IVF at 40 yrs old

[Lucille89]

Hello. I’ve recently had my AMH tested after 6 unsuccessful rounds of ivf (all were blastocysts from one cycle, eggs retrieved when I was 34). My AMH is 10 pmol/l.

I’m 40, have one ovary (lost one ovary and both Fallopian tubes due to surgery) I’ve had an ectopic pregnancy (pre ivf) and a miscarriage at 16 weeks. All other transfers were unsuccessful.

I know AMH is an indicator of egg quantity, not quality. Realistically I’m aware my eggs probably aren’t great due to my age. I’m thinking a lot about what to do next… I’m thinking either IVF with my own eggs again but with PGS, or find an egg donor in the U.K. - or just stop trying. Has anyone in their 40s been in a similar situation - what did you do next? Any success stories?

Hi there’s a thread on here and bf over 40 part 2 , lots of lovely ladies discussing options and sharing advice - why don’t you join it?
I’m pregnant at 40 with ivf at argc ( with 3 follicles and low amh) , my friend on forum is pregnant at 42. It’s still possible
I did pgs with one I have frozen but not used yet due to multiple mmc so I think it can be a good idea to avoid going through that trauma again

www.mumsnet.com/Talk/infertility/4327731-Anyone-doing-IVF-at-40-pt-2

Hi @Lucille89 sorry to hear you've had a rough time of it.

When you say 6 unsuccessful rounds of IVF, I'm assuming you mean 6 embryo transfers rather than 6 fresh cycles (i.e. a complete process of stimulation hormones, egg collection, development to blastocyst etc)? I think that's what you mean as you said all blasts were from one cycle. If so, then it's not unusual for someone of any age to need more than one cycle of IVF before they are successful. I'm sure 6 failed transfers has felt awful but know that you're (sadly) not alone and yours is by no means a hopeless case.

Has your clinic suggested any tests (beyond PGS) to check other factors - e.g. a thrombophilia screen? It could be that your transferred embryos were all aneuploid but after 6 transfers I think checking for other issues would be warranted. Do you have a partner, or are you using a sperm donor? If you're using a partner's sperm, have they been checked out?

Your AMH is good, so you seem to have the ovarian reserve to try again with your own eggs if you want to. PGS could definitely help identify any euploid embryos before transfer, and if you got a similar number of blasts to the 6 from your first round then it could save you the time and money of transferring one by one. At 40 you still have options, so it's obviously an intensely personal decision but I don't think you have to stop trying yet if you don't want to.

I also only have one ovary, my AMH hasn't been tested since last year but it was 9 then. I'm single which is why I have to go the IVF route. My first round of treatment (age 41) resulted in one 5AA blast, fresh transfer, BFN. My second (also 41) I got 5 blasts and all transfers were frozen because I was at risk for OHSS. My transfers were 5AA (BFN), 4AA (chemical), 4AB (BFN). One blast didn't survive the thaw and I still have a 3BA in the freezer. I'm now 42 and currently on stims for my third round, hoping for EC next week. My original plan was to bank blasts from this round, then do a second collection and PGS everything (including my 3BA in the freezer). I'm now leaning towards a fresh transfer, though I know my chances are not great. At some point in the next 6-8 months I'll have to stop, both because of money and because I'll hit 43, but I want to feel I've given it all I can before then.

As @Loveintherain said, the Over 40 thread is good if you've not already found it. Lots of luck.

@Loveintherain thank you, I came across this last night, I’ll have a proper look at the thread later.

Hi @lucymills1234 thanks for responding. Yes, 6 transfers from one cycle. My blastocysts were all day 6 and excellent quality (according to the embryologists)

My DH had his sperm screened twice and all fine on that front. I’ve had all the recurrent miscarriage tests too as we lost in the second trimester. All fine there. I’ve tried the endometrial scratch, glue, Era test, medicated and natural cycles.

If we were to try again with my eggs we would do Karyotype screening for both of us first, and also PGS. Seems like a lot to be honest and a huge cost! I just don’t have much confidence I have good quality eggs. I eat well, exercise, bmi is 19.5… Realise that is no correlation to egg quality. I am looking into diet and supplements and seeing if I can do anything else there.

I’ll definitely have a look at the over 40 thread as suggested. Wishing you luck on your current cycle.

Yes good luck @lucymills1234 for this cycle 🤞

Thanks @Lucille89 @Loveintherain !

Sounds like you've tried all sorts @Lucille89. I'm a couple of years older and single but like you all my day 5 blasts were great (3 of 4 transfers were AAs, other was AB), my BMI is 20, diet is decent (definitely not perfect, but good) and I exercise. It's infuriating when you feel you are doing all the right things and it's just not happening.

When I started IVF I just took a bog standard prenatal and CoQ10. After my last failed transfer in August I started on loads of the supplements recommended in It Starts with the Egg (I feel like such a cliche!) as I thought why not give it all a go for this round and see if it makes a difference. In case it helps, I take this each day: Proceive Conception (prenatal), Zita West Vital DHA (omega 3 supplement), 400mg Co10 in ubiquinol form, 600mg N-Acetyl Cysteine, 200mg Vit E, 500mg Vit C, 200mg R-Alpha Lipoic Acid and a couple sprays of the BetterYou Vit D spray.

In terms of diet, it's not much different than how I normally eat - lots of veg, protein (fish, lentils, yoghurt), very little processed food. For the last year I've also had very little alcohol (none during treatment) and switched to decaf tea/coffee except for maybe 1 normal tea a day.

Thanks @lucymills1234 it’s always helpful to know what other people are trying, especially when we have tried so many things already! I’m still very much undecided, but am keeping log of info and resources in case we decide to try again. Thank you for sharing. x