# No embryos to transfer. All had chromosone defects !!!



## toptottyontour (Sep 19, 2014)

Hi there. i'm new to this site although been a lurker for some time   I'm 45 and have no children or previous pregnancies. We have been TTC for nearly 5 yrs and had one natural pregnancy which ended in miscarriage at 6 weeks, a year ago. We realised time was running out so have gone down the very draining, financially and emotionally, IVF route. We have unexplained fertility issues although my egg reserve is low (to be expected I suppose.) I've just unsuccessfully completed my first round of IVF. We did short protocol. This was recommended due to my age. I responded very well to the treatment and 14 eggs were collected. Of these 10 were mature enough to be fertilised via ISCI and 7 fertilised. 5 made it to day 3 chromosome testing (3 x grade 1's and 2 x grade 2's). However the results came back on day 4 and all were defective in one chromosome or another so none were transferred. End of the cycle. We have a follow up consultation tomorrow to decide our next step. We are desperately trying to avoid the egg donor route as we want a child that's biologically 'ours'. Has any one else had a similar experience to me and if so what did you do  Did you try again using your own eggs? Did you try a natural cycle to see if egg was better quality without drugs? Any advice appreciated especially good news stories


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## Kiwi16 (Mar 21, 2013)

Hello - I have a good news story (but maybe one you aren't ready to hear). I have been exactly in your shoes, I will never forget the day they called to tell me that there was not one chromosomal normal embryo, my heart broken in two.  The consultant at our follow up appointment told us we could keep trying but the chances were really slim and more than likely we would be throwing money away, donor is the best and most viable option. For the next six months I cried, my husband went travelling for three months and we almost lost each other, the grief was almost unbearable at time. After a year of counselling and a lot of soul searching we decided to try donor egg and I am a very proud mummy to my six month old ds. We couldn't be closer, it's me he wants to comfort when he walks at night, it's me he comes to when he falls trying to move. I simply wouldn't change him for anything.

Good luck with tomorrow, the next couple of weeks and whatever path you decide to go down. Keep communicating with people and ultimately do what is right for you and your family

X


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## deblovescats (Jun 23, 2012)

hi
I know it's a big step to take and you have to be ready but it's worth considering. I am single and had got to 45 with no likely partner on the horizon so decided to go it alone. I considered OE but as I'm financing myself singly, went with the recommended route as I wanted the best chance of a child, and went for DE. 1st DE IVF and 2nd FET - BFN, changed clinics and with different DD got my much longed for baby - a son born July. I wouldn't change him for the world and am planning trying for a sibling next year with my 3 frosties from same donors. I went through all the doubts and wanted genetic child, but ultimately, all my money could have gone on a dream which didn't come to fruition. It's amazing how many people say he looks like me - people see what they want to see, and he's absolutely gorgeous. I don't regret my choice -even though it's hard on my own! 
Go for it.
Deb


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## beckalouise (Aug 29, 2010)

Hi TTOT 😊

Firstly big hugs,  hope you don't mind me sharing this.

My very close friend had 2 early losses when she was 40/41. They decided to do IVF as 'time was running out'. Heartbreaking like you all her embies were chromasomally abnormal and non were transferred  . Anyway fast forward a year and she is currently on mat leave with her perfect naturally concieved miracle.

Even having my own miracle, her story amazes me.  I know she is just a few years younger but I wish you all the very best in what ever you decide x


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## Altai (Aug 18, 2013)

Hi top  sorry about your failed cycle. Unfortunately this is a stats for older women. I am now 45, too, have done 5 ivf cycles, several ovulation inductions & not even a sniff of bfp. I will be doing one last cycle possibly so called combined japanese ivf to freeze embryos for a potential combo de/oe cycle mid next year. 

Big hugs and best of luck in yr next steps


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## toptottyontour (Sep 19, 2014)

Hi Ladies thankyou for taking the time to reply. So happy for you Ladies that are now mums and I hope your dreams come true soon Altai. I realise that donor eggs are a surer route but we both really want to do all we can to try and have a biological child and it may well be that that is the route we end up going down. We'll see what comes from our post IVF failure consultation meeting today. Apparently all the Doctors at my clinic have a weekly meeting on a Tuesday to discuss failure further. In the meantime my kitchen resembles Holland and Barrett as I've gone OTT researching supplements that help egg quality and i'm having acupuncture !!! I'll keep you informed.
I still would like to hear from someone who has been in a similar situation as mine and tried again and/or changed drug input to see if drug free worked !!!


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## goldbunny (Mar 26, 2012)

hi so sorry you didn't get to transfer, i'm not in the same situation but in many ways i do understand how painful it is. Two things occur to me though
1) i wonder why you had pgd - did you suspect a problem, or, had you had immunes testing/karyotyping done? if you haven't had karyotyping done and were just doing pgd because of your age, have you thought about having it done, to see if issues are with you or with the sperm? it might help clarify your thoughts regarding using donor egg or sperm.
2) our first cycle results weren't brilliant, we had only four fertilise out of 11 eggs, and they were very low quality embryos. We didn't move to donor eggs, we just had two more goes at icsi, DH cut down on alcohol, hot baths etc, took his vitamins... i had massive folic acid doses (after immunes testing, not randomly!) we had much better embryos on both our second and third cycles. What i am saying is that cycle results do vary, so it is possible that on another go you would have a different outcome. 

i hope the follow up consultation brings you support and ideas. good luck.


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## Greyhoundgal (Oct 7, 2013)

I'm so sorry for what you are going through   but I did want to say that numbers is the key here. As Altai has said, only a certain number of eggs in a woman over 40 will be chromosomally normal so the chance of getting one or more in any one cycle might be quite low. If you read Dr Sher's blog, I think he would recommend embryo banking which would mean putting aside the embryos from several cycles which might give you a statistically better chance at one normal embryo.

I also wanted to mention a book to you as I see that you are on the holland and Barrett band wagon   try reading Rebecca Fett's It starts with the Egg. This is a very sensible read about supplements and might stop you taking a whole load of expensive supplements which may not help and focus you on a smaller number of proven ones.  

I really hope you find your way forward and achieve your take home baby  

Grey xx


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## toptottyontour (Sep 19, 2014)

Hi Goldbunny thanks for replying. We opted for chromosone testing to save us heartache further down the line. Statistics show a massive rise in defects for my age and due to miscarriage in January this hit home. Surreal really as my eggs all appeared great. They cell divided on schedule and were graded 1's and 2's. This gave us hope but if we hadn't tested we would have got to day 5 transfer and probably ended in a miscarriage at some point. Don't think we've had immunes/ karyotyping done so this is something we will raise later because the fault may not lie with me !!! Thanks for best wishes x

Hi Greyhoundgal thanks for replying and the egg banking idea. Not heard of this so that's another option to discuss later. I have read the Rebecca Fett book and I agree it is very good. Especially the section on BPA in plastics (i'm clearing out my kitchen cupboard this weekend!) and Ceoliac disease (thinking of getting tested for this as its in my family!). Thanks for kind wishes x


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## urbangirl (Jul 28, 2010)

Hi Toptotty, I agree with Greyhoundgal, it's a numbers game and at the age of 45 I would expect most embryos to be chromosomally abnormal for most women.  I am sure there will be some normal ones but it might take time and committment, not to mention finances, to keep going until you get that one.  That's the position I'm in at the moment, at this age you can't really make a decision from one cycle when it might take quite a few to get that one normal embryo, if it ever arrives.  The trick is being able to decide when to stop.  There are lots of factors that affect egg quality and it looks like you're doing the best you can in that aspect so lots of luck to you.  By the way, 14 eggs collected is a huge amount for someone with low reserve, I'm lucky to get 2 or 3!  You have good numbers to work with


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## Polargirl1 (Jun 28, 2013)

Hi Top
I'm so sorry to read your story. I do agree with Urbangirl, it's a numbers game and just a question of doing it enough times but that's obviously dependent on finances and emotional and physical energy. However you seem to have responded amazingly well so there is certainly hope but I think it probably will come down to finances and energy unfortunately.

I am undergoing my second IVF in Feb after my first resulted in a Downs pregnancy so I am also undergoing Array CGH to test for chromosome abnormalities. I have been told to expect about 1 in 10 embryos to be "normal" and on the basis I only got 5 eggs last time, it may take me at least 2 attempts to get there (we can only afford to do it twice more).

The book that Grey has suggested is excellent and makes lots of sense and I would definitely recommend. There do appear to be ways to improve egg quality without taking loads of supplements and by changing diet and lifestyle slightly.

Wishing you all the best xxx


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## toptottyontour (Sep 19, 2014)

Hi Ladies, just an update. We went for our consultation yesterday and as I expected we were advised to go down the donor egg route if we try again. The consultant said all eggs were 'badly' defective and it was highly likely if we try again we'll get the same result. I asked about taking DHEA and was advised against it as its for poor responders and i'm not a poor responder. I also asked about a more detailed sperm test and was told that would be @£400 but they didn't think the problem was with the sperm, but if we wanted to do one then it was up to us. So we've come away with decisions to make. If we want to try again whatever we decide it will be in January. Thanks for all your input and best wishes to you all X


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## urbangirl (Jul 28, 2010)

Toptotty, I just wanted to say, my first ivf was my worst and I was told my eggs were no good, but I just carried on and made a lot of changes, diet etc. Now, despite being 3 years older I get almost everything going to blast. I haven't done the cgh so a lot of my embies may have problems (I'm banking), but regardless, there are a lot of things that can be done to improve all the other parameters of quality so that when that good egg comes long it has the best chance. I think your consultant was wrong to say subsequent ivf's will be the same, they are extremely conventional in their views. Good luck whichever way you decide to go, ART is not an easy path for anyone


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## RB76 (Jul 27, 2011)

Hi Toptotty

My story is both similar and different to yours, we tried ivf three times with array CGH on third try as wanted to throw everything at it - I did have one normal embryo out of nine, but the other eight had multiple abnormalities which seems to be similar to what you experienced. I was only 35 at the time! But having had no sniff of a BFP and feeling increasing drained by the whole experience we chose to move to DE on the advice of our clinic when that cycle also failed.

I will echo what's been said about it being the best decision we ever made - I'm in no doubt we'd be no further on now if we hadn't decided to go that route, after no sniff of a BFP ever before.

I understand that you want to try the natural remedies etc and it does work for some. Unfortunately, those stories are in the minority and I just wanted to say, don't totally shut the door on the DE idea, as it's made our world complete after years of heartbreak. 

Good luck


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## Stacey10 (Jun 7, 2013)

Toptotty I would suggest you google Epigenetics and read up on it, that may help you come to a decision regarding the use of donor eggs, you should look at the use of donor eggs as being given the basic plan for a baby , your body, blood etc makes and feeds the baby, it's not unusual for the child of a donor egg to look like their mother as they take on genetic traits of their mum


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## toptottyontour (Sep 19, 2014)

Thanks again Ladies for your support and info. We've not ruled out donor eggs just feel that we may give it one more go with our own as we've only done IVF once. It is a money issue though as we get no help and each cycle with all the trimming is costing @ £9000 so we wont be having many go's. (As much as we want a baby we don't want to get into debt.) My 1st period post IVF arrived today bang on time although slightly heavier. We may throw caution to the wind in 14days !!!! Would love to prove the doctors wrong one way or another


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## Rosalind73 (Apr 25, 2012)

Hi toptotty,

Sorry to hear your bad news. Do you mind me asking where you are having your genetic screening?

Presumably it's array CGH?

I've looked into this and am going to do it on my next IVF cycle. You should be able to get the data from your clinic about the percentages of normal embryos for your age, and also what percentage of women have at least one normal embyro - according to how many embryos your produce.

So for example if you test 4-6 embryos, you can find out the average percentage of normal embryos amongst them, and the percentage of women who have at least one normal. All this info comes from Reprogenetics (the lab in Oxford that do the genetic testing for all the London clinic). Your clinic should also be able to tell your their live birth rates for all the CGH cycles they have done (so when they have transferred a normal embyro back). When I last asked, I think my clinic (the Lister) said they had done about 90 cycles over the previous 2 years.

I have also spoken to Prof Dagan Wells, who is head of Reprogenetics and he told me about some new forms of PGS (genetic screening) about to become available. They are not more accurate than CGH, but one is a bit faster, which apparently means you can have a biopsy on day 5 afternoon and still have a transfer on day 6...thereby avoiding having to freeze, waiting a month and then the cost of a FET. So is cheaper and better for those who might have embyros that develop a little slower. With CGH, if your embryo isn't ready to be biopsied on morning of day 5 and has to be biopsed later that day or on day 6, there isn't time to do the testing and have a transfer on day 6, so you have to freeze.

The other new one is a bit cheaper, but can only be done on frozen embyros (as they don't have the lab staff to do it work on it quickly, so batch together embyros from different people), so with that one you can't have a fresh transfer - you have to wait until they do the testing and then transfer the following month.

Let me know if you want any more info.

By the way there is a weak correlation between how embryos are graded and whether they are genetically normal. So a high graded embyro is a bit more likely to be genetically normal than a low graded one, however just because an embyro looks pretty (i.e. is top grade) it doesn't mean it is normal.
See this research:
http://www.fertstert.org/article/S0015-0282%2810%2900600-X/abstract

I'm afraid there's nothing you can do to turn genetically abnormal eggs into normal ones. It's just a question of age. And stimulating drugs don't turn genetically normal ones into abnormal ones.

In my opinion, the best thing you can do is to try and produce as many embyros as possible and you are lucky in that you seem to be a high responder. The more embyros that you have, the more likely there will be one normal one in there.

x

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## Rosalind73 (Apr 25, 2012)

although I think it would be wise to double check the stats for your age first....


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## urbangirl (Jul 28, 2010)

Rosalind, that's very interesting info, I'm not sure about stim drugs not having any effect on chromosome integrity of the developing egg though. I'm a 'poor responder' so it's really pertinent to me, a couple of consultants have advised me not to go above the 5 or 6 dose mark of FSH (one dose being normally 75iu or something, I think) specifically because above that dose there's an increase in abnormalities.  I'm not saying you're wrong, as I don't know, just interested to know if your clinic told you that? Or did you read about it in a study?


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## Rosalind73 (Apr 25, 2012)

Hi urbangirl,

When you talk about quality - what are you referring to? Whether eggs are mature or immature?  Whether they fertilise? Whether embryos are highly graded or not? I know the last two things are different from whether an egg/embryo is chromosomally normal (although there is a weak correlation between the two). Take myself as an example - I recently had a miscarriage and the genetic analysis was positive for trisomy 21 (Down's), however the pregnancy was from a top grade blastocyst. 99% likely due to a chromosomally abnormal egg (and not the sperm). High or low dose stimulation would not have caused this embryo to have Down's syndrome - it was predetermined by the aging of my eggs. And likewise there is nothing I could have done about this chromosomally faulty egg.

With respect to the actual quality of our eggs, I don't really know that much about whether you can influence that. I've never really looked into it after I was told by a very reputable fertility consultant that many people who go for low dose IVF misunderstand what is going on when you use higher doses of stimulation. He said that every month, you will have a number of eggs that are decent quality (i.e. would fertilise etc.), and if you use a low dose of stimulation you may retrieve some or all of them - depending what your ovarian reserve is to start with (i.e. the number of eggs that you have to play with). If you use a higher dose, all you are doing is getting those decent ones, plus some crap ones as well (which would have been crap anyway whether or not you retrieved them). So with the higher doses, all you are doing is increasing your chances of getting all of the reasonable eggs. 

Having said that, for poor responders (people with low AMH for example) who don't have that many follicles there in the first place, I think there is a danger of overdoing it with the drugs. But my understanding is that what may happen is you overstimulate the ovaries, which results in them giving up and not responding as well as they might have done had you not overdone it. But again I don't think that relates to the quality of the eggs that are retrieved rather the number that you will end up with. But I'm not a doctor so I don't fully understand it, but I think that must be what your doctors must have meant. Again using myself as an example, I've got a very low AMH and I've been told that I have to be careful with high doses of drugs for the above reasons. But for those who aren't low responders, in general the older you get, the higher the doses of stimulation required.

Again I don't know too much about it, but I think the follicles that are produced in any given month have been developing for about 2-3 months prior to becoming antral follicles, so in theory perhaps there are some things that might influence their quality e.g. certain hormones (male hormones e.g. testosterone, foods etc.) Although I think this is very hotly debated, and I don't know what the evidence is. Personally my feeling is that there's not that much you can do to influence egg quality, so I don't pay too much attention to it. There are plenty of other things to worry about!

If you don't mind me asking, what makes you say you're a poor responder? Do you have low AMH or high FSH? Do you have low antral follicle counts? Have you not responded well to stimulating drugs?


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## Rosalind73 (Apr 25, 2012)

Sorry to be clear, when I was talking about actual quality of our eggs and whether you can influence it, I was referring to quality parameters about the egg, but not whether they are chromosomally normal or not


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## Rosalind73 (Apr 25, 2012)

i.e. whether they fertilise or not, whether embyros grow and develop, how they appear and are graded and so on


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## Altai (Aug 18, 2013)

I've been reading dr sher blog and he's of the same opinion that high doses of drugs won't effect chromosomal integrity of eggs, that's predetermined by your age.
If fact,  US clinics are known for their preference of high stims and their success rates are the highest in the world. But that obviously depends on afc & amh to start with. 
I got most of eggs on 450 dose & lowest on what started as modified natural/converted to mild/converted to full stimm. Though  now planning on lowest drug intake like clomid.


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## Altai (Aug 18, 2013)

Rosalind- sorry to read about yr mc.


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## Rosalind73 (Apr 25, 2012)

Thanks Altai - I think I've actually had two miscarriages since I last saw you. Not good at all.

I think it's pretty much an established fact that you can't change the chromosomal make-up of your eggs, but whether you can affect the quality (if they fertilise, how embryos grow and develop, how they are graded) is another question. Personally I'm not convinced, but perhaps someone else has some evidence either way about this.

Good luck with you next cycle. I really hope this one works out for you. Are you trying Clomid so you can do back to back cycles? Or because you want to try a different way of stimulating i.e. with natural FSH?


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## toptottyontour (Sep 19, 2014)

Hi Ladies here's an update. I contacted my clinic (Care Nottingham) for some stats. They told me they had only treated 6 women aged 45 during the last 3 yrs and out of the six none had normal chromosome's in their own eggs so based on these stats 100% of 6 had defective chromosome's. Not a very high number of candidates for the evidence. They also said that they had treated younger women who had had all their eggs show chromosome defects on one cycle but were able to get a normal on the next !!!
Considering Care Notts has treated so few older women i'm now wondering if I may need to look at another clinic that possibly specialises in older ladies. Do any of you have any suggestions/ recommendations  May be just a mad thought really as I responded well to all the treatment to egg collection etc but maybe somewhere else has different techniques. Realise these, if there are any, wont change an abnormal egg but I've got to look at all options. We want to try one more time with our eggs and its important our money is well spent !!!


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## Roadlesstravelled (Apr 3, 2010)

Hi toptottyontour

I don't go on here much or post at all really but I guess I came across your post by accident and maybe felt it was fate so should reply.  I only had one go at IVF with my own eggs at aged 35 due to the low chances they gave me and went on to DE, if you feel that you need to give your own eggs another go and will regret not then go for it, I personally don't regret moving on to DE as I feel that my beautiful daughter was the baby that I was always meant to have.  There are some clinics abroad that do a tandem cycle, which you may want to consider, you cycle at the same time as a donor and if you get your own eggs they are transferred however if you don't or they don't fertilise or are abnormal you haven't cycled for nothing you have the donor eggs transferred!  Just a thought if you are thinking of best chances, trying your own eggs but also if you are going to move onto DE after anyway.  If you have your own eggs but back the DE are frozen so if it is a BNF or god forbid a MC you have frozen eggs to transfer so don't have to do the whole IVF and meds again.  Just a thought.  really very good luck I hope you find that lucky one egg but if not I am sure that there is a DE baby out there just waiting for you guys x x x


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## RB76 (Jul 27, 2011)

Can I als add a chromosomally normal egg doesn't guarantee anything either, one of our nine was normal on our array CGH cycle but it didn't stick. This was also at care nottingham.
Roadless traveled I feel the same about our daughter having had a similar journey x


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## Rosalind73 (Apr 25, 2012)

Hi toptotty,

Just to clarify, when you say "6 women aged 45 during the last 3 yrs and out of the six none had normal chromosome's in their own eggs so based on these stats 100% of 6 had defective chromosome's", do you mean that they did 6 cycles of IVF with women aged 45 and all of them had CGH?

I would be surprised if they all had CGH, but maybe they did. Nevertheless there should be a little more data on CGH for women aged 45 as there are other clinics that do it too. Do you know where Care Nottingham send their biopsies? (presumably they don't do the testing themselves). In London, many of the clinics use Reprogenetics in Oxford, so my clinic was able to give me the Reprogenetics stats for all women my age they have done CGH for. Which was a much bigger sample and gave me a much better idea of what the averages are. I would imagine it would be similar in your area - that they use an external laboratory (or maybe even Reprogenetics in Oxford) which can give their stats for all CGH cycles in women aged 45. 
An embryologist at Care should be able to give you this information.

With respect to women aged 45 who have done IVF (i.e. not necessarily had genetic testing) - if you scroll down to the bottom of this page on the HFEA website, the live birth rate national averages for women over 44 is 1.6% (in the 3 years ending with 2012), and Care Nottingham had 1 live birth from 8 cycles:

http://guide.hfea.gov.uk/guide/CloserLook.aspx?code=101&s=ppv=NG86PX&d=0.1&nav=1&rate=i&rate_sub=FSO&bdy=2999&bda=o44&bds=FSO&bdt=ivf#cyclesCancellations

They don't give a percentage for those 8 cycles, because it's too small a sample. So equally, 0 out of 6 cycles does not necessarily mean that your chances are 0%. The national average IVF success rate of 1.6% is going to be the best indicator that you have (as based on data from all the clinics i.e. the biggest sample possible).

But as you say someone can have zero normal embryos in one cycle, and then a normal one the next time (although you need to bear in mind that by aged 45, I think it's around 95% of embryos that are abnormal on average...so you might have to do a hell of a lot of cycles to find a normal one)

RB76 is right as well - even having a chromosomally normal embyro does not guarentee success - for stats about this you need to ask your clinic what their live birth rates are for all their CGH cycles (they don't tend to subdivide by age as I guess they don't have enough data, and also once an embyro is chromosomally normal, age of mother is much less relevant).

So for example, my clinic said from around 90 cycles (I think that must mean 90 transfers of normal embyros as opposed to just 90 CGH cycles - so what I said in my first post was wrong, they must have done many more than 90 CGH cycles over a 2 year period), the live birth rate for a normal day 3 biopsy is 40% and for a normal day 5 biopsy is 59%.

If you can make it to London, the Lister are very good with older women.

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## Altai (Aug 18, 2013)

Rosalind - so sorry, didn't know it's been twice. must be devastating  

Damning starts for 45 yo.  

Doing clomid just for the sake of something new, plus I didn't get many follies in the last two cycles and one was empty. running out of eggs And  am freezing embryos. 
I was planning combo oe/de cycle in russia in jan but my coparent was refused visa. 
Am still going ahead with oe cycle in jan but in serum. 
Will be searching a donor once again, took more than 6 months to find the first one 

Road - some clinics advise against tandem as difficult to sync and almost always one of the tandem is out of sync and Potentially leading to a defective embryology. 
I've been advised  to do a combo cycle where one part of a combo are fets. In my case mine will be fets.


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## Rosalind73 (Apr 25, 2012)

It's actually been two miscarriages since I last saw you - but four in total (including one chemical). It's been a pretty **** couple of years to be honest. And doesn't look good on the egg front - I'm wondering if I might just have all bad eggs.

I know, I'm really sorry the stats are so depressing for 45 year olds (they are bad enough for my age (41) and really scare me, so I can imagine how it must make you feel). I was wondering if I should have posted them or not, but I think for most people it is better to know so they can plan accordingly. Plus they are only the average, and there is definitely variation between different women, so let's hope that you and everyone else we know will do better than most.

Sorry it's taken you such a long time to find a donor - that must be incredibly frustrating. I hope you do well with Clomid - it does work in a completely different way to the other stimulating drugs, so who knows!

I have everything crossed for you and your next cycle at Serum.


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## Rosalind73 (Apr 25, 2012)

how funny, I typed s**t and it changed it to poop!!!!!


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## urbangirl (Jul 28, 2010)

Rosalind, I was talking specifically about chromosomal abnormalities, my consultants advised me not to go above 5 or 6 doses because there are studies indicating that above that there are a higher number of abnormalities in the eggs/embryos, they weren't talking about any other parameters of egg quality (Altai, you had 450, that is a 6 amp dose, so the max. I don't think they give a higher dose than that in the states (I've tx'd there).

Regarding the stats for 45 year olds, I think it's impossible to know because of the low number having IVF. Quite a lot of over-40's have early abortions in the first trimester in the UK, I can’t remember offhand how many 45+’s there were in that group but it was a lot more than 6.  I’ll have to go thru my files and see if I can find the doc. Because they are early abortions, too early for chromosome testing, it was postulated that they weren’t carried out because the mother has discovered a chromosomal abnormality but likely due to ‘accidents’ of older women who didn’t think they needed to use contraception anymore because they were too old. Obviously no one knows how many 45+ women are having sex without using anything so it’s impossible to know what percentage the women having abortions represent of that group!, it could still be only 1%....

Toptotty, Care’s a good clinic, you should get quality care there regardless of the fact that they’re not inundated by middle-aged ladies! Though you can’t go wrong with the Lister, either- I’d go for the most economical of them if it were me.


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## Roadlesstravelled (Apr 3, 2010)

Atali thanks for info tbh I have not done the tandem cycle just trying to think of options! Good luck Hun in jan heard great things about penny xx


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## toptottyontour (Sep 19, 2014)

Hi Roadslesstravelled I've not heard of the tandem cycle you mentioned and am getting drawn towards this option. Do you know any details re where this is done ?? Would consider doing this abroad due to the fact that donor eggs are given anonymously abroad and if I went down the donor egg route this would be my preferred option. Thanks.


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## Rosalind73 (Apr 25, 2012)

Urbangirl - perhaps what I suggested before about what happens with high dosages of drugs, applies also to whether eggs are chromosomally normal as well as other quality parameters. Which is that if you use maximum drug dosages, you will produce more eggs, but that will include ones that were no good in the first place (in addition to eggs that are more likely to be chromosomally viable).

Maybe that's what your consultants meant - so not that the higher doses are causing chromosomal abnormalities, but that they are stimulating additional follicles containing eggs with chromosomal abnormalities. And the pay off is that by using higher dosages, you are sure to get all the ones that do have potential.

Although, as mentioned before, it does seem to be the case that with poor responders you can over-stimulate the ovaries, so need to be careful about that


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## urbangirl (Jul 28, 2010)

Hi Rosalind, no, my consultants were clear that it was a case of higher doses causing chromosomal abnormalities so that you would end up with more non-normal eggs than you would with a lower dose, not a case of producing a larger number of eggs and among those more chromosomally abnormal ones being brought into being. Because of this I am of the opinion that chromosomally normal eggs can be turned abnormal by poor handling.  My feeling is also, for example, that if a lab was really below par chromosomes would be affected when the embryo was making it's early divisions.  They're so fragile in every way....


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## Roadlesstravelled (Apr 3, 2010)

Hi toptottyontour
I think dogus in Cyprus do it. Maybe try there site xx


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## Altai (Aug 18, 2013)

urban - but did yr consultant told what he meant by higher dose? is it 300? 450? or 600 and more?
Because I think 300 would be a pretty standard dose. Well at least my so called mild ivf ended with 300 and was still considered by clinic as mild.


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## Altai (Aug 18, 2013)

rosalind -am actually glad it fall through with the donor last month 
it would have cost me fortune compare to what I could pay today


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## pucca (Dec 12, 2008)

I read your post toptottyontour and I know how you feel . If you want to continue with your own eggs do a tandem . Then you will always have eggs for transfer. I would consider donor more and more as your body is telly you it might be too late and too draining not to expand your options , good luck !


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## toptottyontour (Sep 19, 2014)

Hi Ladies not sure if you're still about but i thought id give you an update.
A lot has happened since i first posted about my first ivf cycle and my chromosomally abnormal embryos.
Im currently in Cyrpus having just completed a tandem ivf round with Dr F at Dogus. Have nothing but good things to say about this team. My ivf experience was completely different in every way and so much less stressful. I had 4 embies transferred, 3 from donor and 1 miraculously mine!
I had the same amount of eggs on day 5 as last time, 5. 1 showed abnormalities, 1 showed nothing and 3 were NORMAL!
Decided to only transfer 1 as it was top grade the other 2 were slightly behind development wise.(They prefer to only transfer top grade if possible). Was amazed at these results.

Things I've done in the last 3 months, whether they've played a part or not :-
Started taking extra supplements daily on top of pregnacare  (coenzyme, omega 3, royal jelly and wheatgrass. )
Weekly acupuncture and chilling regularly to Helen Mcphereson ivf cd.
My Ivf protocol was different, i cycled with Menagon and Centrotide and am lead to believe it was a gentler protocol than my last cycle.

I obviously don't know if this cycle will be successful or not. Its now up to mother nature but I've got further than last time with better results and after having better treatment. 
Ps thanks Roadslesstravelled for putting me onto Tandem IVF and Dogus.


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## Rosalind73 (Apr 25, 2012)

Hi toptotty,

That's amazing news, you must be so pleased. Just to get this straight - are you saying you had 5 of your own embryos genetically tested and 3 were normal? 

Or that you had 3 good quality blastocysts (but didn't have the PGS)

Good luck - really hope it all works out!


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## mamochka (May 23, 2013)

Top - great news! Are you ready for twins and more?!?! Are they supporting your immunes as well? Best of luck!


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## toptottyontour (Sep 19, 2014)

Hi Ladies, i had 5 embies pgd tested at day 3 (like last time) and 3 were normal. Last time i was told all 5 had chromosone abnormalities so none were transferred. This time 1 of the 3 was top grade so i had it transferred with 3 top grade donor eggs. It was very important to me that i had pgd testing. Last time all my embryos looked great so if they'd not been tested i would have had a day 5 transfer and heartache would have met me somewhere down the line. 
I'm taking a concoction of meds to hopefully support some of these embies ; -)


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## urbangirl (Jul 28, 2010)

Hi Toptotty, that's so encouraging, I really hope this cycle is the one.  

The retesting illustrates that you can't judge someone, whatever their age, on just a single cycle.  One consultant told me to do just one more cycle, have all the eggs tested and then I would be able to go on to DE with confidence it was the right thing, but I told him don't be ridiculous- how can you judge someone's entire crop of eggs just from one cycle, I'd need to do about 10 to get a good idea of quality at my age! 
Three out of five is really good for 45 years old, what did they mean by one showing 'nothing'?  Did that mean abnormal or they just didn't know?  If you actually had a possible 4 out of 5 that is probably as good as the average 30 year old!!
Heaps of luck for you for the 2ww.


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## toptottyontour (Sep 19, 2014)

Hi Urbangirl I was encouraged on my first cycle to go straight for donor as they just look at your age. Then when my pgd results came back as all eggs defective (even though to the eye they looked great) it was almost 'a told you so' attitude and donor egg was rementioned. I too didn't want to rule out my own eggs on one cycle alone hence opting for the tandem cycle. That way I was guaranteed some eggs at least to be transferred if mine did show defects again. Sometimes when eggs are tested the results are inconclusive and don't indicate one way or the other so they are treated as defective even though they might be ok, so yes I could have had 4 normal eggs on this cycle. Very pleased with the result regardless of my outcome post egg transfer (although it would be the icing on the cake if I get a BFP next week) and like I said earlier I did make some diet changes (more supplements) and had acupuncture over the last 3 months so whether these played a part or not I don't know. My IVF cycle was milder too so it probably all helped. 
Ps thanks for good luck wishes and same back to you x


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## mamochka (May 23, 2013)

Top hi - just to confirm you tested PGS eggs or embryos?


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## toptottyontour (Sep 19, 2014)

Hi Mamochka  had my fertilised eggs (embryos) pgd tested at day 3 for chromosone abnormalities.. Got results at day 5 then transferred embryos that had tested normal (no abnormalities.)


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## Rosalind73 (Apr 25, 2012)

Hi toptotty,

This is really amazing news and should give all of us over 40s hope that we do have some good eggs left in there somewhere.

Do you mind me asking where you had your treatment? 

And was day 5 CGH ever suggested to you? I.e. taking a biopsy from your blastocysts rather than day 3 embryos?

xx


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## hanrcar (Dec 4, 2011)

thats great news and just shows how cycles can vary. i have had 3 cycles first one at 40 BNF, 2nd different clinic at 41 and had PGS on 5 day embryos all 5 tested abnormal, donor eggs were mentioned but i wanted to keep trying with my own eggs. Next cycle i did a different protocol and felt better had 10 embryos 5 tested and there was 1 normal who is now my 8 month old son. I am now doing another cycle and am on day 9 of stims, i am now 42. Seem to be responding well had 16 pretty large follicles on day 7 ultrasound. But its totally a numbers game and just finding that good quality egg. The only question i have if anyone has any information i would appreciate it, is my clinic waits to do the PGS on 5 day blasts, and i have heard that sometimes normal embryos don't make it to blasts so i wonder if by waiting until day 5 i am losing out. I will ask my Dr at egg collection but welcome any feedback.


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## toptottyontour (Sep 19, 2014)

Hi Rosalind73 I had my treatment at Dogus in Cyprus. It was a tandem cycle. 5 day testing has never been mentioned to me either in the UK or Cyprus. That's a new one on me !!! You may be able to enlighten Hanrcar on 5 day PGS 

Hi Hanrcar best of luck with your current cycle.


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## Rosalind73 (Apr 25, 2012)

Hi hanrcar,

My clinic are strong advocates of blastocyst transfer as a selection tool when you have more embryos than you can transfer on day 3. They believe that if an embryo doesn't survive until day 5 in the lab then it wouldn't have done so in the womb either. Whilst I always broadly accepted this, I initially worried about the exceptions and whether it was the case 100% of the time.

After having done a lot more reading and heard a lot more opinions, I am now more convinced and also I think it is generally accepted to be the case. Read what Dr Sher says about how they tested the embryos that didn't make it to day 5 and they were nearly all anueploid i.e. chromosomally abnormal:

http://haveababy.com/fertility-information/ivf-authority/blastocyst-vs-early-embryo-transfer
I quote Dr Sher: "The study revealed that a high percentage of the embryos that developed to blastocysts had originated from chromosomally normal (euploid) embryos and were thus "competent" (highly likely to develop into normal babies) while with few exceptions, those that did not develop into blastocysts were almost invariably chromosomally abnormal (aneuploid) and were thus "incompetent"."

Having said all the above the "few exceptions" and 10% of 'normal' day 3 embryos that don't develop to day 5 that he mentions in below article are a bit concerning:

http://haveababy.com/fertility-information/ivf-authority/blastocyst-transfer-preferred-approach
Again I quote Dr Sher: "if a day-3 embryo is found to have its full quota of 46 chromosomes (i.e. it is "euploid") as assessed by day-3 metaphase CGH, then, regardless of the age of the egg provider, more than 90% of such embryos will develop into a blastocysts by day 5-6 post fertilization."

But again if you have more embryos that you are going to transfer at day 3, then you need to let them get to day 5 to know which are the better ones. Plus if you are going to do CGH testing, then also bear in mind that day 5 CGH is more accurate than day 3 testing.

Hope that's helpful.

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.uk or its owners are not responsible for the content of external internet sites


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## Rosalind73 (Apr 25, 2012)

I should qualify that my clinic say with the lab they use (not theirs, they send the biopsies somewhere else), there is a 5% risk of mosacism (getting the wrong result) with CGH day 3 and 1% risk of mosacism with day 5 CGH.

Also they quote the risk of damage to the embyro as 5% with day 3 CGH and much less than that with day 5 CGH.


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## hanrcar (Dec 4, 2011)

Thank you Rosalind I really appreciate your insight. My clinic does the 5 day PGS screening as it feels its much more reliable than the 3 day (due to mosacism and they are more likely to withstand the freezing and defrosting at Day 5 as well) but what got me thinking is a friend in her late 30's cycled the same time as me on my last cycle and her clinics approach was put the strongest Day 3 embryos back and test any that remain on day 5 and she has a beautiful baby girl from a day 3 and 2 normal frosties from those that tested normally on Day 5 but maybe that embryo would have made it to day 5 anyway.


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## cosmopolitan4112008 (Oct 18, 2013)

I didn't read other comments,  so if it is a repetition, sorry.
Go for day 5 genetic testing on your embryos, I.e. Once they reach a blastocyst stage (could be day 6 also). Day 3 testing isn't reliable.


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