Would you do a 4th IVF? Support needed

[Anonymous]

OK, just got a negative on my 3rd IVF. This time we tried NCIVF and transferred a 3 day, 10 cell embryo. Last year we did two stimulated cycles and transfered 2 8-cells and the 2nd time 6- blasts. Nothing took. I just turned 42 and we have a beautiful 4 year old DD who we conceived naturally.

Do I start looking at donor eggs? Another practice to change protocol? Not sure what to do, of course today will be emotional and need to discuss with DH. I really wanted a sibling for DD, but maybe it is not meant to be.

[Anonymous]

i'd get a second opinion. i just got a second opinion after a year's worth of failed IUI and IVF attempts, but i feel more hopeful already.

[Anonymous]

DH and I are thinking about doing a 4th "hail mary" IVF cycle at Cornell if our 3rd cycle at a local clinic does not work. After that we'll move to DE. Of course, everyone is different and doing a cycle in another city is obviously much easier when you don't already have a child. My advice is to talk to your RE and also maybe get a second opinion before deciding what to do. I know the CCRM clinic (another "top" clinic) will do phone consults. Or you could talk to another local clinic. Good luck!!!

[Anonymous]

Nope I would quit while you're ahead and switch to donor eggs, esp. if none of the 6 blasts took. Good luck.

[Anonymous]

Nope I would quit while you're ahead and switch to donor eggs, esp. if none of the 6 blasts took. Good luck.

[Anonymous]

I echo a previous poster. I wouldn't do another local IVF because the good local clinics (SG, dominion, columbia) use the same protocols and have roughly the same success rates. Dominion differs in that they offer NCIVF but I see that you already did that.

If I was you, I would either move to donor egg or consult with either CCRM or Cornell. Their success rates are 10-20% greater than the DC area options. I believe that both clinics offer phone consults and are extremely used to dealing with out of town patients. I believe that the consults run around $300-450 but are reimbursed under many insurance plans.

[Anonymous]

Another vote for Hail Mary. We did a fourth IVF at St. Barnabus with Dr. Sable who was still practicing at the time. It worked. I have elementary aged b/g twins. Good luck.

[Anonymous]

I'd get a second opinion and then decide. You may just need assisted hatching or more stimulation. Good luck

[Anonymous]

First of all, I'm really sorry for your BFN. That sucks. I have severely diminished reserve even though I'm not as old as you are. (I also have a 3 year old that I conceived naturally.)

I'm assuming your issue is AMA/DOR and that you are trying to find a good egg? I've stopped treatments - I just don't have the money or energy to put myself through it anymore, and I also failed at one the out of town clinics. So the first question you need to figure out is if you have it in you to keep going, and whether you can afford to.

In terms of doing another NCIVF, you really have to do 3 to get the same success rate as 1 IVF, so doing 2 more may give you a shot if you can emotionally handle the possibility of BFNs.

As for cycling out of town, it sounds like you stim well for your age, so I'm not sure the protocols at Cornell or CCRM (or SIRM) would much improve your chances (unless you're producing a lot of immature eggs and think you could get more). Also, if you're producing that many blasts, and willing to transfer them all w/o genetic testing, then going someplace with a better lab won't help (unless you're losing a lot of embryos.) So that leaves the genetic testing that CCRM and SIRM offer as one way to help you, by screening out the abnormal embryos so you transfer only normals, rather than transferring the embryos that look good but may not be normal (assuming you have a selection to chose from). Finally, given that you conceived naturally, I don't think the co-culture that Cornell offers would help (at least, that was my RE's opinion).

[Anonymous]

I really think you need to discuss this with your RE. We had had 3 failed IVF's -- each time ended with a chemical pregnancy. Our RE, said that based upon our results, he thought that we could get pregnant, but recommended that we do PGD. We did PGD on IVF #4 and got pregnant that cycle. We also went back for baby #2, did PGD, and got pregnant on our first cycle that time.

We went to Shady Grove.

Good Luck!

[Anonymous]

OP here, thanks everyone for your advice. I think I'll go in for another consult to see what is suggested. How do I ask for my file so I can bring it somewhere else too for a second opinion? Maybe I'll call now for that so I have it.

FYI, the first cycle 8 eggs retrieved, only 2 mature, both fertilized with no success. The second we stimmed longer (plus I was doing acupuncture) and we had 17 eggs, 11 mature and all went to blasts. At that point nothing went further. This NCIVF cycle we retrieved a good egg, transferred at 10 cells and prayed for the best.

I'm thinking I might go to Shady Grove in Annandale for a consult. A bit far away from where I live but really the closest after Dominion, my current practice.

And yes, I need to think how much more time, effort, stress and money I can handle. That is one reason why we had a year break from doing it last year.

Thanks again, and more opinions welcome!

[Anonymous]

I got my medical records from Dominion when I switched to SG and getting them was no problem. I requested them a year ago, so I can't remember the exact process, but I think it was pretty easy/fast. Good luck! Resolve is also having a one-day conference tomorrow near Tyson's that might have some good info for you if you are free.

[Anonymous]

I don't think you can really count the natural cycle IVF, at least not the same as the stim IVFs. If you're going to try natural cycle IVF, I really think you have to commit to doing at least 3. It sounds like you're a pretty reasonable responder though, so if you have the money, I think trying again makes sense. But if money is tight, you might want to start considering DE.