Can you have ok eggs in your 40s?

[sirensong]

I realise the percentage of healthy eggs plummets as you get older but do most women over 40 (before mid 40s) still have some ok ones in there somewhere?

I'm 41. My scan showed 20 follicles, which made me feel my situation wasn't a total write off. (Although my AMH was 12.5 so does that mean some of the follicles might be empty? Unsure which is the more accurate measure).

However, even if 20 eggs were collected via IVF (realise it could be fewer) would almost all likely be duds or is there a correlation between higher AFC and retaining any quality at an older age? Is it a total fluke if you manage to get a good egg or is it related to anything measurable?

Both your follicle count and AMH are really good for 40! That means that even if only half your eggs are good, if they get you on the right protocol you should get a decent number of embryos.
Coenzyme Q10 is good for egg quality but usually recommended to start a few months before egg collection. I used zita west egg health supplements for months before egg collection. I got 13 eggs and 9 embryos first round and 15 eggs and 8 embryos second round (50% genetically normal). My most recent follicle count was 29 and my AMH 16 so not dissimilar to you - I was 39 at the time.

good luck 🤞

Thank you for your reply! Did you get them all PGTA tested? That's a really great haul. What was the outcome?

I'm wondering what strategy to take/ what sort of clinic to go to. If I should try to do a few rounds of embryo batching while I have eggs vs just getting on with it. I haven't actually been trying naturally until very recently but I'm assuming the IVF/genetic testing route might save time given the likelihood of miscarriages.

I've just been taking Pregnacare Conception, which seems to have 20 mg of Coenzyme Q10. Is that a high enough amount do you think?

We only PG tested the most recent batch of embryos (couldn’t use the first batch for complicated reasons relating to sperm donor). Out of 8 embryos, 7 biopsied well and 3 were totally normal, 1 low level mosaic (basically mostly normal) and 3 abnormal. After 2 miscarriages and chemical pregnancies I didn’t want to transfer an embryo that wasn’t genetically normal. I would definitely recommend PGT if you’re in your 40s and get a good number of embryos to test - the risk of course being you might not get anything to transfer. For me though, I would rather not transfer than transfer a genetically abnormal and miscarry again as I was approaching 40.

I think if you’re taking CoQ10 daily that’ll be fine. An anti-inflammatory Mediterranean type diet is also good in the lead up to egg collection. I wouldn’t stress too much though, it’s a stressful enough process.

We transferred the first of the PGT normal embryos in march and I am now 9 and a half weeks pregnant…everything looking good so far, which is why I’m such an advocate of PGT.

I got pregnant (unplanned) at 42 so I must have had at least 1 good egg in there then.
(an almost immaculate conception as I was hundreds of miles away from my husband for 3 weeks from day 7 of my (clockwork 28 day) cycle.)

@GB844 Amazing, congratulations! Have you frozen the remainder for a possible sibling?

@redbluegreenyellowbrown love this! That's a baby that really insisted on being born.

Thank you…I’m still a nervous wreck despite things looking good on scans! We do indeed have the remaining normals/mosaic frozen for siblings in future.
Good luck whatever route you decide to go down!

@GB844 thank you and very best of luck!

Were you on any kind of package btw?
I've looked at Access but you can't batch. King's is 9.5k for three frozen rounds, including one transfer (+ medication) which seems less than Lister. Also wondering whether to pursue my one round of NHS IVF.

I was eligible for NHS treatment which in my area (Yorkshire) is IVF with embryo freezing and as many transfers as it takes to get a live birth. PGT and any other fancy things (embryoscope) were all added extras that we had to pay for.

Ok that's interesting. So you were allowed to add private aspects to the NHS path.

Hi
Your stats sound good. I think even with age response to treatment varies person by person and even cycle by cycle. You have every chance but get seen and get started sooner rather than later. Fertility drops more steeply in your early 40s.

Find out waiting times and if NHS IVF is a really long wait and you can afford to go private do so.

I am just 42 and I did 3 cycles as I had a much lower AMH than you (5.8). 22 eggs, 16 mature and fertilised, all made it to day 3, 6 blastocysts and 2 genetically normal (which is about the 33% for my age group). We are trying for baby no2.

Wishing you all the luck. Women in their 40s have healthy babies and pregnancies all the time.

Thank you @Faith2024

A hellish complication is that I recently discovered I have a hefty fibroid. I need to speak to a specialist asap to determine if I need that removed first. Whether or not I need an operation, I assume that three rounds of banking asap may be my best bet to lock in some options in case I have a sudden dip in my stats.

Do you mind me asking which clinic you used and whether you were able to do do back to back collections? I also know nothing about protocols, no idea what would be suggested for me.

All the luck for your baby number two!

@sirensong sorry I did not mean a sudden drop or to make you feel like there was an emergency since both your AFC and AMH look good. I meant more like that there might be a significant difference within 12 months after 40.

I don’t know much about fibroids but whether you have to have it removed or not depends on where it is & if that will affect implantation or create complications. Only a doctor will be able to give you sound advice.

I am with CRGH, I have had a positive experience with them but they are also on the expensive side. I have also heard good things about Kings and Lister. If you are thinking of embryo batching which is what we did I would also look at lab capabilities when choosing a clinic. You can attend the virtual open evenings etc.

I did 2 back to back but was recommended to take a break for 3rd one for a month. I know some clinics do back to back fully.

I had my baby aged 42 after third round of IVF. First round was a double transfer (BFN) with 2 frozen. Second round single transfer (BFN) and none to freeze. Third round was a double transfer with one to freeze (BFP singleton). I didn't PGTA test (wasn't offered). The only supplement I took was Pregnacare otherwise carried on as normal with diet etc. I think my AMH was 12 and tested when I was 40.

@Endlessironing so glad it worked for you, and thank you for your reply!

40 here AMH of 20 had one round 6 excellent eggs 5 fertilised, my clinic insisted on a day 3 transfer due to they said they like to have 6 good embryos, unfortunately the day 3 ended in a chemical, had a FET only 2 survived thawing and became quite low grade, this resulted in bfn. I am starting again egg collection next month, been taking supplements for the last 3m (I didn't do this before, wish I had but went in a bit blind and naive) we are male factor infertility plus my age so IVF is our only option.
I have been told eggs are still good quality at 40, so we are having one more try.
Financially it's shocking but I feel we would regret not having one more go with our eyes wide open

@camelinastorm so frustrating about those two that didn't survive the thaw. Very best of luck with the next round.

What supplements are you now using?

@sirensong I'm taking quite a few it's not the best having to take so many and some of the tablets are huge, I'm taking;
Co-enzyme10, magnesium, vit E, vit D, vit B, L-arginine, omega 3, folic acid, and low dose aspirin

@camelinastorm were you recommended to take those individually rather than a conception multivitamin? Or are you just making sure those in particular are covered by a higher dose?

@sirensong hi, I would advise not to delay any treatment needed..
I did 3 EC with testing last year when was 41, AMH 17, collected always good amount of 17 and 22, good fertilisation rate.. but 10 we tested and all are abnormal. Now turned 42, AMH 14, I am a good responder but 6 different clinics abroad said with my history only donor route. Quantity and good hormones don't mean quality.
I had also 4 chemical at 40 and before ivf..
very difficult to accept giving I do have lots of eggs..
i am on a high amount of all supplements 1.5 years too. My dr thinks that I am unlucky and very low chance to continue withy eggs.
Good luck as this process is really cruel sometimes 🌺

Wow @TT82 that's really difficult to go through, I'm so sorry. It seems like a total roll of the dice.

@sirensong the multi pre natal ones seem to have a lower dose and don't contain some of the others, I was advised to take seperate as the clinic stated they were better quality. Also forgot vit c that's a gummy so don't see it as a tablet 🤣

@camelinastorm did you also do an NHS round?

@sirensong no we are secondary infertility so not eligible, so had to go straight down the private route unfortunately

Hello Mumsnet community,

Can I piggy back off this conversation??

I’m reaching out to see if anyone has some advice on the following situation.

My partner and I have been going through IVF for the last year and a half after three years of trying to conceive naturally. I (female 40 years old and three months, unexplained infertility - other than my potential age - AMH of 6 ) and my partner (male 38 years old, with low motility, mobility and morphology), which we have been using icsi to address.

The first three cycles really weren’t great, one day three embryo and one 5 day blast 3BC was and didn’t implant.

With Cycle 4 - we got 2 day 5 blasts (4BB transferred and 3BB frozen) - it didn’t implant.

With Cycle 5 we got 4 day 5 blasts (5AA transferred, frozen 2 5ABs and 1 4AB+) - it didn’t implant.

Prior to cycle 5, doctors recommended genetically testing the embryo as repeated implantation issues is likely as a result of the genetic make up of the embryo. We didn’t think it was worth it at the time as we never got more than 1/2 embryos and didn’t want to risk false negatives and having nothing left to give a go at implanting. The results of cycle 5 came as a big (but pleasant) surprise.

But now that we have had both not great quality and great quality embryos fail to implant and that we are able to produce more than one/two embryos, I understand the logic of genetic testing (hindsight is a beautiful thing!)

I’m now trying to figure out the quickest way in trying to obtain a successful outcome, given my age.

Is it to do the 4 frozen embryo transfers over the next 6-7 months, which would take me to my 41st birthday. Or should I do another round of stimulation (given that my clinic is closed for Christmas the soonest I could go again would be January/ February - where I would be 40 years old and 6 months) and genetically test those embryos. Has anyone faced the same predicament? How did you proceed?

Apologies for how long this message is. Any information or share experience would be gratefully appreciated whilst I await my follow up consultation. Much gratitude and appreciation xxxx

Hi @AmpleFox, I'm the OP. It's all such a maddening throw of the dice isn't it.

I decided to give trying naturally a chance while my fibroid surgery referral rumbled forward and was pregnant on my 4th cycle of trying 3 months after my above post. It ended in a medically managed miscarriage at 9.5 weeks after a month in and out of the EPU. I am now on my first embryo batching/testing cycle and will likely do 3 rounds.

You will hear mixed views on the testing - some people think embryos can self correct. My view is that it took 7 months in total from starting TTC to getting my cycle back post miscarriage. If that happened again, my hormones could have radically reduced in the meantime and a while year vanished. Going straight to testing eliminates that waste of time. After 40, many more embryos are abnormal than not - about 1/4 or 1/5 are ok as a population average but obviously an individual could have a run of zero normal embryos or loads fine in any given round. If you get a euploid embryo, you eliminate the majority of the age related issues and your chance rockets.

Egg quality loss manifests as non fertilisation in the first place, non implantation, miscarriage or NIPT/ scan bad news down the line. Embryo grade doesn't reflect chromosomal status. Your body can do the sorting, or a lab can. A test is cheaper than a transfer, and again, far quicker. I'm looking at the long game not rounds individually, so will view having nothing to transfer (if that happens) as saving time on miscarriages, not a frustation in itself.

If you can afford another round could you send everything collected for testing and on the same cycle give one of the frozen embryos a chance?

Have you also had other tests done to make sure there aren't other reasons for non implantation?