* Author Topic: Decision - continue at 41 or DE?  (Read 1238 times)

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Offline Springs

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Decision - continue at 41 or DE?
« on: 6/12/07, 13:11 »
Hi Ladies,

Ellie has pointed me in this direction, and after reading a lot of the threads I think she was right! ;)

I know I have to make this decision myself (with DH who is a star  ^smlove^) but...have posted the full story on Negative cycles, so briefly: have had 4 cycles of IVF all of which were negative. Had a natural m/c at 20weeks with a difficult manual placenta removal, and after no luck a year later was told to have IVF as time was/is running out, and 2 years later now have no tubes (ectopic from first natural FET, then hydrosalpinx)  >:(

My dilemma is: we had an excellent first IVF, although bfn, as had 7 frosties. Unfortunately have only had the ectopic from the subsequent 2 FETs although all survived thawing. Next two IVFs were not great, had multiple follies of varying stages of maturity, and had OHSS the second time although not hospitalised (so now have PCO). Did manage 2 good grade 1 embies on IVF#2 and 2+1-not-so-good on IVF#3, and had the last FET in between - all bfn, and no frosties. :(
As we were not too optimistic with the 3rd IVF, we went ahead and organised DE at Reprofit for 2008, but as there was such a long wait we decided to have a "last" go with my eggs (so I could sign off feeling we had tried our best), and used the short protocol with more blood test and scans...would you believe, after only a week of Gonal-F at a lower dose we had a good result with 10eggs, 5 fertilised, and all 5 survived to day 3 when we had 3 (2x8cell, 1x6cell) transferred. But, another bfn. :'(
So, do we give up and wait the 4 months until DE, or do we postpone DE and try once again with my eggs, as we had such a good result? We have 2 frosties, but I will leave those until after another cycle, as my lining is not always great.
How have you ladies reached your decisions??? I have read Rozie's post about DE and can completely see her point...that was how I felt after IVF#3...but now, I don't know! I am 41, and will be 42 at the end of the year, so am quite keen to increase the family asap, but on the other hand, I don't want to feel that I gave up too early...but am I just deluding myself after so many negatives?  :-\
I know I am still dealing with the last bfn as everyone including the clinic thought it would work...so if all the signs were so good and it still failed, is there any point??? Not sure how many more times I can face AF coming in on day 12 every single time! ^bigbad^
We haven't had our follow-up with the cons yet, but she was not very optimistic before IVF#4, but then we were all surprised with that result.

Sorry, I thought I could keep this one briefer, but it seems to have expanded again. Why can't we know more about why the wee embies don't implant??  I feel so frustrated, I can relate to others who have posted here who hate the lack of control!! ^tantrum^

Thanks for reading if you have made it this far: please share your wisdom with me (please!!) :-*

Good luck and baby dust to everyone... ^stocking^ ^fairydust^ ^stocking^

Springs

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    Offline daisyg

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    Re: Decision - continue at 41 or DE?
    « Reply #1 on: 6/12/07, 13:46 »
    Hi Springs,

    Difficult questions.  The first thing I would address is why have you miscarried and why are you bleeding on day 12.   If you or DH have any issues other than age, then moving onto DE may not be an answer for you either.

    It is really up to whether you have the emotional and financial will to continue for a little longer - perhaps after having some basic miscarriage/implantation failure testing which will be relevant for TTC with own eggs and DE.  Certainly you have got pg and that is a positive sign.  Sadly, over 40 the incidence of chromosomally abnormal embryos will be an increasing problem.  However, it may not all be down to your age and I think this is worth considering.

    Here is a list of basic tests, many of which your GP should be able to do.  Otherwise there are private doctors or maybe your clinic who could help.

    https://www.fertilityfriends.co.uk/forum/index.php?topic=80433.0

    Testing includes things like karyotyping for you and DH, clotting, autoimmune, thyroid, uterine, etc. 

    Were you given reasons for m/c?  It certainly is a bad sign that you have bled consistently on day 12 - this suggests that you were either not on enough progesterone or you do not absorb it.  Many women with this issue find that injectible p4 delivers high amounts.  Without adequate p4 you cannot sustain a pregnancy- hence the bleed as you womb lining breaks down due to low p4.

    The other issue is whether you are at a top clinic for your age.  One which has good live birth rates and experience with women over 40?  This is another consideration.

    Finally, you do have issues like PCOS which can be a problem.  Are you being adequately tested and medicated for this?  Have you had an insulin resistance test etc?

    Why is your lining not great?  Have you discussed this with the clinic?  Do you achieve a triple stripe?   These are also important questions and will affect you if you choose to do DE.

    Basically, DE can only address the age of your eggs.  If you are having bfns/m/cs for any other reason then you and your DHs sperm (e.g. dna fragmentation testing) need to be tested.

    Only you can decide of course - but if you have the finances and the will, then maybe another cycle with your own eggs after addressing some of these issues is a way forward.  It is really, really important to go into donor egg treatment having had some closure over giving up on your own eggs and many women need that final own egg cycle to get this closure.

    In my own case - I got pg on all 3 ivfs I did from age 44 - 44.5 but miscarried all of them.  I was then told to move on to DE, which I also miscarried.   It was only then, after testing, that clotting and autoimmune issues were diagnosed.  These were treated and I was able to have a successful donor pregnancy and birth.

    Best wishes and good luck,

    Daisy
    x

    Offline INCONCEIVABLE

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    Re: Decision - continue at 41 or DE?
    « Reply #2 on: 6/12/07, 14:53 »
    If I had that kind of response I would carry on trying with own eggs.  The Create is quite affordable and mild stimms may be a way to go,not to strenuous on the body or the purse....
    I only got 3 eggs on my only ivf cycle and I still couldn't make a decision to move on to de... You will regret it if you do not try and until you are sure that you have exhausted all possibilities with own eggs...


    Offline Springs

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    Re: Decision - continue at 41 or DE?
    « Reply #3 on: 7/12/07, 10:33 »
    Thankyou for your replies, Daisy and Inconceivable.

    I will email my cons with a list of questions as some of the points you raised Daisy seem quite pertinent. Unfortunately we are not based in mainland UK which makes our clinic choices slightly more limited (transport and links) but our clinic is not very proactive at suggesting any tests or investigations, although they are lovely people and very supportive.
    My gynae cons (not clinic) attributed my miscarriage to fibroids, hence their removal the following year. Unfortunately I now have a lot of scarring and adhesions from the myomectomy and laporotomy, and had to have the hydrosalpinx-affected tube removed by a bowel specialist, albeit using keyhole surgery.

    My lining became thinner after having both tubes removed, as subsequently we had to cancel each attempt at natural FET due to only getting 6mm or less, and my periods were lighter. The following GEEP cycle was the only cycle when I have not bled before test day, so your comment about the progesterone seems very important.
    My FSH is 7.5 or below each time I have been tested, but other than oestradiol  and the regular screen I have not had any other investigations. DH's sperm has always been assessed as not being a problem; again, other than blood screens he has not undergone further testing as we always get some fertilisation.

    When I mentioned to my gynae cons that my clinic thought I had polycystic ovaries he did not seem to agree, and other than a satisfactory uterine saline test, has not advised further tests. I don't have any of the listed symptoms of PCOS other than producing lots of follies of varying sizes  (even in natural cycles).

    But you have both helped to organise our thoughts, and the fact that DE won't magically solve all our problems is a very good point...I think we hoped it would! My emotions are still all over the place, and I seesaw from thingking I need to try again, to not wanting to face yet another failure with my own eggs, but I also agree that we need to sort out the existing problem before facing the possibility/likelihood of failure with DE as well.

    Cheers Ladies for replying,

    Springs

    Offline Springs

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    Re: Decision - continue at 41 or DE?
    « Reply #4 on: 7/12/07, 11:01 »

    Sorry, I forgot: I had all the bacterial tests done after my initial miscarriage and after the ectopic; also the full bloods a couple of times as I was readmitted to hospital after the laporotomy with further internal bleeding. Also had diabetes and glucose tests done by GP and hospital, and I gave blood before this last cycle so had more tests then too!

    Springs

    Offline wendie

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    Re: Decision - continue at 41 or DE?
    « Reply #5 on: 10/12/07, 17:36 »

                              Hi ya Springs
                                     This is such a difficult dilemma,we in our totall madness have had two IVF's this year using my own eggs,on both occasions i responded really well to the medication produced lots of eggs and had 2 embryos put back the first time and 3 the second,both had a negative result. and i really felt i wanted to keep trying, but as you all know its so expensive, we had a long and very honest talk with my consultant who pointed out that i have no problems producing eggs but they are 43 year old eggs, which gave me a 5% chance of success. i had thought of using DE because of the success rate,but you have to think long and hard and its such a personal decision. we decided to try a DE IVF as we couldn't afford to go on and on. and yesterday we came back from Alicante with two 8 cell embryos on board, i was so impressed with the clinic we used and i got information about the donor that helped me. i don't know if it will work but i now have a 50% chance now. wendie :-*

    Offline Springs

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    Re: Decision - continue at 41 or DE?
    « Reply #6 on: 12/12/07, 13:24 »
    Thanks Wendie,

    it helps to get another viewpoint. Good luck with your 2WW and lots of  ^reiki^ ^reiki^ ^reiki^ vibes for the test date...I'll look out for your posts.

    Which clinic in Alicante did you use (if you don't mind me asking) and what sort of donor info are you given?

    Cheers,
    Springs

    Offline wendie

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    Re: Decision - continue at 41 or DE?
    « Reply #7 on: 12/12/07, 20:11 »

                             Hi Springs we used the IVI clinic in Alicante, they have a website and from my first consultation to ET was 6 weeks. The information i was given was that my donor was 31, same blood group as me,same eye colour and hair colour her birth date all the blood tests and screening she had done,and that she had  counselling sessions,and that she had proven fertility which i took to mean she had a child or had a pregnancy,she is a housewife and her height and weight,which was a lot more than i thought i would be given. they also sent me home with a really clear pictures of both embryos and information sheets of dos and donts.
                                   I hope this helps wendie :-*

    Offline Springs

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    Re: Decision - continue at 41 or DE?
    « Reply #8 on: 13/12/07, 13:25 »
    Thanks Wendie,

    Alicante sounds like a good clinic giving you all that info. We are booked with Reprofit for next year, but Stepan has indicated that he thought we should continue after our last result and postpone DE...but he is really booked and not looking for extra patients!  ;D
    We have our follow-up cons on 19th, and I sent her a long email with lots of questions (from Daisy's reply). She is very reassuring, and checking their stats they have 17% success rate for 40-42 yr olds, but that was back in 2005 (latest year HFEA stats available).
    How are you feeling? Enjoy the rest if you are having one!  ^reiki^ ^reiki^
    I always have a "holiday" during treatment but then its awful going back to work, so next time I might book longer off! We usually only take the week of treatment, but last cycle I had 2 weeks (mainly because it was a week earlier than expected) which unfortunately made no difference.

    Fingers (and everything else) crossed for you, and all the other ladies presently "PUPO"  ;)

    Springs