IVF for multiples?

[Somerloving]

I would love some advice from you ladies.

In 2018 we began trying for our first child with no luck. We went to a fertility clinic and had 3 rounds of clomid, no luck. I was diagnosed with pcos. I had a lap and dye procedure and was told my tubes were clear. Luckily I got pregnant naturally the next month. When my baby girl was 3 months old we started trying again. At this stage I was 38 and time was ticking, especially since I would love to have 3 children. Fastforward 9 months and still no bfp. I have an appointment with the fertility clinic again next week for a review. I have been using opks and getting positives every month but can't bbt because I'm up a lot wit my daughter during the night.

I had 3 day bloods done which came back normal however my 21 day bloods showed I had low progesterone. I haven't got my amh results back yet but last time it was checked in 2019 it was very high cause of the pcos. Partners semen analysis was very positive.

My question is what should we do next? Im seriously considering doing IVF with a view to getting pregnant this time but also having embryos in the freezer for baby number 3. I understand it may not all go smooth sailing but the alternative is to potentially try for baby number 3 in my 40s which I'm not optimistic about. Financially it would be a huge struggle for us at the moment to afford the €5000 for IVF but I feel like its now or never.

What do u guys think? Should I go clomid/IUI now and concentrate solely on baby number 2 or should I do IVF, struggle financially, but have a shot at having a third?

If you would be happy with 2 children then try the non-IVF route. If you are certain you want 3 children then you need to bank embryos now. You might get lucky again and fall pregnant with number 2, but it's highly unlikely you will be as lucky by the time you're ready for number 3.

What criteria did you meet for PCOS? It sounds like you have a high AMH, but you've mentioned your hormones are normal, are your cycles regular? Is the clomid going to provide a benefit if you're regularly ovulating?

Also for costs, you should factor in spending more than this, hopefully you'll get a good number of embryos given your AFC, but you should expect to do around 3 transfers as the chance of an untested embryo working is 1 in 3. Have you considered banking embryos for the future and then continuing to try naturally?

Hi Gardenlady, thank u for the response. I really feel like I want to have 3 children and I agree with you that my chances will be pretty slim if its 2/3 years before we are ready to try for number 3.

I have a pretty regular 36 day cycle and according to opks, I nearly always ovulate around cd19/20. However because of the low progesterone reading I got last month, im not questioning am i actually ovulating every month at all. I had a chemical pregnancy 3 months ago so I know I'm ovulating at least some of the time. Realistically I'm not keen on clomid because it didn't work for me before.

As far as doing IVF, I don't think we could financially do 3 rounds, 2 would probably be the maximum. I love the idea of having embryos in the freezer but im nervous of the reality of it, the stress, the tax on my body etc. I just think if we did it im not going to look back and say that was a mistake but I might if we don't do it.

Most of us on the infertility forum are having IVF. If you don't want to put your body through it then clearly IVF isn't an option for you. You will have to go for less invasive options instead, but accept that the chances of a second and third child are less likely.

It's good that you were able to have the first, many of us have to turn to IVF because we can't, I've been through 4 unsuccessful transfers without a hint of a positive myself and unfortunate stopping IVF just isn't an option for me. You may find a clinic tells you to try longer before IVF, when I first saw the private clinic I'd been trying for a year and was told to go away and keep trying and it was only because I insisted that we moved to IVF.

Could it be that you are ovulating and need progesterone support? That might be an option to try if you're not ready to move on to other treatments yet.