Any over 40s & recurrent implantation failure?

[DaisyTee]

Hi
just wondering if anyone else out there in their 40s has experienced Recurrent Implantation Failure? What investigations did you do? Any changes you made? I guess I’m just looking for someone in a similar position to me.

I’m soon to be 42, ttc for 3 years.
2 rounds of failed IVF.
1st round: x2 day 5 Grade B blasts.
Fresh Double transfer. BFN
2nd round: x4 day 5 blasts. x2As & x2Bs
Fresh double Transfer. BFN
Frozen double Transfer BFN

I was on the long protocol both times, responded well to meds, no issues. 8 and 11 eggs collected.

I’ve one more round left in me and wondered if people changed up their protocols even if previous protocols went well?

I have a review appointment next week so looking for advice on what to ask/ push for.

@DaisyTee sorry to read about your BFNs, I've had 2 FETs that led to BFNs, Im working up to my 3rd FET now. I'm 38 so I too am in that bracket where age can play a part where embryos are concerned as we've not PGTA'd, so I'm not sure of chromosomal issues.

Have you had any tests at all?

I would definitely explore before any further transfers, perhaps these:

*Hysteroscopy (I had this and removed adhesions, cervix was widened as too tight and polyp removed)

*Miscarriage tests such as antibodies, blood clotting, Lupus (I only had one chemical but wanted this done to rule things out, found out I had thyroid antibodies so am on Prednisolone for any transfers to suppress an immune response towards an embryo)

*Karyotype testing to rule out genetic illneseses (we had this which was clear)

*TSH levels (needs to be under 2.5 to support implantation, I have mine checked every few months)

*EMMA/ALICE/ERA ( I've not had this as yet but have added probiotics in now anyway to help with uterine microbiome which would be the likely remedy for the EMMA test anyway)

• Baby Aspirin added to help with blood flow to uterus which has given me the best grade blood flow since taking it

I ought to add the tests I have had were all before my BFNs through FET and ironically my chemical was before any meds or tests... so I'm on the fence as to how much its all helped but nonetheless its trying and can't do harm making the uterine environment as improved as possible. A lot of the issues above age 35 are likely abnormal embryos so regardless of making changes would fail anyway, so could be trial and error and perseverance.

This time I've added the probiotics which I didn't do before so we shall see what happens!

Good luck!

@DaisyTee our first 2 embryos were also good grade embryos that led to a BFN. If we do another collection we will definitely PGTA whilst their fresh if we get any, so you may want to consider testing perhaps

Most common reason is the quality of embryos. I would recommend PGTA.

Hi Op - I would echo Sunflower360 re. initial tests. I have had most of those myself and am on similar medications mentioned. I am also on clexane which does the same as aspirin, I was told it's more effective as it enters the blood stream but not 100% sure about that.

I also had the ERA test done recently, and that tells you how many hours of progesterone you need prior to transfer.

My first round I was on the long protocol, I was 39. 16 eggs collected, 14 mature but they forgot to do ICSI so eggs wasted. Subsequently, between 40-41+ I was on the shorter protocols and each time I got on average 8-9 eggs, 2-3 blasts. I have done 6 collections in total, the final 2 abroad, 2 months ago.

I have had a PGTA-normal embryo transferred once and that failed, so I have since decided against testing (I only had 6 blasts and didn't want to discard any! Discarded 3 in my PGT round); a few people I spoke to said to give them all a chance as it's already natural selection getting to day-5 so they can/might sometimes self-correct in the womb. I think though, if you have a lot to begin with, then definitely go for it - just know even that isn't a gurantee.

So, definitely get those tests done. Also worth reaching out to Tommy's clinic (if you are in the UK) - https://www.tommys.org/research/research-centres/tommys-national-centre-miscarriage-research-clinics to see if they can offer any initial tests for you.

Good luck and keep trying!