got so far is that the cycles are going as well as can be expected given my age, but I can't help but feel that maybe this is all a bit of a hiding to nothing, which is why it would be nice to know if anyone has formed any useful views or had any advice about how many goes to give it.

I will look at the multiple IVF threads now so thanks for the link!

I'm pretty sure if you can get to blastocyst the 50% chance is the same whatever your age - can't remember where I got that information from! I do know women who have babies from a 2 cell embryo day 1 transfer, so there is always hope.

One of my friends had 3 rounds of IVF for Number 1 and 5 rounds for Number 2 with a few FETs in between. They'd decided round 5 for Number 2 was their last try and it obviously worked.