# IVF or ICSI and Chromosome Testing for Over 40s



## Attie (Nov 24, 2010)

Hi FFs, just wondered if any of you have a view on this.

I've managed to get my follies up to 9 this cycle (from 3 in June) with DHEA, time off work, acupuncture and high protein/antioxidant/fluid diet.  No MF problems in our case.

At my age - 43 - 90% of my eggs will be chromosomally abnormal.  So of the 9 follies probably only one will contain a chromosomally normal egg.  But which one?

We have no reason to have ICSI, and there are some small risks attached (risk of passing on poor sperm gene to a son and possible tiny increase in childhood leukaemia).  However, I'm desperate to make sure we have the highest chance of fertilising and transferring the one chromosomally normal egg!!

If ICSI is likely to result in more of the eggs fertilising, do you think I should go for ICSI?

Also, if we end up with more than the 3 embryos I can have transferred, what do you think about having them tested to make sure they are chromosomally normal?  Some centres say the risk of damage to the embryo outweighs the benefit.  Also an embryo may have some normal cells and some chromosomally abnormal cells, so just because the cell you select is abnormal doesn't mean the whole embryo is abnormal (and vice versa).  Plan B would be to transfer the "best" 3 and freeze any others, but FET is much less likely to be successful, so I'd really like to get my one normal embryo into the fresh transfer group.

Does anyone have any views on this?

Thank you!

Attie


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## Attie (Nov 24, 2010)

In case anyone else is interested I've done some research:

1) IVF vs ICSI in over 40s - the latest figures on cdc.gov (2007) show that for all age groups where there is no male factor IVF results in more live births than ICSI. However, at ages 43-44 the difference is very small and not statistically significant. http://www.cdc.gov/art/ART2007/PDF/COMPLETE_2007_ART.pdf (Figure 31)

2) The jury's still out about chromosome testing of embryos, but a new test has been developed for chromosome testing of eggs which involves testing the polar bodies before the egg is fertilised. The test is called 24sure and is approved by the European Society of Human Reproduction and Embryology. 
http://www.eshre.eu/ESHRE/English/Press-Room/Press-Releases/2010-Press-releases/Welcome/Press-releases-Rome/O-042/page.aspx/1063

Would love to hear anyone else's views if you've received different advice.

Attie

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