Letrozole v IVF chances at 43?

[LetrozoleIVF]

Which has the higher chance of success or are they both similar (and low I assume)?

I have unexplained secondary infertility. IVF is so expensive and I was wondering if the cumulative success rate might be better with multiple Letrozole cycles ?

Hopefully someone will come along who has done IVF at 43 and been successful. But in the meantime I would say that unless you have a known fertility reason to need IVF like sperm quality (and need ICSI) or have blocked tubes etc, then in your 40’s I’d probably stick with the letrozole.

I’ve just turned 44 and have 1 DC too and would have loved a second child- but I have just had a chemical pregnancy with my last chance at a FET. My embryos were made at 40 but I think I’m going to have to accept that even at that age most of them would likely have been aneuploid - I must have just got very lucky to get one that must have been euploid and which became my only DC.

By the age of 43/44 we statistically would likely need multiple IVF cycles (probably 3 or more) in order to just get one euploid embryo AND then you have to hope everything is right with the uterine environment too and that we are lucky enough for it to implant and develop. I’m not saying it can’t be done but you need £££ and masses of luck. I don’t have that kind of money (and I am a SMBC so had to go the IVF route) so have to accept that I’m done now. But if I had a partner then I think I would have tried the medicated cycles instead. Good luck!

How many months into 43 are you? And do you need letrozole to ovulate or would it just be a punt to see if it improved effectiveness (ie. you already ovulate unassisted)?

Unfortunately the unexplained infertility is liked explained infertility and just age. Do you know your underlying stats like AMH/ FSH/ AFC? IVF can be done at this age but you have to really want it to go for it. Success relies on luck, upper 10% fertility or mutliples cycles to increase the odds.

Thankyou for the replies it really helps. I think IVF will be too intense and too expensive especially as likely multiple rounds will be needed. I feel like Letrozole will be a better option , maybe a bit more gentle on my body as well? I do ovulate regularly but apparently it could just give a better chance each cycle so I think it’s probably worth a try .

We have had pretty much everything checked and everything seems fine, i do have a lot of stress though maybe that’s not helping

I was 43 in April

Hi @LetrozoleIVF, I was in the similar boat.
secondary infertility, due to age, also turned in April 43. Currently pregnant with donor egg. I know this route is not for everyone, but I wish I went straight to it when we started 3 years ago. Or if we stopped at the beginning, but not tried with my own eggs, lots of chemical and early losses. My quantity is bery good, hormones, get pregnant easily, but no quality. Did 3 IVF cycles, all 10 embryos are uneuploid. After last mmc that required surgery, we were so mentally broken.
Wishing you all the strength whatever you decide

@LetrozoleIVF being the 42 side of 43 rather than 44 side could make a difference if you reconsidered IVF.

The possible advantage is that natural conception is one chance per month (or two if elevated FSH is causing double ovulation) and the risk of miscarriage using up critical time vs potentially trying a year's worth of eggs in one go with IVF, depending on AMH and AFC, and testing everything to reduce miscarriage risk. This is where relevance of personal numbers comes in to consideration. If numbers are low, natural route regains ground

Good luck whichever path you take.

At 43 it’s a numbers game, trying to maximise the chances of a ‘good’ egg being in the right place at the right time. The advantage of IVF in that could be, accessing more eggs per cycle, and reducing variables around timing. If you think about it various eggs are in the running to be ovulated each cycle, but usually only one will emerge the winner. With IVF you can hopefully develop and harvest more of those eggs, which increases your odds of finding a winner. You can also make sure that there are no timing errors with sperm being around to attempt to fertilise, and even do ICSI or IMSI to maximize chances there. Then you also have the testing option.