Secondary infertility - accept it, or wipe out savings on IVF?

[CC81]

Hey all, I've contributed to various threads on here in recent times, but my situation and thinking have now moved on. I'm keen to hear from others who are struggling with the same current dilemma.

I've had tests at a private clinic and also NHS. I'm still ovulating and am physically fine, as is my husband - but I have a low ovarian reserve (AMH is 0.9, AFC is 5 and FSH is around 16.5). I'm nearly 39.

It's been a shock, as we conceived our first child naturally (immediately) only three years ago. We're extremely fortunate to have her - and this process has made me realise that even more.

However, we'd dearly love to give her a sibling. If we can't, I know it'll be an awful struggle seeing people around us have second and third children. We also worry about her being lonely - but I'm aware this is a stereotype of single children, and probably the result of stupid social pressure and expectation. It's hard to shake it off, though.

IVF is an option for us, but it's very unlikely to work. We're wary of wiping out our savings on a stressful, unpleasant process when we could be concentrating on the child we have; and investing in our future instead.

There's a lot of appeal in the idea of not bothering with IVF and accepting what we have... BUT I don't want to regret not trying, for the rest of my life.

Natural conception is still possible, though also unlikely, as my egg quality may have declined along with the numbers. I'm doing acupuncture and taking various supplements.

My feelings are confused, as I'm also reeling from the idea that my egg supply is so crap for my age. While I'm relieved that I'm internally 'normal' (womb, ovaries, etc.) and my blood results show I'm fine, I worry about what it means for my general health. Maybe nothing.

If this was our first child, there'd be no question of trying IVF - and we'd also look into adoption. But as it's second time around, it makes the decision so much more complicated. And finally, I feel guilty for feeling upset when some people are going through hell to conceive their first, or fighting other health issues.

Hi @porger80 - yes, it sounds like we're very much on the same page :)

My feelings are confused by the shock of discovering I have a low egg supply (despite all else being fine), plus the social pressure of seeing families with 2+ kids everywhere (even though there are plenty with one; and many with none). And yes, as you say, that crappy end-of-month feeling when you get a big reminder about the whole issue.

It's therefore difficult to be truly sure how I feel about our individual situation. We don't feel there's anything 'missing' from our family unit. It's more that another child would be a happy addition, and it's tough to discover that we probably don't have the choice (with a 10% chance).

It sounds to me like you have a very sensible attitude towards this and I'm sure we can both move forward positively. I just wish I could skip the painful decision-making part!

Hi all,

I posted an update on another thread which you may find useful/interesting (latest post):
www.mumsnet.com/Talk/infertility/4020561-IVF-or-Natural-Natural-Modified?pg=2

Basically, I've now had consultations with two private clinics - one about conventional IVF and one about natural modified.

The latter is much more appealing and probably better for my situation.

But equally tempted to do no treatment at all, as recently I've felt better about leaving it up to nature (and the consultants both said our chances with IVF aren't actually that different to natural conception, as everything else in my body is working fine).

Now we need a bit of time NOT thinking about it quite so much, to figure out our true feelings. If that makes sense.

OP update: Three days after my last post, I got a positive (natural) pregnancy test. Utter shock. Had a scan this week and am 7.5 weeks with twins. Even bigger shock!

It may not work out... but as you can imagine, it's given me a whole different perspective on IVF and my suitability for it.

It's reminded me how very tough early pregnancy is... not just the feeling sick and exhausted, but the horrendous waiting and worrying. I'm not sure I'd cope well with months and months of that, with IVF and then (if lucky) pregnancy.

It's also made me realise that, as others have advised, IVF isn't to be entered into lightly and I should really thank my lucky stars for my first child.

If this natural pregnancy works out, then we'll be absolutely delighted - but if it doesn't, we think we'd try one more time naturally and then stop if no success by 40.

Don't know if that's helpful to anyone, but this year been quite the rollercoaster...! And low AMH obviously isn't a complete barrier.

Wow this thread is a real rollercoaster! So happy it worked out for you @CC81

@CC81

Amazing news!!!!! Huge congratulations- welcome to the twin-mummy-to-be club! 🤣🤣

Thanks @ivfbeenbusy and @farfromperfect82 xxx

It's still very early days, but we shall see...!

Congrats @CC81! Can I ask how long it took you to get pregnant in the end? I need to feel some hope! I also completely agree that numbers like AMH are only relevant to IVF doctors. Who knows what is possible round the corner

Thanks @porger80 - hope all is good with you.

It was cycle #8 (October), as we started trying in January, but missed March and June.

The Create consultant said he wished I'd never had my AMH tested, as he doesn't think it's helpful and makes people stressed - and success is more likely when relaxed.

When we conceived, we were coming round to the idea of not doing IVF and sticking with one child - so I can see there may be some truth in that. The year before that was pretty stressful - first lockdown, then worrying test results!

Hi @CC81 how is your twin pregnancy going?
Thank you for your original post it is exactly the position I’m in now!
I’m 37, have DD who is 5, and have had two miscarriages in the last 18 months: first from a surprise pregnancy and the second just a month ago from TTC a sibling.. After the second miscarriage we had some investigation tests done which showed AMH of 2.4 and AFC of 5- everything else ok.
I think we’re tempted to try IVF as I feel it may be too late to conceive ... But I love our family of three! But getting pregnant even for short time made us realise how we would love another one.. Anyone else feel similar?

Hi @Beckybee83 - I'm now at 10 weeks 1 day, after a private scan with a consultant at 9w 4d. He said everything was looking good, so far.

I'm still extremely cautious and won't let myself look beyond 12-13 weeks, when we've done all the tests etc. I'll be having an NIPT test on Monday and am VERY anxious about it. There's only a 2% chance of problems, but I always tend to expect the worst! So I'm not thinking of them as 'babies' yet - more just as a medical process that I'm going through.

Really sorry to hear about your losses. It sounds like you've managed to get pregnant, which shows that a lot of your system is working (no blocked tubes etc) - and that's the part IVF would usually assist with (i.e. conception).

Are you taking any supplements? Have you had your progesterone levels checked etc?

My AMH was 0.9 when tested and my AMH was also 5, so these definitely aren't the be-all and end-all of fertility.

@CC81 thanks so much for your reply- I will keep everything crossed for you and completely understand your caution- I felt the same with our recent pregnancy although it was hard not to begin to get excited 😞 Yes I’m taking supplements and am trying to keep my diet and lifestyle as healthy as possible. We’ve been talking to Care, who have been really good and realistic about our chances altho IVF seems like a gamble for everyone! I’m worried if we don’t try IVF and TTC naturally then we may runout of time- and Doctor is in agreement altho have said I may not respond too well to the IVF drugs because of ovarian reserve... I’ve a mixed bag of feelings as if we hadn’t accidentally got pregnant last year I don’t think we would have ever thought of having another- we always planned to have one and we’re v happy as a three 😊 But now I think with the grief and knowing time isn’t on our side I feel really like I must try! It’s so hard. My husband is amazing and has said he’s happy either way, and would be happy to have another but is happy just as we are- so I feel the pressure is all from me! Thank you for taking the time to read and respond, talking to people has been so good ❤️ I’ll be thinking of you in the coming weeks xxx

@Beckybee83 - Thank you - I'll be thinking of you, too. Let us know how you get on!

I felt the same, about IVF potentially speeding things up.

However, now I'm looking at it from 'the other side' (being 10 weeks pregnant and really worried!), I've realised I probably wouldn't want to go through all this anxiety again; and especially not with expensive, invasive procedures on top.

I'd also be worried that IVF may not collect the 'best' eggs, on the months we did cycles, compared with those naturally selected by my body (like this time).

But you're right that it's a lottery and a gamble - and everyone responds differently. If you have the funds and are willing to go through the process, it may well be worth a go.

@CC81

Glad to here you are doing ok! Just on the NIPT - I had it done at a similar time - just after 10 weeks and the first draw came back insufficient DNA and I had a massive panic. I had it redone at about 13weeks and then got a low risk result. Sometimes the 10th week is just a bit early when it's twins so don't stress if it comes back no result for the first one

Do you know if these are identical twins? If they aren't then you'll only get NIPT results for downs/Edwards/pateus as they can't do all the other chromosome ones when it's non identical twins x

@ivfbeenbusy - Thanks for the warning!

I'm doing the IONA, as the lab is local and should get results in 5 days - so we were only going to find out about the three main syndromes at this stage anyway. Apparently the IONA has a lower redraw rate than other NIPT tests, so I'm keeping fingers crossed!

We may do a more detailed test (like Panorama) at a later date, but for now we're just hoping for some basic initial reassurance. If it's bad news, we'll have to do more investigations anyway.

The twins are very separate, so the consultant thinks it's most likely they're fraternal. The bright side is that it's the lowest-risk twin pregnancy; and also that if one twin has a problem, hopefully the other won't.

It's so horrible waiting!

That's good - bizarrely my blood sample for the Panorama test was couriered to America!!! So it was 2 weeks for the results

I'm having fraternal twins too as these are IVF babies - 2 embryos both at completely different stages and one was frozen one was fresh and so have one twin which is much smaller than the other and whilst I'm still under specialist care to keep an eye on her growth they are less worried than if they were identical twins/sharing same placenta. Although I nearly had to deliver them last week at 29 weeks which was a panic 😬

@ivfbeenbusy I hadn’t realised you’d had a scare with the twins. Fingers crossed everything goes smoothly for you now until they arrive. When are you due to have them? My Panorama results took 15 days to come back too, I think the lab is in America whereas other labs are elsewhere.

@CC81 not long now until your 12 week scan, though I know it seems like forever.

@Beckybee83 good luck with your journey, whether you decide to continue trying naturally or going down the assisted fertility route. I think there’s something to be said for putting it in the hands of the experts and seeing what happens if you’re getting anxious about timescales. In a way it took the pressure off us, watching my period come and go every month and the years pass by in some ways was more stressful than going through the treatment cycle.

Thanks @CC81 and @TheMagicDeckchair!

@CC81 yes I do agree re the natural egg selection, altho am panicked that mine maybe low quality as miscarriage investigations point towards chromosomal issues... so IVF may not (and statistically for me most likely won’t) solve it..

@TheMagicDeckchair I’m feeling like considering IVF is maybe me trying to control something I feel I have no control of after two losses... the staff at Care have been great and we’re considering going ahead with it.

Will keep you all posted

@CC81 best of luck with the tests x

@Beckybee83

Just on miscarriages and chromosome testing....I had 5 miscarriages abs decided to do PGS testing on a round of IVF. Didn't get any normal embryos - all had chromosome issue which i was told was unusual for my age. Decided not to test again and got pregnant with twins on my next IVF cycle....

@ivfbeenbusy
I’m so sorry for your losses
Thank you for sharing your experience- this is so helpful- we were actually considering PGTA testing but Dr said if we only got one embryo to maybe good to just use it without... I think if we are lucky enough to get any eggs and embryos if we go through IVF we may just miss the testing ... did you have to ask to have two embryos implanted? Xx

@Beckybee83

Yes it s a big risk as legally not allowed to transfer abnormal embryos in the U.K. so you could end up with nothing to show for spending all that money and have to destroy the embryos

Yes I asked for 2 embryos to be transferred - they agreed only because I had done 5 egg collections and 3 transfers already and spent £35k so we were totally out of money. Also I was 37 and physically well enough (I thought! Twin pregnancy is brutal) to carry twins and we wouldn't put back 2 grade aa back together. Many clinics are refusing double transfers though at the moment x

Posted on a couple of threads I started:

Hi all, just a note to say I'm going to (try to!) take a step back from forums for a little while, in an attempt to stop focusing so much on my pregnancy. It's constantly on my mind and the intensity is making me more anxious - so I need to reduce the attention I'm giving it.

So if you don't see updates from me for a bit, that's why! But I'm fine otherwise, so far

I very much appreciate everyone's responses to my posts and have found them really, really helpful. Thank you. x

Hi @CC81 congratulations on your pregnancy that’s wonderful news, just caught up on this, I originally posted in September when I was about to start my next ivf round an pleased to confirm it was successful and I am now 11+4 I’m very sick but so happy!! Wishing us both a happy an healthy pregnancy...how exciting for you natural twins!! Wow xxx

@CC81 just saw your previous post...I haven’t been on here much either for the same reason! I just pop in every now an then x

@CC81 hey, I've got an almost identical situation :-* aged nearly 39, 6 montha ago my amh was at 1.1, 5 follicles counted. Don't know what fsh is as the recent test was ballsed up. We didn't begin treatment in July because I was told to put on weight and thought me and my oh should get on the supplements train. Plus we sold our flat.

I've always dreamed of 2 kids. To the extent it was foolishly '2 or none'! But after several consultant meetings this year I decided finally I'd see a lead consultant at the Lister to ensure I got a full picture assessment (local consultant would only do long protocol), Create would only ever do mild so I thought I'd speak to someone able to pick from any treatment plan. Anyway, the news this last week was 'ivf is unlikely to improve your chances over iui and it may still be 18 months or never that you conceive again'.

Because I had already decided I wouldn't ever do the full blown long protocol because of our low chances, having now heard our chances are virtually equivalent to iui we've decided to do iui because it'll save us money and be less disruptive to health and life. The consultant said Create's approach of freeze all 3 cycle was irresponsible because frosties sometimes don't make it, so why would you take that approach for someone who was going to make few embryos if any anyway.

It's heartbreaking but at the same time I already feel some calmness coming on about the fact we may not have a sibling for my toddler. I don't know if its because I still feel hope for iui or even a donor egg route... but my heart tells me that probably won't sit right with me ultimately and so it won't likely happen... and the iui... well, im older than the last time (its how we conceived our first because my oh has ED).

I'm aware I'm not writing v articulately so apologies. In answer to your question, for me its a matter of balancing things with our finances and ensuring I don't ruin harmony in our little family by longing, trying for a second I very likely won't have. But it does break my heart and I am going to give it the best go I can, but not forever. 18 months, mixing home insemination and iuis with maybe 3 medicated (apparently 2 or 3 medicated iuis would give me equal chance of a round of ivf) will be it for us, then we'll have a bloody good holiday, get a dog (never would if we had 2 kids because of the commitment) and move on.