39. Clinic pushing me to use donor eggs

[Hazeydaisy]

I'm struggling to deal with my emotions after my last appointment.
I'm 39 , I know I'm not a spring chicken but I have alot of friends whos grandmother's had kids in their 40s?
Is it really impossible now adays ?
My consultant is really pushing for me to go for donor eggs . Honestly I don't feel its something I could do. I would struggle without a biological connection with my partner. We came to terms that if we could at least have one biological child, we'd be happy to adopt subsequent children. I want to have that experience of having my own child. I'll be 40 next june. He's basically telling us we're wasting our money and time ( and his) by trying to do ivf with my own eggs.
We waited a few years for nhs and still didn't get anywhere so we're now going private due to my age.
What are your thoughts on doing ivf with own eggs? Realistically ?
He said our chances are extremely low and there was the comment about some women are already grandmothers by the time they are 40 but your only trying for a baby.

Is everyone else's doctor really pushy towards using donor eggs

@Hazeydaisy im sorry your experience has already upset you, the process is hard enough as it is without hearing that. Would there be a reason why he suggested donor eggs (underlying medical issues/low AMH) or has he solely recommended that based on age?
I was 38 when I had my first collection (collection in June and my birthday is September) but not once was donor eggs suggested. They couldn’t find any underlying issues with either of us and my AMH was showing OK for my age, had that been different then maybe they would have suggested donors, I’m not sure.
I appreciate they want the best outcome for everyone but without feedback as to why that was suggested I wouldn’t have been happy either, you can’t make such a huge decision without all the medical data/facts.
Im currently 15 weeks pregnant with my own eggs (these eggs were taken when I was 39) and so far the pregnancy has been plain sailing, I worry about it every day but as time goes on I begin to feel it’s actually going to be ok 😊
If the doctor didn’t provide feedback so to why, contact them and ask for this information before making your decision. Good luck x

@Hazeydaisy urgh! I have heard some unscrupulous clinics push donor eggs to improve their stats... According to the NICE guidance every woman under 40 should get 3 NHS IVF cycles regardless of AMH/FSH etc. And at least one cycle up to age 42!

Age really is the biggest determining factor in success but according to NICE (who use evidence based medicine objectively to determine UK national guidelines) you definitely aren't too old!

I would definitely get a second opinion and go to another clinic.

Let us know how you get on. So many fertility doctors can be so thoughtless and unhelpful, I hope your next one is much better x

It sounds like he handled the conversation really poorly. He isn't wrong in that your chances of success are low. Over 40 it's less than 5% so at 39 it's not going to be much more than that. You will probably need multiple cycles to achieve success and even then there is little guarantee. So in some ways he isn't wrong (despite framing it very badly). It would probably be quicker and possibly cheaper to use donor eggs. Robert Winston's book 'the essential fertility guide' is very pragmatic if you want an impartial expert opinion. From recollection, if there isn't a diagnosed reason for failing to conceive he says you are as likely to conceive naturally at your age, as you are with IVF. That obviously relies on you having had all relevant tests though to rule out any causes. His website also has a very interesting Q&A section where he has responded to individual queries. Good luck with whatever you decide.

This is only my experience, so it can't tell you what yours will be. But I had my first round at 38, second round at 39, and I'm 16 weeks pregnant with 2 embryos in the freezer. It is in no way impossible for IVF to work at our age. Plus my AMH is low - 3.6. I'll be 40 at the beginning of next year.

I don't like the sound of your consultant. Is this your very first round? If so, he doesn't even know how you'll respond to the drugs yet. If I were you I'd get a second opinion from a different clinic.

There are plenty of women on these threads who've got pregnant using their own eggs in their late 30s and early 40s.

Wishing you the very best of luck.

Thanks guys.
My amh is not low, in fact it's rather high as I suffer from pcos. I'm not sure if this is the reason he's pushing me .
I'm thinking he's baseing it on my age group as he didn't particularly say because of my pcos. He said because your almost 40. I just turned 39 over the summer. Isn't the decline gradual ?
I honestly just feel so frustrated right now that we wasted all these cruitial years waiting for help with nhs and that may have significantly changed my odds

@Hazeydaisy If I were you I would absolutely try with my own eggs first, and probably up to 3 or 4 rounds. That was always our plan. Yes, you'll almost certainly have fewer quality eggs left, but it's a numbers game and about catching the right egg at the right time. It really doesn't make sense to me that your consultant is pushing you to use DE immediately.

I agree with trying your own eggs first. Your consultant sounds massively insensitive. The only thing I would caution is that at 39, it really needs two or three rounds to give yourself the best chance of success. So it's sadly necessary to think about how much you can afford - if you paid for three rounds with your own eggs and they didn't work, would you then have the money to keep going with your own eggs or to try donor eggs at that point? Or would you then have to stop treatment? Donor eggs can be a pragmatic solution in a financial sense, but obviously finances aren't the only consideration and it's usual to try your own eggs first. I'm sorry - I can imagine how shit you must have felt having that conversation.

I’m the same age as you, have PCOS and am currently pregnant with my own eggs after IVF. I had consultations at three clinics before starting and nobody once suggested donor eggs. I also know quite a few people a similar age and older in person and from online IVF support groups who didn’t/ aren’t using donor eggs so I don’t think it’s a standard recommendation. The only people I know of using donor eggs have had multiple unsuccessful rounds with their own eggs or have complex genetic conditions or were aged 44+ when they started IVF. Personally, as you’re paying privately anyway, I would try and book in for consultations at a couple of other clinics to get a second opinion. You may find a consultant you feel more confident in as well.

@countrypunk to be fair I think he was trying to give a more realistic picture, albeit delivered very poorly. Far too many consultants are overly positive about people's chances with their own eggs when they are older, leaving a lot of people with false hope and a whopping bill. It isn't untrue that probability of success over 40 is very low (5% or less), and it is true that donor eggs would likely be quicker and possibly cheaper.

OP yes decline is gradual of course, it doesn't suddenly drop off a cliff but the decline is much more rapid after the age of 35, and more so again after the age of 40. There is no reason to not try with your own eggs, but it's probably helpful to know the facts rather than the sugar coated optimism of many private clinics who essentially just want your money. The book I mentioned is really good and not expensive, I'd highly recommend it.

@countrypunk thankyou.
DH thinks we should look at another option for a clinic but options where I am are limited. Using donor eggs would cost more money. Perhaps that's why he's pushing me to opt for donor eggs urgently?

@Hazeydaisy Maybe the consultant is trying to get you to the desired result of a baby as quickly as possible. Or maybe there's more money to be made. Whatever the reason, he needs to listen to you and suggest the best course of treatment according to your wishes. If you don't have full trust in the people treating you, you need to go elsewhere. It's not appropriate at this stage for your doctor to be heavily pushing for DE.

Your chances are specific to you. Yes, they can give you an average chance of success based on your AMH, AFC and age, but that will likely change after they see how you respond on your first round. I was not a great candidate for IVF at the start, but my chances increased after my first round because I got a surprisingly good number of eggs, an embryo to freeze, and I got pregnant on the second transfer (later miscarried). All of those outcomes made it more likely that I would eventually have a baby if I kept going.

This is quite a useful predictor of success tool - it's based on actual results: w3.abdn.ac.uk/clsm/opis

I wish you loads and loads of luck ❤️

My mother had a natural child at 38 so you really can’t say that 39 is too old. I think his attitude stinks especially if you’re paying private. I would stick to your guns and give it a go with your own eggs. We have just gone through ivf and although I’m 36 we only ended up with one fertilised egg and I’m now 4+3 pregnant. It really does only take one

Definitely definitely try your own! I have many different gynae issues and I had twins through a cycle at 38.5. Made 6 embryos that round too.

Hi,

I'm sorry to hear how insensitive the consultant was, there definitely so much more to it than age so I think giving you eggs a try is a good idea, even if it's just to know you have as those regrets can linger.

A colleague of mine did EC at 39 and she got a good number of eggs but it was a full failed fertilisation. At that point her consultant said it was egg quality and she would be best to move to donor eggs, but atleast it had almost been proven for her how very unlikely her chances were.

Good luck with your decision

Hi OP, I just turned 39 and have just started my first round. My clinic (in Ireland) has never suggested donor eggs, but they were firm in their recommendation not to wait any longer as their success rates only decline a little between ages 35-39, but drop significantly at 40.

I wouldn’t go donor eggs yet op, that consultant sounds awful. At my clinic the average age was 40! I had success at 41.

Hi @Hazeydaisy they said this at my app too as one of the options. Even though my levels were fine and my husbands results also fine (AMH was 13.4) I had a bad first round where they thought I was a poor responder and again suggested it. It was just that the drugs weren't strong enough.
I already have a child and I didn't want to use donor eggs. Anyway had my second round and it worked out much better with different drugs and higher amount. I'm now 15 weeks pregnant and 2 high quality embryos still stored. I am 40. Consultants obviously have to be real with the chances at our age but I would be inclined to go with a consultant who is more positive as you need that positive mindset especially if you want to use your own eggs. Good luck x

Sorry that's my AMH not husbands! X

Thanks ladies for your responses. We've decided to push ahead and use my own eggs. I don't know why i let the consultant get in my head. I know its more challenging at this age but doing a bit of research I now know its not impossible. I guess we'll do a round and assess the situation based on that outcome.
I have pcos and was previously told by an nhs gynae that I could be a high responder due to that so I'm assuming egg quantity is not the issue in my case and more quality.
I get he was probably trying to ensure we have a baby but I did make it clear egg donation was not an option in our case and just found it really baffling that he was pushing so hard without me even having done a round to see how I would respond first. I'm not sure what he's baseing it on since I've never tried ivf before to know .

Im trying to stay positive and hope maybe there's still a chance. I'd read rebel Wilson has pcos and she said it affected quality but she now has a beautiful baby girl so I'm not going to give up hope just yet.

Hi - I don’t know where you are in your journey now, but you must absolutely not feel pressured to use donor eggs! I was livid when I read your message. I know lots of women who have had successful pregnancies at age 39, 40 and in their early forties. One has PCOS. I got pregnant using my 43 year old egg. The embryo was PGTA tested and was a normal euploid. You have time but please just get on with it now to maximise your chances. I don’t know where your consultant is based but, in my experience, doctors in England are more optimistic about women being able to fall pregnant in their early forties. Wishing you all the very best!

I hope things are progressing OP.
Regarding Rebel Wilson, obviously don’t know her full story but she used a surrogate.

I do know people who’ve had successful own egg IVF at your age.

Also regarding the women having babies in their forties years ago, I can’t remember the science but one of the consultants we saw in England said it was somehow ‘easier’ as this was after having several babies already.

This made me angry. No one is denying that your success rate will likely be better with DE from someone younger but your consultant seems to completely not get the fact you at least want to try with your own first (as most women would!).

I read that the major limiting factor for fertility in women is egg quality not biological age. So yes a woman in her 40s may struggle to get pregnant with her own eggs but using some one else's can often get pregnant and carry that baby to term.

Anyone paying for fertility treatment wants to spend as little as possible and no-one wants a long protracted journey to get there, maybe your consultant just doesn't understand that using DE in line with these aims is not something you want to do at this stage.

I'm 37 and my AMH is lower than yours and on my recent cycle on high stims they only got two eggs but both fertilised and one made it to blast. It didn't stick unfortunately but 100% fertilisation rate I think is pretty good and 50% making it to blast is right in line with the statistics.

If I was you and using my own eggs was important to me I would at least try and see how I responded to medication first and how fertilisation rates were before I thought about DE. Also I think they are pretty expensive as well so there is also that to consider as well!

Best of luck with your journey x

It would be madness to go straight to donor eggs without even trying your own. I have low AMH and did two rounds of IVF with no embryos and was told donor would be my only option. I researched donor but in the interim overhauled my diet, got advice on supplements, got my DH properly checked out which found a problem with the sperm and got that fixed. I now have a healthy 2 year old and am pregnant again with my second. I am 39 soon. Go ahead with your own eggs, make sure you ask why you are on whatever protocol they give you. Personally I would’ve asked for a different consultant but if you’re NHS I know that might not be possible.

make sure to follow a high protein low carb diet during Stims (and before if you can), obviously no alcohol, minimum caffeine and minimum sugar and make sure your DH does same and also make sure you’re both taking good quality pre natal plus omega 3 supplement plus Ubiquinol.

It will depend on what your AMH and AFC are.

This isn't necessarily true. In terms of realistic probability of positive outcome, and with limited financial resource, it could be very sensible to go straight to donor eggs if you are over the age of 40 where success rates are less than 5% with own eggs compared to up to 50% with much younger eggs, and if donor eggs is something you're happy to go down the route of. Different people are in different situations. There is no right or wrong for everyone.