IVF at 44 - 19 eggs, all bad :(

[Kleintje]

I'm (just) 44 and have done two back to back rounds of IVF.

I got pregnant naturally at 42, miscarried at 10 weeks (trisomy 21 - down's) and then decided I couldn't wait any longer for it to happen naturally. Since I have no other fertility issues other than advanced age, doc gave me a 25% success rate (which I now think was rubbish).

First round: 15 (!!!) follicles, 11 collected, 7 fertilised ... just one frozen.
Second round: 10 follicles, 8 collected, 4 fertilised ... NONE frozen.

Out of a total of 19 eggs, only one made it through to day 6. My one lonely embryo went off for pre implant genetic testing and came back as abnormal - Trisomy 16. Dr says they don't recommend transfer.

Obviously I'm gutted - with such a good response to the meds, I expected at least a couple would be normal, even at my advanced age.

Now I am torn about whether to try again:

• My response was good, my eggs are ripening and fertilising properly, my levels are all fine for my age. My DH's sperm is stellar (docs words). But out of 19, not one made it through. So do I conclude they are all duds and everything is just too damaged to ever result in a baby?

• Did the clinic drop the ball? Did they screw up on the growing/freezing process? I'm being treated in Portugal and I'm not thrilled about the level of care I am receiving.

• Is the genetic test result a false positive? t16 could be incompatible with life or totally fine depending on whether it's in all cells or just a few.

Any advice? Anyone have the same experience? Shall I try again?

Has your husband had a SpermComet test? If his sperm DNA fragmentation is high that could be a factor. This issue went undetected with my partner due to his “stellar” basic sperm analysis and caused a lot of unnecessary heartache. We saw urologist Jonathan Ramsay in London and he detected a hidden infection in my partner which has now been treated with a simple course of antibiotics.

The other things we’ve done is work with a fertility nutritionist - Mel Brown - to optimise diet and supplements for egg and sperm health. So that’s worth considering.

No he's not had any other analysis done. Did you have a similar issue with not being able to get past day 5 because of his sperm?

If the embryos are fine up to day 3 and then start stopping off afterwards. This can indicate a sperm issue. I think all men should have the DNA frag test because like pp said it can cause a lot of heartache. If this is happening then I suggest you get that test booked. There are lifestyle changes and supplements he can make to improve it but they take 3 months to see the benefits.

I'm sorry that your rounds haven't gone as you expected, it can be so rough. The fertility world is so focused on the women and they will probably try and push you to donor eggs before even testing his sperm more. So again, I'd push for the dna frag before doing that unless you are fine with it.

Best of luck!

I have a history of secondary infertility and recurrent miscarriage and recently started IVF. We’re doing ICSI and PGT-A in the hope of popping a healthy embryo back someday. I’m having egg collection tomorrow so we’ll see how things go over the coming days. I don’t know much about the causes for drop off but read the same as pp so I’m interested to see what happens now he’s had treatment.

Have you considered the donor egg route?

@aliceAbsolum considered it ... not 100% sure about it...I feel like I need to try at least once more with my own before I consider that route.

Fair. I was the same. You can do a tandem cycle where you stim and the donor stims at the same time. Abroad though not the UK.

@AliceAbsolum do you mind asking where you did that? I'm considering donor eggs but as I'm single there would be no genetic link at all. I like the idea of giving my own eggs one more try at the same time of having a donor 'in reserve'.

@Kleintje Sorry you've not had the results you'd want. I'm nearly 43 and have had 4 rounds of IVF with donor sperm, so no male factor. I have good numbers of eggs each round (11, 18, 12, 13) and have created some 'good on paper' blasts - so far I've had 6 transfers of AA or AB/BA rated blasts and all I have to show for it is one chemical. I've got a couple more embryos in the freezer. I didn't have PGS which in retrospect would've helped.

In terms of whether you try again, you do seem to have a good ovarian reserve on your side... but aside from the tests which others have mentioned I guess it depends how many times you're prepared to try in order to find the one 'golden egg' which is viable. How many times you can put yourself through it emotionally, physically, financially - for some people that's once, for others it's 10 times. I started IVF thinking I'd be really logical and would be able to detach enough to know when to stop but that was wishful thinking!

If you're not happy with the care you're receiving, maybe have a free consultation with another clinic? If nothing else, it's a fresh perspective on your situation.

It was Miracle IVF in North Cyprus

@lucymills1234 have you had an era

I was the same as you, 43, 4 failed cycles tho good Embroys

My era showed I needed more progynova and implant day or two later

5th worked was a fet and she was 5 last month

My one and only Bfp in 10yrs of ttc

@lucymills1234 - what is an ERA.

So glad it worked out for you!

I should add I asked the doctor if there was anything he'd do differently if I did another round and he said no, because my response was good and the eggs were mature/ripe when collected ...

@Kleintje it’s not me that’s had an ERA it’s @Blondeshavemorefun

Blondes, thanks for the suggestion. An ERA hasn’t been suggested to me. I actually had a transfer yesterday so am back in the TWW for the seventh time… it’s an embryo that was 3BA when frozen. It was actually the lowest grade of 5 embryos I got in that round of treatment. But the transfer was really problematic (couldn’t get the catheter in) and by the time they actually put it in, it had started to hatch so progressed to a 5BA. Hoping that progression was a good sign!

This FET has been medicated when I’ve always had natural FETs before, so I really really hope doing something different helps but know it’s down to the embryo…

They usually suggest one after 3 failed ivfs and esp fets

It’s to check the lining is receptive

www.igenomix.ca/fertility-challenges/what-to-know-about-endometrial-receptivity-analysis/

Mine showed needed extra drugs and day or two later

Actually ended up being on drugs to keep lining at right thickness for a week or two extra due to us being on holiday and ivf clinic then shutting all august so got scanned after holiday and all fine then had the fet

And the next ivf our 5th worked

@Kleintje the most likely issue is your age, after 41 there is a significant drop off in the ability to create embryos. There are some advanced techniques out there that you could explore. Things like Pro-nuclear transfer (cytoplasm donation), my understanding is that the cytoplasm of donated eggs is transferred into yours. The good news is you have a lot of eggs collected. I would suggest that you find a clinic that specialises in IVF in older women, there is a clinic called IVMed that was based in Ukraine, I know the head embryologist and I believe he is currently in Slovakia but willing to work elsewhere, if you want his details send me a message. You may benefit from having a chat with him as he will know the advanced options to try and optimize your ability to create embryos. Now this will be expensive, but if you want to make sure you've tried everything then this seems to be the way to go.

@Kleintje could be your age. Have they suggested any diet to increase your chances, or vitamins or anything? I followed a strict diet trying to increase my eggs' quality, and I believe it helped (not sure, but I feel like it helped because I had a much better result in my 2nd round). I actually had a bad experience in a clinic in spain, and then I decided to switch clinics. The greatest decision in my life! They were amazing, loving, supportive and cheaper btw! If you want you can give them a try too, because I know they specialize in ivf for 40+.

@IsabelHerna yes, my age is obviously a factor. Nope they didn't suggest anything and I didn't feel like they made any special effort because of my age.

What was the diet they suggested for you? I tried to eat much more protein than normal (I am a vegetarian) and keep my blood sugar regular (and of course stopped drinking) in the three months leading up to the treatment.

What is the name of the clinic that specializes in women over 40?

@Blondeshavemorefun - ah! I didn't have any transfers as my one embryo came back positive with t16 in the pre implant genetic test :(. I've been pregnant naturally so I am able to get pregnant.

[quote Kleintje]@Blondeshavemorefun - ah! I didn't have any transfers as my one embryo came back positive with t16 in the pre implant genetic test :(. I've been pregnant naturally so I am able to get pregnant.[/quote]
Yes I read that. Sorry

Reply was to @lucymills1234

I hope you manage to get preg soon. Obv age is against you 🥲

I had a similar first round (8 eggs leading to 1 low grade aneuploid) and changed my protocol (meriofert to gonal f and pergovefis), added a month priming with HGH and then HGH and dexamethasone during stims. We got improved results with 12 eggs leading to higher grade 1 euploid and 1 mosaic. We are working on further improvements for round 3 soon. Seeing Melanie Brown and jonathan Ramsey, mentioned above (DP has some DNA fragmentation on Comet test).

Don’t give up yet, there’s plenty you can do - lifestyle, supplement (consider e.g. nmn, Truniagen, dhea, melatonin, ubiquinol, other anti-oxs) and investigation wise. Good luck!

@Phrenologistsfinger the clinic hasn't mentioned anything about how I can improve the quality of eggs. The doctor almost balked when I told him I had stopped drinking and had been taking vit C and CoQ10. I really need to find a clinic that focuses more on improving the quality of the eggs but I don't know where to start (I'm in Portugal, but will travel to Spain for the next round if I do one as I have been totally burned by what was supposed to be the best clinic in the country).

I mean vit D, not vit C.

can you pls suggest me some good clinics....we were thinking of IUI....please can anyone advice how is fertility plus in London(Amit Shah and Dr gudi)

But why are you saying age is against at 44 ... I have heard ladies getting preg at 44 and 45 naturally without any issues and baby born also normal all healthy....