PGD/IVF for women over 40.

[mythreesons]

Hi, Dr. Potter:

I am 43 years old and I am pregnant with my third son (I will be 44 next month). I never thought I would get pregnant at this age naturally since my DS#1 required a flushing of my tubes and DS#2 was conceived through IVF, so to me it is a miracle.

My OB-GYN told me that after you give birth, you are naturally fertile for 18 months. My question is I want to undergo PGD/IVF and was wondering what you think my chances are. From what I read, PGD can really damage the eggs of older mothers, so is there even a chance?

[atomic sagebrush]

I'm not Dr. Potter, but i would get a new OB or at least a second opinion from a reproductive endocrinologist. That is not reality based advice and you should not do anything on the basis of that because it is simply not true. If it were, Michelle Duggar would have like 4 more kids by now.

At 44 your best odds of conception BY FAR will be with donor eggs and I ~personally~ think you will be throwing your money away cycling at 44 without at least looking into them.

I am your same age and so this is not a case of "easy for her to say", I just don't want you to go into a situation where you make life-altering decisions on the basis of advice which is inaccurate.

[nuthinbutpink]

Dr Potter is probably off for Memorial Day Weekend.

44 will be difficult with your own eggs. You can always try and see though. Look at ASRM: Infertility, Reproduction, Menopause, Andrology, Endometriosis, Diagnosis and Treatment to see IVF stats by age.

[mythreesons]

Thank you for taking the time to reply. .

I agree that my chances are pretty low. . I guess my question really is if there was even a chance so that it is worth it for me to try.

About two years ago, DH and I went to two REs in the hopes of conceiving our third child. I was advised to use donor eggs. I decided to try on my own. I have a client who is 47 and conceived on her own by changing her diet. I tried it and managed to get pregnant on my own, which I was never able to do with DS#1 or DS#2. A miracle really. I was just wondering that if I tried soon after I delivered DS#3 if it would help boost my chances just a little bit to make it worth a shot.

DH and I always wanted 3 kids, so although I will always deeply regret not having a daughter (and trust me my GD was pretty bad this time realizing this will probably be my last), I won't regret having my son. We both decided if we go for #4 it would have to be HT.

[MatildaMai]

How old is DS2 and how did you respond to the IVF meds then?

Given you have managed a natural pregnancy at 44 you obviously have some good eggs left! I don't know if you are in the US or would have to travel or how tight the $ situation is and all those things matter. Breastfeeding is tricky too as you'd need to wean to pretest and cycle.

But if it were me with your history and $ wasn't an issue, I'd be tempted to have a shot at one cycle and while looking for a donor. You can always cancel the cycle if you don't respond, and if you respond ok but don't have any normals then there is your answer. Kind of expensive way to know whether or not it will work, but I think I would want the peace of mind of at least knowing I'd tried before moving on with a donor.

Good luck!

[mythreesons]

Thank you for responding MathildaMai. That's a pretty name and your daughter looks like a very cool kid. .

DS#2 is 4 and turning 5 this year. He was a one hit wonder. I did try MS/IVF/PGD once before at 39 after spending 6 months breast feeding my son. Responded well. Got really good eggs after MS. When added PGD to the mix, eggs were not good. Only given 50% chance of it working. Transferred 2 but got BFN. I later read that PGD after MS could mess with the eggs especially with someone of my age. Wanted to try MS again but aged out of the program. I worried about IVF/PGD because of that experience so I did not go that route. Maybe I should have. Too late to worry about that now I guess.

Tried swaying on my own but with fertility issues, I couldn't get pregnant. Then told eggs too old and to get donor eggs. At that point I just wanted to get pregnant because DH and I always wanted 3. Somehow I miraculously got pregnant on my own. Really I had just given up all hope. Hoped luck was on my side because all my symptoms were completely different this time around. Ha. Ha. I should have known.

Did try MS/IVF in Mexico. Cycled here in the U.S. Their protocol is very different. I did not respond well. Asked them to use the protocol I used here but they wouldn't. Maybe it was that. But then maybe it was me.

As you can imagine, all of my fertility issues costed us a lot even with insurance. But we would still try if we had a chance. Otherwise, I couldn't put my family through that financial burden. The maximum amount of times I would try would be 1-2 times max depending on the response. Donor eggs is not the route my husband and I feel comfortable with for us both personally and financially so I guess it would just end there.

I saw you went to Dr. Lin. He was also recommended to me. Can you please tell me what you thought of your experience? I chose Dr. Potter because he is the expert in this field.

[ever hopeful]

I'd certainly give it a shot if you can afford it, or if your desire is as strong as mine was, you will go through the rest of your life thinking 'what if'. I was given around a 10% chance first time at 44 but got pg with my DD but sadly had a m/c at 9 weeks (5 probe FISH at Genesis). My 3 sons were conceived easily and naturally though at 38, 41 and 43. Given it had 'worked' first time, I then went on to do a tandem cycle (had 1 DE and 1 my XX) transferred and our DD is now 14 weeks old.

If you start stims and Dr P will no doubt put you on his highest dose (I was planning my 2nd cycle with him, but went back to Cyprus), and have little response, you won't actually have lost that much money, but will have at least tried and you never know, you might well get your DD. I wouldn't wait too long though after you DS3 is born, which might even mean no BF (if that's what you were planning).

Really good luck xx

[MatildaMai]

I went to Dr Lin bc I am an infertility patient, not just a GS patient. I only have one ovary and all 3 of my biological kids are IVF. felt that he listened to my history and was willing to tailor a protocol to me rather than insisting I try what is used for everyone else. I knew the usual US style protocols probably wouldn't work well on me. BCPs over suppress me, and I respond to antagonist protocols best. I can't fault my experience with Dr Lin or his clinic. I think I triggered too early though and the lupron/luveris didn't agree with me.

[nuthinbutpink]

For 2011, Dr Lin's practice had a 49.1% live birth rate which is not that great. It's not terrible but not in the top US clinic bracket. I see their website has not been updated since 2009 when rates were higher.

Dr Potter's success rates are much higher. Dr Lin was fairly conservative on here and success was varied. It's been a while since anyone cycled with him.

[mythreesons]

Thank you all for taking the time to respond. It has really meant a lot to me and it has helped a lot!

Ever hopeful, you give me a lot of hope. And you make very valid points throughout your post. I will definitely heed your advice. Thank you. Can I ask how long you waited after DS#3 was born to try IVF/PGD?

MathildaMai, your story is very inspiring. You took your fate into your own hands and now you have two beautiful sons and a beautiful daughter.

Nuthinbutpink, you answered a very, very important question for me. So many seemed to be leaning towards Dr. Lin but I really feel that if I do this, I would need aggressive treatment.

Today, I am 4 1/2 months pregnant. It has been hard to completely enjoy the pregnancy knowing that it may well be my last and I was never going to have my desired gender. I am going to see what Dr. Potter says, discuss these options with my husband, and see what our new insurance will or will not cover. I was classified as having infertility for my DS#1 and DS#2, so I had infertility coverage in the past. It also helped to pay for a part of my IVF/MS/PGD attempt after DS#2.

This time going in, I am going to prepare myself for the worse though. I think I really put myself up for a fall when I convinced myself that the opposite symptoms I had during this pregnancy meant I was having a girl. I am going to take the rest of my pregnancy to try to enjoy it if it is to be my last, and if I can undergo PGD/IVF, I will go in there knowing that it is a long shot and accept that. I guess I am just not ready to give up unless I absolutely have to. It's just that it feels like such a losing battle sometimes.