Going straight to donor egg for secondary infertility?
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Anonymous
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I'm almost 39. I got pregnant very easily with our child at almost 36. Easy pregnancy and delivery. Now we've been trying for baby #2 for 10 months. I have not gotten pregnant yet despite carefully timed BD, and an ovulation predictor kit. My Day 3 bloodwork isn't great. FSH is 12 and AMH is .3.
I've seen some REs for initial evaluations. I would like a second child, but don't think I'm able to go through IVF emotionally or physically. I don't want to try repeated IVF cycles only to have them fail. I have a strong family history of both ovarian and uterine cancer and don't want to take the meds for several cycles only to have those cycles fail. Instead, I'd like to go with what has the highest rate of success for my age and numbers, and that appears to be donor egg. I am completely open to donor egg. But would it make sense to skip traditional IVF and go straight to donor egg? I guess part of what makes donor egg more appealing is I feel like because I can't get pregnant on my own at my age, nature is telling me that my eggs are old and bad, and if I did conceive, I'd be worried about how healthy my eggs are at this point. A donor egg from a young and healthy donor would allay many of those concerns. My husband's sperm is fine. My only qualm about donor egg is that my OB told me that there is a higher rate of pregnancy complications, such as pre-eclampsia, with donor egg than with own eggs, due to the mother's body rejecting the donor eggs in some way/immune issues with the donor egg. Pre-eclampsia in particular is one of these complications. So that concerns me. What would you do? Also, any suggestions as to the best clinic for donor egg (I would prefer a large selection of potential donors due to my heritage/ethnicity, as it will likely be harder to find). Thanks! |
Anonymous
| I used donor eggs twice, and it was a great experience. Glad I did it. My first was a preemie but no other complications. At SG You can use their fresh donor database or frozen which has more choices, or another frozen database of you own choosing, I believe at Shady Grove. Check on costs of using an external donor database though. I did a few own egg cycles before moving to DE. Hindsight being 20/20 I would have skipped that and done DE shared risk at SG right away. |
Anonymous
| Don't have info to respond re: donor egg question, but I did want to weigh in on the egg quality concern. The concern is very real, but there are things you can do in the IVF process. First, the whole process actually lends itself to getting the best egg (watching them hatch, getting to blastocyst stage, only implanting the healthiest one). But also, you can use Pre-Implantation Genetic Screening (PGS), which is an extra step that examines your embryos for chromosomal abnormalities. It's got an above 95% success rate. If that's your only concern, I would talk to an RE before you skip straight to DE. |
Anonymous
That assumes that in the first place she will have embryos that will make it to blastocycst, which is not a given. Even if they do, it assumes that some will be normal, again, not a given. And it also assumes that a normal one will implant, which is also not a given (there could be lining or other issues). With DE again, it's not a given that a PGS tested normal embryo will implant, it may take more than 1 cycle. OP, you FSH is very high. I would research it and talk to an RE about the implications. |
Anonymous
| OP here. My FSH is 12. You think that is very high? The REs and my regular gyn did not seem concerned. They considered my FSH slightly high, but not that outside the range of normal. They were more concerned with my AMH. |
Anonymous
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I had my first at 39 - my fish was like 7.2 or something. At 42 my fish was 12. Two OE IVFs failed. Got pregnant twice naturally and miscarried both times due to chromosomal issues. Did DE and got pregnant on the second try.
Personally I needed to try with my OEs, but it doesn't sound like you feel that strongly. You'll likely have success sooner with DE. |
Anonymous
| 12 is above optimal, but not massively. Anything under 10 is optimal. |
Anonymous
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For most people, you will have better success getting pregnant with DE. You might have some immune issues or other non-normal issues, in which case you will have problems getting pregnant either with DE or OE.
I had problems with both - and finally got pregnant on the 4th DE transfer, all with PGD normal embryos. For that cycle, I did immune treatment at SIRM, and it finally took. The pregnancy went well but I was induced at 38 weeks for reduced growth. The delivery showed that the reason for that was the umbilical cord attached closer to the side of the placenta than to the middle. I read that one theory for the cause of that is imperfect implantation. To the point, there is an increased risk of preeclampsia from DE, but it is more likely to actually get you pregnant. You could take a baby aspirin each day during pregnancy, which some studies have shown reduces preeclampsia risks. Also, all the people I happen to know who had preeclampsia had it with OE pregnancies. The OBs test for it all the time. The kids were all fine - just delivered a little early. I would say go for it with the DE. |
Anonymous
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OP, I know that blurb about women using DE having higher risk of preeclampsia has been circulating, but I don't know how substantiated it is. The only citation I could find was from a recent French study. It's certainly possible there's an association, but I think if women using donor egg were having preeclampsia and pregnancy-induced hypertension right and left, it would have come out before now. A lot of women using DE are older, and a lot have twin pregnancies - both increase the risk of of BP-related problems.
FWIW, I had my first baby (OE) in my thirties, no BP problems. I had my second baby (DE) in my forties, no BP problems, and no complications. If you are at all attached to the idea of an OE baby, you may want to give it a try. On the other hand, if you go to DE, you will probably get a baby sooner. An additional benefit is that if you don't spend $$$$ trying with your OE, you won't feel as stressed and strapped for funds when going to DE. Although I didn't go to DE immediately, I didn't spend much time on OE. I wanted a baby. I didn't want to say "I wish I had done this sooner." No regrets at all - I'm happy I didn't waste time. If you're comfortable with DE and worried about the risks that OE presents to you, you may decide you prefer to go directly to DE. It may be worth a session or two with a therapist who specializes in ART to help you sort out your feelings on this. |
Anonymous
| I think for poor responders (often those with high fsh respond poorly to meds), trying naturally (but effectively, make sure you have studied Taking Charge of your Fertikity) can be just as effective as IVF. In your shoes, I might try for another year naturally, and then go right to DE. |
Anonymous
OP here. Thanks for your thoughts, I was thinking the same thing. If I were to do natural cycle IVF I'm not sure how that would differ from trying naturally in terms of statistics, as my husband's sperm is fine and my uterus/tubes are fine. I think we will try naturally for another year or so, and then consider DE. I am totally open to DE, I want to do whatever has the highest success rates with the most minimal meds. |
Anonymous
Natural is not as good as IVF once you reach a certain age because the "shell" of the egg gets tougher and the sperm can't penetrate. That's why it's very common to use ICSI with older women. If I were you, I would either go to a clinic that works with older women or try NCIVF. If that doesn't work, move on to DE ASAP. |
Anonymous
| If you aren't interested in doing IVF with meds and genetic testing on the embryos, at your age I would go straight to DE. I worked with ORM, btw, and found their donor pool to be impressive. |
Anonymous
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I would try on your own and then go straight to DE. With an FSH of 12, the odds of regular IVF working are pretty low at your age. If you want to check, you could ask Shady Grove to run their statistical model on you and give you your odds (they input age, AFC, FSH and AMH). But since odds are slim, I it is probably not worth the time/expense.
If you want your kids to be closer together, you could always go to DE now. The traditional IVF process is so exhausting/miserable that I just honestly wouldn't recommend if if your odds of success are very low. I just had dinner with a friend who went straight to DE and her infertility experience was so different from mine because she wasn't as worn down from all the failures as I was when my 4th IVF cycle finally worked. At the time I was 33 and had an FSH of 10.3. |
Anonymous
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OP, get yourself to an RE. I don't think your OB is particularly current on these issues given what he said about donor egg pregnancies.
An RE can test you and tell you a lot more about your particular situation and your best options. Whatever route you choose I wish you luck. I had my kids in my 40's from donor eggs and they are perfect, the pregnance was relatively easy and healthy, and we have no regrets. We used Dr. Abassi at Columbia Fertility and I loved her. |