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Over 40 and TTC with IVF/ICSI #28
107 replies to this topic
Posted 27 August 2015 - 07:39 AM
I have sent you a PM which also includes some comments about PGD. I agree it's certainly adds cost to the process - and time.
I have to admit on the risk of damage to embies I wasn't given a lot of info although my FS did talk about the current research. It's seems they don't really know for sure whether there is damage caused by the process.
I agree the PGD does avoid the TWW but i don't know if it's any better as I feel frustrated, disappointed, desperate as I haven't actually got a transfer so feel I'm not even in the starting block for a chance at a pregnancy.
I think as time goes on, don't rule it out, you may decide to do one cycle of it for example and see how you go. One thing I was thinking was whether I could do a dual cycle e.g transfer a good day 3 fresh and in that same cycle if anything gets to day 5 and is able to be biopsied then I do the PGD testing. That way you have two chance in the one stim cycle. I don't even know if I can do it, I haven't asked yet and won't be able to until my appointment in Sept.
Posted 31 August 2015 - 09:24 PM
Thanks for the info about PGD. I'd thought they took the cell on day 3, so don't know if our embies would last to day 5. Your plan of dual cycle sounds like a great idea. When I thought PGD was a day 3 cell, I wondered if they could take the cell and then transfer the embie. That way if anything was up, we could make decisions earlier.
In terms of embie safety - my FS suggested that with older eggs that embies can collapse when you interfere with them? (He is very pro cycles being as natural as possible though.)
I hope the time goes quickly until your appointment.
Posted 31 August 2015 - 09:46 PM
G - it's certainly the case that older eggs are more fragile. I lost 7 from my original 19 within 24 hours of being fertilised. The embryologist told me they ' disintegrated' overnight. When I asked why she said some eggs don't like having a need stuck in them to be fertilised via ICSI. I wonder if I had not done ICSI a would those have fertilised by themselves. I'll never know and if I do another PGD cycle, I will have to do ICSI a again.
There are 3 day and 5 day biopsies done but the current research shows that day 5 is better as gives more accurate results and with day 3 there can be more errors because less cells are being examined.
Posted 31 August 2015 - 09:56 PM
Thanks GL for clearing up when they do PGD.
I get so tired of hearing about my "older fragile eggs"!
My DH has motility issues so we have to ICSI - that combined with the Teflon coating on my older fragile eggs! Apparently in the Petrie dish some motility-issue sperm will swim over the egg and not try to penetrate it. I've heard of some couples expecting to have to do ICSI, but on the day the scientist has given some sperm a go to see if they can get the job done unassisted. Maybe that would be option for you if you are worried about ICSI?
Posted 01 September 2015 - 07:56 AM
G - I guess we have to weigh up everything in the equation - I would be devastated if I did standard fertilisation and none of them fertilized ! At least with ICSI you are pretty much guaranteed to at least get some eggs fertilized. I think in your case ICSI is certainly the way to go. My DH has had up and down results in terms of morphology so I paid extra for some extra sperm selection process to pick the strongest ones for ICSI - I'd have to look at my paperwork to see what's it's called.
I have a close relative who got pregnant at 45 naturally. That baby is now 16. It gives me hope that are some good eggs still in there. In fact I seem to be surrounded at the moment with people I know getting pregnant " accidentally" in their 40's. Not sure if that gives me hope or just makes me more frustrated that I can't!
Posted 06 September 2015 - 03:07 PM
Just got BFN on cycle 3. So now need to organize to start cycle 4 next month. So frustrating and sad. We also need to decide whether to stay with current FS or get second opinion.
Posted 06 September 2015 - 04:16 PM
Hi G - sorry to hear that. I think if you've had 3 cycles with this FS maybe seeing a new FS might be of benefit. There seems to be such variation between specialists and how they approach things. Some specialists might have a fresh approach that just might change something - at least that's what I would think after 3 cycles. At our age we don't have time to muck around unfortunately I think it's worthwhile giving a change some thought.
Posted 06 September 2015 - 04:40 PM
Thanks GL. It's like you've read my mind. I always said after 3 cycles I'd get a second opinion, but hoped it wouldn't be needed. It's difficult when you really like your FS, but I know he is a bit conservative. My GP thought FS might suggest I get a second opinion, but he hasn't yet. That would smooth the way for sharing of records, although they are both associated with the same clinic, so hopefully bloods can be accessed. (I don't feel ready to terminate original FS yet.)
I'm aiming to get going again with my next cycle, so we might end up cycling together in early October?
Posted 06 September 2015 - 04:55 PM
Hi G - I like my FS too and think it's important to like them. But at the end of the day we're seeing them to try and get pregnant. The other problem is joining another waiting list to see another FS - if it's a long wait time that's no good for us either. I rang my FS in Jan and the next appointment was end of March but I got lucky and got a cancellation at the end of Feb. At our age we hope to find the happy medium between conservative and going all out ( whatever that means - maybe it's the infamous Wazza that everyone talks about). I have my next appmt on 21 Sept and hope to start my next stim cycle at beginning of Oct - so we may very well be cycling together. I am thinking I will probably do PGD again this cycle and see what happens and if no success a third cycle of no PGD. My FS keeps saying not to think too far ahead in the future and to take one day at a time but I think planning ahead for the next step gets you through.
Posted 06 September 2015 - 05:06 PM
I made an appointment some time ago in case we ended up in this situation - 6 month waiting list. It's the same clinic, so as long as they can transfer records then hopefully I don't need extra tests etc. If there is a delay I'd be tempted to go again with current FS and then transfer. I don't want to muck around that is for sure.
Posted 06 September 2015 - 08:36 PM
G - I think I will only be able to give up this process when I know I've done everything I can to make it work. If I've tried everything and it hasn't worked I hope I will be able to accept the situation and try and move on. So if you get the chance for a second opinion I'd take it.
Posted 08 September 2015 - 09:30 AM
G - have you looked at the website called fertilitylabinsider.com - you probably have but as I'm a chronic googler of information I found it and it's got a lot of good technical information - some encouraging and some not.
Posted 08 September 2015 - 11:30 AM
Thanks for that GL. I hadn't come across that site before. It has some good information. I think we all spend lots of time googling whilst doing IVF! How are you doing?
Posted 08 September 2015 - 12:51 PM
G - just counting down to my next FS appointment on 21 Sept when I hopefully can plan for next cycle at beginning of Oct. Seems like a long time away. Some days I feel a bit of positivity that I have a chance and then other days I feel like it's a lost cause. I guess most people probably go through the same thing. This process has made me feel really old which depresses me!
I guess you are counting down too until your ( new) Fs appointment.
Posted 08 September 2015 - 01:06 PM
Hi GL - sounds like we are going through a similar thought process. I'm excited about seeing the new FS, but scared that he'll think its useless, or that it won't work. I'm a bit annoyed with my first FS that we didn't transfer more embryos last time, so that is helping me move on from him. I think the trouble is that the more I try, the closer it seems to a point when I might need to accept that I need to move on. I feel really old too and just wish we'd started this journey earlier. I also know women that started in their 20s and were then in their 40s before it worked for them, so maybe we can skip all that and get our BFPs now?!
Posted 08 September 2015 - 05:51 PM
G - I always think of a relative who was advised to give up because her egg quality was terrible and nothing would grow to day 5. She wanted one last try and transferred a highly fragmented so called poor quality day 3 embryo that is now 2 years old.
I know what you mean about the new FS - there is always so much negativity at our age that you come to expect it. You want them to be realistic but give you a little hope as well. I've not asked whether my clinic has had success with anyone over 40 recently because I just don't want to know and it won't make any difference to my decisions.
Edited by Green lady, 08 September 2015 - 05:52 PM.
Posted 11 September 2015 - 07:26 PM
We had our appointment with new FS today. Good and bad. Still have advanced maternal age! What he has done is put me on lots of medications and supplements and DH has also been given quite a list of things to take. Basically we are searching for a good egg in there. I have PCOS and higher AMH, which might work in our flavour. Maybe. We might do PGD, but he said it depends on how many 5 day embies we get - risk being none... We are a bit overwhelmed at all the info right now and I'm a bit confused by a couple of the meds and we'll need to follow that up on Monday.
Here's hoping! G.
Posted 11 September 2015 - 09:24 PM
Hi G - it sounds like at least it's a different approach which might be good. I also have a good AMH for my age - surely that's got to be good - if you still have eggs it's just a matter of getting that good one in there!
If you can have options with the PGD i.e you see how many you get to day 5 and if only one you could decide not to do the PGD , then that would be good as it's gives you some flexibility.
My FS has said that current research shows that frozen transfers are showing better results than fresh - he says there are advantages in waiting until the next cycle to do the transfer once your system has had the chance to recover from all the stim drugs. That's something else to think about.
That's interesting that he has recommended some supplements - mine has only suggested the CQ10 for me and my husband takes nothing ( as he doesn't believe they do anything ).
It is so hard to get day 5 embies and even with much younger people the numbers still aren't great, however that makes me think day 5 is hard because they're not good at growing outside the body in culture. Even when they get to day 5 they can still be abnormal ( which I'm tested one was). There's just so many pros and cons that make your head spin. I'm not surprised you're feeling a bit overwhelmed with the info.
Anyway it's a new approach and a reason to have hope and be optimistic!
Posted 16 September 2015 - 05:50 PM
G - how are things with you. A ny more progress after your appointment with the new FS?
I'm just patiently waiting for my appointment next Monday when I can hopefully plan my next cycle start.
Posted 28 September 2015 - 12:06 AM
How are you going? How was your FS appointment?
We had a really productive appointment with new FS. We're both now on medications and supplements and have been for a couple of weeks - side effects haven't been much fun. I've started synarel today (CD 20) in preparation for cycling next month. I'll be doing a very different protocol as well. Fingers crossed it works.
I hope you are dong well, G.
Posted 28 September 2015 - 03:48 AM
Hi G - that's good. Hopefully the change will be good for your cycle and reults.
I am about to start pill for about 2 weeks and then start injections and orgalutran. Last time I was on Gonal f and this time will be doing menopur which is FSh and lh mix rather than pure FSh. Hopefully that will give me better quality. Tentative egg pick up is 30 October - will he 3 months since my last pick up. Trying not to think about the time wastage that has occurred so far.
Posted 28 September 2015 - 11:52 AM
Hey GL, hopefully time might have been good for your body to recover and will help with egg quality too, but I know I don't like to waste a second. I'm even wondering about back-to-back cycles, but I also wonder if I'm pushing my body too fast...
I'll be on both Gonal-F and Menopur this time (I haven't had Menopur before) and think EPU will be around 23 October.
Posted 28 September 2015 - 12:22 PM
G - you will be bit ahead of me. I will be doing an fet again if I get any PGD tested embryos that are normal. So will be late Nov before I have any possible transfer. If I get no normals I will probably transfer the untested frozen one I have as two cycles of none normal will be a pretty dire reult and I think my FS will recommend I call it a day. 23 Oct isn't long to go for you - th change in protocol should give you some renewed hop of a better result. Fingers crossed for you
Posted 28 September 2015 - 12:53 PM
GL - the new protocol does give me some hope, but still a long shot. My FS wants us to do PGD too, so transfer would be later. He also wants day 5 ET at a minimum, so not sure how we'll go. Hopefully your change will enhance your results. Have you thought about booking a second opinion FS if it doesn't work this time?
Also have you considered medications and supplements? Our FS#1 was against them due to lack of evidence, although didn't think they were harmful. FS#2 pointed out that whilst there is some evidence, further evidence would be slow if not impossible to accrue. When I thought about this I agree - given we're paying for IVF, we wouldn't agree to a study where we are randomly allocated to a group receiving a potentially helpful drug vs placebo/sugar tablets group. We'd want the drugs as time is ticking by.
Our second cycle was also our worst.
Fingers crossed for both of us, G.
Posted 28 September 2015 - 03:49 PM
Hi G - maybe I should book a second opinion now since it would be after Xmas anyway before I'd have a chance of seeing him. I don't know much about supplements. I only take elevit, coq10, extra iron, extra bit d and vit b 6. My husband takes nothing - he's in the medical profession and doesn't think there's any proven benefit to them.
I've read about dhea as improving egg quality but haven't asked about it yet.
The advantage of the PGD is if you can get one normal your chances of it implanting apparently go back to as good as someone in their mid thirties. I think for you it's worth a try even if you only try it once. Even if at day 5 they're not suitable for biopsy they can still be suitable for freezing. I have one of those in the freezer now but not sure when I'll use it. My FS said wouldn't hold out much hope for it as it was a day 6 however fertilitylab insider says otherwise when I asked a question on that website !
So far you've tried three day 3s and that hasn't worked so trying day 5s is the next logical step. My FS said there is evidence at the moment that frozen transfers are having better success rates than fresh as your body has had time to get the drugs out if it's system. So that's something to try as well.
Edited by Green lady, 28 September 2015 - 03:50 PM.
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