I am 43. No live children. Never had fertility issues (did elective termination at 22 yo after conceiving while on contraceptives).
I naturally conceived and had a stillbirth at 39. TTC since. PTSD since. 8 IVF since. And one painful miscarriage on my 41 birthday.
I only recently found my dear partner has high DNA fragmentation levels never diagnosed in our IVF journey.
I have normal for age yet low ovarian reserve.
Experiencing stillbirth left me with a thin endometrial lining, but I conceived with 7mm.
I was recently diagnosed with adenomyosis.
I am a therapist and scientist and used up all I have to research on the matter. Like many of us, I reached the point where science and medicine failed to advance yet. I can't bring myself to use a donor. Sometimes I wish I could.
I turn to you, beautiful, strong, and wise women (even if you don't always feel like one); please, can you share any new frontier treatment that worked for you?
Any over 42 against the odds success stories will be immensely appreciated. ..
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Chinchan
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I am same age, also adenomyosis plus severe DOR and done many cycles. Happy to share frontier ideas but need to know more on where to the problem could be. Can you share the details on the outcome of your ivf rounds? some specific questions: what was your fertilisation rate (divided by # of mature eggs)? Did you have many empty zonas, broken zonas, self dividing eggs, abnormal fertilisation? How many embryos did you have on day 3 and day 5 if you went for blastocysts culture. What was your transfer protocols in details, how many embryos did you transfer? Did you do frozen or fresh, what meds/add-ons did you try? How many embryos did you transfer and which day were they? Did you have more than 1 pregnancy on IVF? Did you have any answers or hypothesis already on what could have gone wrong?
Hi Lilly, thank you for this reply. I did both agonist and antagonist. Long and shorts. Double trigger and single. I had a total of 21 egg collected—only fresh cycles. All-day 3 transfers. Long agonist and antagonist with double trigger had a significantly higher yield. Had 3 natural conceptions and 1 IVF. We saw highly recommended doctors, and they all said there's nothing wrong except for my age (I started art at 40). My fertilisation rate was excellent, actually, 75-100% each time, but the maximum eggs I ever got in a cycle was 4. The whole time we were unaware of my partner's issue, but by the time we found out, my eggs were so frail none of them survived the icsi needle.
I tried acupuncture, supplements, DHEA, coq10, melatonin and was just about to do PRP in Athens, but then corona came.
In how many transfers did you spend your 21 embryos? So from what I understand your last or couple of last cycle gave no embryos, when you started to do icsi instead of IVF?
I wish I had 21 embryos! I had 21 eggs. 12 embryos, all transferred fresh on day 3. Do you get any treatment for adenomyosis? I was told there is nothing to do about mine since I have no symptoms (diagnosed accidentally in a routine scan).
I have the feeling that the problem with you is implantation. There are many things you can do about this. And donor eggs would not help for this, so you are best to fix this and continue with your own eggs in my view.
A few responses on your points:
1/ regarding PRP, you can probably book one for July if you are UK based and happy to take the vaccine because by June you should have it. However note that it works only for a small proportion of women and the effect takes 3 months. So that brings you to October. I personally would not wait that long to do other IVF trials and then you see if the PRP helps. Before you book, check also the fat cells injections also performed by some clinics in greece. Note that prp and fat tissue injections could help with quantity not for quality.
2/ regarding the icsi, you did not say whether all eggs or how many injected died in your last attempt. It’s an important question because there could be an easy solution for this: a different size of needle. Clinics can use different models depending on how fragile eggs are. Can you share happened exactly in your icsi attempts?
3/ can you check if you had any of the above (it gives important information) and in which quantity: empty zonas, broken zonas
4/ I can share ideas for implantation but firstly I need to know what you have tried already. Can you send the list of meds that you took from the day of egg collection onwards for your transfers?
5/ have you done a serie of test called trombophilia?
6/ regarding the adenomyosis, it cannot be cured but there are treatments that can make it less active. Those require frozen transfers rather than fresh. You could try this. The treatment depends on the location and severity of your adenomyosis. Do you have the info? Or can you share a scan?
If you can give the details on 2,3,4,4 and 6 I can send you some ideas
Thank You Lilly. It's so kind of you to give it such a thought. I did the thrombophilia tests. Did you try the PRP? Or do you know anyone who did and was successful? I spoke with the doctor who pioneered it, and while he strongly recommends it, I never heard any success stories on any forum.I was always told implantation could not be the problem if I conceived four times. What were you thinking about re treatment?
None of the lab reports had mentioned anything about the eggs other than MI or MII. My last three cycles had five eggs in total And all five did not survive the handling. I was never offered a different needle. I will look at it. Thanks again for your kind reply and your time
I read from 1 person that she had success in getting more eggs with PRP on the forums. So not a large number. I think there is no harm, so worst case scenario you will just waste some money. But check the second treatment I mentioned.
Conceiving 4 times does not mean implantation is not a problem. The 4 times are probably a small proportion of the number of attempts at conceiving. Maybe not even 10% success rate if you have been TTC for many years. Adenomyosis is know to create problems for implantation, depending on its location and severity (hence my questions on it)
All 3 natural conceptions were literally on the first cycle. I was in my early 20s the first two and was under the pill! The first time my doctor said I missed taking and forgot about it. The second time I had sex once that month. The third time I was 39 and actually wanted to get pregnant. It worked the first month of trying. That’s what makes it so tragic and hard for me to accept.
There's some interesting research that for older women you need to retrieve early (like largest at 15mm-16mm). The one cycle I had with eggs like yours (broke apart during handling) they were "over-mature" caused because they retrieved too late and I'm old...just a thought. Although sounds like Lilly12255 is hooking you up
I heard about the HIER protocol for early retrieval. Do you have any further information to share about it? My doctor told me it wasn’t for me because I had a maximum of 4 eggs retrieved and I would need more to survive the IVM but I understand now that no doctor ever really saw past my age. Do you mind sharing more details? Even my partner’s urologist told him it all falls on my age and then shamelessly went on to prescribe terribly under-researched, unproven and mostly ineffective treatments.
I'm not sure the number of eggs matter. Will DM you the clinic that does this early retrieval regularly. They do 2nd opinions, which I found very valuable when I was at a crossroads in my treatment.
It is really hard to find REs who appreciate what they do is more of an "art" than a "science." Yes a woman's age and other stats matter and give good indication of success - but we all know that they don't do research on women not undergoing ART so the don't totally know. When a women falls pregnant naturally at 45 do they know what her AMH/FSH was - nope. Plenty of women who look "perfect" on paper struggle for years and those they "write-off" take on the first go. If it were pure science DS + DE + PGS + surrogate with known pregnancy would work 99% of the time and I think the stats are like 75% - 80%.
Sorry to rant - just find it very frustrating that we are often treated like we are are the summation of numbers on paper and most REs don't seem to think their job is to look for bespoke treatment for us as individuals. But that's "medicine" for you...
Hi, I was older than you but I did have PRP done at a clinic in Greece. My LH, FSH and AMH levels did increase enough for me to go back and try ivf with the clinic. There were four follicles showing on the scan that were of the right size, but unfortunately only one egg was collecected, they told me that they do not understand what happened. The egg was not suitable. I was obviously upset that this failed but they then put me under immense pressure to use Donor eggs. I feel that the way I was treated was dreadful and that they were trying to take adavtage of me being so upset. Less pressure was put on me once my partner was with me. While on my own they kept telling me how much he wants a baby and this was the only way we would be able to have one. Back here in the UK we are considering what our options are but if it is donor eggs I will definately not be going back to that clinic.
Hun I just want to say I used a donor and its the best thing I ever did. My son is my world. He is my everything. When u hold your baby in your arms genetics won't matter
Thank you Rainbowhop, for telling me that. Being pregnant with my Son taught me how strong the attachment gets during pregnancy. Max was still born and for me the grief and longing are for a child I feel I knew him well already. I used to joke during treatments and say I hope they accidentally swap my eggs with younger ones and I'll never be able to tell. When we applied for egg donation we learned about my partner's problem and that threw me off it again. I know it's all in my head and personally know mothers who used donor and could see how it made no difference to them once they were pregnant. What was it that helped you take that route?
I decided to use donor when I had repeated failures. Low ovarian reserves and endometriosis. My husband had sperms fragmentation too. In the end we couldn't afford numerous rounds with my own eggs and I just wanted to give myself the best odds to get pregnant and have a healthy baby. I guess I had to decide what I wanted and that was a baby to give all my love too and raise and care for. I had a lot of anxiety during pregnancy and had some worrying moments about if I've done the right thing. Even after he was born I can honestly say I felt the rush of love everyone talks about. But he is 6 months next month and now I know I love him more than life itself. He is the baby meant for me. My faith has strengthened through this process. I think he is my angel.
Hi, I wonder if the DHEA is causing the problems with your egg quality? I would get the levels tested. Have a read of: drgeoffreysherivf.com/poten...
The problem with day 3 transfers is that your husbands sperm issues went undiagnosed. I really believe that men over 40 should have the DNA fragmentation test as standard as I believe I had failed cycles because of my husbands sperm. On our successful round my husband was also taking supplements & we used PICI to ensure we were using the most mature sperm
Thank you for posting the link about DHEA. I have just turned 44 and have been taking it for 3 months in the hope that it would help my egg quality. Reading this I’m not so sure. Will go get my levels tested. Thank you
I am furious at how even today, men go undiagnosed. We are advised to do the most painful and invasive tests right from the beginning while no one ever mentioned the possibility of SDF - requiring ejaculation! My partner is 38, but I think ANY partner of a woman with low reserve should undergo all possible investigations. We don't have the eggs to lose, while for them, it's a simple, non-invasive procedure. They wait for us to have endless pains through ART and sometimes three miscarriages before recommending more tests. Any woman who went through it knows one is enough.
I can't believe this happened to you. I would be furious. I did only 2 IVF cycles with my own eggs (one in Slovakia and one in the USA) and the first thing both clinics did was DNA fragmentation testing of my husband's sperm before they would even proceed with treatment. I assumed this was standard everywhere but clearly not. Also both clinics advised to do 5 day embryo transfer to lower the risk of putting in unviable embryos.
i had a successful IVF cycle at 43 years, and i think the things that helped me were: 3 months of micronized DHEA, and maybe early egg retrieval (at a lead follicle size of 18mm from memory), and also a slightly lower dose of drugs. The difference with my previous cycle at 42 was quite marked. If these treatments had failed i was gonna try a final time and use human growth hormone - there seems to be some quite good evidence for its efficacy in fertility but it is pricey. I also had a thin lining due to blood flow issues and not lack of estrogen, so for me pentoxifyline + vitamin e daily seemed to help. If you want any further info on these treatments, let me know and i can send you the studies.
I guess you referred this question to articsnowfox. My previous clinic recommended anything micronised 3x25 daily. I think it is worth it to do testosterone and dheas blood test to make sure there is no counter indication. Also ask your doctor about it interfering with the treatment protocol. I was on long agonist once and the DHEA interfered with the down regulation keeping my progesterone too high
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