Should we just go straight to DE? Harsh and honest opinions wanted please.

[lupinsoryourlife]

I'm going to be 39 in December. Being ttc since March 2016. Fell pregnant naturally in spring, but mc at 6 weeks.

I had low amh (measured at 1.8 last year) Don't even want to think what it might be now! FSH is really high (measured at 20 in May) irregular periods ranging from 18 to 70+ days. DH has low motility (5% progressive) all other parameters normal, including DNA fragmentation.

I've just come into a small inheritance, which means we finally have the money for some treatment. NHS won't help us due to my clearly peri menopausal state I'm finding myself torn between what to do. Part of me wants to try a round of ivf (probably mild) to see what happens. The other part of me thinks that's a waste of money and DE is a far more sensible decision. I'm just very aware that we don't have that much money to spend and I really want us to maximise our chances of having a baby. I fell my spring pregnancy was almost a red herring. People keep saying it's a positive sign, but tbh I can go months without even ovulating. Ttc under those conditions is so stressful and upsetting. Plus what's to say I wouldn't just miscarry again as I suspect my egg quality is probably pretty rubbish.

Of course I want my own biological child, but I also want to be realistic.

Wwyd if you were me?

Are you planning to go on waiting list in UK for De or go abroad? I was on UK waiting list for 2 years by time I got to the top of the list I had twins by icsi, 4th cycle. Good luck whatever you decide x

We're planning to go abroad.

We couldn't afford multiple cycles whilst on a waiting list. We simply don't have the money. Really wish money wasn't such a factor, but it is I'm terrified of it running out before we get our baby.

Congratulations on your twins. Amazing result

If you really want a baby, then with that FSH, donor egg / embryo gives you your best chance (up to 40% per cycle rather than 1%).
It's the medically correct decision.
However, it needs to feel like the right decision for you and your partner. Counselling may help as may talking to other couples who have made that choice.
All the best

If money is a factor I would go de. I would also have immunological testing and everything else I could throw at it

DE sounds like the statistically best way to go. So things to think about would be - what puts you off that idea? Are those factors things you could come to terms with?

AMH not a measure of egg quality though. Conception requires a genetically normal embryo, and the chances of that drop as both partners get older.

Ivf produces a larger number of embryos in one go, giving you a better chance of finding a normal embryo faster (and you only need one).

At your age I also had low amh. Not as low as yours, think it was about 3 but dropping fast, so it more than halved over 10 months and fell below the norm for my age group (also 39).

Three rounds of ivf, with Icsi all in my 39th year produced:
Round 1: 12 eggs / 8 blastocyst
Round 2: 4 eggs / 3 blastocysts
Round 3: 4 eggs / 3 blastocysts.

First round we transferred 4 embryos (1 fresh, 1 fet, 2 fet). I have low progesterone and first tow transfers I bled out before test day due to wrong progesterone dose. Round three I had an endometrial scratch and was on lubion, conceived, miscarriage at 6 weeks.

I conceived every transfer thereafter confirming to me they'd got the drugs support regime right. Two further early miscarriages.

Now 14 weeks with what looks to be a strong, healthy pregnancy I'm 40 and our ivf treatment from first stims to last transfer took almost exactly a year. Based On embryo transfer we've done since they got the drugs support right would suggest our genetically normal embryo rate is 1 in 6 blastocysts. Younger couples rate would be 1 in 2 or 1 in 3.

Though our blastocyst rate was very high, abnormally so. A friend going through treatment at a similar time would average 1 blastocysts from 4 eggs, but 1 in 2 of those balstos were normal. More blastos seems good, but as you can't tell by looking which are normal, it can just take longer to find 'the one'. If you calculate on eggs harvested to normal embryos, the hit rate for me and my friend at similar ages was similar, it's just a question of when the abnormal ones drop out.

Luck of the draw when you find that one. It wasn't 'not working' before, just a matter, for us, once the progesterone was right, of finding the embryo that will make it.

So you need to factor in whether you can afford a few rounds to find the embryo. But even with doner eggs they have to get the other things right, drug support etc. So you may need a few transfers to get that right anyway.

Maybe look for clinics that offer a three round for two deal if you want to use your own eggs?

Where are you based? Could you try one of the London clinics with very good results where people have had failed ivf elsewhere?

Thank you for all the responses

fridgedooropen TBH there's nothing actually putting me off de. Obviously I would love a biological child of my own, but ultimately I just want a baby. I'd come round to the idea of de before I fell pregnant naturally. Then of course the natural conception gave me hope I could conceive myself. It's difficult as well because family members (hello dm) clearly think if we just keep trying we'll get lucky again. Obviously I realise that is far from the case.

My DH is of a similar mindset to me in that he just wants this horrible limbo state to be (hopefully) resolved as quickly as possible. He's just wants a baby too.

GoodLuckTime Many congratulations on your pregnancy💐 I am so sorry about your miscarriages to get there though. Tbh reading your story makes me doubt I'm strong enough to cope with it though. Just the one mc has been a terrible struggle for me. Although I appreciate de still aren't a magic bullet. I see posts on FF of people failing 5+ with de, and that really scares me.

Are there clinics doing three for two deals? I didn't know that. I've seen some such as Guest who do third free de cycles. That really appeals to me. Ideally I would like to go to New Life in Greece, but they are more expensive. It's so hard knowing where to go.

heateallthebuns We are in London, but sadly U.K. treatment isn't an option for us. The small inheritance is just too small. It would run out very quickly. Although obviously I'm great full for the chances it has given us to at least try somewhere!

In the nicest way, amh isn't that helpful - nor are tales of successful cycles with low amh.
Your major issue is your fsh which is why no NHS clinic will take you on with an fsh over 10 (some use 8). (Many private clinics will also decline to treat you with an fsh this high because your ovaries are highly unlikely to respond to stimulation.
If you are not emotionally or ethically averse to de, it is the most likely way to achieve a child.
Natural conception is different, not impossible (as you have demonstrated) but miscarriage risk is v high.

I appreciate your straighttalking Nan0second

My instinct tells me that oe ivf will be a waste of time and money. I think I need to stop talking to other people (friends and family, not you lovely lot) and just make a decision. Really want to get the ball rolling asap.

Listening to yourself is the most important thing, op.

I've been considering writing a post for a while now setting out what I learned doing ivf. Not a how to, or must do, but just stuff I found out did / learned that made a difference for me.

Big on this would be getting support for your mindset. Most clinic offers counselling, ours did, but I didn't use it as I got the impression it was focuses on decision making eg donor eggs rather than the wider issues.

So I sought out an NLP counsellor and saw her a few times before we started ivf. I've done NLP to turn around other aspects of my life and it really works for me. This counsellor really helped me reset after nearly two years of trying naturally and no joy. Also helped me resolve and move on from feeling angry at DH (I felt he wasn't taking it seriously) and our first doctor who I felt badly / obliquely advised us. That few sessions of therapy helped me go into ivf in a much stronger and positive mindset.

However I ditched her after I saw her at the end of our first round and she frame it as 'failed ivf' as if the process would never work for us.

Then went back to my first NLP counsellor and dug deeper, facing up to and coming to terms with what life would be like if we weren't successful and also other issues with my parents etc.

Honestly at this age, or indeed any age, miscarriages are part of the pregnancy journey, they get more frequent as you get older. Although though at the time, mine felt like progress to me as we'd been trying so long without any whiff of a positive test. Also filled in some pieces of the puzzle: one was a chemical pregnancy and it clarified I'd had several natural chemical pregnancies, period slightly late, then very heavy sudden bleed. At the time I felt I was going a bit mad with so many months of trying and nothing tangible (like a line on a test) to show for it.

You are right we cannot tell you what to do, what ok for you, what's not, how much time or money to give it. All those things are personal decisions and what's right for one couple wouldn't be for another.

Spend some time listening to yourself. I'd recommend talking less / very little to others about it, even family. You need to a make choices that are right for you and you can live with, not anyone else, no matter who they are. Find someone not invested in the outcome (like a counsellor) if you need to talk it over.

Hi Lupins
Sorry you’re going through this. On a purely logical and statistical perspective, then yes I’d say go straight for donor eggs. One of the problems with your situation is that it’s not purely a medical/academic decision and emotions come into your thought processes.

With your own eggs, with those numbers your chance of pregnancy is

Have you spoken to a consultant recently to gage how long you’ve got to go for a DE? (I don’t know if peri menopause or menopause make a difference there?). Perhaps you’d feel more at peace with yourself if you carried on trying naturally for another year? If you had no luck, you could always go with a DE then as the biological clock ticks for own eggs only. Is your husband taking supplements, not drinking, smoking, wearing loose pants and eating a lot of fruit and veg? Lifestyle changes make a great difference to sperm quality. It’ll be important whichever route you go.

GoodLuckTime I'm due to start infertility counselling tomorrow, so planning to bring all these issues to my counselling.

I've definitely talked too much with people other than my DH. Unfortunately I'm someone who always feels they need to justify their actions to everyone. I really need to make a conscious effort to realise that the only thing that matters is what DH and I want. If I'm totally honest I don't want to try own egg IVF. Perhaps I would if we were wealthy, but we aren't and it's thousands for something highly likely to fail.

EarlGreyT Thank you for sharing your experiences. I'm sorry to hear you've had to go through so many unsuccessful cycles I really hope you get your baby soon. I wish you the best of luck. Tbh I don't think I would wonder "what if?" If I was successful with de. I'll just be utterly thrilled to be a mother. I think my reluctance comes more from other people's perceptions that I might not have tried hard enough. However I need to realise that other people's opinions are irrelevant. It's what I want that matters here.

jojoSM2 From what I understand menopause has no effect on ed. you just need a decent womb lining which can (hopefully) achieved through medication. I don't know if I can face another year of trying naturally. The mental distress caused by my cycles being so irregular/not ovulating/body just generally not working is so immense. I just want to be taking some action to end it all! DH is fine for morphology/count and fragmentation. It's just motility that is poor. He's been on sperm improvement protocol which upped it a bit, but it's still not great. He doesn't smoke, drinks very moderately and we both eat quite healthily/take supplements. I'm hopeful icsi can overcome the low motility.

Ironically when I did fall pregnant naturally we had given up for a while, and were eating/drinking worse than we had it ages. Go figure

If you’re premenopausal then DE is your best chance. Most clinics won’t even see premenopausal women if they say no to DE.

Yes go for de

Your age means you can fall preg but also higher risk of abnormality and mc

De will give you a better chance and if you want to be a mum then this is your best bet

Rather then trying with own eggs - possibly having one to transfer or none

De will be with a younger person and much more likely to have some to freeze if fails with fresh

Fwiw I ttc for 10yrs - 2 diff men. Husband sadly died after 5yrs and I met someone else who was mad enough to agree to a baby when he had 3 kids in their 20's - bless him

Anyway did 2 cycles in uk with own eggs at think 39 and 40. Failed and had 4 embryos implanted in all

Licked wounds and researched abroad. Much cheaper and pedoanlly think their technolofynand freezing is far better

3rd fresh failed - was 41 but with icsi and better tech we had think 5/6 to freeze - 4fet failed but 5th was successful and was 42 when had fet , 43 with bf and 3mths after giving birth 44.

If all our frozen had failed we would have done a last attempt and would have used de

Time isn't on your side. De gives you time

Thank you again for your input everyone. Congratulations on your new baby Blondeshavemorefun

DH and I have discussed things at length again and we have decided that we are going to go for DE. Currently researching clinics abroad now, although I've not been that impressed with the two I've been in contact with so far, so will keep looking.

It's been a hard decision, but we feel it's the right one

Thank you again for all your help. It was very much appreciated.

Good luck lupins.

I hope you don't mind me saying this (and I'm biased as I used them), but I recommend embryolab in Thessaloniki. There's also new life in Thessaloniki which is literally across the street. The doctors and the psychologist at embryolab have worked in the uk so are fluent in English, but you also get a coordinator/translator who translates for the embryologists and coordinates everything for you. We had a Skype call with them and one other clinic and I felt it was clear that they were the one to go with.

Since male factor is one of your issues, I would think about using a clinic which offers IMSI as well as ICSI. A lot of the Spanish clinics only offer ICSI, which is the main reason we excluded most of them.

Good luck.

Thank you EarlGreyT I actually had a Skype chat with New Life last week and was very impressed by her through they were. I did mail Embryolab too, but they never got back to me. I've heard good things about them though.

I didn't think about IMSI. I'll have a look into it thank you. We've only got low motility, which I thought normal ICSI would overcome. Although I'm happy to do anything that might up our chances of success.

How through they were even...