Older Women Questions

Egg Freezing at 38-39

I decided to freeze my eggs as I am single and haven't found a partner to start a family with yet. I recently completed two cycles of mild stimulation protocol for egg freezing with a clinic and the number of eggs retrieved is low. I am disappointed with the results.

I'm 39, My AMH is 4.5 pmol/l and my AFC is 5 (taken around day 26 of my cycle). All other factors general health/weight/blood tests etc are normal. The Dr informed me my ovarian reserve is low.

In cycle 1, I was put on Bemfola (300iu), Cetrotide (0.25mg) and Ovitrelle (250mcg) and out of 8 growing follicles they managed to retrieve and freeze 4 mature eggs.
In cycle 2, I was given Gonal-f (300 iu), Cetrotide (0.25mg) and Ovitrelle (250mcg) and out of 8 growing follicles they manage to retrieve 5 of which 3 were mature and suitable for freezing. The Dr thought I would respond better to Gonal-f but I didn't.

My question is whether a different protocol could improve my results or should I expect a similar result? I was informed I need approx. 16-20 eggs frozen for a good chance of success with the eggs in the future but given my current results I would need many more cycles and it is getting too expensive. Therefore, I now need to decide whether to stop treatment, hope for the best and stay with the 7 eggs frozen or try a different clinic/protocol to improve my results. Any advice would be greatly appreciated. Thank you

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Thank you for providing the information of your results and details about your cycles. I agree with your consultant that your egg reserve is low. This means that the potential of your body to grow mature eggs is low. I noted that you were on fairly high dose of hormones (300 IU). The maximum dose we can use is up to 450IU to stimulate the ovaries. In view of your results, I would expect to get approx. similar number of eggs with each egg retrieval - I hope this information is helpful to you.

Fyi, we are taking part in an event to help people conceive but who may be struggling. Our lead fertility doctor will be attending amongst other IVF specialists so it may be worth you looking at this, you can find out more here: www.manchesterfertility.com/about/events/talk-fertility-event-stuggling-conceive

 

41 IVF, IUI, Clomid or natural

I'm 41 and have had 3 miscarriages in the last 2 years. My AMH is 10.4 and my day 3 FSH is <6
I've had some recurrent MC tests already but all came back normal apart from MTHFR gene which I'm now taking folate for rather than synthetic folic acid.
What fertility route should I explore or should I just keep trying naturally? Don't have much time left so I need to make the right decision. Thanks very much

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

I am sorry to hear of your pregnancy losses. It makes sense to continue to try on your own, as you are able to conceive. IVF does not result in a lower risk of miscarriage by itself, so I would only recommend it if you were having difficulty conceiving over a period of some 6-12 months. It is worth thinking about Pre-Implantation Genetic Screening (PGS) but this requires a careful discussion with the specialist because it is not without its problems.

Pregnancy after 40

Hi

Im 39 and i hope to have a baby by 40. My mom had 8 kids and the youngest 2 she had at ages 40 and 42, my bro and i. She had all natural births, healthy kids with no miscarriages. Can i be as fertile as she was? Whats the most amount of healthy kids can a woman have from age 40?

Thanks
Sabrina

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

This is a difficult question to answer, we would advise you to come to our clinic for a fertility MOT check. From the results of this our doctors should be able to advise you of your chances of conception. If you would like further help and advice, please call us on 0161 300 2730.

Chances of IVF success at 40

Dear Sirs

My husband and I have been trying for a baby for 6 years now. We discovered low sperm count early on and my husband was prescribed clomid. We managed to conceive naturally twice within 3 months both times, but the first one was terminated for medical reasons (T21), and the second was a miscarriage. We have done 4 IVF cycles. The second one resulted in yet another miscarriage. We had 3 good quality blastos and transfered one. We recently discovered high DNA fragmentation for my husband and proceeded with TESE. We got three vials of very good quality sperm. We proceeded with 4th ICSI recently where I had an antral follicle count of 17, got 12 eggs, 11 mature, 7 fertilised but we only got one 4CC blastocyst and got a BFN. We have 3BB frozen embryos left from the previous IVF and two vials of good quality sperm (we have tested fragmentation and it is about 20%). What do you think our chances of success are at 40? I am really disappointed to only have achieved a 4CC blasto after all this effort and having performed TESE. My most recent AMH was 7.2 pmol in January 2017. I also have been diagnised with a blood clotting issue ie taking clexane and baby aspirin

Many Thanks

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

It appears from your history that the early embryonic development has a very important role to play in the outcome, which is leading to chromosomal abnormality and miscarriages. The quality of embryos is affected by aging (male and female), presence of other factors such as DNA fragmentation etc. Unfortunately in your situation, there are additional risk factors to contribute to miscarriage (blood clotting disorder) .

You may wish to consider additional testing such as a preimplantation genetic test for the frozen embryo or for any embryos in a fresh cycle before the transfer. You can discuss this in more detail with a fertility specialist.

If you'd like to book a consultation with one of our specialists, please telephone our team on 0161 300 2730.

Donor embryos transferred from another clinic

I have 2 frozen embryos in a clinic in Prague. I am approaching 49 and the cut off for transfer of embryos in that country is 49. The clinic has advised getting the embryos transferred to a clinic in another country. Is this something that your clinic would consider if I did go down this route?

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Unfortunately this isn’t something we would be able to provide in this instance. There is however, some helpful advice on the HFEA website you can refer to if you’d like to know more about the process and steps you can take. https://www.hfea.gov.uk/treatments/explore-all-treatments/importing-and-exporting-sperm-eggs-and-embryos/

 

IUI or IVF

Hello, I am almost 43, and would like to know if I should try to conceive via IUI or IVF? I already have 2 children, both conceived naturally and within 2 months of trying. My youngest child was conceived when I was 41. Does this mean that IUI success is possible even at my age now? Thank you.

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Both IUI and IVF have less than 5% success rate. It will be useful for you and your partner to have an MOT (with AMH testing too for the woman) so you can better understand your chances.

If this is something you'd like to look into, please telephone our team on 0161 300 2730 for more information.

Query re Serum FSH and LH Levels

Do Serum FSH levels of 19.6 u/L and Serum LH level of 18.4 u/L in October 2016 and Serum FSH level of 56.8 u/L and Serum LH level of 27.7 u/L in December 2017 indicate that the menopause has taken place and that fertility treatment could not occur? If so was this the case in October 2016? I am a healthy 41 year old lady who would have liked to have frozen eggs.
Thanks very much

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

The outcome of fertility treatment depends on many factors. Without having any other information, it is fair to say that an FSH of 19.6 IU/L predicts very low response to any fertility treatment which includes ovarian stimulation and therefore routinely not recommended. It is ovarian failure, not menopausal change.

FSH>30 IU/L, like yours at 56.8 IU/L suggests proper premenopausal stage where very often the periods are disrupted and estrogen production is insufficient.

It is not clear if you are enquiring about freezing your own eggs or donor egg treatment? Egg freezing would not be an option available for you I am afraid. Using donor eggs is certainly a good idea, which you can try with good chances, indenpedent of your FSH level or menstrual cycle status.

To discuss this more, please call us on 0161 300 2730.

Why no ivf for the over 50 in the U.K.

Hiya my husband is younger than me. I was told by my doctor the cutoff was 46 for ivf treatment so did not follow up on it as it was to late for us. But have been told by a clinic it was 49. I have not had a children yet but would have liked one but no one will consider ivf with donor eggs as I'm 50 why is this the case. If I wanted funding for the treatment I understand that there should be a cutoff but as I would fund this ourselfs why can I not be considered

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Many women, typically those in their 40s, use donor eggs to get pregnant because the quality of their own isn’t suitable anymore due to age. We offer IVF with donor eggs for patients up to the age of 50 and have no waiting list for this treatment. Please call us on 0161 300 2730 to discuss this with a patient advisor.

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