Would you move to IVF after terminating for chromosomal abnormality (T13)?

[Anonymous]

Deciding on next steps and looking for advice. I (38F) have a daughter who just turned 3. She was born right before I turned 36 and was conceived naturally after being treated for an ectopic. Husband and I started trying for a second in fall of 2022, no luck until about a year later when we conceived in October 2023 on our second round of IUI. We had decided in advance that if three IUIs didn't work we would move on to IVF. So we were overjoyed when I got pregnant. Unfortunately we got abnormal NIPT results and confirmed via amniocentesis that the baby had full Trisomy 13. I had a D&E two weeks ago at 17 weeks.

In the immediate aftermath it seemed obvious that when I was cleared to try again we should go straight to IVF with PGT to avoid this happening again. Now that the dust has settled and I'm feeling a bit calmer, I wonder if it's worth trying IUI again. The more I think about the cost, time, and impact on my body, the less certain I feel about IVF. I understand that IVF can take a very long time and involve long periods of waiting, which I know will cause enormous stress. Part of me thinks maybe we should "roll the dice" again with IUI since we know I can get pregnant. And plenty of people have healthy babies after having to TFMR. But I turn 39 soon and if we were to have another trisomy pregnancy, I'd be heartbroken - and it'll set us back many months.

I feel like I know what the answer is and I'm just resisting it. What would you do? Alternatively, have you gone through a TFMR and then had a healthy subsequent pregnancy at advanced maternal age? I'd love to hear your story.

[Anonymous]

I would stick with your plan of one more IUI. If you can get pregnant on an IUI (which you clearly can) it's obviously the better option - much cheaper, easier on your body, etc. And if you can't, and you have to move to IVF (which SUUUUUUUUUUUCKS, trust me), then you will at least feel that you had to make the move at that point, not that you could've avoided the process.

[Anonymous]

No, but saw your post on recent topics and wanted to send a hug

[Anonymous]

Since you’re already in the system with a RE, it doesn’t seem like IVF would take that much longer. It seems worth at least asking about that. Regarding IVF being hard on your body, I did 6 rounds and it wasn’t that bad. I was in my early 30s though. Pregnancy was so, so much worse for my body. To me the biggest factor would be the expense. I wish you luck!

[Anonymous]

I'm so sorry for the TFMR.
I would do one more IUI, then move to IVF. In my experience, IVF itself isn't a long process. From my first injection to date of frozen embryo transfer was roughly 2.5 months. The lead time often is initial workup (day 3 labs, HSG, semen analysis, etc), which you have likely already completed if you are working with an RE.
We wasted a LOT of time with IUIs (we did 6). I wish we had moved to IVF sooner.

[Anonymous]

An ivf won’t prevent the same from happening again.

[Anonymous]

Anonymous wrote:An ivf won’t prevent the same from happening again.

It will if the embryos are tested.

[Anonymous]

Anonymous wrote:An ivf won’t prevent the same from happening again.

Of course it can. IVF with good genome screening can identify major chromosomal problems. If you have multiple embryos to choose from, you can even use more advanced pgt techniques and choose the embryo with the highest long term health score, which can add years to their predicted life expectancy. Of course, all this is expensive.

[Anonymous]

I had my first son at age 38. My next pregnancy at age 40 resulted in Trisomy 18. My loving rainbow baby was delivered at age 41. I say keep trying!

[Anonymous]

Try mini-IVF. Easier on the body and less cost. I got 3 eggs and 1 pregnancy with identical twins from it. I also did 3 IUIs prior to IVF. I was in my 40s I first started. Don’t wait too long. Good luck.

[Anonymous]

Absolutely. At 38 85% of my IVF created embryos were abnormal. You don't have a ton of time before the odds of having a pregnancy are below 5% (above age 42)

[Anonymous]

My best friend had a trisomy 18 around her second pregnancy maybe? Her last child was conceived naturally around age 45 with no issues. She’d sort of given up and assumed she wasn’t going to have another, but also wasn’t using birth control and it just happened. The trisomy was somewhere around age 35 and she has a whole houseful of kids. It was just a one time thing…

[Anonymous]

Anonymous wrote:Try mini-IVF. Easier on the body and less cost. I got 3 eggs and 1 pregnancy with identical twins from it. I also did 3 IUIs prior to IVF. I was in my 40s I first started. Don’t wait too long. Good luck.

Did you PG test the embryos?

[Anonymous]

OP, I’m so sorry for your loss. I went through a TFMR due to cystic hygroma and other issues discovered at the NT scan. Since I had just turned 37 and had two prior healthy babies, we decided to try again and conceived immediately. We lost that pregnancy due to a blighted ovum. At that point, we did an RE work up, with numbers that looked good on both sides. The RE was supportive of our trying for another 6 months or moving to IVF with PGT. We were on the cusp of doing IVF but found out we were pregnant, and that pregnancy led to our healthy 20-month old daughter, delivered at age 38. Wishing you the best.

[Anonymous]

If you think you might want not only a second but a 3rd child go straight to IVF. If you're pretty confident you want just one more child I would do another IUI or even 2. You are being monitored for the IUIs right? Medication? Or just testing for ovulation at home and going in based on that?

FWIW I found the stims period of IVF to be somewhat difficult with all the appointments and shots but not that bad. My recovery from retrieval was downright easy, I've had more uncomfortable dental procedures. But this is highly variable, not to mention an order of magnitude more expensive.