44 - worth another shot?

[Football61]

Hi, I’m at a bit of a crossroads. I’m 44 and single, and had my first IVF cycle in May. My AMH is 11.5, my AFC is 13 and my uterus is healthy.

I went into my first cycle with very low expectations, given my age. But I was feeling quite hopeful after my egg collection. I had 16 eggs collected, 14 mature, and 13 fertilised. But I was brought back down to earth with a huge bump by Day 3, when 10 of the embryos were dividing abnormally. By Day 5, I only had one full blastocyst, which I sent for PGT-A. I was spiralling by that point, so sent another poor-quality blastocyst for PGT-A too. Unfortunately, they both came back abnormal. A pretty crushing outcome after having 16 eggs collected.

I now need to decide whether to have one last go with my own eggs, or to move to donor eggs. I had an appointment with the Medical Director at my clinic today, and I think I’m swaying towards doing another cycle with my own eggs in August - but I’m not sure if I’m on a fool’s errand. If all 13 of my embryos were abnormal, I must have a severe problem with my egg quality? The Medical Director said that my chances remain incredibly slim - but it might be worth one last go, given I still have a pretty good ovarian reserve.

I’m going to re-start taking DHEA (I took it for a month before my first cycle) and have another try with the Human Growth Hormone (I had a bad reaction to it, so stopped). I’m on Folate, Levothyroxine and CO-Q10 (should I move to pure Ubiquinol)?

Is there anything else I should be doing? Very grateful for any advice before I enter my last-chance saloon. Thanks ❤️

[Ivfgotadream]

I’d check on taking DHEA as it’s my understanding it’s more for when you have low egg numbers, you’ve got great egg numbers for your age. I’m sure yo are aware of the stats for abnormal embryos over the age of 43…that something like 99% are likely to be abnormal….I wouldn’t bother PGTA testing and just go to transfer with with you get

[JoyfulStar]

I think only you can make that decision on whether you give your own eggs one last shot. Is there a reason why you are going down the PGT A route? It is an improper science and even the HFEA give it a red as there is no evidence it improves chances of pregnancy.

As someone who got pregnant a few weeks before my 44th birthday, I would say it is possible although our chances are very slim. I transferred 2 day 3 embryos. All the best with your decision.

[Football61 in reply to JoyfulStar]

Thanks, and that’s brilliant that you got pregnant just before you turned 44. I’ve carried out lots of research on PGT-A, and I know that it doesn’t improve chances of pregnancy. But I do believe that it potentially saves time. If I had transferred one of my abnormal embryos this month, it could have potentially been two months before I miscarried - and I just don’t have two months to waste (I’m going to be 45 in January). If I do another cycle in the summer, I’m pretty sure it will be my last one. And so if I end up with just one blastocyst, I think that I will probably do a fresh transfer, rather than send it for PGT-A.

[JoyfulStar in reply to Football61]

Thank you. Good luck with your next cycle and I really do hope you get that miracle baby 🌈

[Yellowlove in reply to JoyfulStar]

This is lovely to hear. I did 6 egg collections at age 42 with my husband, 43, we kept going in the hope that we’d get that one embryo. We got 12 and all of them came back abnormal, so we’ve moved onto donor eggs. I do think it’s an individual choice whether you keep going or not, but we’ve been trying naturally for so long and did 6 rounds with my own eggs, so I can say we tried and will never have any doubts or regrets. Good luck to everyone on here, it’s an awful journey to be on but the success stories are all so lovely to hear x

[rainbowbaby8320]

hello! I have a slightly different opinion about pgta which I just wanted to share…although I think you should consider everyone’s views!

I had a horrible miscarriage and this wasted time for me - it went on for months! So I value pgta now? Wasted time means you are also putting the few good eggs you have got in the bin while you are waiting for the miscarriage to end… I’m 41.5years FYI… pgta does not increase chances of pregnancy per se… but it avoids wasted time which I think indirectly is correlated with lack of pregnancy for older women? To prove the increased chance of pregnancy they would need to run two parallel universes which they can’t…

If a woman had 6 good blasts, at age 41, she could spend a very long time and considerable funds transferring them one by one? This is what I did and it made me decide pgta is worth it. I would have realised about egg quality sooner? I wasted precious embryos and time assuming my egg quality was poor (and it was ok - turns out I had another problem!!) … I wouldn’t have gotten to that conclusion without pgta … so what hfea says is true, but it has other very good uses besides improving rate ‘directly’.

have you changed anything in your diet besides coq10 supplements etc?

The book ‘it starts with the egg’ could improve egg quality a bit to get one out of your many eggs to be euploid etc x

[rainbowbaby8320 in reply to rainbowbaby8320]

sorry! Think I was a bit confusing in my reply… I transferred three good embryos , one was mc and then next two bfn….

But somewhere along the line I must have developed an auto immune disease which is now blocking me from getting pregnant… after those three embryo transfers I did pgta and then got one which was euploid… then that one was bfn which led them to believe it’s not egg quality which is the issue for me… now I’m doing pgta to avoid wasted time and babies x if I didn’t do pgta on that one, they would still be telling me it’s probably egg quality - so the pgta was essential in my scenario…. Without it I would still be transferring embryos one by one and soon my egg quality will be worse too x so I would likely have given up after several more attempts without realising it was never my eggs that was the issue in the first place xx

[Football61 in reply to rainbowbaby8320]

Thanks so much for writing to me, and I’m really sorry to hear about your difficulties. I hope you manage to find a way through - I have everything crossed for you 🤞🤞.

It’s really interesting to hear a positive perspective on PGT-A, as I flip back and forth on it. Ahead of my first cycle, I explicitly told my clinic that I wanted to do a fresh transfer if I only ended up with one blastocyst (but I would do PGT-A on all the embryos if I had more than one). But after I had 16 eggs collected, they convinced me otherwise. So when I ended up with just one full blastocyst on Day 5, I had no choice but to send it for PGT-A - as I hadn’t been taking the pessaries, etc for a fresh transfer. I was pretty furious at the time, as I basically spent £2,650 sending one embryo for PGT-A (although I ended up sending another one too). Now, with hindsight, I guess it’s good that I haven’t wasted time with a potentially awful/drawn-out miscarriage. But on the other hand - £2,650 is an awful lot of money to spend when it could have just been a BFN after the 2WW.

My diet has always been atrocious. Almost everything I eat is processed, and virtually zero fruit and vegetables. But I tried to turn things around a couple of months before my first cycle - I’ve drastically cut down the processed food, and am trying to eat my 5 A Day. I mentioned this to my Medical Director yesterday, and he didn’t think that my poor diet is linked to my poor quality eggs. Please do you mind me asking if you take CO-Q10 or Ubiquinol? Any particular brand? xxx

[Hope43yrs in reply to Football61]

I wish you all the luck with whichever option your gut feeling tells you. I’ve read on another post that Ubiquinol is better than CO-Q10 for ladies above 40, this was posted by a member who is treated by a fertility nutritionist and she also gives more advice I will try to find the post and PM x

[Football61 in reply to Hope43yrs]

Oh bless you, thanks. I’m really struggling to find some online! Not sure if the ones on eBay look a bit dodgy 😬😬 xxx

[Hope43yrs in reply to Football61]

Hi,

I had a look at H&B, I know it is more expensive but it is trusted provider, at this moment they have 2nd at half price which makes the overall price per bottle cheaper than other shops, also if you need 200mg take two as I’ve read they are easy to swallow, hope this helps xx

(Brand Solgar is one of the most trusted one) x

[Itisajourney in reply to Hope43yrs]

Thank you for sharing. Can I please jump in? Are the intake quantities the same for ubiquinol and CO-Q10?

[Babytocome in reply to Football61]

Hi,

Sorry for the difficult time at the moment, thinking about vitamins etc, I am over 40’ too… I followed a doctor from Harvard on you tube that is called “ the egg whisper” she gives good advice on brands and vitamins, Maybe it will help out to have a look

[Gerbear22 in reply to Football61]

Hi just thought I’d add that I tried both.Tried CoQ10 on first cycle and Ubiquinol on second cycle.Second cycle embryos were a better quality and I now have a 6 week old baby girl.Now could be just a change of medication and just pure luck but I personally believe that the Ubiquinol helped the quality of my eggs.I’m a poor responder and was 40 when I had both cycles.x

[Football61 in reply to Gerbear22]

Hi - thanks so much for replying, and huge congrats on your little girl. Please would you mind me asking where you bought your Ubiquinol/what brand? Am really keen to buy some today. Thanks xx

[Gerbear22 in reply to Football61]

Thank you x I used Quest ubiquinol Qu10 100mg.I took 200mg daily as advised by my acupuncturist.x

[mumma_in_the_making]

I think you have to trust your gut instinct with this one. It sounds like everything started off so well so it could definitely be worth another try with your own eggs. Good luck x

[Football61 in reply to mumma_in_the_making]

Thanks so much - I really appreciate it. My gut instinct is telling me to have another try, but the only thing holding me back is the money side of things. My clinic is pretty pricey - one cycle of IVF is around £10k, all-in. And it becomes £12,600 if I do PGT-A. But I don’t want to look back in five years and kick myself that I didn’t have another try, purely based on finances. It’s such a tough decision 🤷🏻‍♀️ xx

[Kitkat10]

Hi, just to say I’m having a similar decision to make although my egg numbers are much lower than yours. Last cycle at 42 I had 6 eggs collected and 3 x day 5 embryos, none of which were successful. I think after reading your story and knowing my numbers are much worse, I’m swayed more to DE now for me. It’s such a hard decision to make isn’t it but I spoke to a lady who had a DE baby after unsuccessful OE and she reassured me that she feels 100% certain the decision was right for her. I guess weighing up cost and time may help although the time pressure on DE is much less. I don’t think there is a wrong or right decision, just what feels right for you at the time. Good luck with your next step 🍀🍀🤞🤞

[Football61]

Thanks so much for writing to me, and I’m so sorry to hear that your last cycle wasn’t successful. Before I started looking into IVF at the start of this year, I didn’t even know that donor eggs existed - so it has been a real lifeline for me - if I’m not successful with my own eggs. Wishing you the best of luck ❤️❤️

[Orangeflowers]

I'mSorry to hear that both your embryos were abnormal 😞 It's disappointing after such a great start.

With regards to coq10/ ubiquinol - Ubiquinol is definitely better as it is more bioavailable. My clinic advised me to up my dose to 600mg a day. It is the supplement with the best evidence base, but I'm aware it can't drastically turn around outcomes and it's effects are more likely to be subtle. It hasn't worked for me yet. It is expensive. The most affordable I've currently found is HTN on Amazon.

With regards clinic - for speed, it might be best sticking with your current one, though it is expensive! I think you can get 3 rounds for 10k (without meds) at Kings in London. And clinics abroad e.g. in Greece are a lot cheaper.

Have you considered mild IVF? It might be better for embryo quality.

With regards to whether to try again - I think it depends if you have the emotional energy for it and whether you'd still be able to fund donor eggs after that, if that is what you wanted.

As you have only tried one round, I think it might be worth another go. However, in my own case I repeatedly did that and each time the outcome was the same. If you still make blastocysts, then by chance a next one might be normal.

I looked into the stats quite a bit when I was 43 and the research says that we need to send 17 embryo biopsies for testing to get one normal at that age. However, obviously you could get lucky on the first or second attempt. I know people on here who haven't tested and have got lucky at 43.

It might be worth asking your clinic about the DHEA as I've heard it can lead to worse outcomes for some, though with others it improves outcomes.

Hoping you are able to find the right next steps and get a good outcome. This is so tough. Keep us updated x

[Football61 in reply to Orangeflowers]

Hey, thanks for writing - and thanks for all your support over the last few weeks - it’s much appreciated. Hope all well with you.

I think I’m 95% sure I’m going to do another cycle in August - and I’ll stick with my current clinic. I’ve got the emotional energy for another bout, although I’m not feeling too hopeful. Guess I just need to do everything I can to try and boost my chances, and keep praying 🙏

Bought some Ubiquinol from Solgar. Will double check the DHEA with my clinic - I hadn’t heard about it worsening outcomes for some patients? It made my face look like an oil slick during my first cycle (classy!), but want to stick with it even if there’s a remote chance it might work.

What would you classify as ‘mild IVF’? I think that I was on quite low dosages during my first cycle. The Medical Director at my clinic was creating a new treatment plan for me this weekend, so I’ll see what he comes back with. I asked him whether fewer eggs will mean better quality, but he didn’t really give me a straight answer 🤷🏻‍♀️

xxxx