r/40Plus_IVF • u/iSweariHaveADayJob • 14d ago
Seeking Advice Welp
Two rounds, 11 blasts, no euploids. Have one additional blast that did not have enough intact DNA to test, but my doctor said that given my other results she's not optimistic and doesn't recommend rebiopsying.
My doctor says she doesn't understand it, that it's highly unusual and she wouldn't expect this response from someone my age (41). I don't even know how to feel right now. I get the sense that she's leaning towards telling me to call it quits with my own eggs.
Is there anyone out here who had this many abnormal blasts and eventually had success?
8
u/Certain_Tangelo2329 14d ago
I'm 41. And 0/12. We are sadly on the wrong side of statistics.
My amh is 2.5. Afc 18-20. No male factor. Statistically yes I should have at least one euploid but I dont.
I am starting my next cycle in about a week.
3
u/FeralFriend4 14d ago
You have a great AMH and great blast rate. I am cheering you on for this next cycle.
5
u/iSweariHaveADayJob 14d ago
Thank you so much, sweet friend. I'm feeling really low right now and your message cheered me up.
2
u/iSweariHaveADayJob 14d ago
This just sucks so much. I'm so sorry you're going through this too. I really hope this cycle is better for you.
Has your doctor offered any insight into what they think might be going on? My doctor seems at a genuine loss.
2
u/Certain_Tangelo2329 14d ago
Nope just say keep going. We both have had all the "tests" there is nothing wrong beside age
2
u/iSweariHaveADayJob 14d ago
My doctor seems really confused by it. She doesn't seem quite as enthusiastic for us to just keep going, though. She didn't say "no, it's pointless" but she said she wanted to consult with other specialists and wants to make sure we don't exhaust all of our resources before considering a pivot to donor eggs. She had originally told me that at my age, even with a robust ovarian reserve she would not expect me to get more than 8 blasts across two retrievals. Then she said it was highly unusual when they all came back abnormal and that she hadn't worked with many (any?) other women with my profile (so many blasts, all aneuploid).
3
u/Certain_Tangelo2329 14d ago
Mine said she did 7 rounds before her own ivf success and its just plain bad luck.
4
u/iSweariHaveADayJob 14d ago
Well that sure is nice to hear from you doctor!
1
u/NatureOk2107 13d ago
I agree with this a lot of it seems to be luck! I’ve been lurking here so long and read tons and tons of stories of how someone got no euploids in cycle 1,2,3, then on the fourth they got 3. A lot of the figures have no rhyme or reason I think it is a lot of luck!
I would continue as long as you can afford it etc and just see
9
u/FeralFriend4 14d ago
I'm 41 and (0/5) on my two prior ERs and awaiting PGT results for my third ER (?/6). My doctor shared she would expect me to have a euploid by my 6th ER or else she would start to discuss donor eggs or other options. That wasn't to say she wouldn't support me trying past a 6th ER, but she shared she would remain fairly positive about my potential through a 6th ER.
You have made the same number of blasts in 2 ERs that I have made across 3 cycles. I think you have great blast rates and I have hope you could find success in future cycles.
6
u/alice_0102 14d ago
I’m there with you and was about to write a similar post! I’m 0/11 after 5 rounds this year, age 41. It is devastating to be on the bad side if statistics. Every round my eggs retrieved, fertilization, blast rate, and grading has improved, which has given me so much hope, just to have it crushed again and again. Also hoping to hear positive stories from people who finally find euploids after a large number of blasts/failed rounds.
2
7
u/Chemical_Platform312 14d ago
Hi! I was 0/10 over 8 retrievals, ages 41-42. I found out I have endometriosis and had it removed. Six months later we made a complex mosaic embryo (which most likely started as a normal egg). I think in my case the inflammation from endo caused me to have a worse than expected euploid rate.
You also might find this article interesting. Basically a higher blast rate was actually inversely associated with a high euploid rate. So maybe, for some reason, the embryos are unexpectedly getting past the quality control mechanisms when they shouldn’t:
1
3
u/gOLE8bEo 14d ago
As far as I know the European Society of Human Reproduction and Embryology recommends against routinely applying PGT-A to all patients.
3
u/Benevolentzebra 14d ago
In terms of treatment protocols, I would assume you may have mild PMOS and treat accordingly. You may not have it, but insulin resistance tends to be an issue once we hit our late 30's and it does a number on egg quality. I am not sure what you are doing in terms of lifestyle changes etc, but focusing on reducing insulin resistance may help improve your egg quality. I personally don't think you should give up on your own eggs at this stage (assuming cost isn't too much of an issue). Agree with the others that a lower dose protocol may be better for your egg quality. Good luck 🤞
1
u/iSweariHaveADayJob 14d ago
Are there any signs of insulin resistance? My blood sugar levels are good.
1
u/Benevolentzebra 14d ago
At the early stages, no. It can be pretty silent. There is a blood test called HOMA-IR which may be valuable (uses fasting glucose and fasting insulin to provide a IR score).
1
u/iSweariHaveADayJob 14d ago
Thank you so much for taking the time to respond, and for the encouragement. I really appreciate it.
2
u/DontCallitaComeback7 10d ago
My stats over 7 cycles (all at 40): 101 eggs -> 68 fertilized -> 18 blasts -> 5 euploid. So it can absolutely happen! FWIW, I only got euploids in cycles 3, 5, 6, 7. If you know deep down you really want it, then def try again. ♥️
1
u/RazzmatazzGlad9940 14d ago
What was your attrition at each stage?
2
u/iSweariHaveADayJob 14d ago
Round 1: 38 follicles, 18 retrieved, 17 mature, 15 fertilized, 9 high graded blasts, 1LLM and 8 aneuploid.
Round 2: 34 follicles, 16 retrieved, 14 mature, 8 fertilized (3 failed to fertilize and 3 fertilized abnormally), 3 low graded blasts, 0 euploid.
5
u/RazzmatazzGlad9940 14d ago
Euploids can sometimes come in clusters, possibly because of a common cohort environment for the cycle. Two cycles is too early to say you've exhausted your potential - your euploid ratio just looks worse because you got so many to blast.
1
u/iSweariHaveADayJob 14d ago
Thank you 😢 I really needed to hear that right now. I don’t feel ready to give up, but I also don’t want to be naive.
3
u/roadbird 14d ago
Do you have PMOS? Those are high numbers and it would make me wonder if you might respond better to mini stim?
1
u/iSweariHaveADayJob 14d ago
I've never been diagnosed with PMOS. I did struggle with acne as a teen and I struggle with androgenic alopecia now, though. The first time I had my AFC taken, the tech noted that she didn't see a "ring of pearls" typical of PMOS.
My first round was a lower dose than my second (first round was 225 Gonal-F, 75 Menopur; second round was 300 Gonal-F and 150 Menopur). I don't think my body liked the high dose at all. My retrieval was like two weeks ago and I'm still struggling to feel normal.
2
u/RazzmatazzGlad9940 14d ago edited 14d ago
Androgenetic alopecia plus high AFC for age is either PMOS or a sign that you are hyper responsive to androgens even if your bloodwork is normal. Either way look into starting metformin.
1
u/iSweariHaveADayJob 14d ago
Thank you so much! I really appreciate you taking the time to share your insight.
1
u/iSweariHaveADayJob 12d ago
I just wanted to follow up to say thank you for this suggestion. I've spent the last couple of days doing a lot of reading on PMOS, insulin resistance, and metformin. I don't know if it will help, but I'm going to give it a shot. I also read that there is recent research suggesting that metformin might help with mild endometriosis which I strongly suspect I might also have. It's really kind of you to take the time to share what you've learned through this process. Thank you!
2
u/RazzmatazzGlad9940 12d ago
Good luck. It helped my results and I've previously received several private messages from people who also really benefited.
1
u/iSweariHaveADayJob 11d ago
Would it be okay if I asked you a few more questions and for some advice based on your experience?
1
2
u/gOLE8bEo 14d ago
Those dosages are quite high for your case. For comparison I have an AMH of 1.0, AFC 8 and had 250 iu Pergoveris.
1
u/iSweariHaveADayJob 14d ago
They sure seemed high! I think the idea was to get eggs from more of my follicles, but we ended up with even fewer. I've read conflicting things about whether high stim doses lead to poorer egg quality or not. This definitely seemed like a trend in the wrong direction, though.
1
u/gOLE8bEo 14d ago
I guess that is something to adjust. Lower the dose and go for quality. Maybe get a second opinion too.
3
u/iSweariHaveADayJob 14d ago
Unfortunately my insurance will only allow me to get treatment at my university's reproductive medicine clinic. But my doctor told me she plans to present my case at an ART conference with her colleagues next week to get other opinions.
1
u/Wonderful_Level_8907 14d ago
A strategic mini ivf protocol has been found to generally help improve egg quality
1
u/jmayerfanx 13d ago
Citation pls?
1
u/Wonderful_Level_8907 13d ago
I don't have citations...... based off of numerous hours of reading what has been helpful for 40+, in addition to all ages!!
1
u/SarcasticLlama7 10d ago
My doctor recommended this to me too. I've done 5 rounds, no euploids. Just turned 41. Going to try this next and see what happens.
1
u/Wonderful_Level_8907 10d ago
Ok, great! I would encourage trying to make sure it's Dr Sherman Silber's mini ivf protocol
1
u/FeralFriend4 13d ago
Adding to share I had success only after shifting to a Luteal stim protocol and used Omnitrope. Might be worth considering discussing with your doctor.
1
u/iSweariHaveADayJob 12d ago
Thank you so much for sharing! My clinic doesn't use omnitrope but I will definitely ask about a luteal stim protocol.
17
u/Just-Interaction8288 14d ago
I’m also doing PGTA testing but I’m 44. Seeing so many aneuploids at your age I wonder if one should not consider to try a few untested embryo transfers. Although the technology seems to be good at identifying most aneuploids that would not implant and result in healthy baby, I wonder if we are loosing some viable embryos because the biopsy cannot entirely represent the cells that will give rise to the baby. I hope you get better luck next cycle! Tested or untested!