
My RE has just started me on clomid. I'm 40 TTC for 1 year with 2 pregnancies (1 MC early and the other a Trisomy). My testing has revealed to my RE DOR. Basal FSH is fine but AMH = 1 and my FSH on the clomid challenge was 10. I produced 3 follicles with the clomid (I only have 1 ovary). Should I be worried about twins or as my RE explained most of those eggs will not fertilize so it is not a big risk? |
It can happen, but odds are very low. The majority of a woman's eggs (70-80%) are chromosomally abnormal by the time she reaches 40, so odds indicate that you will most likely have 1 good egg in a group of 3. Not to say that you might not end up with two good ones, but you are most likely to end up with one. |
I agree. Our RE said the odds are incredibly low at that age, and even a few years younger. Of course, there's always a risk. But it's very low. |
OP I wouldn't worry about it if I were in your shoes. |
OP, I'm surprised you were put on Clomid. I'm AMA also and I've been told older women aren't put on it because it thins your uterine lining. Good luck with everything. |
Let me guess - you are at Shady Grove.
Clomid really isn't very good for a 40- yr old. You would be more likely to succeed on injectibles rather than clomid. I'm sorry I wasted 4 cycles on clomid. |
OP here - Actually this month is the clomid challenge but my CFA RE has suggested trying clomid for 3 months depending on my response. Since I responded well I think he will continue with this course. My uterine lining on clomid was fine from the ultrasound. I thought that older women weren't put on clomid because it doesn't stimulate them well since they often have elevated FSH anyway - I will ask the DR |
That's not the only reason. I did 4 cycles of clomid at age 39 & stimmed great on it, but it still is generally not a good drug for older women. I over-responded at 100 mg and cancelled the first cycle, then we cut back to 50mg and I still produced multiple follicles (again, almost enough to cancel the cycle but we went ahead). My FSH was just over 6 at the time, with everything else normal & regular, ovulatory cycles, so no dx of DOR (but frankly, we all have DOR/egg quality issues at this age.) My lining held up ok until the 3rd cycle of clomid when I started to have issues and was put on estrace. There is evidence that injectibles produce higher-quality eggs, so getting 3-4 follicles on clomid is NOT as good as getting the same number on injects. Clomid is cheaper, but if you have insurance or can afford the meds and additional monitoring, I would push for injectibles instead of clomid. I really regret wasting what ended up being 5 months messing around with clomid when I should have gone straight to injectibles. Good luck! |
Thanks PP (OP here) your story is very helpful. I will talk to my RE about these concerns.
I guess the answer to my question is that I really shouldn't be worried about multiples. ![]() |
It's possible, but really not very likely, so I wouldn't spend your time worrying about it. (Unless there's some medical reason twins shouldn't even be an option, then I'd look at natural cycle IVF.) |
My first cousin has identical twins from fertility meds + IVF. My RE said he had identical triplets (not all survived past birth) from IVF. There is some evidence to show that as we age, in your body's desperate attempt to reproduce, identical twins are more likely (one final beautiful egg! let's split it! says your body). You cannot prevent identical twins (one embryo splits, remember, not the case of implanting two embryoes). You should not worry: there is nothing you can do. However, sounds like you're running through every possible outcome: identical twins is a possible outcome. But, as far as fraternal twins, you're even less likely b/c getting two great eggs is pretty rare, than having both fertilize, both implant ... you get the idea.
FWIW: I panicked after my cousin with the identical twins. My RE went through the odds, and it's really very small, so I relaxed. Still not sure we'll buy a new car until we know we're pregnant with our hoped-for second child, rather then twins. But at this point: we've TTC for almost a year and who knows if we'll even have that second child. |
Yes, but how old was your cousin? 40+ My RE says he has only seen a few woman at that age give birth to multiples. |
as A 40+ woman TTC the biggest obstacle is conceiving at all, so I wouldn't waste time worrying about twins or spend more than a month or two on clomid since other meds or natural cycle IVF is the better option. |
My cousin w/ identical twins was 44.
Agree w/ the last poster on one point: biggest obstacle is conceiving at all. Up to you as what;s your best method. |
Simple answer...NO...wouldn't worry about multiples at 40+, especially with clomid and only 3 follicles.
Longer answer, clomid isn't really a good option for over 40, but if it is only your clomid challenge test, then maybe make the best of it. At 40+ my doc didn't even do the clomid challenge, as he felt it wasn't going to tell us much. Signed, a 42 yo mother of twins. |