Treatment dilemma

[Partimerunner]

Hi all, hoping for some advice please if anyone has been through a similar decision. I’m 40 and have had two rounds of IVF so far. One fresh transfer from 1st round (negative) with none to freeze and one FET from 2nd round (chemical). I have one good quality blastocyst from the 2nd round left and can go ahead with the FET in July. My doctor has said this is one option and the other option he is to do another round of IVF given my last round was fairly decent in term of embryos and quality.

In that scenario I could do a third round of IVF with my current clinic in July or August, or change clinics to one of the London ‘boot camp’ style clinics although that could delay me to September or October. I’m very confused in terms of what to do next and the ticking clock in my head isn’t helping! Sensible thing may be to do another round of IVF to bank some embryos but I am really tempted to do the FET although I keep thinking that if it was successful (big if) then I’d have missed my chance to bank some more embryos this year. If the July FET failed then at either clinic I’d be doing another IVF round in Sept/Oct anyway. Any advice very much appreciated! Thank you

[Yellow611]

Hiya, do you already have a third round paid for? Have you had your amh done? I can't understand why the consultant wouldn't just say use up your frozen embryo and then pursue more treatment if that's what you want? Are you paying for it? Or is it on NHS? Sorry lots of questions!

My thoughts are that if your amh is low and the consultant thinks every month counts for your ability to produce eggs, then I can see why he wants you to do it as soon as possible. However, if this isn't the case, you could be paying for more treatment unnecessarily as you don't know what's going to be happening with the frozen embryo.

I think fully understanding why you wouldn't use up the frozen embryo first, is important. Also why can't you bank more embryos this year? Is there a wait if the FET didn't work, preventing you from starting until after Xmas?

[IVFmumma]

Such a hard decision! Only you can decide the best option for you, but maybe something to think about is if you potentially wanted more than one baby (ie a sibling one day) it might be an idea to do another cycle now to hopefully bank embryos for future use, then either do a fresh transfer with that or do a FET shortly after. I'm not familiar with boot camp style cycles but sounds like it's a longer lead time to retrieval / transfer based on you saying SEP/Oct time so I can understand that's playing on your mind. If the recent cycle gave you a decent outcome then maybe you could go with that again? But I'd see the appeal of trying to maximise outcome with a boot camp cycle too. So tough!

Given it's such a numbers game if I was in your situation I'd probably do another full cycle to have some more options/chances up my sleeve.

Good luck with what you decide - who knows, the next FET could be the one ✨

[Purpledoggy]

Finance and whether you might want a sibling would be important factors. I can totally understand the time issue-I had 3 frozen blastos from my first round after BFN but decided to do a second fresh round first as I was 39 at the time so wanted to bank a few more while the going was good (AMH 7.6 pmol/L the previous year). That second round ended up being successful fresh so we still have some frozen. However, we had paid for a 3-round package (with refunds available for unused rounds) so financially not quite the same. The main thing is not to have regrets on whatever you go with, whether financially, success, sibling etc xx

[Partimerunner in reply to Purpledoggy]

Thanks so much Purpledoggy

[Hidden]

I tend to agree with the others, I think a lot comes down to if you wanted more than one child. A year can make a big difference in egg quality so I would be tempted to do another round now and bank some embryos. I don’t necessarily advise moving to another clinic if you like yours and sounds like you are doing ok with results. I moved to a London clinic for a second opinion and tbh they just carried on doing what my other clinic was doing anyway! And it just delayed things and made things twice as expensive for no difference! Heaps of luck xx

[Partimerunner in reply to Hidden]

Yes the expense of changing clinics is a consideration Hidden . Mine is very reasonable but I am tempted by the higher success rates of others, but it comes with more cost

[JoyfulStar]

I agree with the other comments that only you can decide and that the main thing is not to have regrets with whatever you decide.

From my own experience I chose to bank embryos after my first unsuccessful round mainly because I was 43 at the time and I was advised that this was the best approach for me as they rarely saw success with 44 and 45 year olds. Therefore I did 3 rounds back to back and banked embryos from the first and third round. My second was disappointing. I got pregnant after a fresh transfer of 2 of the embryos from the third and final round.

The pros of this approach was it was reassuring to know that I had embryos in reserve if things did not go to plan. Also, it gave me peace of mind to know that I was doing all I could to get success before “it was too late” I would not have done any more rounds if it did not work. It was also cost effective this way as it was cheaper than 3 separate fresh rounds.

The main con of this approach is that I was successful with my first transfer after banking embryos and now have a 4 month old daughter. This means I now have 3 excess embryos that I have to make a decision about. DH and I do not feel up to raising up more kids due to our age.

I do not regret my decision though and I think it was worth it.

All the best with your decision x

[Jumpppy]

Personally my biggest regret in my journey was not banking at 36 when I knew I wanted siblings. My RE convinced me to do a fresh transfer and not bank and it took me ages to get back on the IVF train after 1st round worked. I banked the second time, but the process was longer and harder each round. However as you bank your body "rides" the estrogen from prior cycles and often the results improve as you go.

I suppose it also matters what the diagnosis is? And how you feel about doing all the work on the front end and potentially having more embryos than you might want to use? The fact that your RE is suggesting this approach is interesting-was she worried about decline you are seeing?

Good luck!

[Partimerunner in reply to Jumpppy]

Thank you Jumpppy

[Partimerunner]

Thanks so much for your responses, so helpful. According to my doctor I have numbers on my side based on the last two previous cycles but I am a bit concerned about egg quality given my age, hence the temptation to move to a different clinic with higher success rates if I do another full IVF cycle. Not convinced about my current clinic but then again we only have had one good quality blasto transferred with them so the far as first cycle I did with them was short protocol and only one blasto which was early stage and not good quality. The long protocol worked better second time round.

Financially we are fully self funded and don’t have another round paid for yet but are fortunate to be able to keep going for now.

AMH is 11 although that is from 12 months ago last time it was tested and recent AFC is 11.

I think you’re all right in terms of the sibling consideration and the time factor, just need to discuss that with my husband so he can help me decide!