So I have just turned 40. My partner and I have had one NHS funded ICSI cycle which resulted in 10 eggs; 6 fertilised but only one could be used. Our implantation failed 13 days post implantation. I have to say, I was pretty naïve going into the whole process. I knew, because of my age, that our chances was minimal so I went into it telling myself that it probably wasn't going to work. At the same time, I kept getting positive noises from my clinic which was boosting my confidence that I might get a positive result - I know 3 couples that all had IVF success stories on their first try, 2 of them have 2 IVF children each, so thought I might get lucky too. Anyway, it didn't and I was devasted.
Once we got over the initial shock we decided to try again, but were self funding. I started reading a lot more about the process and what I needed to do to get myself into the best shape for treatment. Our initial consultation explained that since I was on Protocol 9 (the second highest drug regime) for my first try, I have practically no chance of conceiving, but since I didn't have anything to compare it too - they would facilitate one go at self funding via Protocol 10 (the highest drug regime possible). By this point I was in a better position to ask informed questions, and it was decided that we would wait 3 months so I could start taking some supplements which might (only might) improve my chances. I also started reading about different things that could be tried and decided to switch from traditional ICSI to PGT-A testing as the book I was reading suggested that the major obstacle for people my age in achieving a successful pregnancy was chromosomal abnormalities and that PGT-A testing will be able to tell which embryo's are chromosomally abnormal and thus increase the chance of implanting a chromosomally normal embryo and therefore achieve a pregnancy.
I was just wondering if anyone had any knowledge or experience of this type of testing, particularly aged 40 or over? What your experience of it was? What questions did you ask/wish you asked you clinic? What was the outcome? I have read that success rates can be increased by 3-4% of you implant frozen and was wondering if anyone had any knowledge of this?
Apart from my initial reading I have found it difficult to find much information on the process, what to expect in the UK? So any sign positing to any useful links would be helpful
Thanks in advance
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Systema23
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Sorry your first round didn't work out 😞 You did well to be honest - 10 eggs is really great. I'm surprised you were told the chance of success is so low. I am also surprised that the advice was higher stim dosage. I am not sure of what your diagnosis is - that can have a big impact on success and why you were given the advice you received. (Or maybe you need another opinion?)
You are doing the right thing taking supplements they help many 😀
You should be aware that ICSI and PGT-A are NOT interchangeable, PGT-A is really an add-on. ICSI is recommended where there are male factor issues, or for some clinics they use ICSI for everyone. You can ready my profile for more details, but don't be mislead into believing PGT-A is a silver bullet for success. It has its place, but not a great idea for everyone. If you only get 1-2 embryos (totally normal for 40), it could be expensive per embryo and if the results aren't what you want in the UK you cannot change your mind. You should consider the pros and cons carefully.
Thanks for reaching out. We started with a male factor issue, i.e. his sperm is fine but he cannot ejaculate during sex. After my last round the issue seems to be my low AMH level - which is only 0.8; and the fact that I am now 40 years old. They said my chances are 3.4% of a successful pregnancy - hence why I am preparing myself for the worst.
N yeah I thought 10 eggs was really good as well, until they explained that the best one (and only one they transferred) was 3AB - which I don't know what it stands for - do you? They called me the day after transfer (5 day blastocyst transfer) and said the rest were basically junk and they had to bin them. So think the fact that most were showing as chromosomally abnormal is why they are preparing me for the worst.
Would really like to look into the grading more before my next round - I feel like they don't give you any information at Glasgow Royal Infirmary, you really need to look for it. So, for example, when I had my consultation for this round of treatment I brought up PGT-A and was kinda fobbed off, and put down the ICSI only route. I was told that it would be to expensive and based on my last round I wouldn't have had any to transfer. However, since they also suggested waiting 3 months (which at 40 is a risk in itself) to give the supplements a chance to work I started reading up on PGT-A and contacted them again and said I wanted to proceed with the PGT-A add on - which delayed my treatment again. I know what you mean about the pros and cons - I have been told that they will not transfer chromosomally abnormal so I could pay for tests and get no transfer at all. That in itself is a risk but I figured it is a calculated risk.
I read your bio, so congrats on being a mummy, it sounds like you had quite a ride as well. My own experience was 5 years in the making, I had to change medication for epilepsy as the medication I was taking caused birth defects and learning difficulties for children; then stop smoking; then put on weight so my BMI was too high coupled with covid lockdowns and backlogs.
morning! I’m 40, and currently 7w6 days pregnant with a euploid embryo after 5 previous transfers of non pgta tested embryos; 3 failed, 2 BFPs which resulted in miscarriage. The main reason I did pgta this round, was to reduce risk of miscarriage, as due to my age, highly likely they were happening due to chromosome abnormalities. I had 6 embryos tested, 3 abnormal, 1 euploid and 2 mosaic which is fairly normal for my age. I would highly recommend the testing; why would you waste money at our age, doing rounds where there’s a high chance of chromosome abnormalities and therefore miscarriage? I feel like I wasted my 5 rounds before this little bean hopefully results in my rainbow baby 🥰 hope that helps and best of luck! xxx
Thank you soooooo much for your message, that really cheered me up this morning, Good luck with the rest of your pregnancy, I am sure you will make a fabulous mum xx
So sorry about your result. I had a very similar experience just recently and was devastated too. I had 10 eggs which I’d frozen at another clinic. 6 fertilized and 2 were considered Grade A blastocysts at Day 3 - they implanted both and none of them implanted. It’s so hard to know what went wrong as there are so many possible scenarios. I am having a follow up call with my clinic in a few weeks and these are the questions I have for the next attempt which I hope helps you:
Could failure have been because of scar tissue in the uterus ?
Could failure have been from lifting 9kg baby and folding the pram ?
For the next attempt shall we do an Endometrial receptivity assay test to determine uterine receptivity at the time of embryo transfer ?
Why did you insert blastocysts after Day 3 and not 5 ?
For the next attempt shall we do PGT-A testing (to test embryo viability before implantation)
Hi Artcaffe. Thank you for reaching out. I am so sorry that it didn't work for you last time. Thank you for the suggested questions, particularly the Endometrial receptivity assay test one, never heard of that before, so will definately look into it before my consents appointment next week.
Good luck with your appointment, I have my fingers crossed for you. x
Hi, I’m 43 years old. For my second tries for a sibling I had 4 embryo transfers and none of them implanted. My last cycle I had 6 embryos (icsi) of which only 1 ended up being normal after PGTA testing. I am currently pregnant with that normal. I am am so pleased I didn’t spend thousands of pounds (and time) on those abnormal embryos. I do recommend it after 40. But some people believe that some of the abnormal ones may have a chance so I guess if you only have 1 or 2 embryos then it’s worth transferring them without testing. X
Thank you for sharing your experience. I have already been advised by my clinic that if my embryos are chromosomally abnormal they wouldn't implant, and I can understand why. My fear is they are suggesting that they will look at them, as they normally would and if they don't look normal in the first place they won't send them for testing. That's something I need to quiz them on at my consents meeting.
Many congratulations and good luck with your pregnancy xx
Hello! I am 44 and went into IVF purely because of having the option to PGT-A test any embryos. After the birth of our son 4.5 years ago we had been trying naturally for a sibling but suffered four devastating losses. For two of those I knew that they were caused by chromosomal abnormalities and with our advancing ages I realised that often cited numbers' game felt too precarious and I knew I couldn't possibly risk another pregnancy without having given myself the best chance of it going to term. We did two rounds of back to back embryo banking with PGT-A testing (16 mature eggs, 9 fertilised, 5 good quality blastocysts, 2 euploid, 3 aneuploid). We also did the ENDO Quartet (EMMA, ALICE, ERA, Natural Killer Cells), thrombophilia panel and thyroid profile on my side to rule out or be able to treat any uterine or immune factors playing a possible part. I would highly recommend all of these tests, I personally really needed them for my own peace of mind before going into my first transfer hopefully in April. There is definitely a risk that the clinic will allow some embryos to perish ahead of taking the biopsy on day 5 if they don't meet the clinic's criteria for freezing and no one will know if these might have given you a baby. I decided to trust my clinic's process with regard to PGT-A as they had very encouraging success rates with PGT-A especially in my age group. So far I've always felt very well informed by my consultant, she is keen to back up any recommendations with scientific evidence behind it and she will always be transparent if something isn't as established yet but she may have observed good results personally. She also tweaked my protocol slightly after the first egg collection and generally I felt the treatment she recommended was tailored to me and not just the one size fits all approach. I would definitely encourage you to advocate for yourself and ask for evidence for whatever your doctors recommend next. Unfortunately, as with so many things, one thing may work for one and not for another even if the baseline situation looks similar but try and do what feels right for you. Wishing you the best of luck for your next steps! X
Just wanted to add something regarding our fertilisation method which may be worth considering for your next round. We were initially recommended to go for IMSI which is like ICSI, only they use a higher magnification microscope to select the sperm. After our investigation results came back, our consultant then recommended PIMSI as my partner's DNA fragmentation results were very high and we wanted to improve our odds at the best sperm being selected. For PIMSI they will add a substance to the sperm culture and the assumption is that only chromosomally viable sperm will bind to this substance making it easier for the embryologist to select the most promising looking sperm and then narrow the selection down further via IMSI. Good luck!
Just wanted to say thank you for all the information you provided, it has certainly given me a lot more to think about but also made me slightly more positive. x
Sorry to hear your first round didn't work out. As someone else has already mentioned ICSI and PGT-A testing are very different. I'm no expert but my understanding is ICSI is the way they fertilize the egg and PGT- is the testing they do on the embryo.
My first round (aged 35ish) we used ICSI and achieved 2 embryos, had 2 separate transfers neither of them worked.
Second round (aged 37ish) we achieved 11 embryos through ICSI, 8 grade A and 3 grade B. We tried a transfer but again didn't work. As there was no indication of any other issues we were told the most likely reason the embryos were failing was due to them being abnormal but only way to confirm would be through testing.
The cost of the testing is not much different to the cost of a transfer and so if we had a small number of embryos, as we did in our first round, we would have been advised to just put them in and see what happens. However as we had a large number we were advised to test otherwise it's pot luck whether they were choosing a normal one or not at each transfer and we didn't want to waste the time, money or emotional pressure of going through another 7 or so transfers. Therefore we went ahead with testing our 7 remaining grade A embryos. 4 came back normal and 3 came back with chromosome abnormalities.
I am now 26 weeks pregnant with one of our PGT-A tested embryos.
From my experience I would stick with using ICSI, and if this produced a small number of embryos go ahead and try the transfer without the testing. If a higher number of embryos then may be worth trying the testing. Think about the financial and emotional costs involved either way. It's such a tough process and so many different options it's hard to know what's best but hopefully your clinic will be helpful and offer some good guidance for you.
Hello, I would not recommend PGTA testing if you are only likely to produce 1 or 2 blastocysts, unless you are planning on banking embryos over 2 or 3 cycles, biopsying them on each round and sending them for testing together
PGTA is expensive and does not increase the overall chance of a pregnancy, only maybe the speed it happens if you can select the normal embryos from a bunch of blastocysts to test.
Risks of PGTA are that the blastocyst is damaged by the biopsy, doesn't survive the freezing process or is identified as abnormal and cannot be transferred.
Also the embryo has a good chance of not been suitable to biopsy. In which case you will miss the chance of a fresh transfer
If like me you only produce 1 or 2 embryos you have the best chance transferring one or two fresh, if you are prepared for possible miscarriage
Thanks for providing me with some of the drawbacks of this PGT-A process. It really helps to get a balanced viewpoint. I wish you luck with your journey and hope we both have something to celebrate x
Hi there, sorry to know your first try did not work. I can't share with personal experiences but PGS and PGD worked out for a few friends of mine. You can also find all pros and cons of PGT-A in this article: fertilityroad.com/mag/pgta-... I hope this helps you make an informed decision. Best of luck.
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