40 y.o. need to make decision another IUI over IVF, very low reserve, mentally at edge

[Gentleblue]

Hello and thank you for this forum, which I just found exist.

We tried naturally for over a year, but was not aware my only 1 follicle produced monthly never grew to more than 8-10 mm and so I assume have not had the ovulation (based on ultrasound tracking of a few last months).

Beginning of May was stimulated with Gonal F, follicle grew to 20mm we were advised to try naturally..did not work.

Beginning of June again Gonal, Ovitrell and IUI - was not successful. Again follicle was 20mm.

How do you mentally handle the stress? Last weekend I flew off the handle totally, blaming myself and being just angry, then sad, the whole range of emotions. The hope is so tiny.

My partner was tested he is healthy and all is good. I feel old, incapable to fulfill my dream of family, just feel like a failure.

Today doctor said what I knew already, IUI after 40 is 8% chance, but IVF would be x3 more. Although she says it will also most likely to fail first time and we need a few cycles.

What scary is I never had thyroid issue and after hormone stimulation it went to 10 from 2, so I am on the hormones for this too every day now. I understand that IVF has stronger med and it may affect my body more.

I wanted to freeze my eggs earlier, but only had 5 follicles in a cycle so was told would need like 3-4 cycles. I did not do it back 5 years ago, regret about this now for sure.

I am new to this forum, sorry to write such a long post.

I did not have babies yet, generally healthy just do not produce enough anymore follicles.

[JA-fnuk Partner Nurse Fertility Network UK]

Difficult and stressful time for you and partner Hope you get some replies to your post Make sure you have support -take a look at our website fertilitynetworkuk.org Access to Support then click Fertility Groups and scroll to UK-Wide Groups to find closed Facebook Group "40 and over Fertility Group " and follow prompts to register Next meeting 26th June 7pm

Take care

Janet-Partner

[Gentleblue in reply to JA-fnuk]

Thank you very much for your kind message. I would love to attend the meeting on 26th.

[Kitkat10]

hi, you are absolutely not a failure. It is a very stressful time. I had IVF at 40, it took 3 cycles to work. I think that is fairly average.

I felt the same way before starting treatment, it’s a hard process to navigate. Would you stay at the same clinic for the IVF? They may offer a review appointment or similar so that you can ask about further testing and protocols which would best suit you. Good luck xx 🍀🍀

[Gentleblue in reply to Kitkat10]

Hello and thank you so much for your message and kind words. I think, that I made it more stressful for myself by making pregnancy tests. On day 9-10DPO, and I saw two think lines, which made me so happy just to find out it was still a trigger..After that I have checked twice a day and had only one line from day 11. I should of stopped and just waited, but curiosity and anticipation.. I do feel cared at this small clinic, so would stay for the IVF. We are going together to chat more in details about the IVF procedure next week and then I was told we start with a protocol on day 2 of period. Thank you so so much! xx🤗

[Fruitandflowers]

It is very stressful. And it does normally take a few rounds and that's at any age as everyone responds differently and the first round or two can be a bit of an experiment. Egg freezing is a bit different as they're freezing eggs not embryos but that doesn't mean the eggs were good quality or that they would make good embryos. I think the media and the clinics gives us the impression that it's easy to freeze our eggs and once we get to IVF it will work straightaway and will result in twins or even triplets, when actually it's much harder even for young healthy couples with excellent test results. Also 40 isn't really that old for IVF - I've just had my second baby a week before I turned 40 and had my first just before I turned 38, and I had been TTC for a very long time before that with no success. It's a good idea for you and your partner to take supplements for egg/sperm quality if not already doing so, then have a good chat with your clinic about what protocol may work best for you and have a look at funding packages if you need that as they have multi-cycle options which make it much more affordable.

[Gentleblue in reply to Fruitandflowers]

Hello and thank you for your message and support. I agree, I have read that even during egg de-freezing, thrawing I believe it s called, some are not good enough for use and then of course the quality. I am bit worried about the pain during the egg collection, but I am going to do it for sure. Just getting myself back together mentally and physicall for the next cycle. So happy I found this forum! I have been taking Q10 for many years, having read this could help with egg quality. I also been taking fish oil, folic acid.

[Fruitandflowers in reply to Gentleblue]

Egg collection can be painful but a lot of women just find it uncomfortable. Most clinics offer full sedation which pretty much puts you to sleep and you don't remember any of it, so if you opt for that you shouldn't need to worry about that aspect.

[IVFat40]

I started IVF at 40, I would recommend reading 'it starts with the egg' by Rebecca Fett for improving egg quality, especially in our 40s. I also found a fertility nutritionist helpful. My son came from my 3rd egg collection, so it did take some time and heart ache but we got there. Very good luck with it hun.

[Gentleblue in reply to IVFat40]

Hello and thank you for your great tip on a book! I just got it and will start reading. I have read somewhere, we only need 1 egg. Well I only have 1 follicle, but I am praying and hoping for that one to work. Thank you x

[Twiglet2]

I’m so sorry you’ve had a tough journey so far. My advice would be to move to IVF asap , IUI has such a low success rate I wish they wouldn’t suggest it for people over 35 as it just wasted a lot of time for us (we had 6 IUI and none worked at all) get the IVF ball rolling it could work for you and has done for lots of ladies your age xx

[Gentleblue in reply to Twiglet2]

Hello and thank you for sharing. I cannot even imagine what you went through with 6 IUI! My doctor called yesterday to check what we are planning next and sad IUI is about 5-8% chance, while IVF times more. I also feel, there is no more time to wait and moving to IVF is my next step. Preparing myself mentally and physically. Thank you so much for support xx

[Twiglet2 in reply to Gentleblue]

Honestly apart from egg collection (which isn’t as bad as I thought) IVF is just the same for me mentally and physically as IUI but with much greater success xx

[SKC111]

Hello, I am also 40 & have recently read “the joys of later motherhood” and take a look at Dr Tim Childs on insta, he is amazing and has great advice. If I was you I would prob jump straight to ivf as the chances are better. Wishing you all the very best ❤️ xxxx

[happypupp]

Hi, you're like me 5 years ago! My antral follicle count (NHS checked) was obviously higher than when we, 4 years later, finally made up our mind and embarked on our IVF journey - with of course a higher egg quality and a lower chromosomal abnormality rate, which steeply increase with aging especially over 40. This means even if IUI successfully helps you fertilise the egg, there is a higher chance of the embryo not surviving or being unviable due to chromosomal abnormality.

What I would recommend based on my personal experience:

- Get your AFC and AMH checked, these numbers will help IVF Drs decide which protocol to employ

- Get a full thyroid panel done including antibodies. NHS typically only checks TSH but it doesn't give you a full picture. I had elevated antibody, which calmed down after going gluten free.

- Hire a fertility nutritionist or at least have a free exploratory call

I did all of the above plus made more changes to my diet/supplementation and I'm now 24 weeks pregnant. moore about my history in my profile.

[Nakijo in reply to happypupp]

Congrates. Can you please share the supplements you used?

[happypupp in reply to Nakijo]

My choice of supplements was adjusted as a result of consulting my fertility nutritionist but based on what's recommended on It Starts With The Egg book, everyone's health situation is different so I would start with the book.