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Discussion Starter · #1 ·
Given that we have excellent early embryonic devt and lots of blasts etc, and my tubes are clear, I'm wondering what exactly IVF does for us. and thinking of switching to eg IUI again.

Im interesed to know how ladies over 40 successfully conceive.....

many thanks
anna
 

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Hi Anna,

I had 2 failed cycles of IVF and then amazingly conceived naturally!!! I'm 40 and have PCOS. I thought that I had no chance without assisted conception, how wrong was I. I believe the stimulation drugs taught my ovaries what they were there for and taking pre-conception vitamins helped with the implantation.

Everyone is different but there is always hope.

Ellie
 

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hi there
After 3 IVF cycles, 1 FET, 2 pregnancies and 2 miscarriages, we conceived naturally on the cycle after my FET miscarriage, and had our daughter in September.

There is certainly evidence that after around 42 there is no increase in success rates in doing iVF, it's thought the eggs just become too fragile. So def worth considering IUI, although it doesn't usually offer much of an improvement over just trying naturally, even with hyperstimulation.

Wishing you all the best
 

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Discussion Starter · #4 ·
many thanks for your replies.

i had always thought it was issues of fragility "out of" body that caused older ladies probs with IVF.

however, my dh and i get better and more blasts than many younger women who get bfps. :-(

So, I now think it's additioanlly because our eggs are poorer quality - only one of [insert some horrifically high statistic] is still good. Therefore with 2 or3 going back each time we have to try harder to find the elusive good one.

hence why i'm thinking for those of so called "unexpaliend infert" (proabbly poor eggs) ivf is not the route and iui or natural might actually be BETTER, notwithstanding stats.
 

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Anna,

I am not sure how old you are regarding ivf etc etc as you outline in your post above. I don't think there is a lot of evidence to show that over 40 eggs are more fragile than any others (certainly Cornell no 2 in the world for ivf does not agree with this at all). I personally think that, apart from eliminating peripheral factors I've mentioned below, one of the most critical factors is the quality of the clinic you go to. How good they are, how good their lab is, they have success over 40 etc. Also being able to make and replace as many embryos as possible is another apparent key to achieving live births in over 40s according to a lot of research.

I would assume aneuploid eggs are a factor over 40 and anything that can increase the number of eggs/embryos produced is good but there is no way of knowing if they are normal without PGD etc etc.

Just for info. regarding continuing to ttc without intervention (or minimal). I have belonged to a really good website for about 4 years called TTC over 40. Run by a woman who had her last child at age 46 via FSH injectibles and sex with DH. Her website has lots of support and info. and is a good resource for women over 40 ttc.. might be of interest for you while you are considering options.

http://www.fertilityover40.com/Forums/FertilityOver40Forum/tabid/60/view/topics/forumid/4/Default.aspx

You can read her story (Pat - the board moderator/administrator). She did try for quite a few cycles though, using the same strength injectibles as for ivf and using a trigger injection then sex. She got pregnant almost every time but miscarried or had chemical pgs until final success... but there is evidence that, as long as you and DH do not have any other issues, this can be a way forward for over 40s. It does need dedication to keep going month after month as there is no time to wait. You also need a good local clinic who will prescribe the right protocol and monitor you closely and correctly for each cycle. She does however, have several grown up children, and this may be a factor... BUT her only ivf cycle failed.... yet she still managed to have a live birth at age 46.

Finally, I would also eliminate all other causes of potential failure if possible e.g. DH's sperm (dna fragmentation etc), karyotyping for you and DH, uterine issues, bacterial infection (e.g. ureaplasma/mycoplasma), clotting, thyroid, insulin levels, ANAs etc.

I think in many cases I have seen over the years, women have been told that all their issues stemmed from 'old eggs' and while I agree that this is a huge contributing factor to over 40 failure, I believe that this means women do not investigate other possible causes of failure until much too late. This happened to me and I don't want anyone else to go through it too... also don't forget how much sperm contribute to potential success or failure!

A lot!!! I know....

Best wishes,

Daisy
x

/links
 

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Discussion Starter · #6 ·
Much appreciated Daisy, thank you.

I think I have all the various tests done (massive clotting panel, ledien, mthr, both karotyping, HSG, all hormones) or in progress (NK panel etc) or advised against (sperm frag, dna analysis, - owing to 100% fert rate and vg devt thereafter-) or decided against (PGD)

I think with unexplained in over let's say 37, very often the issue is indeed "old eggs" (horrid term) BUT.... I DONT think ivf is always the answer.

I DONT buy the "fragile cytoplasm/less active mitochondria" argument as, just from reading people's tickers on ff, it is clear that older women can have a great rate of eg blasts and fail while younger women can have a far worse reaction in embryological terms and succeed.

I think it's chromosomal either fundamentally or with tiny issues that can be transcended in younger women but with me will result in eg a poor interaction with the lining. 

it's very interesting indeed to know at 46 this lady achieved pg - I wld argue she "found" the good egg at that point. via injectables. cf yet another exhausting IVF cycle. I will definitely register with that site, thank you.

have agood weekend,

Anna
 

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I'm 40 and 14 weeks pregnant, I have had two children naturally but it took a very long time to conceive them, two years for the first, 10 years for the second and had two miscarriages.  We had been trying for a third for two years before deciding to have some help due to my age in the form of clomid and became pregnant in the second month of being on it.  I suspect I may have been having some ovulation problems and clomid helped to rectify it.

Ursiex
 

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Ursie, Im so happy for you and if anyone deserves it you do. your children are indeed beautiful and very happy and loved i the photo.  ^hugme^ 
 
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