I have just finished a fresh round at 41 years old. I have an AMH of 22 so the Drs are always more hopeful of outcome. We are a usually able to get at least 4 good quality blastocysts up until now.
This round they pushed for as many eggs as possible, so I was stimulated for longer. We got 26 eggs and the Dr made us freeze all to avoid OHSS, also as we were expecting to do PGT. 11 fertilised and now at day 6 we have ended up with 2 3CC blastocysts which cannot be biopsied and also were barely the quality able to be frozen.
This is been really disheartening and unexpected. From such a high number of eggs to barely anything to transfer.
We have decided to explore options before going through an FET of the low quality ones, where the embryologist is even concerned about them surviving thaw.
I’m wondering if it’s just the because it’s been 6 months since our previous cycle and time has had an effect on my eggs, or the protocol wasn’t right.
Just looking for some reassurance of whether to try another cycle and that there is hope being over 40 and using own eggs.
Particularly if anyone has high AMH at this age- any tips for egg quality? We have been told DHEA is not relevant for anyone bordering PCOS- but please let me know if anyone knows anything different.
(We are not considering donor eggs at this stage)
Just wanted to touch base with anyone who has been in a similar position and also a little motivation to keep going I guess.
Thank you xx
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Maui2020
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You could try natural modified ivf with lower dose stims, if you have a look way back in my posts I’ve written about it. The lower the dose of drugs the better the embryo quality in general - applies for younger patients with lower Amh, and often applies for older woman too regardless of amh. Quality over quantity approach. I always had nothing even reach day 5 at 450iu but then got 5 blasts frozen on only 150iu xx
Thank you.. tbh I was getting a bad feeling about it all when I was being much stimulated longer than usual and then coasted suddenly at the end. It’s making me think the protocol was a bad one for me. I’m really going to push for minimal stimulation next time, it’s good to know how much of a difference it made to you xx
Hi I’m nearly 42 we did two rounds with my eggs and the third round was known donor egg
I also have good AMH the last time it was tested it was 19.3, the Dr said we could try a third round with my eggs and ‘we might get lucky’ but we decided to bail out and go the donor route.
Unfortunately AMH is only an indication of your egg reserve not the quality of them.
First round I had 21 collected, ended up with two 5 day blasts, the second cycle we had 12 collected and ended up with three 5 day blasts, both protocols were short with different drugs
For our second round I religiously followed the vitamin cycle from the book it starts with the egg, to try and improve egg quality - it didn’t work, the one they put back failed and the other two were severely chromosomally abnormal after being PGT tested.
For us the donor route was the best option as I’m 19 weeks.
Sorry I don’t have any positive news regarding using own eggs
Thanks for your reply. It is interesting to hear, as we could go on cycle after cycle hoping to get lucky, because of the false hope of high AMH and always responding to drugs. I think this last cycle has been a bit of a harsh reality check. Congratulations on your pregnancy, wishing you the best xx
I agree with your points, I think in a way IVF gives a bit of false hope, especially to us older ladies, as I was 37/38 when we started, the doctors seemed really enthusiastic about my AMH, even saying it was better than average for my age.
That said myself and my husband are led by our heads and not our hearts, after round two having spent nearly £30,000 and only had a half full sharps bin and some unused needles to show for our journey so far we decided that the dr suggesting we could go again with my eggs was really just a money making exercise.
Logically the embryos got to day 5, so unlikely my husband was the cause, so our plan was to do known donor egg, if we had a few to play with and the first one failed we would do ERA on my lining but luckily we didn’t get that far!
I had for the 1st 2 IVF only 6 or 7 eggs collected and always had 2 or 3 embryos (day 3) with fresh transfer. The clinic we were did not want to try blastocyst as they thought that we had the risk to loose all the embryos beyond day 3.
After those 2 failed transfers ( 2 and 3 embryos), we decided to change clinic.
That new clinic advise me to have an open myomectomy as I had fibroids and they thought that the fibroids might not help implementation. Before that we decide to have 3 back to back cycles and to froze the blastocyst this time for a later transfer, after the operation.
We had in total 7 blastocyst, all top grade.
I had my operation and have been recommended to have 6 months of recovery.
After the 6 months and lockdown, I had a FET and became pregnant but unfortunately had a miscarriage at 8 weeks, heartbroken. We had tested the embryos (after miscarriage) and they found out that it was genetically abnormal (trisomy 20).
After 3 months I had a new FET of 2 embryos, unfortunately unsuccessful.
I have cried a lot and then asked to my clinic if we can test the remaining embryos just to speed up the process, but they said that it was not a good idea as they were already frozen.
So we decided to try the last IVF round, my AMH was at 3.6, when I started doing IVF at 39 It was at +10.
I had during that Stim only 3 eggs, growing very slowly, 3 eggs collected and 2 Blastocysts, top graded again, they have sent both for testing and one come back normal. I’m 43 years old and I m 34 weeks pregnant.
So it is possible, it is a long process, heartbreaking, but it is possible.
I wish you the very best and to every woman going through this difficult process.
Congratulations Oumichka2015, I admire your strength and felt all your heartbreak, and I’m so pleased to have read your wonderful outcome.
I want to be realistic, but my gut and my heart are really pushing me forward to continue, it sounds like the same thing happened with you and the resilience paid off.
Thanks for sharing your story, wish you so much happiness XX
What a story! A massive congratulations for your pregnancy. I really admire your strength to keep going. All the best with the rest of your pregnancy 🙏🏾
Congratulations! your story is such an inspiration. May I ask, which clinic did you use? My current clinic has the same mindset as your old one that they don't want to wait for blastosysts unless we have 6 or more embryos. and we always had max 4...
Hi Maui, I am 42 now but went through 4 rounds of ivf to get our miracle. She's now 18months old. In the end she was the last blastocyst as the other 2 were no good. Our last chance on NHS too. There was a lot of heart ache over the years. From the medication and how it made me feel and having 3 negatives. Wishing you positive wishes 🌟 💖. Kind regards Caroline. Xxx
The negatives are hard to pull yourself back from. And those slim percentages we are given means logically we shouldn’t be surprised but we still hope for it badly. I’m so glad you’ve got your little bundle of joy xx
We are all definitely warriors going through ivf. It's hard to explain to people if they haven't been through it too. I had used my own eggs too. Thank you. Xx
Hi Maui, I'm 43 and have done 4 IUI's and 3 IVF's, I had an AMH of 21 but that was a while ago, they didn't retest it recently. I was overstimulated on my first IVF, had 10 eggs but actually ovulated before collection so threw a tantrum in the clinic! They did find 2 left, one made it to day 3 and they transferred but BFN. The second IVF there were 5 normal fertilised, and they transferred 2 on day 5, BFN and the others stopped developing so none to freeze. I also was not comfortable with the protocol, it didn't feel right to me to shut your ovaries down and then over stimulate them. Following on from a post I saw here, I looked at research from Dr Norbert Gleicher, centre for human reproduction, he has very good success with older women. He has a few youtube videos which are very interesting, I highly recommend them and they influenced my next cycle. He recommends DHEA and also triggering early as eggs can over mature very easily with older women. I insisted on the short protocol for my 3rd IVF which I also found much easier on my body. I also triggered a day earlier than the clinic recommended which was taking a risk but I felt at my age it was not a numbers game, it was going to be quality over quantity. 6 mature, 5 fertilised, 3 abnormally which was probably due to my age and 2 were transferred at day 3 and I am now 12 weeks pregnant and Non Invasive Prenatal testing has come back with low risk for chromosomal abnormalities. I could just have gotten lucky but I just felt that I wanted to try a different protocol that felt right for me. It was my last try financially as well. I think with this journey, there are so many different medical options and protocols that it can be so overwhelming. You really have to go with your gut and what feels right for you and then at least you know you have tried everything. Wishing you all the luck whatever you decide.
That is really interesting, it’s the exact opposite of the protocol I used. I’m disheartened because had I not been so overstimulated I could have had a fresh transfer and at least had a shot this cycle. I’m really on board with what you have said, as my best outcome has been when they aimed for 10-15 eggs, even though they all failed, they were fantastic grades.
I’m really glad it worked for you.
I’ll check out the research, I’ve seen a lot from Center of human reproduction.
Do you mind if I ask how you ovulated early on your first try?
Could I ask which trigger you used on your successful try?
Thanks, yes I found that research fascinating and it just made sense to me and was the opposite of what I'd been doing too!! It's really unusual to ovulate early and I think it was that I didn't have enough Buserilin to stop me ovulating. They were very surprised that it happened and they upped it for the next round and there was no issue. I was just annoyed because most of the eggs had reached good sizes so I wanted to trigger beforehand but was persuaded to wait! At my age, I don't think the little ones are going to be too useful so don't see a lot of point in continuing to stimulate to try and get one or two more to catch up. I used Gonasi as trigger for all 3 of my cycles and they changed from Buserilin to Certrotide for the last one because of the change in protocol.
The other thing I did was up my folate (not folic acid) considerably too following on from research too. It's hard to know what worked but I like all the information I can get to know I've tried everything. xx
Coincidently a very similar thing happened to me on my very first round- I had over 25 follicles, was given 0.3 buserelin for trigger and they only collected 7 eggs, which was baffling. When I changed clinic they also said likely not enough trigger so I’m always a tad paranoid about that, which is why I asked. I was also interested in whether your trigger matured the eggs slightly if you used it early. Was that the idea behind changing it? I’m impressed they listened to your request and appreciated the research you had done.
Of my 20+ follicles they were all of such varying extremes that I think some eggs were too mature and some not enough- so it’s not a big surprise now that I had low fertilisation also.
Funny you mention the folate, I have been taking extra for a few months, as I got an overall check done with the GP and my levels had showed up borderline.
Can I also ask what dosage of DHEA you took? I hadn’t realised it was beneficial for high AMH xx
That's really interesting and so frustrating when it happens. The clinic use gonasi 10,000 as standard so I think that's referred to a double trigger, I had that for all three so don't know if a lesser dose would have made any difference. So the idea behind triggering early is to not let the eggs overmature which apparently happens very easily in older women. The research advised to trigger when the lead follicles were between 16-18mm. My follicles measured 17mm, 2 x 16mm, 4 x 12mm, 11mm, 7mm and 6mm and that was on day 8. They always responded quickly so I always triggered on day 9 or 10 but this time it was day 8. I thought I would only get 3 mature eggs but I got 6 so it must have helped a few of the 12's to catch up. In fairness to the clinic they gave me their advice but said if I felt strongly about it, they'd go with it.
When I asked about DHEA, my consultant said the feedback was mixed but I should get bloods done and if my testosterone was low, it wouldn't do any harm. It was on low end of the scale so he prescribed 25mg 3 times a day. Got repeat bloods done and it was rising so doing it's job and I took it for just over 14 weeks. I don't know if it made that much difference because I was disappointed that 3 of them fertilised abnormally which obviously means they were low quality but it only takes the one!
On the folate, Carolyn Ledowsky is a great resource on taking high levels of folate for repeated miscarriages or failed cycles so another interesting one to look up. As if you didn't have enough to think about! xx
That’s given me a lot to think about, but most of all, it’s given me hope that it can be protocol over just being told I have crap eggs. The embryologist was a bit shocked when I told her the last round at another clinic I had 4 good quality blasts as I’m sure she was about to blame the whole thing on age. Thank for sharing and massive congrats to making it to the 12 week milestone Xx
Thanks so much, I definitely think that if anything is less than optimum, the first thing is 'the age of your eggs'. I am a realistic person but for me I think it's worth trying everything possible first before going down other avenues. Best of luck to you xx
Hi, I’m 42 and have had five rounds of IVF. Also PCOS. The first round was long protocol and I overstimulated and ended up with 24 eggs, 16 fertilised and then 5 made it to day 5. I did a fresh and frozen cycle with those but no implantation. Decided to do a fresh round but this time I took coq10 and also vit d and 10mg of folic acid. My doctor said he prefers higher folic acid for over 40s. We were aiming for Less eggs with quality over Quantity however I ended up with 31 eggs of which 17 fertilised and 10 made it to day five. Again failed implantation so my doctor did immunology tests and a biopsy and found that I had high NK cells in the uterus. Due to Covid things were delayed but I’ve had since had 2 successful frozen transfers with the intralipids and prednisolone but both miscarriages at 8 weeks and 7weeks. So heartbreaking. My doctor has now advised to do a fresh cycle again on short protocol and do the PG testing as my embryos looked good quality on this last collection and I honestly think it was the coq10 that made the difference so would advise to take that to help improve egg quality. Fingers crossed for you xx
Thanks so much for your insight, I don’t see many posts of women our age with a tendency to overstimulate- I was told we are a bit of an anomaly that they’re always a little stumped by. Sounds like you have a great protocol as even with getting high egg numbers, you’re getting great blastocysts numbers also.
Would you mind sharing which drug and dose you use?
Sorry to hear of your miscarriages. I can’t imagine the heartbreak. I really hope you have the winning formula now and all falls into place 🤞🤞 xx
I’m so sorry you are going through this My wife had a filed cycle 4 months ago with a high number of eggs after a long stim cycle. She switched clinics as we were just baffled at the results (13 eggs and none made it to blast; we also have a child from an IVF cycle she did 3 years ago so it just didn’t compute for us). Overstimming to get more eggs is definitely the opposite of what’s recommended at my wife’s new clinic. I feel like this is a particularly bad approach for older women or anyone concerned about egg quality. I’d try again with lower stimming. Her new clinic (we are now traveling to go to the best in the US-CCRM in colorado) said they won’t stim her nearly as long in hopes for better quality eggs. Anecdotally, I think there is something to this for a lot of people. I know many folks who had a bad outcome after overstimming (my friend has 40 eggs ans only 2 PGD normal embryos) and better luck with a lower stim cycle. Don’t give up! The fact that you produced that many eggs is really good news; you’ve just got to get the protocol right. Best of luck!
Thanks so much, it helps to have some reassurance when you’re feeling down and hopeless. I always worry producing lots of eggs is giving me false hope, but I’m hoping it was just a bad protocol… and by the sounds of it, this seems to be the general consensus. I don’t know what my clinic were thinking as they really pushed me to my maximum. It’s been an expensive lesson to learn but I hope it’s worth it in the end xx
I’m 40 with AMH 18.5. I did 2 IVF cycles with PGT-A testing - one resulted in 13 eggs, 8 correctly fertilised and 5 blastocysts at day 5 - 2 of these were euploids. The second cycle I had 8 eggs collected, 5 correctly fertilised and 2 blastocysts in the end, one of which was a euploid. I’m very happy having 3 euploids in the freezer and looking forward to FET
I was on a short protocol both times and both times had very high estrogen levels so was at risk of OHSS and was recommended to go for a freeze all option which was my plan anyway since I was doing PGT-A. As for vitamins/supplements, I’m taking Pregnacare, Q10, vitamin D and Omega 3-6-9.
I do believe women in their 40s still have good chances of a healthy pregnancy especially with good AMH levels. There are lots of success stories including successful natural pregnancies after unsuccessful IVF. Also, Marisa Peer’s book “Trying to get pregnant (and succeeding)” really helped me to stay positive whilst going through the IVF cycles.
Wishing you all the very best in your journey and know you will succeed
Oh I definitely need everything I can to keep me positive right now- I’ll check out the book if you think it helped you. But honestly you ladies reaching out is helping me through a tough time.
It sounds like your protocol was spot on and that’s amazing news about the euploid embryos.
It shows the odds are not so grim for healthy embryos. Hope you get good news very soon xx
A good friend took 7 transfers but finally became pregnant at 41, had a gorgeous baby boy at 42 ☺️ My first cycle was also a freeze all because of OHSS , 17 eggs but only 2 made it to blastocyst and then the FETs that followed didn’t work - sometimes I think over-stimming is good for numbers but not for quality?
Sorry you’re going through such a hard time and good luck for the next step xx
I’m definitely learning that the hard (and very expensive way) and will be certain to not do that again. I’m worried my clinic are not so versed in a mild approach so it’s giving me a bit of anxiety doing another cycle with them again as I don’t want to accidentally end up in a similar Situation mid way through, and they aren’t the easiest to have an interactive conversation with, it’s more a “here are your instructions approach”.
It’s a lot to think about (and worry) about.
Are you midway though a cycle? How is it going?
I was just reading your post and almost laughing to myself. Every single cycle my husband asks me for the one date he needs to be at the clinic a month in advance!!! Arghhh! Lol.
Yeah, it’s definitely a hard and expensive way to learn …. 😣 Yes I’m doing the stims now - so far so good, egg collection next week and hoping for a fresh transfer 🙏🤞
I know, right??! What’s so hard to understand?? 🤣 X
I am 46. I was 39 when my eggs were collected and embryos (blastos) frozen. I’ve had a total of 4 FET and now have 2 children! My daughter was born when I was 40 from a low grade embryo. My son was born when I was 45 from an embryo considered too poor to grade! With him I did natural unmedicated FET.
That is wonderful! And amazing to hear that poorly graded embryos beautifully formed into children. The lab asked me on the phone- do you even want to freeze these or discard them?! I’m thinking of another fresh cycle but that’s given me hope that the ones I do have could potentially work despite being practically written off. It would be so ironic if they did!! Thanks for sharing x
They just don’t really know, it’s a lottery. My view was that I’d rather they were ‘discarded’ in my body instead of down the sink, and if they happened to take then wow. This is why I did a non medicated cycle (super relaxed about it) but easy for me to say as I had no issues with womb lining etc.
I’m not sure I can add much to the various comments above other than to wish you the best of luck. Don’t give up, you will get there. Your AMH is nice & high which means you have plenty of egg reserves but of course quality is key. Maybe chasing high number of eggs isn’t the right strategy for you and perhaps taking a different approach might be better in the hope you get better quality eggs. It’s worth a shot id say! Are you considering a double transfer? Might be worth it. Xx
I’m never sure if the potential for eggs makes me chase false hope, but I least I can see where it may have all gone wrong, and it’s definitely not the protocol for me. I was so caught in deciding whether to PGT test I didn’t imagine not having a choice. We keep getting strongly advised against double transfer, but I’ve decided to take more control now and I will insist on it.
Hi there, maybe I should sit this one out as I'm 38 and not 40+ but I have a much lower AMH than you (9) so I thought I'd share my experience. In my first round, I had a short protocol with one trigger. They retrieved 12 eggs but all from my left ovary as the follicles on the right side were empty. Never got an explanation for it. Just a shrug and "it happens". 8 were mature, 5 fertilised and none made it to day 5. This time around I took DHEA (50 × 3 times a day), CoQ10 (500 once a day), Melatonin (3mg once a day) and folic acid (1mg once a day) for three months before starting treatment and did a long protocol. Downregged with buserelin, stimulated with pergoveris at 300 × 14 days and 450 for 2 more days (16 days of stimming was tough, I won't lie) and triggered with a double dose of ovitrelle this time the usual 36hrs before pick up. I was freaked out I'd ovulate ahead of pick up but I was on a lower dose of buserelin throughout stimming. I had 18 eggs picked up, 12 fertilised and 7 made it to day 5. I put one back (4AB) as a fresh transfer 3 weeks ago and it's still there but of course anything can happen at 6 weeks. Whatever happens though, the longer protocol worked infinitely better for me, despite the low-ish AMH. Don't mean to confuse you as the consensus above seems to swing in favour of shorter protocols but for me, it yielded no results. Good luck and hope you get there. 😘
Hi! I have PCOS and high AMH and took DHEA for 3 months before my last ICSI cycle and it made a HUGH difference to embryo development and blastocyst formation.
This was my 8th ICSI cycle and I got pregnant on fresh and frozen on this round but unfortunate lost both.
This was the first time we got a blastocyst!!! And even one to freeze. (We’ve had terrible ICSI results but it’s also due to sperm quality and dna fragmented sperm)
Check my profile for more info, but what you should so I check your testosterone levels! Mine had dropped significantly from I was 33-38 resulting in poor egg quality = poor embryo development (Referring to research by Dr Norbert in the New Your clinic as mentioned in some of the posts above)
I am waiting for my next ICSI cycle and hoping we will get the same good results but that it’s sticks this time. Popping the DHEA pills religiously
Good luck and don’t hesitate to ask me any questions, I just have to go to sleep now
Hi Barenina, sorry to hear of your losses. Sounds like things are moving in a good direction for you and hope it continues. I saw on your profile you already have a child from ICSI. We are also luckily enough to have an ivf baby from 2017. For this reason we kept following the same formula and never did further testing. Someone else on here recommended that NK cells can change after pregnancy, so 8 failed transfer later I hesitantly went for testing and skeptically tried intralipids for our last FeT. I’m now 13 weeks pregnant so a long way to go. But never got this far in 4 years. Sounds like the DHEA is working wonders but also something to keep in mind as well.
Thank you Oumichka! I never forgot your words funnily enough, as I had another failure before this transfer, but kept reminding myself it’s possible and took from your strength.
How are you? I hope all is well and you’re now a mummy..?! X
Hi again! Sorry I didn’t see your post was 6 months old! So happy you are pregnant now and that you found out about your NK cells and that the treatment worked 👌💫
I had NK cells looked at nearly a year ago but came back fine to the doctors surprise.
Thanks, even we are devastated about our losses we are getting closer. Baby steps 🤪
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