* Author Topic: 40+ Advise needed, please!  (Read 234 times)

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Offline Morganite76

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40+ Advise needed, please!
« on: 27/01/20, 12:26 »
I have been through ART with Bristol Center for Reproductive Medicine. In spite of a FSH of 19.6 (high), testosterone of 0.1 (low) and AMH 1,7 pmol/L, I had 8 folicules (5 very nice ones), only 4 eggs, 1 three day embryo; and sadly no blasts for transfer. I understand that I am old (43). But somehow, I am not very happy with this outcome, in spite expected before I started.

Should I have asked more questions to the doctor? For example, in older women, above age 43, it appears that early egg retrieval doubles pregnancy chances. Mine were retrieved quite late, with folicules larger than 20mm... Why did they make this decision, then?

Also I read that a intramuscular administration of a dose of hCG (usually 10,000U) - as trigger - works better than hCG (Ovidrel). I was given Ovidrel 250 mcg. But other's clinical experience strongly suggests that 250 mcg of Ovidrel is most likely not equivalent in biological potency to 10,000 units of hCG. It probably only has 50%-70%of the potency of a 10,000U dose of hCGu and as such might not be sufficient to fully promote meiosis. For these reasons, I now suspect that I have not prepared myself well enough, and chose the wrong clinic to have treatment... Am I being unfair?

My question to you is whether I should try another cycle with my own eggs, of if I should try with donor egges. Also, do you have any recommendations?

Many thanks!

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    Offline equine_m

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    40+ Advise needed, please!
    « Reply #1 on: 1/02/20, 17:48 »
    Hello,

    I cannot see anything would be lost by going somewhere else for a second opinion.  It sounds like you do have some doubts about your current clinic, so testing your concerns with another consultant should provide you with some more information. IVF for ladies like us who are 40 or over is quite specialist and I'm not convinced all clinics are quite as geared up as they suggest.

    Offline Mochashosh

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    40+ Advise needed, please!
    « Reply #2 on: 1/02/20, 19:44 »
    Hello there

    How do you feel about your current team?  Would you be willing to go back to the original doctor and put these questions to him/her to hear the response? It may be that they have good answers, and that you need to find out what these are in order to know whether you have faith in this team for another cycle or whether to go elsewhere.

    If you don't feel that the doctor would be receptive to your questions, that already tells you what you need to know. 

    I think it's worth asking the question about your trigger to someone with medical expertise in the area.  Remember that there is a difference, often quite a large one, between achieving a pregnancy and achieving a live birth.  So, whilst a different trigger might give you a higher chance of a blatocyst (I wouldn't know, not having read the research), that won't necessarily give you a higher chance of pregnancy; that depends largely on the genetics of the sperm and the egg, which won't be influenced by the trigger.  Also, a blastocyst doesn't necessarily give you a better outcome at our age.  I've mostly had blastocyst transfers, but the time I was pregnant was on a Day 2 transfer.  And if you look up stats for big clinics like the Lister, they don't show significantly higher success rates with blastocyst transfers in our age group. 

    Remember that the grass isn't always greener on the other side of the fence.  I changed clinics after 3 failed ICSI cycles (pregnant on my 2nd cycle, but early miscarriage), and got BFN for my 4th, plus a load of stress. In retrospect, perhaps not the best decision.  I believe I've now found a clinic that suits me better.

    Should you continue with OE?  Well, that depends how you feel about a donor.  I would have used OE for sure at 43.  Now that I am older that's no longer a possibility.  For me it's DE or nothing, which might well mean nothing, because I feel really negative about DE.  So, I'd say give it another go unless your clinic has a very strong reason to advise against it.  Your chances will be higher for sure with DE, but perhaps that's not the main factor for you.  It sounds odd to say that, but I it's a very individual choice based on whether you're willing to stack the odds in your favour of having a baby to love, or whether you're willing to go for longer odds, but still have the possibility of your own genetic baby.

    I hope that you make the best decision for you, and that you get to hold your beautiful baby very soon.
    xx