# Need Advice on OE or DE.....Turning 40 in July



## amteach (Dec 12, 2017)

I really hope this post does not bore everyone but I am looking for some input and I feel like only people going through fertility issues actually understand what I am going through. I also hope I don't offend anyone  
My story:
I was married young when I was in the military and after one miscarriage, went onto have two healthy babies. This marriage did not work out and after a few years we split from each other and I never heard from him again. I met a new many, who became the father at home and life was good. I didn't think I could get pregnant because I took medication with my son and then in 2013/2014 (35 years old) boom. I was pregnant. Well, sadly I had a missed miscarriage at 3 months and then ended up needing a D & C. The doctor was quite aggressive and I ended up with Asherman's (scarring in the uterus).
Fast forward to 2015 and I took a job in the UAE. I had 6 surgeries by a doctor to remove scarring and no pregnancy. Went to see an IVF doctor here in 2017 and was told let's try a cycle I think you are okay.
Cycle 1 (37 years old): I was on a combination of Menopur and Gonal F for 14 days. They retrieved 8 eggs, 8 fertilized, and transferred 4 to me. No freezing because that was illegal here in 2017. BFN
I went and had an evaluation and was told scarring was still there and we should pursue surrogacy.
Cycle 2 (same doctor 3: Combination of menopur/gonal F, one trigger. Flew for egg retrieval to Georgia and they were only able to get 5 eggs. 5 eggs fertilized, transferred 2, BFN, froze 3 and then transferred later BFN.
Cycle 3: (38 years old changed IVF docs in the UAE): Stimulated in the UAE, Menopur and Gonal F combo. Went for retrieval in Georgia. Retrieved 11 eggs, 11 fertulized, 10 made it to day 5. Transferred 3, BFN. Unfroze the remaining and tested and only 2 were inconclusive. Transferred them and it was a chemical.
Cycle 4: (39) Doctor in the UAE advised me to have a different doctor complete a hysterscopy and see if they could get my uterus in good enough shape for a transfer. After two surgeries, I was cleared. We did several months of building lining to see how high they could get it. During this time, I was on my thryroid medicine, 2000 metformin, and 600 ubiquinol, as well as a prenatal. Cycle mediation was 450 menopur. My doctor said Menopur helps with quality. Retrieved 16 eggs, 11 mature, 11 fertilizied, Day 3 NGS testing, 4 normals. Transferred 2 to myself and it was a BFN, froze 1 (the other wasn't strong enough to freeze).

So here is my dilemma. I turn 40 next month   My husband and I are looking at surrogacy again because it is not looking like my uterus is going to accept anything at this point. The dilemma is do I go with my own eggs or just move onto eggs of someone younger than me that gives me a higher chance? I just want to add to our family   I have spoken to a few clinics in Georgia and they suggest trying with my own eggs again without doing PGS because it damages the embryos? They said since I get so many eggs I should go again on my own but part of me is thinking of all of these embryos we have made there is nothing to show for it.
Anyways, I guess i am just looking for thoughts. Maybe my geriatric eggs are telling me I should have thought about this years ago.   

Appreciate any feedback. I know it was long and I thank you for reading this. If we do move forward it won't be until October or December. We are moving to Egypt in August and need some settling time plus it needs to be scheduled around my breaks at work. SO that puts me even older!


----------



## CatLadyTTC1 (Mar 14, 2019)

Hello. 

Have you considered a tandem cycle? It depends on how you feel about DE. Also has your DH sperm been thoroughly tested? There are some threads about sperm testing. Isn’t always the eggs. 

I’m in the process of a tandem in Cyprus, happy to answer questions xx


----------



## amteach (Dec 12, 2017)

Thank you for your reply!

I never heard of a tandum cycle. What is that?

Thank you!


----------



## CatLadyTTC1 (Mar 14, 2019)

That’s ok my lovely. 

Tandem is when you and your donor cycle together  on the day of egg collection we’re both in at the same time (note that you don’t see her) and then they’re fertilised with OH sperm or donor sperm. 

You get to chose your donor. You’ll need to look at laws and such like on how much info you’ll ever have from the donor etc. We did it as the clinic in England said I had dud eggs (which I don’t) I have just been ‘harvested hahaha) and had 6 eggs and my donor produced 12 eggs. If you’d like to read more there’s info on the Dogus thread in Cyprus and turkey.  Not all countries allow tandem so you’ll need to look at that as well. 

I’d never heard of tandem either  for me it cost the same from the clinic I just had to pay for my drugs - meriofert and cetrotide as well as some steroids and something else. 

Happy to answer any more questions xx


----------



## CatLadyTTC1 (Mar 14, 2019)

Hi amtech thought I’d update to say my 6 eggs have created 2 embies and the donor produced 12 eggs and 7 embies xx just for an idea for you  

Hope you’re ok and getting your head round everything.


----------



## Londonwriter (Mar 18, 2015)

Amteach - my view would be to go OE as you’re getting a *lot* of PGS normals for someone of 39. To put things in perspective, I just finished a 5-day PGS cycle where I had 12 eggs, 7 mature eggs, 7 blastocysts, 6 frozen, only 1 PGS normal. 

Do bear in mind, however, that you’re using Day 3 PGS testing, which isn’t as accurate as Day 5. The jury is out on the benefits of Day 5 PGS testing. There is some evidence that, like PGD, PGS can damage embryos. My clinic seems to get noticeably higher success rates with older women with PGS (68% clinical pregnancy rate for women of 38-39) and there’s evidence with Day 3 and Day 5 PGS testing that it reduces the risk of miscarriage. However, there is something of a selection effect, i.e. to do PGS testing on a lady of my age, she needs to have enough blastocysts to test, which automatically selects out a lot of the least-successful patients. I’d say the big question with PGS is probably the long-term health impacts (if any) of biopsying the exterior of a blastocyst, but it seems to be a reasonable selection tool for older ladies who - like us - have a lot of eggs.


----------



## amteach (Dec 12, 2017)

CatLadyTTC1: That is great news on the eggs! Thank you for the information on the tandem cycle. I think we are going to go with a surrogate and they don't allow tandum cycles at the clinics we are looking at.

Londonwriter: Thank you for your feedback. I guess I just feel like we have already spent so much time, money, and emotions and no baby that going donor would assure us a baby but that  might not be the case. I guess one more try won't hurt. It will give me a chance to start supplements again. 

Thank you all for your feedback!


----------



## mumsey2be (Apr 24, 2019)

AmTeach i am currently 15 weeks after an FET of a double donation 5 day embryo (we have 8 in the freezer created for us from frozen eggs and frozen sperm from the same donors). i wish i had started on DE earlier and saved the heartache. But anyway. Our clinic said you need two things to have  successful pregnancy. 

1. A good quality healthy embryo
2. A good healthy womb. 

It sounds like to some extent the latter has been the issue for you? If your womb is in good shape now, that's really great. The clinic also said it was difficult to be precise about timing for implantation - that they make their best guess of when to put the embryo in but that there is a very short window, specific to each woman, of when implantation is possible. They cannot control this or know this os they may their best guess. So you can have 1 and 2 but miss the window. 

I know not everyone agrees with this but i think a fresh cycle is really unnecessary and much more expensive. Frozen eggs that survive a thaw, turn into an embryo when fertilised and then that embryo survives a thaw - to me this is a darn strong egg!!! Also we were able to have these 8 embryos created at no cost to us at all and saved for us. We only pay when each was transferred at £2000 per FET including the drugs this was a fraction of what we were paying before ( and we never ever got to my 2 eggs even fertilising. 

So for what its worth - i think if you dont care that much about genetic link, it is cost effective and easy to have your husbands sperm fertilising donor eggs - do to a clinic where one lady has several eggs stored - so you can have as many embryos as possible. Then once they have established the grade fo these you can either do a fresh transfer immediately after or wait till you are ready and do a series of FET's for less than the cost of 1 IVF cycle. We went to Gynem in Prague btw. 

Message me if more info would be helpful,. xx


----------



## ocdm19 (Mar 9, 2019)

Londonwriter said:


> Amteach - my view would be to go OE as you're getting a *lot* of PGS normals for someone of 39. To put things in perspective, I just finished a 5-day PGS cycle where I had 12 eggs, 7 mature eggs, 7 blastocysts, 6 frozen, only 1 PGS normal.
> 
> Do bear in mind, however, that you're using Day 3 PGS testing, which isn't as accurate as Day 5. The jury is out on the benefits of Day 5 PGS testing. There is some evidence that, like PGD, PGS can damage embryos. My clinic seems to get noticeably higher success rates with older women with PGS (68% clinical pregnancy rate for women of 38-39) and there's evidence with Day 3 and Day 5 PGS testing that it reduces the risk of miscarriage. However, there is something of a selection effect, i.e. to do PGS testing on a lady of my age, she needs to have enough blastocysts to test, which automatically selects out a lot of the least-successful patients. I'd say the big question with PGS is probably the long-term health impacts (if any) of biopsying the exterior of a blastocyst, but it seems to be a reasonable selection tool for older ladies who - like us - have a lot of eggs.


Dear @Londonwriter, hope you wouldn't mind me asking what happens to your embies that are PGS tested not normal? I heard that in UK it is not allowed to transfer abnormal embies once they've been tested? Many xxxx!


----------



## Delectable_Sunshine (Jun 6, 2016)

Can you please post a link to the Cyprus and Turkey page?
Thanks.


CatLadyTTC1 said:


> That's ok my lovely.
> 
> Tandem is when you and your donor cycle together  on the day of egg collection we're both in at the same time (note that you don't see her) and then they're fertilised with OH sperm or donor sperm.
> 
> ...


----------



## miamiamo (Aug 9, 2015)

agree with Londonwriter, particularly in terms of reducing mcs x


----------



## Londonwriter (Mar 18, 2015)

ocdm19 said:


> Dear @Londonwriter, hope you wouldn't mind me asking what happens to your embies that are PGS tested not normal? I heard that in UK it is not allowed to transfer abnormal embies once they've been tested? Many xxxx!


If they're slightly abnormal, you can transfer them at many clinics after undergoing genetic counselling about the implications. Severely abnormal embryos are not transferred. The genetic counselling issues didn't come up with me because my five abnormal embryos were completely mangled (multiple missing chromosomes plus bits missing). I only had one abnormal embryo with some fraction normal cells, and that was severely abnormal; beyond the point where they won't transfer.

The clinic disposed of the embryos. Or, at least, they should have disposed of them, but keep trying to charge me for their storage.


----------



## ZC (Mar 14, 2016)

Would suggest you seek out the help of a clinic and doctor that treats women 39/40 plus. There are significant differences in competency in embryos when treated with different protocols. As you have seen in your good retrieval.

Have a read of this link. It's relevant and could be helpful. And in particular the part about Menopur and the effects on egg maturation and embryo quality.

I remember a new clinic changed me right to puregon and it was my best cycle at age 41.

https://haveababy.com/tag/estrogen-priming/page/2

I would suggest you find the right protocol and doctor and then consider. embryo banking and testing. Then you will have maybe lost 6 months and can move to DE when ready.

If you want to ask anything about DE message me directly.

Best of luck to you.


----------



## Delectable_Sunshine (Jun 6, 2016)

Catlady, can you please post a link to the N.Cyprus IVF group?
I've been searching for it but not found.
Thanks.


----------

