Poor response to IVF age 39. Is there any hope?

[Annabel82]

Hi all,

Wondered if anyone had any experience of this? We had our first round of IVF a couple of months ago. We weren't successful. However, the embryologists were positive and said it had been a good round. Although we had a 4AA embryo, we only got three eggs. One developed slowly but was not good enough to freeze by day 6. The other didn't fertilize normally.

Having got a 4AA embryo, we felt relatively positive and assumed it could just be a case of keeping going (despite low egg numbers) until we found our golden egg. However, when we had our consultant review she seemed very disappointed with my poor response. She is willing to up my dosage to 450 meriofert for a second round but didn't seem very hopeful about our prognosis overall.

I'm feeling very defeated. Is it worth continuing? My AMH was 6 when tested over a year ago and my afc is 10 but according to a sonographer 'some of them aren't doing much.' I've had two miscarriages over last two years.

Any words of advice would be much appreciated,

TIA

@TwinkleInMyEye123 Care Leeds x

Ah ok. I started out with Care London and found it hard to imagine they’d say those things.

@TwinkleInMyEye123 they’re only just in the process of being taken over by Care. I was very taken aback. Whole stance compared to previous appointments had changed based on one round. Who knows!?! Such a stressful time for anyone going down this road! Thanks for your message x

39 would be nothing to Care London. They deal with that age and upwards all the time.

@TwinkleInMyEye123 Thanks. Think I’ve become a bit obsessed with my age!

I don’t think any of the Central London clinics would bat an eyelid at 39 nowadays.

@TwinkleInMyEye123 we started trying just as a turned 37. I’ve had two miscarriages. Consultant is adamant it’s age related poor egg quality. I feel like she hasn’t got much evidence for that and that it’s just a stick response for anyone over 35. I’ve known loads of people get pregnant naturally in late 30s so feel like there could be other issues she’s overlooking x

Agreed, that’s very frustrating. Are there many other clinic options near you? I’m convinced they wouldn’t be so dismissive if you came to London but appreciate that’s a long way.

I was 36 when I started treatment and they told me I was young.

As others have said, think your consultant is over dramatising things a bit. 39 isn’t old and while a bit more difficult certainly not completely over the hill in fertility terms and even less so for IVF! They need to adjust their regimen rather than blame it all on egg quality, that might be fair if in say early/mid forties but late thirties on average should still have a number decent eggs I’d hope! If not then they need to look at other issues, not your age. I have heard of natural modified being successful for people with lower AMH so perhaps that might be worth looking at. I’d get a second opinion either way. 39 is older and will be a bit more difficult than if you were 29 of course but hardly hopeless! My mother had me naturally at 40 on first try! Best of luck with it.

@TwinkleInMyEye123 I’m coming up to the dreaded 35 and my consultant thought I was way too concerned with it and also said 35 was young and not to worry! I think some consultants have an old fashioned view of women becoming wizened old hags at age 30 🤣

@TwinkleInMyEye123 you’ve definitely got plenty of time on your hands at 35 x

@Annabel82 I am 39 (almost 40) and we started ttc at 37 too. I have had 2 mcs and 8 chemicals in that time. Plus in 3 rounds only 1 normal embryo out of 33 eggs. We fall down at embryo development and euploidy - sadly this is pretty much egg quality in our case. 90 of that is down to the egg acc to latest studies. I think it is largely due to biological age, also I have immune issues.

Don’t want to scare you but every month does count I wish I had known more or we would have done everything faster. There is a lot you can do re protocols, growth hormone, supplements etc set out in the ‘it starts with the egg’ book. I’ve done it all. I think my eggs are worse than some my age but I am also not too unusual.

The thing is, we have been exposed to so much more air and water pollution, plastic and other endocrine toxins that harm sperm & eggs are getting broadly worse (ROS and DNA and mitochondria). Not everyone, it’s a trend. I have had this convo with my embryologist and our Urologist independently and unprompted (both working on studies). And apparently it is not just our exposure, it goes back to our mother’s exposure affecting her eggs and then my eggs (present when I was in her womb). It’s not insurmountable but I think dismissing age issues because someone’s mum or friend had a baby at 44 is risky, so much better to be hopeful yet informed. We are all individual. I wish i knew all this sooner.

maybe a bit doomy but my 40th is coming up so I’m feeling it! Sorry! Knowledge is power though.

^90% of embryo development

Having said this, there is still hope of 1/3 embryos created being genetically normal at our age. We have 1.5/5 so not too far off.

@Phrenologistsfinger eeek!!! That sounds really scary!!!!

@Phrenologistsfinger do you mind me asking what kind of grade embryos you’ve had? Mine looked good but obviously wasn’t!!

@Phrenologistsfinger also do you mind me asking what kind of advice your consultant has given you? X

@Annabel82 it’s an average remember - some do better, others worse. Aside from dismal round 1, last 2 rounds gave us identical outcomes! Each time we have got a day 5 4BB and a day 6 4BC, never anything better. One of the 2 4BBs was normal, one of the 2 4BCs was mosaic (but has a chance). When you pgta test, the grades become irrelevant though (as the grading is used as a proxy to indicate chromosomal normality and so the chance of success).

@Phrenologistsfinger our consultant also told us not to bother with pgta test. Can I ask which clinic you are with? X

Consultants view is it is likely my age (and beyond that actually science doesn’t really know enough about embryo development and why it fails yet) but I have managed to get a couple of good ones on ice recently so worth trying again. It’s basically luck, finding the good egg in amongst the others. There will be some hopefully! I do think growth hormone and steroids during stims have helped.

I’m at the Evewell. In my case they are quite keen for me to do pgta testing, due to age and history of losses (10) although I am starting to lose faith in it - but mainly because I keep getting abnormals! I’d like it better if our blasts did better, haha.

@Phrenologistsfinger wishing you all the very best of luck. Fingers crossed xxx

@Phrenologistsfinger I’m sorry for your losses. It’s a horrible situation to be in. I find myself wishing for 43 to be here … somehow in my head this whole thing will be over one way or another by the time I’m that age!! X

@Phrenologistsfinger i think statistically it takes three good embryos for a live birth? Sounds like it’s just a numbers game for you x

@Annabel82 we had 5 5-day blastocysts, a mix of As and Bs but all aneuploid. Consultant thinks it’s bad luck and to just keep going. I’m already doing everything I possibly can for egg quality (supplements, diet, acupuncture, avoidance of toxins, etc.) so there’s not really anything else to suggest. Been told around 40% will typically still be euploid at 40.