# Oh, what to do. Try again or not?



## 1watson (Dec 4, 2007)

Hi, I need some advice.    I'm 42 (just) and have today had a BFN (official date) on my first ICSI cycle - though no AF yet and will test again if it doesn't arrive by the weekend.  I have wondered whether 11 days after blast transfer is long enough and any thoughts on that would be welcome.

I was pgt many years ago with former partner (one careless night!), but that ended in 12 week miscarriage.  

The cycle (at Guy's St Thomas's, London) went really well.  I have a good FSH I am told and had 24 eggs collected, 19 of which were successfully injected, 17 of which fertilised.  I had some mild OHSS.  I had two very good blasts which were put back on 1st December, but, although they left another couple for another day, in the end I had nothing to freeze as my clinic tells me it is very strict about what it freezes.  I felt like things couldn't have gone better and that I stood a really good chance of getting a BFP.  I've have what feels like AF pain for a week but symptoms such as very sore and veiny breasts and being off garlic have subsided over the last week.

Our problem, as far as the tests have shown are with sperm having low motility and a high rate of abnormalities which problem, insofar as it works, would be overcome with ICSI.  

Anyway, today was my BFN, which I have to say I was expecting.  I can't explain just how terrible I feel.  I feel that I have let the embryos down.  I called the hospital this morning and the nurse told me that she didn't know if it was worth my trying again because even though I responded well to the drugs, age is a factor in the success of reimplantation and my age, she told me, could not be "corrected"!  Thanks for that sensitivity!!!!!    Anyway, I'm not sure that I can easily afford the emotional investment of another attempt if it is pretty much bound to be a hiding to nothing, let alone the financial one.  

How can I know if my body is too old to support a pregnancy?  Does today's failure mean that this is likely to be the case?  

Any thoughts anyone?


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## INCONCEIVABLE (May 1, 2007)

Gosh if I had that no of eggs I would keep trying until I was 45...

It's a number game I think and you shouldn't give up after your first attempt...

You shouldn't listen to an opinion of a nurse... They seem to be enjoying it being insensitive....I have also had similar experience... Even drs would have diff. opinions... Geeta at the Create is v. encouraging with ladies over 40 and she has successes with 43 and 44 yr old women... It's also cheap £ 2500 for an icsi cycle on 150 gonal f drugs excluded, so you can have a few goes... It's not as intensive as my previous cycles have been and I would recommend it...Also the LIster and the ARGC are good choices - more expensive but good....and neither will bar you based on age... You are a fantastic responder with no obvious pathology of age...

Good luck...


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## Debs65 (Jul 12, 2007)

I would try again!  Don't give up hope just yet! 

I am just 42 too.  I had a BFP this year after 4 IVF cycles at Guy's ( 2 ICSI and 2 FET).  All my treatment went well all the way through.  My first ICSI cycle in July 2005, 2 embryos were put back and there were none to freeze - BFN.  On my second cycle 23 eggs were collected, 14 fertilised, 2 were put back with assisted hatching and I had 10 embryos frozen - BFN.  Third FET cycle 4 were defrosted and 3 embryos put back - BFN.  Fourth and final FET cycle 6 were defrosted and 3 survived and 3 put back with assisted hatching of which one implanted - BFP.  I am now 27 weeks pregnant expecting a baby boy!

Some things that may have helped me, not sure for certain though may have been just luck! - I lost half a stone, after 3rd cycle and natural miscarriage thought I would take my mind off it for a while and joined a gym and ate more sensibly -  I had one session of acupuncture day before embryo transfer - I had assisted hatching, to help the embryo implant - I had few days off work after embryo transfer and rested as much as possible.

You're not too old to support a pregnancy as I and many others have proved!  Just because it has failed once doesn't mean it will again.  I think it's all down to luck in the end but don't think there is any harm in trying one more time.

I wish you the best of luck whatever you decide


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## Ellie.st (Mar 11, 2005)

I'm so sorry about your BFN - it's so hard, especially when you thought it might have worked.  The thing is that even people much younger than us are more likely to have a BFN than a BFP.  On fact, even a couple trying naturally without any problems have only a 25% chance of success each month.  Obviously, the chances of IVF/ICSI success do tail off once you get into your 40s but, speaking as the 43-year old mum of a wee girl just two weeks short of her first birthday, it is plainly rubbish to say that older women can't support  a pregnancy. 

As Debs says, it's probably down to luck as much as anything else and only you can decide how long you want to keep trying for.  It might also be worth seeing if you can get your GP or clinic to do the tests which Daisyg has listed on the Investigations and immunology board.  I also personally think that taking supplements and an organic diet helped me (I followed Zita West's advice) plus on my third cycle (I had had two BFNs before that aged 40+), I had acupuncture (including before and after ET).

Give yourself time to grieve over this BFN, and then you can start thinking about what you want to do next.    

Ellie


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## 1watson (Dec 4, 2007)

Oh we've tried naturally alright, for several years in fact.  It seems DH's sperm really are far from what they could be which is why they suggested we went straight to ICSI instead of trying IUI first.

I suppose the bottom line is I feel so awful I am almost frightened to put myself through the pain of a BFN again, but then again the alternative is even worse.  Maybe I just need to get my head together a bit, the BFN was only yesterday after all.  I just can't help feeling that as it couldn't have gone better until after reimplantation, what could change next time to make it work then.

All very negative, sorry, sorry, sorry.  Still a bit too raw to make decisions yet I think.


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## Ellie.st (Mar 11, 2005)

I think  you are right - it's all too raw yet to make any decisions.  I was like you in that my first IVF cycles went perfectly right up to the end of my 2ww while my second cycle also went great until I started bleeding Day 12 after ET.  My third cycle, on the other hand, was a nightmare for various reasons - but that was the one which worked.  I had always thought that I would only have the strength to go through one cycle, and the BFN that first time was devastating.  However, once some time had passed, I realised that it was very unlikely that it would have worked the first time, and that it was worth trying again as I had responded well and we had had good embryos.  I also did quite a bit of research into supplements etc which might improve our chances next time around.  (There's loads of information on this site and Zita West's book "Fertility and Conception" is also very good).

It is all down to luck, I think, but if you responded well to the drugs and had good quality embryos, it is probably worth trying again if and when you feel ready.  Does your clinic offer a follow-up consultation after a BFN?  I found it really helpful to get the clinic's feedback after my BFNs, and it is also a chance to ask if there was anything they might do differently next time around.


In the meantime, take it easy.  I don't think anyone realises how hard a BFN is until they have been through it themselves. You will start feeling better in time, however, and that's when you can start thinking about what you want to do next.

Ellie


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## Sally Kate (Jun 13, 2007)

Hi 1Watson

So sorry to hear of your BFN.

I'm 42 as well.  If this is of any comfort, although your cycle outcome was  very disappointing, it sounds as though you had an excellent response both in terms of the number of eggs collected and your 2 high quality blasts (right at the top end of the spectrum for someone our age I would've thought). 

My consultant tells me that a good quantity, and the quality of eggs, tend to go together.  Stats tables showing positive outcomes per cycle, show significantly higher success rates in cycles where 8 or more eggs are collected, even for women of our age.  So although we are all affected by the ageing process, the rate of decline (sorry can't think of a less depressing word!) varies between individual women.  Producing sufficient numbers of good quality eggs is one of the very hardest bits of the process - and it sounds as though your body is doing a really good job.

Do you get a review appointment with your consultant? It would be worth asking them to assess your odds in a future cycle based on this experience (one of the consolations of having done one cycle, is that you now have lots of information about your body's response).  Might also be worth asking if the OHSS might've had a bearing on implantation?

Ellie.st mentions acupuncture - and my clinic recommends this too. I've tried it and whatever else it does or doesn't do it is really good for dealing with the stress of attempts.  Finally, not sure if this is the case for everyone, but I have found subsequent attempts (and failures) slightly easier to cope with than first time around.

Very best wishes


Sally Kate


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