over 40 IVF journey

[facevalue]

I wanted to explain my situation. I just turned 40. low AMH. no other cause for low fertility.
1st: we had short protocol ivf - one embryo- BFN.
2nd: long protocol and a scratch one embryo- BFP and a healthy baby
3rd: long protocol- two embryos- BFN.
4th: long protocol- 3 embryos transferred - BFP chemical pregnancy.

I get low number of follicles each cycle and maximum eggs are 5 and max fertilise 3 with ICSI.

I really don't know why my dr advised ICSI because we have normal sperm count and shape etc!

I am keen to try again. Twin pregnancy isn't scary for us. We would love lots of kids if it happened naturally or with IVF.

I feel a little lost at the moment. My family advise me to try with a new clinic and new dr just for a fresh start.

I'm in london so i can in theory attend lots of clinics and I do like London bridge as a location as easy to get to and from on my way to work.

I heard some talk about mild IVF etc and about uterus blood flow scans- i'm not very sure what I'm asking

Have you ttc naturally? Low amh means you don't respond well to the drugs, but is generally not a barrier to natural pregnancy.

Twin pregnancies are 'scary' not because of two babies at the end, but the increased likelihood of complications at every step!

I'm wondering if there might be an egg quality issue, @facevalue? It's a big step, a hard one to take at that, but would you consider donor eggs?

@physicskate ttc naturally is a task now and i won't even pretend that it is on track. i know lots of couples get put off sex because it's a task now while looking after a toddler and feeling crap it is not going to be my realistic plan.

@RedPandaFluff there was no issue with the embryo quality ( top grades everytime) . I don't think we need donor egg having had a healthy baby already 1/4 worked so far.. i am still hopeful

Perfect embryos can still be chromosomally abnormal (sadly I know this from bitter experience - I'm just about to turn 40 and finally got my BFP after 4 cycles). I can understand that donor eggs aren't something you want to consider though, so maybe PGS/PGD testing for your next batch of embryos might be a sensible next step?

@RedPandaFluff interesting .. do you mind if I ask you what you mean? did you have conventional ivf cycles then change to PGS? i don't know a lot i just assumed I would offered this test if needed in my case . we are paying privately so i don't see why that was not suggested.

what do you recommend as i said before apart from the one chemical pregnancy at 6 weeks i never had a miscarriage

Hi @facevalue - you'd have a normal IVF cycle, then the resulting embryos would be PGS-tested (ie they examine a sample of cells from the embryos) and then the best embryo/embryos are transferred to you. The testing doesn't rule out all chromosomal abnormalities but it means you're not going to transfer any that definitely won't result in a successful pregnancy, so you're saving yourself the heartbreak of the TWW with embryos that didn't have a chance. My consultant told me that even in a young, healthy woman 50% of embryos are chromosomally abnormal and it's the most common cause of failed IVF and chemical pregnancies. It was the explanation I was given for my failed cycles/chemicals even though the embryos were graded "excellent" hatching blasts.

Having said that, there are lots of arguments against bothering with PGS testing - it's expensive, it's probably most useful when there is more than one embryo, and there are other (cheaper) options you might want to try first - aspirin, prednisone, clexane injections etc. Sadly there are so many reasons IVF can fail - it's often a case of trial and error, which is pretty gruelling when it means repeated cycles.

I think it would definitely be worth getting two or three consultants opinions - clinics often offer free consultations, and even if the clinics you're considering using don't do this, maybe it's worth paying a bit to get some proper medical advice and opinions on what your options might be.

Hi I have a similar story and journey to you.

4 rounds of ivf, one child, I miscarriage, 1 embryo tested and not suitable for transfer. Sex life ruined so low chance of natural conception.

I was recommended Colin Davis at Evewell - perhaps try him?

@twinkledag thank you for sharing . Do you mind me asking what happened with your 4th attempt ? did you see colin already or it's just the recommendation so far.

very helpful comment thank you

4th attempt we ended up with 1 6-day blasto to PGS/PGD (can never remember which one is which!) and it was not suitable for transfer.

We then went for a last ditch attempt at ARGC - had the consultation but in the meantime I was recommended Colin Davis from the women on here so I went to see him too and we are in the process of getting all our ducks in a row and trying with him after the summer.

Worth a consultation with him? He's lovely.

I'll tag you on my post where he was recommended to me.

fingers crossed @twinkledag i hope it works for you guys . thanks for tagging I might look him up

I couldn't find the post but if you search Colin Davis on here you may find it 😊

Hi @facevalue just seen on another thread you got your BFP, so pleased for you! Which clinic did you go with in the end?