IVF 40+ - experiences and recommendations please!

[Alicana]

Hi, we are considering IVF as we have been ttc for over 2yrs now following an ectopic. We had tests last year and all seemed ok, but thought we try in our own for a bit. I am now 42 and am looking to IVF as an option as things don’t seem to be happening naturally. Does anyone have any recommendations or experiences? We are London based. Many thanks!!

Just bumping this for you as we are considering IVF and I will be 39/40 so I am interested in the responses.

Good Luck on your journey!

Hi ya. I don’t have any recommendations as I’m not London based. But thought I would just reply to say I had IVF at 41/42 and am now pregnant after two egg collections and two frozen transfers. So it took a little while but has worked for us.

I haven’t made a data based comparison of results so this is partly anecdotal based on my own experience, but I found Gavin Kemball at the Lister helpful. Feel free to pm me for any other details.

Following also x

Hello - I started my IVF journey when I was 39 (42 now). I had 1 NHS round and 3 private in the UK. I later went to Prague for a duostim cycle. So, 6 collections in total, 2 fresh and 2 frozen transfers - 2 BFPs but sadly ended early..

I have 4 embryos in the freezer so keeping my hopes up until there is none left.

I would recommend you look at options abroad, and consider a duostim cycle (if your numbers fit the criteris). The experience was much more pleasant in Prague for me and relatively cheaper if you can juggle work and appointments.

Good luck!

@MsPeony could you please let me know the clinics name in Prague

Hi @Alicana , I'm 41 and we're currently doing a duo stim cycle with PGT-A testing. Because of your age I'd recommend doing the same, the doctor said this gives us the best chance really. I'm not London based, our clinic is Bourn Hall and they've been good so far. I think you need to make sure that whichever clinic you choose, can do PGT-A testing...some of them don't. Good luck!

Hi, may I ask what the purpose of the duo stim is? X

Hi @MoonPieHazySky , The purpose of the duo stim is to have two back to back egg collections and ideally collect lots of them! Instead of transferring the best embryo after our 1st egg collection, we'll freeze all good embryos and I'll go straight into stims again. Then we'll do our 2nd egg collection a couple of weeks later. This will increase our chances to have at least one high quality embryo (although this is not guaranteed), and we'll transfer that one at the end. Since I'm 41, a single cycle is less likely to succeed and egg quality will decline further next year. So collecting as many eggs as possible now feels like the right thing to do. We're also doing PGT-A testing on all embryos collected from both cycles, to make sure we're only transferring a healthy one. Hope this helps. X

I'm over 40 and starting privately at King's Fertility. Entitled to one NHS round but coughing up for the sake of being able to do it straight away and on my preferred timeline.

I chose them because they're decently rated and cheaper than others in London for what I want to do. You can do appointments at either Denmark Hill or Canary Wharf. I'm doing a 3 cycle embryo batching package with short protocol, high stimulation and PGTA testing. The costs are: £10,395 for the underlying 3 rounds (£13,500 at Lister), £1,355 per round for the drugs and £1800 per 4 embryos sent for testing.

Where this is cheaper compared to other places: 1) all blood tests as needed throughout the cycle and advanced embryology are included. Many charge extra meaning you end up with an unpredictable/ higher bill (eg £999 for supplementary embryology per round at Lister + up to £800 per round for bloodwork) 2) if you have fewer than 4 embryos for testing you can be partly refunded or roll the untaken spots over to the next cycle. 3) one frozen transfer is included in the package - Lister, for example, doesn't include one in theirs. Additional embyo transfers are £1600 vs £2350 at Lister. Picking on Lister here but just one example of how the clinic price differences can really start to stack up.

You mention your test results being ok - can you remember what they were? Knowing your AMH and AFC may help people to recommend clinics more specific to your needs. If you don't intend to batch, take a look at Access packages. That would bring the price down a lot somewhere like Lister.

If you are likely to produce several embryos I would recommend PGTA testing as others have, if you can afford it. This is to save time and heartache. Just 15-20% of eggs at 42 are likely to be chromosomally normal - this variously manifests as non-implantation, recurrent miscarriage and possibly bad NIPT news in the second trimester. The faster you can find a euploid embryo, the better. If you manage to find one, you eliminate most of the age disadvantage and success odds rocket to 50-70% per transfer. Get three, and you have a 95% chance of a baby.

Good luck!

Thank you so much, that’s really helpful! Best of luck, hope all goes well for you :) X

@MoonPieHazySky Duo stim consists of 2 stimulations within one cycle; the second stim phase is focused on the follicles that didn’t grow quick enough. So, you can potentially get more eggs.

@middleagedspreading It is Fertility Port - https://fertilityport.com/?gad_source=1&gclid=CjwKCAjw9p24BhB_EiwA8ID5Bl4ls2Nw8dzyqKKSzxwaOHo_gD6y9EoI3CxnHyIKHA5nJWpchL5MaRoCKNMQAvD_BwE

@MsPeony could i ask what clinic in Prague you used?

Does Dual Stim work better than two cycles?

Xx

@ELFxx I use FertilityPort (via Praga Medica). There is no agent fee, and you should get a free first consultation with the doctor.

I wish I knew about duostim when I started my journey. They will need to know assess before they determine if it's suitable for you (my AMH was 14 so a normal responder). IMO it saves a bit of time: works on the slower follicles in the same cycle.

All the best!

@MsPeony how many eggs did you end up having across each of the duostim collections? I'm quite keen for the sake of time but my consultant has said I'm not a good candidate because of high response to single round stimulation. Given my AMH is 12.5, so less than yours, I'm wondering if their advice is nonsense...

@sirensong I got 8 (7 mature) eggs for the first stim and then 7 (6 mature); 4 fertilised at each stim phase, but only 2 made it to blasts. So 4 blasts in total for my duostim cycle.

I was on menopur 300 and orgulatran for the first stim (9 days); and then meriofort 300 and orgulatran for the second (12 days).

Hope this helps.