Success with less aggressive treatment than IVF

[CestCeleste]

My fertility doctor is recommending ivf with more than one embryo as am over 40.

While I’m not doubting his professional expertise I do feel like I’m being very quickly pushed down the ivf route without trying anything else.

For example he says there is no point in iui, trying clomid, trying DHEA.

Anyone have any success with anything less invasive than IVF despite a recommendation to proceed directly to ivf.

The problem is over 40 and your egg quality is already lower which is why he hasn't suggested IUI - your also unlikely to produce loads of eggs with more than half expected to be chromosally abnormal so he's saying IVF is best chance

There are clinics within specialise in natural ivf where you don't take drugs and they collect the one egg your body naturally selected that month. It's also cheaper. If you aren't sure about full ivf then maybe that's an option?

The problem is over 40 and your egg quality is already lower which is why he hasn't suggested IUI - your also unlikely to produce loads of eggs with more than half expected to be chromosally abnormal so he's saying IVF is best chance

There are clinics within specialise in natural ivf where you don't take drugs and they collect the one egg your body naturally selected that month. It's also cheaper. If you aren't sure about full ivf then maybe that's an option?

The problem is over 40 and your egg quality is already lower which is why he hasn't suggested IUI - your also unlikely to produce loads of eggs with more than half expected to be chromosally abnormal so he's saying IVF is best chance

There are clinics within specialise in natural ivf where you don't take drugs and they collect the one egg your body naturally selected that month. It's also cheaper. If you aren't sure about full ivf then maybe that's an option?

The problem is over 40 and your egg quality is already lower which is why he hasn't suggested IUI that's if you ovulate every month - your also unlikely to produce loads of eggs with more than half expected to be chromosally abnormal so clomid is just to force the ovulation bit and doesn't look at quality at all

DHEA is a supplement to increase number of follicles but not quality

There are clinics within specialise in natural ivf where you don't take drugs and they collect the one egg your body naturally selected that month. It's also cheaper. If you aren't sure about full ivf then maybe that's an option?

If you are at all open to ever trying IVF, the time to do it is now. I know it can seem like a big step, but past 40 any time you spend trying other things is, unfortunately, time when your odds of IVF success will rapidly diminish, to the point where within a few years it ceases to be a viable option at all.

That's when it comes to your own eggs, anyway. The option of donor eggs isn't going anywhere, so you could always come back to that later.

So the problem is abnormal eggs and clomid / DHEA with change that - they basically encourage ovulation?

What I don’t get is how he knows my eggs are such bad quality? Surely if bad quality eggs the problem you get pregnant but have a chemical or miscarry early on?

• clomid / DHEA won’t change that

How old are you exactly, if it's not a rude question?

40 and a half

What tests have you had done?

Tests:

Physical exam (no issues)
Swabs for infection/STDs - showed BV and Strep B which I’ve taken a course of antibiotics for and seems to have cleared up
2 intrauterine scans. No real issues. First sonographer thought there was a septate uterus. Second sonographer disagrees with that diagnosis - says it is so slight it’s not an issue.
Day 21 test - was fine, showed ovulation had occurred
AMH test - I think I came out at 8
DH had semen analysis - normal

Just had a hysteroscopy and laparoscopy which found mild endometriosis which was removed (was having some symptoms of endo). Now wondering what my next move is 🤔

You've never had clomid? I had it after years ttc and no fertility issues, many investigations. Fell pregnant after three months. I'm not sure how long I'd give it though if I was 40.

IUI requires good quality eggs and sperm. It’s only really offered when people can’t afford a full IVF cycle. Success rates are poor and you often have to take the same amount of drugs as an IVF cycle as you need to stim and prepare the uterus the same.

Clomid has a higher success rate for healthy women but it can make even mild endo worse, so it should only be offered with caution. As you had surgery to remove your endo this suggests it was serious enough to worry the consultant - a lot of the time truly mild endo is left as the surgeries to diagnose it can impact fertility too.

So the only option left is IVF. You will have 2 possible protocols here - short or long. The one the consultant chooses depends on your egg reserve really.

Thanks for the info.

I just feel like we’ve been trying for a year but are rushing down an ivf route. It’s not that long really but I appreciate the age factor

It’s not rushing though. In your situation IVF seems like the only sensible option. You don’t want to be risking your health and money with the other options when they probably won’t work. I know how you feel though - I started my IVF journey a bit earlier than you but it seemed so sudden that as soon as I reached BMI I was on my protocol, but I was told from the start that IVF (and in particular ICSI) would be the only option for us. My PCOS caused far too much damage for Clomid to work - it helped me ovulate sure but my ovaries couldn’t release the egg.

Yes I think that is basically what the consultant saying - that the other options unlikely to work.

I think we can either try ivf or take a v relaxed “if it happens it happens” approach - but in the knowledge that it just may not happen.

Had you asked me before I got married I would have said a baby would be a bonus and if it happens it happens but now that it’s not happening I don’t know if that’s how I feel any more!

And I am worried if I leave it much longer even ivf won’t be an option.

I don’t know anyone in real life whose had ivf and I keep on just feeling like why us? I know that is not a v productive way of thinking but everyone around me is getting pregnant, even people around the same age. People who smoke. People with alcohol issues 😑

Honestly yes the bitter truth is if you allow yourself a natural ttc time period you may get to an age where UK fertility clinics won’t treat you with your own eggs. I think just go for it - get your three cycles while you’re young. And if it still doesn’t work then you can always ttc while you decide on next steps.