Consultant too positive???

[Fishface199]

This sounds rather crazy but I would like to pick the brainboxes of the Board for advice.

I had my first consultation with a gynaecologist today regarding IVF. He was honest and said my AMH was a bit low at 7 ish (he wanted it 10- 12) but said at my age (40) not to worry too much.

He then said something that utterly threw me. I had a miscarriage 6 months ago and am considering IVF because of age. I asked about multiple rounds. He said if I had 3 rounds, my chances of live birth would be about 70%. I am amazed as this was much higher than I expected and seems to indicate that as long as I keep trying I would most likely have a successful pregnancy.

He also wished me well and said "you will get pregnant". My sister who had accompanied me (DH is out of the country) grinned and nudged me when he said that.

I am confused , are these genuine stats or the patter of a salesman? I am a realist but don't want to get too excited when I know IVF is a painful gruelling process that is often unsuccessful.

You might find actually that there is already a similar question on there that has been answered? That could help give you an idea.

I am thinking of IVF solely because of age. Met my DH at 37 and started trying after we got married at 38. I did get pregnant naturally after 3 months but had a mmc. Its now been 6 months so been to clinics who have all said my AMH is low (but not very low) and have recommended IVF as I am pushing 40.

And this is why success rates matter so much to me, as I have been pregnant naturally, if we are going to look to IVF I want something that justifies the cost/effort/stress involved as otherwise I could just try naturally again.

I read some statistics last night and I think that only about half of embryo transfers are day 5 (fewer for older patients). So getting 2 blasts can't be taken for granted... Have you had an antral folicule count to see how many eggs they might be able to collect? Also, are you taking supplements and being super healthy? See what your husband's SA is like - you might just have a chance of conceiving naturally since it's happened before.

Thanks Jojo, only half of ETs even meet this criteria he gave me? Wow. And he quoted me stats for TWO day5 blasts.

Its just very very frustrating not getting an honest opinion from consultants. I feel like they are selling me false hope. It's like they have rehearsed certain sales patter and when you look more carefully it is not what it seems.

I do need to eat more healthier and am in the process of revising all my diet. I do take supplements.

I have looked around and used the Lister pregnancy calculator and HFEA stats. That gives me roughly odds of about 15% per cycle. I think that is the most accurate and optimistic scenario.

I don't mind going forward knowing this, but why oh why won't consultants be more honest.?!

(Cos its a billion dollar industry I hear myself cry!)

I went to the lister and they were always cautiously optimistic. They never really spoke about general statistics though just about my personal situation. I don't think I would have felt very comfortable if they made sweeping statements about definitely getting pregnant

We went to a clinic first who were very optimistic all plush waiting room with coffee machine. Had three or four cycles, got 5 day blasts twice no luck. They didn't do anything to change protocol each time and it was so untailored, set drugs throughout cycle,if eggs ready on a Sunday, tough, they didn't do egg collections then.

Transferred to argc and totally different, blood tests every day, drugs changing according to results, only know when egg collection is a day or two before as they test all the time and pick most optimal day. No frills and tell you nothing about your treatment. It worked, have twins.

The statistics you quoted sounded wrong and inconsistent. I would do more research before committing.

15% is about right for 40yrs

We have spoken on other threads @fish

Your consultant is lying. No way can he guarantee 70% for 3 cycles

Ivf is hit and miss. Enter works or doesn't

I was told you get roughly 25% of eggs collected to day 5 , for our age

So if have 16 foilicles you may get 8 that will fertilise

By day 5 likely to have 4 left

Now out that to 8 foilicles and have 2 by day 5

These are rough odds

Sounds like you aren't happy with your clinic so research and go elsewhere

When spending £6/7k you need to give it the best chance

How much was your cycle at argc and twins?

Which clinic was it? This sounds very similar to a consultant I went to see in Kent?

I didn't have treatment there in the end as I didn't like the way he came across and I felt like he was showing off.

I had successful treatment at Guys & St Thomas, London. They do NHS and private, it was no frills but everyone was lovely and my DD is now 9.

Lister in London is also good but pricey. Lister get great results to.

My GP recommended Guys and I'm so pleased he did.

I also meant to say, have you thought of trying acupuncture for 3 months to see if you can fall yourself.

I was 38 when I had IVF but it was male factor for us. I do have low ovarian reserves but still produced eggs.

My AMH at just-about 40 was 4.9. This was pretty much the median for this age (i.e. half women will be above, half below). So 7 might be low in absolute terms, but for your age - which is what matters, it's hardly a factor you can change! - it's not bad.
(And yes, I did have a healthy livebirth ultimately, natural conception. Who is currently trying to disrupt my typing...)

Welsh it wasn't a clinic in Kent. But I am convinced it was a sales pitch they are trained to give . Reading the recent exposes into egg freezing, it seems this is the modus operandi of many clinics, to give qualified, best case scenario statistics.

Sproglet for my age I thought my AMH was ok but I have had 2 consultants refer to it as low (even given my age) now I am thinking is that part of the sales pitch, a bit of scare tactics ?

Blondes if only the consultants were as clear as you!

All of this makes me think should I go down the IVF route at all. Leave it to nature. But in my mid 30s I did not freeze my eggs after a friend warned me off, (telling me my eggs are better within my body then in some storage facility). I regret that decision now. So am thinking should I give this a go so I have no regrets later?

I will have to be as realistic as I can and proceed with caution.

Tbh the stats on egg freezing, successfully thawing and then experiencing a live birth from those frozen eggs are pretty poor. Robert winston talks about this too- odds if something like 2 percent spring toinf so don't beat yourself up about that side of things!

I'd say blondes has it exactly right in terms of odds. 70 percent is ridiculous in my opinion.

...spring to mind!

I'm not informed at all about the underlying medical issues (saw this in general chat) but I think some of this is a probability issue -- and in your favour! Even if each cycle only has a 15% chance of working, then if you do 3 cycles you have about a 40% chance of one of them working. (Because chance of none working is 0.85 x 0.85 x 0.85 = 0.61.)

Just like with natural conception (where even very fertile people in early 20s are more likely than not to conceive in any single cycle) it really is a numbers game. And one hopefully v much still in your favour.

Thank you hops!

I am trying to view this as dispassionately as possible so I can manage my expectations. 40% over 3 cycles is certainly a figure I would think is more realistic and worth considering.

Chatty, egg freezing haunts me as I considered it at a time a new vitrification technique was launched, which was meant to be more successful than the old slow freezing of eggs. I think latest stats show a 30% success rate for eggs thawed using this technique. Still no guarantee but do find myself thinking "what if...?" But past is past.

Thank you everyone for your time and number crunching, it means a lot you are able to help an old Fishface like me

I'm 40 and I've been told my chance of live birth rate is 40% as all my hormones, ovarian reserve are good etc.

But same doctor said its about 20% live birth rate nationally for 40 year old.

So I think your doctor really is stretching it at 70%!!!!!

I had IVF at Guy's in London about 18 months ago, privately but it wasn't crazy expensive. We did 2 rounds and our son was born as a result of the second round, a few days before my 43rd birthday. I don't recall the consultant giving us any stats (though they had some on the website) as I think that their view was that this could mislead, give false hope or perhaps even discourage. However I just wanted to say that in itself charging you 200 odd quid for the consultation to interpret the initial tests ( I presume that you had bloods done as well as your DH's SA?) is not cause for thinking you are being ripped off. If the consultation is like ours they will also scan the follicles then, so they can advise you based on the full picture. The follicle scan is pretty important.

I do however agree with you that this bandying about a 70% figure and promising to get you pregnant would make me doubt the consultant's motives.

As to blastocysts, I had fairly low AMH (but normal for my age and no other problems) and they only collected 6 eggs on each round. First round no blasts and I had the transfer at 3 days. Second round 2 blasts which went in at 5 days and one implanted. That's anecdotal, not statistics, but just wanted to give you the info.

In terms of needing your DH at all appointments, it depends how you are emotionally but I found that I was fine on my own for the scans to check how the drugs were developing the follicles, the nurse appointments to learn how to do the injections and the embryo transfer. Egg collection day is intense and you'll need him as you'll be sore and groggy, but he has to be there anyway because that's when he'll contribute the sperm as they take the eggs straight off to fertilise them. I really would consider a better clinic even if he can't come along every time.

Finally, watch out for stats for pregnancies rather than live births as quite a lot of embryos implant but the women sadly subsequently miscarry before 12 weeks, yet these still show on stats as "pregnancies".

And at the end of the day you just need to take the plunge: live births for women my age were supposedly only 5% but we got lucky. I hope you do too.

Thank you Jessie. There's a few more clinics I will look at and tgen I will take the plunge! At least I can then say I gave it my best shot.

I've mentioned stats before about preg and live births

This is why clinics want you to call them on test day so they can tick a box saying successful - even if sadly a mc later

Cynical eh

Always check live births rate on website

@welsh. I'm kent. Where was your clinic

Fet - many clinics now say ivf more sucessful as a fet

1. if survives freezing and defrosting then a good chance they will survive implantation

2. body can recover from ec

@fish what was the new freezing technique?

Without a crystal ball, nobody can tell you that you'll be pregnant. Hopefully you will, but in my experience there are no guarantees.

Blondes, it was called vitrification and apparently whereas 80% of frozen eggs perished during the thawing process, with this technique only 10% apparently did. This made it like a fresh cycle apparently.

Lister clinic have used it and claimed 30% birth rate following on from eggs frozen with this process. Btw it was new in 2012 I believe when I was considering it.

I had donor egg IVF and the success rate per cycle (with the factors I could reasonably assume applied to me) was 30%.

I worked out /explained the chances to DP like this:

100 women, 30% success per cycle for 3 cycles no new factors discovered during treatment which would cause a reduced chance of success.
First cycle 30 women become pregnant.
Second cycle 30% of 70 = 21 women become pregnant.
Third cycle 30% of 49 = 14 or 15 women become pregnant.
So over 3 cycles 30+21+14=65 out of 100 women become pregnant.

So my reasoning was that if we tried 3 cycles with this chance per cycle we were more likely than not to have a baby.

(Btw I had had unsuccessful IVF years ago in different circumstances and much less sophisticated techniques so I really wasn't taking anything for granted)

Our treatment worked on the second cycle and after a slightly tricky pregnancy DS arrived.

I also have an adult DC who is my genetic child and I thought long and hard about egg donation. I completely understand why people have serious reservations about it as a first choice. I have known a lot of people who have spent vast sums, time and heartbreak on unsuccessful treatments. I didn't have the option to use my own eggs, someone else's kindness gave us a real chance of success.

Good luck with your treatment x

Liquid nitrogen is what what my clinic used - is this The same @fish?

If so the. Yes the technique is more sophisticated

I've known a few mums use de as their own eggs not good enough

Each one love their child so much

I know some feel they won't as not their DNA but it's literally an egg from another woman. You being preg will be the one growing and nourishing the baby and tho DNA isn't 100% yours - you will be bio mum

If our frozen attempts from previous cycle hadn't of worked we were going to try de as a last try

Plus as de are younger and hand picked as such - those I've known who had countless failed with own eggs got preg first/second time with de

Obv de doesn't mean will be successful every time but the % of success are higher and worth thinking about if want to be a mummy