natural modified or stimulated?

[Lipe79]

hello all

I am 43 with 12 follicles and 15.5 Amh. My first round ended in only one poor quality blast from 12 eggs. That blast then only survived the thaw by a thin percentage. Got a BFN last month after a FET. No surprises!

Cycle two is happening. My donor sperm has arrived at my clinic, I purchased the best I could this time. I’m a single woman. Now I need to choose the protocol.

Just been speaking to my consultant and she is suggesting I go down a modified natural route this time as because of my age, it’s likely that my eggs are not their best quality regardless of still having more than average for my age. This leaves me wondering what to do. I feel it’s a risk going down this route given that I may only have one egg collected rather than 12 like the last time. But then those 12 were clearly not good enough to form into good blasts.

I can’t financially cope on my own to keep doing trial and error.

Any thoughts and experience on this is most appreciated. Very stressed at what to do - time and money is running out!

[AuroraXen]

Hi Lovely. 12 eggs is great! Your AMH is super. But obviously your first round was disappointing 😔How many eggs fertilised that time? Are you using the same donor this time? Xx

[Lipe79 in reply to AuroraXen]

Thank you for replying! ❤️ I have chosen a new donor this time. I had 6 fertilised (8 of the 12 were mature enough to be selected) xx

[AuroraXen in reply to Lipe79]

So again that was pretty good. I can see why you're a bit torn. I asked because I did 2 ivf rounds solo and had to change the donor for round 2, as sometimes there just doesn't seem to be a natural connection between egg and sperm 😔 In my case, they seemed to hate each other that first round! 😂 Changing donor and doing icsi helped. It's a hard choice for you 😔 Maybe your egg quality wasn't good but maybe it was more to do with the sperm. I've heard the time they arrest can be indicative of the issue but none of it is an exact science. I HAVE heard that modified/natural can be really good for us older ladies though. I think in retrospect I may have tried that, as even though we got blastocysts (not lots!) they seemingly weren't good enough. Maybe natural would have helped 🤷‍♀️ xx

[Lipe79 in reply to AuroraXen]

Wow I’ve just read your bio, you have been on quite a journey and a super stressful one too! So happy to hear your OH saw the light! Best of all the lucks to you.

Thank you for your advice, I really appreciate it. Well the bonus about changing sperm is there already - one big tick! I’m not sure at which point, most of them didn’t make it to day 5 though, just this one blast that was poor graded.

I’m swaying more towards the natural modified. 🫣 xx

[Noworries105]

Hi….,first of all 12 is amazing so well done….,do you know what your FSH levels were at day 1? If high then try to prime. Natural modified actually works quite well in helping to obtain better quality of eggs…..for a lot of people with low AMH or just older, the premature rise in FSH and LH is what ruins the egg quality. I would defo consider natural modified, and make sure the blocker is given before the LH rise occurs…for us that was early like day 5/6. Plus natural modified is cheaper and kinder to your body….. we got success (8months currently) with estrogen priming and straight into mini-ivf with low dose stim (75-150iu max).

[Lipe79 in reply to Noworries105]

hello lovely, thanks for your reply, I’m not sure at all about the levels but that’s a question I am going to ask! - feel so ignorant to all this ivf stuff! Fantastic news about your 8 months…❤️ Think I’m going to go for natural modified thanks to all great the responses. Xx

[Positivechangeplease]

hey. I find it strange she’s suggesting a naturally modified route due to age. I would have thought it’s the opposite way around. However, naturally modified worked for me and if you have regular periods this is the way to go imo

[Lipe79 in reply to Positivechangeplease]

I went high stim first time round and doctor now thinks possibly egg quality was the issue. I’m so new to all this, just literally leaving it in their hands! I do have regular periods. Congratulations that it worked for you and this leaves me with hope. Thank you xx

[JoyfulStar]

Hi Lipe79

I would say go with your gut instinct to prevent any regrets down the line. I would research both options thoroughly using independent sources and speaking to your consultant on the pros and cons of each approach. Lots of women have success with natural modified IVF and if it prioritises quality then maybe it is the way to go. However the HFEA says the success rates are less with these approaches.

I was 43 when I had success on a back to back high dose cycle. So there is no right or wrong. However, it is worth noting that if my embryos made it to day 5, they were pretty good e.g 4BB or 3AB. I did have one round where no embryos made it to day 5 despite having 13 eggs. I then did a subsequent round with the exact same protocol, did a fresh transfer on day 3 and had a BFP. My consultant wanted me to wait till day 5. The thing I have learned from my journey is to do what feels right and makes more sense to me regardless of what consultants say.

All the best 🙏🏾

[Lipe79 in reply to JoyfulStar]

Your experience/stats sound similar to me. My doctor actually did say there’s no right or wrong going either way, I guess she’s experimenting with egg quality. I’m so happy to hear your success story. Us oldies CAN do it ❤️ xx

I think I’m going to try natural modified.

[Baby2023]

I'm on natural modified due to low amh and would recommend. I would also make sure your taking supplements too.

[Lipe79 in reply to Baby2023]

thanks lovely, I’m taking a multi vitamin, vitamin C and D and folic acid. Do you think this is enough? Xx

[Babytocome in reply to Lipe79]

I would recommend to watch “ egg whisperer” watch the video “ivf over 40” super informative, she is an American fertility doctor from Harvard that recommends few supplements to take before going to ivf. Something to consider.

Also she recommends do PGS test, genetic tests to identify which embryos are right for transfer. Hope this help

[Lipe79 in reply to Babytocome]

thank you very much for your help! I will research ❤️❤️

[Bebe294]

hi dear

If I were you with this great number of follies I would work on egg quality before going through ivf again.

I personally had great quality blasts 2 out of 2 eggs with mini ivf protocol and 2 months taking Myo inositol +D-chiro 2000mg+50mg , 2 times a day ( 12 hrs apart) - there are few research on this combination increasing egg quality, although it decreases number of folies but much better quality.

I also took ubiqinol 300, PQQ 20mg, conception multivitamin, vit D, C, Omega 3/6/9 1200mg.

Might not be relevant to you but My partner took the same supplements multivitamins for men but only 100 ubiquinol.

I hope things go great for you.

[Lipe79 in reply to Bebe294]

thank you lovely, I’ve never even heard of some of those supplements so I will be looking into those! Thank you for your recommendations xx

[Baby2023]

Read it starts with an egg. Lots of research on supplements to take. Apart from the above, I also take NAC, melatonin during ivf, curcumin, prebiotic and vit d. It takes about 3 months to take affect.

[Lipe79 in reply to Baby2023]

ok well I’m a bit late to the show but worth starting anyway. Thank you very much for all the great tips. I didn’t know any of this stuff! ❤️❤️