Move to DE or try one last cycle with own eggs?

[Eggdilemma]

I’ve had 3 failed IVF cycles. One at 42 and two at 43. I’m stuck between doing one last cycle with my own eggs or using a donor egg. I keep feeling like I need to exhaust all possibilities to have my own biological child but then I think with 3 failed cycles (got loads of eggs each time but either they didn’t fertilise or arrested quickly, only had one low quality embryo each time) have I already exhausted my own eggs?

I also was quite unwell with OHSS on the last cycle as I get a lot of eggs due to a high AMH. I feel as if maybe my body needs a rest now from that part. But then I feel so sad at closing the door on my own eggs and using a donor. The chances for me at my age are low (I’m nearly 44 now) but I don’t know what’s best to do.

I had this conundrum though was 39 with slightly diff stats, very low egg reserve, high fertilisation and poor blast conversion. It’s the balance of wanting to be a mother versus wanting it to be the motherhood you imagined. I decided on one last round with a different protocol (very very low stims, as opposed to the high stims I’m usually on) and I hit the jackpot (it’s just luck isn’t it). I did decide that after 40, I wanted to start my family even if it meant donor conception. I came to feel it’s about making the decision which will give you the least regret. I can’t imagine ever regretting a child I’d had through donor ivf, but I could imagine regretting the time it took me to get there. But if there are unknowns for you, then it might be worth pursuing till you’re sure that door is closed. Sorry, this is no answer to your question but just exploring how I was thinking at the time.

Fwiw, I can’t imagine feeling differently about my pregnancy if it was through the donor ivf we were about to pursue, as even though it eventually worked (5 rounds plus two cancelled rounds) with my OE, the baby is still an unknown person to me who I am excited to get to know. They might be far more like my partners fam than mine. I don’t really care I just want to love them.

I feel very fatigued by it all. I worry I’m being a bit selfish and that it’s wrong for me to outsource the hard part of stims and egg collection etc but it’s really taken a toll on my mental and physical health. Especially the bit when you get loads of eggs then every day waiting for that call and the number dropped so much and I don’t want to go through that heartache

What does your clinic think? We had the same consideration but with donor sperm. Had three rounds and no success so planned to move to donor sperm but we went to a different clinic and talked through the options with them and they advised us that they didnt think we were there yet. We then felt like we had no choice but to give it another go with my partners sperm as otherwise we woudl always wonder and we had the most successful round yet and I am currently nearly 35 weeks pregnant. So i would find a clinic you trust and get their honest opinion.

I agree with PP that I don't think you'd feel any different carrying them - you bond so much feeling them move and seeing them grow.

And i dont think its at all a selfish choice - i think its a very brave one and shows already how much you love your baby to be and what you are prepared to go through for them. Yes you are 'outsourcing' the stims but no one would choose this and you have tried and it's in no way an easy choice to close the door on a biological child.

My clinic has said with a high AMH there’s a chance and they will treat women with their own eggs till 46. Personally I just feel like it’s not going to happen it’s like a gut feeling. High AMH just means lots of eggs but I don’t know if they are just all bad quality now

@Eggdilemma What has your full attrition breakdown been each time? AFC/ retrieved/ mature/ fertilised/ day 3 cell count/ blast grade

In case that points to anything particular.

I only remember being told an afc at my first appointment (15) . My AMH is 22.6pmol I had that done recently in October 25.

Cycle 1 : 19 eggs /12 mature /8 fertilised / then had 2 embryos left at day 3 (was a freeze all cycle) but when we did the FET one didn’t thaw. They were graded ‘2’ the one we transferred had 7 cells

Cycle 2 : 23 eggs/18 mature (they had added something called luveris to my cycle to apparently try and improve the quality). 4 fertilised. By day 2 only one left. That was frozen on day 3 as a 6 cell grade 2. Another FET but again didn’t work. I was given prednisolone and aspirin too that time .

Cycle 3 : 11 eggs/3 mature. ICSI this time. Still just one on day 3 grade 2 6 cells. It was frozen for a FET as I had what I was told was
Mild ohss but I felt horrific . I’d had a different trigger the other times they felt this cycle trying lower stims and a hcg trigger might work better.

I did ask on the last cycle should they culture the embryo to day 5 but they said no when you have one it’s better to transfer it as they thought it would do better in the uterus.

Right before my first cycle my AMH was 24.2 so it’s dropped slightly but apparently it’s still high for my age (but I’m assuming the egg are all poor quality). I’ve been taking supplements for years now Ubiquinol etc that are meant to help egg quality

Another thing that worries me now is if I pushed myself and managed to get pregnant with my own eggs if they are poor quality will I be highly likely to have a mc? I feel quite scared about that possibility as I know my age alone puts me at high risk but if I have particularly poor quality eggs is it even more likely

@Eggdilemma do you have PCOS?

I have been told so many times in my life I do and I don’t! On some scans they looked very polycystic on others even a month apart they looked normal so it’s been very uncertain. My periods have always been regular

@Eggdilemma your AMH at this age is suggestive you could have it. Did you ever have hormone tests, or for insulin resistance or HbA1c?

Your embryos are folding quickly. If you try again cut all simple carbs and walk a lot, take metformin for any ovarian level hormone imbalance and inflammation and also ask about growth hormone. Your partner also needs to be aggressively on the case his side. Healthy diet, no alcohol, relevant supplements.

Hba1c has always been ok. I’ve never had an insulin resistance test. I do have high oestrogen levels on day 3 tests very often so I changed my diet before the first cycle and have maintained that I cut out all refined carbs sugar etc lost weight and started weight training

Try a fasting insulin and glucose test. Regardless, your eggs need mitochondrial support so if you try again give metformin and growth hormone a go for one last roll of the dice.

Signs of silent insulin resistance include skin tags, a handful of abdominal fat that's difficult to shift, thirst and frequent urination, high BMI.

Thankyou I will see if I can get those tests done asap, I’ve just been looking it up I think I can get it done privately

Can you try your own eggs but with ICSI ? Sometimes it’s the sperm quality that effects things also, I would suggest your own eggs - use ICSI to get the best sperm picked and get blasts PGT-a tested ..you will get an idea of if there is genetic /abnormal chromosomes factors. I am 43 and currently 21 weeks pregnant with own eggs, (eggs collected at 41) AMH was 13 .. 2 failed rounds of ivf and the 3rd round we done ICSI and this transfer worked ! I think the woman is always the focus but more focus needs to be on the health of the sperm also, get partner on CQo10 and yourself as this can help sperm and egg quality , good luck don’t give up with your own eggs just yet I would say till you try these things as it worked for us so far ✨🙏🤞🏽💛

Also your egg collection numbers are high, which is great .. but I have heard less eggs collected can also be good as lots can come up quickly but not be as ripe ? Where a lower does stim might give less eggs but better quality as the energy all goes into the fewer amount of eggs (if that makes sense, sorry I can’t remember exactly the technical thinking behind it) but it could be worth asking about or researching?!

@Eggdilemma i am 42 egg collections was at 40/41 I have similar amh I had had 6 failed well early miscarriages from 5 day blasts at high grade, my very last one has worked up to now. Is there a reason they won’t see if it gets to a day 5 ? My UK clinic pushed for day 3 these failed, I believe they wouldn’t have even made to day 5 in culture, my overseas clinic only does day 5. Each overseas collection I have got about 12 eggs and ended up with 8 blasts, my last collection I got 11 blasts out of these my last transfer worked (3 were transferred each time)

OP's are mostly arresting before day 3. Although reaching blastocyst is preferable for demonstrating developmental competence, if you have only one or two day 3s it's reasonable to transfer at that point.

hi op. I was in the same boat as you although I was on 5th cycle and considering de if this on didn't work. On my final cycle I did icis with aoa and zymot. In previous cycles I was lucky to get one fertilised egg but this cycle I got 6 out of 7. Currently pregnant although very early days. The aoa and zymot was like bloody magic with the difference it made xx I have low amh xx