Chromosomal abnormalities - help please - I feel so stupid/confused
MrsGAT · 06/10/2014 11:41
We've just completed our first round of IVF after silent miscarriage last year. I'm 40, DH is 32. Both super healthy (as I have always been annoyingly anal about diet and exercise, no alcohol etc) and we threw everything at this cycle - acupuncture, endo scratch, nutritionist, every blood test etc - as was hoping against hope for a BFP. We were so lucky that IVF cycle went pretty much text book - I had triple-lined, great thickness endo, and we had 2 good grade embryos put back at day 3.
I was gutted when we then had a BFN last week and I spoke to our Dr (who is great) on the day of the HCG test, who told me alot of incredibly depressing figures about chromosomal abnormalities and this being the reason why something like 90% of IVF's fail. I am now in such a major depression as I just don't get how IVF's ever work. If, past 38, the majority of the eggs of most women have these chromosomal abnormalities, how does IVF work for any of them? I feel like such a total idiot that I had no idea that this is the major stumbling block for women in my age bracket. I was so hopeful after everything we went through that we'd passed alot of the stumbling blocks, and now I feel like I was just stupidly blindly optimistic.
I know all the stuff about egg donation (which is how most celebrities end up still having babies at 45 plus), but I just don't know what to do now in terms of trying again for another cycle as I just don't see how it's ever going to work.
Am I missing something? Does anyone have experience in this age bracket of increased chances with more cycles? I don't see how our Dr would want to change anything medically as our cycle went so well to that point, so how could doing it all again possibly change anything? Or is it just a a chance thing every time?
I'd be so grateful for any thoughts but please be kind/ultra sensitive as am feeling really in not a good place at the moment and don't think I could take terrible news....
Thanks so much
Deux · 06/10/2014 12:01
Hi. I'm sorry to hear you are going through this. So big hug.
If you want to continue with your own eggs then I think you need to be at a clinic that can test your embryos before they are transferred. Also consider having an immune panel work up too.
If your clinic don't/can't do that then perhaps switch clinic to one that does. Assuming you have funds to do so and respond well to stimms.
i think the best value money you spend in the ivf process is for the initial consulatation. Perhpas have some consultations with the top 3 clinics.
On my last IVF/ICSI cycle we had PGS on our embies and it was quite revealing. If the embryologist had transferred embies based on how they looked, she would have transferred embies that were chromosomally abnormal.
As it was, our chromosomally normal embryo that was transferred was ranked as #4 in the morphology department. I was 42 at the time and our DD is now 6.
Technology has moved on since then and there are alternatives to PGS. If you haven't already done so I would suggest a good look at fertilityfriends.co.uk for more info as there are lots of knowledgeable women on there.
Only other advice is that if you have the funds and the emotional reserves, then throw everything you have at it. And go for a top clinic.
MrsGAT · 06/10/2014 12:13
Thank you so much for such a lovely response and your thoughts. Yes, I did discuss at length with our Dr about PGS on the embies, but he was saying (which seems to be backed up by lots of research I've done online, but maybe wrong(!) that they won't do it on less than 5 embies and they can't do it unless they go to blastocyst (day 5) anyway. This seems to be because they won't risk it with less than 5 because of potential damage caused to them and also that at Day 3 they can't tell anyway. Does that make sense? Is that something you've come across? Sadly we only ever had 3, so we couldn't have done it anyway.
Your own story is so interesting as it's sounds exactly the same as the story he told me on the phone to illustrate his point about grading vs PGS of embies and as you say, how without it, they can truly end up putting the wrong ones back, as it were.
Before we decided on this clinic, we did 3 initial meetings and I totally agree with you, it's the most important thing. I have to say I've been very very happy with our treatment by both Dr, clinic and staff - just wasn't the result we wanted sadly.
But obviously if there was somewhere that had more advanced techniques with regard to PGS or something similar, I'd be happy to move...
Thanks again for taking the time
Deux · 06/10/2014 13:04
I've just lost my post which was probably a lot of waffle. I hope I'm not coming across as bossy.
Try to take some comfort that this was your first cycle so it was a bit of a 'trial' and your clinic will have learned from it. Cold comfort I know when you desperately want it to work. Maybe different drugs next time, higher dose, ICSI etc.
From my experience, I would urge you to be at a clinic that has success rates well above the national average for your age group. It's all too easy for a clinic to say 'oh well it's just your age' and then not investigate any further either because they have lower hanging fruit that's easier or they don't have the facilities or expertise to do so. I went to both CRGH and the Lister and they are both good at the 40 - 42 age group and exceed the national average.
Hopefully there will be some others along with more recent experience than mine.
eurochick · 06/10/2014 13:15
In many cases, IVF is a numbers game. I know that is not easy to hear when it takes so much to do each round, emotionally, physically and financially.
I have just had an IVF baby at 38. I did natural/mild IVF (so I didn't get as many eggs per round as you would with full stimulation IVF) and it took 4 rounds to get her. I got a BFP from my first round but miscarried, then got chem pregs on my next two goes, and finally a successful pregnancy with round 4. That was the 5th embie I had put back. That's not unusual in my experience (of friends who have had IVF, plus a few years of lurking around fertility boards). You just have to keep at it.
I have also always led a pretty healthy lifestyle (although not quite to the extent of yours - I like my wine) and our infertility was "unexplained". We started ttc when I was 34. It just didn't happen for us.
Deux · 06/10/2014 13:29
Agree with Eurochick about numbers. We had a total of 11 transfers and 2 children. Our children came from the first and last transfers. We have a big male factor issue.
lozster · 06/10/2014 22:33
I agree with euro chick - it's a numbers game. There is a depressing diagram in a Zita West fertility book showing all eggs in a twenty something (tonnes) with a few crosses through some of them to indicate genetic abnormality. Next to that is a comparison of an older woman - fewer eggs and tonnes of crosses. Bah.
I had successful ivf on my 4th round and had my baby boy at 41. Too few eggs for any screening and too expensive for me anyway. Although I got
lozster · 06/10/2014 22:41
Blummin phone! Although I got pregnant on an nhs cycle, I had previously seen a private consultant and he attributed the success in part to taking dhea. He maintains that this helps with egg quality. I tested sky high for early pregnancy screening tests but amnio showed my little boy to be healthy.
Emotionally I found my first round the worst. The next three I was more fatalistic about. It got easier for me If you can afford to try more times i would go for me. If you are happy with donor and can afford that too, then this stops the clock ticking and I found this reassuring as I went through my last own egg nhs cycle.
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