# What next ? Another IVF at 42 or donor eggs??



## Polargirl1 (Jun 28, 2013)

Hi,

I am just after some advice/opinions. I have had 3 own egg IVFs in the last 18 months, all unsuccessful. I have a reasonable AMH (16) and fairly good responses to the drugs, but know my age is causing the problems.
First attempt 5 eggs and 5 blasts, second attempt 8 eggs and 5 blasts, third attempt (terrible) 5 eggs and I blast.
I had a telephone call with Penny at Serum last week and her opinion was that the final attempt's poor result was my age catching up on me (I thought it might be because they put me on higher drugs, 225 of Menopur rather than 150 as first two occasions) but that's not her opinion. She was very honest but I got the impression she thought I should do donor. She is also dead against PGS!
I have had e-mailed correspondence with Reprofit who are happy for me to do either and also happy to do PGS but I'm completely torn.

Both clinics are cheap compared to UK and we could afford (well, Mr MasterCard could afford!) to do another 2 cycles (either donor or own egg). 

Am I just throwing my money away if I decide on own egg?? Or should I give it one more go just to see if the third cycle really was my age catching up with me??

I would rather do own egg so that my DD has a full sibling but if I had further losses with own egg particularly like last year I'm not sure I'll cope to be honest, but on the other hand the thought of a 50-60% success rate for donor and being pregnant by the end of the year is really exciting.

What would you do in my situation

Thank you x


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## Tincancat (Mar 19, 2012)

Hi Polargirl 
How about a Tandem Cycle if you are not ready to give up on your own eggs?  Your AMH is good for your age and PGS would help screen any embryos so only the best were put back.  If none were good then with back up of donor with tandem cycle you will still get to ET.
Serum do tandem but usually insist on a hysteroscopy so 2 visits to Greece.  The Cyprus clinics also do tandem and usually can all be done in one visit to Cyprus.
TCCx


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## Rosalind73 (Apr 25, 2012)

Hi Polargirl1,

I would give your own eggs one more go with PGS.  A 42 1/2 year old friend of mine who had 2 failed IVF cycles - which produced about 35 eggs (she has PCOS), most of which didn't even fertilise and the rest of which didn't survive to day 5 - found her golden egg on her third IVF cycle. In this last one she only had 6 eggs collected (not many for her compared to before), but one embryo was still going at day 5 and she's now 21 weeks pregnant. So you just never know and may have a decent egg round the corner!

If you don't mind going to Greece, I'd recommend going to Embryogenesis in Athens. They do 24 hour CGH (day 3 and day 5) in house, which means that you can have day 5 CGH and as long as your embryos are ready to biopsied by about 12pm on day 5 you can have a day 6 transfer (assuming you have a normal embryo) which would save having to go back for FET the following month as you have to with Reprofit (as they don't do 24 hour CGH).

Embryogenesis also do it at cost price (800 Euros for up to about 4 or 5 embyros), plus they use exactly the same kit that is used by Reprogenetics in the UK (pioneers in the field of genetic testing) and were trained by them, so you can definitely rely on the quality of their lab and its embryologists. 

And their other prices are the same or cheaper than Serum. In addition they are much more scientific i.e. evidence-based than Serum (which may or may not be important to you).

Penny/Serum feed some people this crap that PGS is illegal but it's perfectly legal in Greece as long as it's not being used for sex selection (same as UK). They told me they would do it if I really wanted to (by sending the biopsies to a lab in Athens - who I wouldn't necessarily trust) but it doesn't work out much cheaper with Serum than in the UK (although depends how many embryos you have biopsied).

Let me know if you need any more info about Embryogenesis.


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## Rosalind73 (Apr 25, 2012)

P.s. I think Tincancat's suggestion of a tandem cycle combined with PGS is a good one too - in case you don't have any normal embryos of your own, then you will still have an embryo to transfer that month.

Remember that even in young women, around 30-50% of embyros are abnormal (humans are very inefficient at reproducing), so if you want to avoid a failed cycle or worse another miscarriage at all cost (completely understandable of course) then it might be wise to have any donor embryos screened as well.


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## klmch (Apr 22, 2012)

Just to balance things a little, I think I would be considering DE if I were you. Personally I moved on from OE IVF a year ago, and believe me, it's not an easy decision, in fact I found it very stressful. It was really only when my first DE failed that I realised how much I wanted to be pregnant, and that I had already considered the DE embryos as mine. Sadly, DE is not the perfect solution as I know too well now after failed attempts, but I do still intend to try DE again. 

You say you have blocked tubes, have these been investigated further? I am pretty convinced that my endo/hydrosalpinx is to blame for my failures but my endo is v bad, so I'm not happy to risk further surgery to hAve tubes removed. Maybe testing for elevated Nk cells or inflammation issues may be worthwhile?


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## Blondie71 (Oct 26, 2011)

I'd get your dodgy tubes removed before doing anything as that can account for up to 65% hindrance of fertility in those of us (myself included) affected. Your AMH is good. Much luck to you


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## Tincancat (Mar 19, 2012)

Yes definitely sort tubes out.  If hydrosalpinx it can leak toxins which can stop implantation amd development of embryo.  Only a few embryos at your age will be.normal but there still might be one and it's worth a go particularly with donor back up.
TCCx


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## Rosalind73 (Apr 25, 2012)

I know very little about blocked tubes or hydrosalpinx, but if you had a miscarriage at 15+3 last year, and it was because of Trisomy 21, then it seems at that point you didn't have any issues with implantation or embryo development in general.

In my opinion, your age is by far your biggest problem - which if you're very lucky you may be able to circumnavigate with PGS. 

I'm 41 and have recently done just that after having had 4 miscarriages (including one chemical pregnancy), which were probably all chromosomal (the one I had tested was also Trisomy 21).


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## Polargirl1 (Jun 28, 2013)

Hi,

Thank you all very much for your replies.

My tubal problems seem to stem from my c-section and they are just covered with scar tissue and blocked. At the time of my first IVF transfer (only transfer) there was no sign of any fluid or hydrosalpinx and the embryo implanted fine (but was subsequently T21) and I haven't therefore thought about having my tubes removed to be honest.

It is definitely my age that is the problem, but i keep coming back to the various stories I have read about ladies at 42-43 having successful own egg treatment and think that i must still have that good egg in there somewhere but how many attempts might it take me to find it??

Thank you for the suggestions about a tandem cycle. I have contacted a couple of clinics in Cyprus and Embryogenesis in Greece and will see what they say. I do like the sound of Serum but couldn't do own egg without PGS i don't think and Penny definitely told me it was illegal and was very critical of the procedure so I wouldn't want to try and persuade her to let me do it.

2 days ago I was dead against donor egg at this stage and wanted to do at least one more own egg, but now I'm not so sure. 

Decisions, decisions....


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## bombsh3ll (Apr 19, 2012)

Hi Polargirl1,

I agree with the advice about hydros, but if your tubes were not fluid filled following stimms (which is the highest risk time for everything to swell with the hormones, & exactly the time you don't want a hydro if doing a fresh transfer, then they are probably not the problem for you with IVF (other than making IVF necessary by the fact they are blocked).

I went for DE at 31 as having had painful OHSS twice I simply couldn't face it a third time. I also have tubal infertility and my worst tube did develop a hydrosalpinx during stimms - DE allowed me the opportunity to transfer fresh embryos in the absence of a hydrosalpinx.

DE is so much easier to go through and has better success rates even when age/egg quality are not an issue as an unstimulated uterine environment is better for transfer, & tbh at 42 with a history of trisomy age probably is a factor for you.

It was the best thing I ever did, gave me a beautiful daughter who is my spitting image, & at the end of the day what does it really matter where the egg came from? It could have come from Dolly the sheep for all I cared if it gave me a lovely healthy baby!

Good luck!

B xxx


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## Tincancat (Mar 19, 2012)

Hi Polargirl 
If tubes are just blocked and no hydrosalpinx then you should be fine to carry on without having them removed.  it's the hydrosalpinx which tends to cause problems.  I nearly went to Serum as Peny is very good.  However some of the things she was proposing didn't make scientific sense to me and I didn't want two trips to Greece with added costs etc.  Flights to Cyprus were very cheap out if season from my local airport which made all a difference to me.  Travel to Athens was not so easy.  Cyprus is very multicultural with army bases from UK and USA so large multicultural donor pool.  Plus I had to consider some countries will not treat single ladies - not an issue for you.
Good luck with whatever you decide to do.  I had the Nifty Test when pregnant with the boys because even though they were donor I felt I couldn't go through another second trimester loss if one had had T21.  Obviously PGS is even better because it's done before pregnancy meaning you would hopefully relax a little more.  It's heartbreaking to lose a baby so late and it will be on your mind with any subsequent pregnancy.
TCCx


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## Rosalind73 (Apr 25, 2012)

Hi Polargirl - I think you hit the nail on the head when you said that you may still have that golden egg, but it's just a question of how many IVF attempts you're willing to go through to try and find it.

Sorry to mention my 42 year old friend again but she's a good example - after her first IVF where only 1 of 12 eggs fertilised, and the next attempt, when of 19 embryos (from 23 eggs) none made it to day 3, she was told by her clinic that her eggs were worse than average quality for her age. She also has a history of miscarriage. 

She was fully expecting IVF number 3 not to work, and was shocked (as was I - secretly I thought her own eggs were finished) that one embryo was still going strong at day 5, and as I mentioned she is now 21 weeks pregnant. So it just goes to show that after 35 dodgy eggs, she still produced a good one in the next batch (of 6 eggs).

It's an incredibly difficult decision to move to donor eggs, but one thing that might shed some light on the whole thing is to talk to the labs that did your CGH/NGS and look more closely at the results.

As the Lister lab told me, for women who (after many cycles) only produce embryos with multiple chromosomal abnormalities, then they are unfortunately unlikely to produce a normal embryo in the future, however if you've had embryos with only one or two abnormalities, then the prognosis is the other way around i.e. that you are more likely to get lucky eventually.

Embryos with multiple chromosomal abnormalities don't implant, whereas those with one or two abnormalities have the potential to do so, so the fact that you've had previous pregnancies is a good sign. Although keep in mind that the last one was a year ago.

P.s. I can give you much more detailed info about Embryogenesis (I don't work for them by the way! I've just come back from having had a successful cycle with them) if you want to chat


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## CrazyHorse (May 8, 2014)

Hi, Polargirl, I have followed your journey, and was extremely sad for your previous loss. I really hope you are able to find a solution that works for you! 

You mention having the money for another 2 cycles, either DE or OE -- your phrasing leads me to believe that you would not be able to do another one or two OE cycles and still afford a couple of DE cycles. Sadly, an awful lot of fertility treatment decisions have to come down to money. For me personally, once I had decided that DE was something I could live with if OE turned out to lead to failure after failure, my absolute stopping point with OE was going to be when I had only enough remaining funds available, without spending down every last penny we had or going massively into debt, to do two DE cycles. (And frankly I probably would have stopped before that if I'd had a couple more OE BFNs or another OE miscarriage.) The thing about DE is that, while your odds of pregnancy are greatly improved if you are 40+ and your donor is young and healthy, there are still no guarantees. It's best to have the ability to do at least one more cycle if the first DE cycle fails and you have no frosties. So that's definitely something to consider in your personal calculus, as you are probably already doing, when trying to decide on your next steps.

Having attempted 4 OE IVF cycles myself at age 40, with terribly low egg numbers, I certainly wouldn't want to discourage anyone under 45 from trying with their own eggs if they can afford it and are informed about their odds. But the other thing I'd say is that, while OE IVF success rates are pretty poor at age 40-42, they get dramatically worse after age 43. Obviously, there's nothing magical about your 43nd birthday that makes your body completely different than it was a month before, but it is a time of life when the decline in number of chromosomally competent eggs really, really speeds up. There's nothing wrong with trying for that golden egg if you can afford it and you and your relationships can handle the disappointment if there are multiple cycles when you don't find it, but if it's too hard on your finances and/or too hard on you and your family emotionally, it may not be worth it. 

It's a very personal decision, and a very difficult call to make if the genetic link to you and to your older child is really meaningful to you. Wishing you all the best with your decision-making....


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## Polargirl1 (Jun 28, 2013)

Hi,
I just wanted to say thank you again to everyone who has offered advice and taken the time to write. It is so reassuring to know that other people understand the situation and have offered their views/advice.
Some days I think I have made the decision but then the next day I change my mind again! However all your comments have been hugely helpful and given me some real food for thought
xx


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## mogscat (Aug 6, 2014)

Hi
Just to back up what Rosalind 73 said, PGS is absolutely legal in Greece (where required medically) and there are several places offering it.  It's an advanced technique requiring the right equipment so not every clinic has the facilities or skills.  I just had a cycle at Newlife who offer it (I had donor egg so didn't use it myself) as do Embryoland, both these clinics are in Thessaloniki.  Newlife follow Greek law to the letter and even made us sign a load of legal paperwork with a notary prior to our transfer as we're not married as well as being very strict on all consent forms etc. 

I think a clinic specialised enough to offer PGS would be best placed to give you accurate advice on whether or not this would benefit you and help achieve success with OE,  so I think in your shoes I'd consult a few clinics offering the technique and go from there.  I'd also check the lab is ISO-accredited to have an indicator of good quality and standards. Sometimes I think clinics advise you to take the treatments they offer, rather than the best ones to meet  your needs.

Personally once I'd received a description of my donor I was very happy with using DE.  For me it was important to have some info about her in advance, and some choice, which is why we went to Greece.  I also needed to have faith in the person selecting the donors as they're anonymous, and it took a lot of searching to find that (I rejected two clinics along the way).  But I do think you have to be comfortable with any decision you make and in the end only you will know.    When the info about your donor and the clinic itself make you feel excited, confident and buzzing, then that's how I knew I could proceed with DE.  

Best of luck whatever you decide 
xx


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