42 years old trying to conceive with own eggs

We are willing to take on the most difficult cases with lower prognosis, so long as we feel there is a chance for pregnancy. Of course, one option for such women is donor eggs, but many women would prefer getting pregnant with their own eggs. The success of this approach depends not only on a novel endocrine stimulation protocol, but also upon a flawless method of embryo freezing such as our vitrification system, and the highest level laboratory air purification system to give the eggs from older women the best possible environment in which to develop. A 43 year old woman who married relatively late in life was told by numerous doctors and infertility clinics that she could only get pregnant if she used donor eggs, and some also recommended donor sperm because of the husband’s age (which was silly). Another example: A 43 year old woman married, at age 38, to a 34 year old man, already had conceived naturally and delivered a healthy son four years earlier.
Another example: A 41 year old nurse married to a 39 year old physician had already gone through three conventional IVF cycles elsewhere with PGD and no success. When they came to us, we initiated several relatively inexpensive cycles of mini-IVF, and retrieved 3 eggs in one cycle, and one egg in each of two more cycles, resulting in a total of three blastocysts which were frozen by vitrification and stored for later transfer. A great example of the superiority of mini-IVF for older women is a 43 year old who had gone through 5 previous conventional high dose stimulation IVF cycles since she was 40 years old. A very determined 45 year old woman underwent four cycles of mini-IVF stimulation for IVF resulting on a total of 14 frozen stored embryos, because she knew how low her chance was for pregnancy per embryo with her own 45 year old eggs. Suzanne Gastineau got pregnant with her first baby so easily, it never occurred to her that a few years later, she would be trying to conceive her second for a year-and-a-half with no results. A dramatic example of mini-IVF for women over 40 is a typical case of what we call secondary infertility, where the couple was able to conceive and deliver a healthy baby when they were younger, but now find themselves infertile in their attempt to have another child a few years later. For example, a physician patient with a zero sperm count because of pituitary deficiency (a rare condition in males), had his sperm count return with the proper hormone treatment, but because the count was still low, they needed ICSI-IVF. A 45 year old single woman had to go through 4 cycles of mini-IVF with embryo banking, and was thereby able to store up 6 good quality embryos derived from her own eggs.
An interesting 38 year old couple saw us in whom the husband was deemed to be azoospermic (no sperm) and the wife’s testing revealed premature ovarian failure with only a few antral follicles and a high day 3 FSH. In fact the remarkable successes with some of these older women resulting from the mini-IVF protocol are causing us to be cautious about how many embryos we transfer at one time even when older eggs are involved. We cannot thank you enough for your willingness to extend your expertise to successfully treat the infertility issues which older couples face. There are several reasons for the remarkable success in our cases of older women using this approach. We can sometimes even achieve pregnancies in women 46 years of age and older with this approach (although donor eggs is a much more sure technique for achieving a successful result for such cases). A striking example of how mini-IVF with back-to-back cycles to store up vitrified embryos can allow older women to get pregnant and have babies with their own eggs is a couple from the north central area of the U.S. Another beautiful example is a 47 year old woman who went so far as to store up 14 embryos with mini-IVF.
Of course we always suggest donor eggs to older women as a much surer way of having a baby, and we are strong advocates for accepting donor eggs once a woman has run out of her own eggs.
This principle can also apply to younger women who have very few remaining eggs who are suffering from premature ovarian failure. We recently took care of such a case, a young woman I had known since she was a little girl, who had undergone multiple surgeries at various clinics for other health problems, but the result of her cure was just one remaining ovary with hardly any eggs left. There are many more such examples where persistence and mini-IVF can be successful with older couples or women with very few eggs.
If a woman absolutely cannot get pregnant with her own eggs, then donor eggs is her only remaining option.
It is ten times harder for a woman to become pregnant at 43 than at 37, doctors have warned.The rapid speeding up of a woman’s biological clock means that by the time she is 43, she will need to go through 44 eggs on average to produce just one normal embryo. Researcher Meredith Brower said that the number of eggs needed for a viable pregnancy rises ‘almost exponentially’ after 42, and urged women to freeze their eggs without delay.British experts said that while, ideally, women would have their babies in their twenties, the realities of modern life mean many have no choice but to wait. No delay: Experts say that women who want to freeze their eggs should do so in their late twenties or early thirties to have the best chance of success later.
When couples are trying on their own to get pregnant the fertility issue that reduces chances for success is related to the quality of the eggs. Although these age and fertility statistics are specifically about IVF success, there is a similar loss in fertility potential with aging in the general "normal fertile" population.
Another point shown here is that there not a substantial decline in success by age of the recipient woman with donor egg IVF. The national summary (as well as clinic specific results) of IVF success rates for cycles done in years 1995 through 2012 are posted on the CDC website. All clinics have some upper age limit after which they will not perform in vitro fertilization with the woman's own eggs. Women over 38 years of age often have very few eggs, respond poorly to conventional ovarian stimulation, and because of lower pregnancy rates, are often just cancelled by IVF clinics for fear that such cases will lower their reportable statistics. Now the couple wanted a second child and had been told that donor eggs was her only option because of her age and low ovarian reserve.

So they were recommended to use donor eggs for her next (fourth) cycle, but they were just not ready for this option. For them the news is even harsher when an IVF clinic tells them they will need to use donor eggs. Finally, we transferred 4 embryos (because her eggs were so old, and as expected, she did not become pregnant.
Secondary infertility is almost always caused just by the declining number and quality of eggs as the wife gets older. However, by the time they saw us, the wife was already 40 years old, and she only had a few eggs retrievable and would have been cancelled at most centers and just told to use donor eggs, which they were opposed to.
Now at age 43, with such a low ovarian reserve, three years later, they wanted to try for another child.
But she was obviously not certain that even this would result in a pregnancy because of her age, and so she decided in her 5th cycle to use donor eggs as well. But despite these clear negatives, which no other clinic would take on (and would only recommend donor sperm and donor eggs), we gave it a try.
We are enthusiasts for this, and we have literally no “waiting list” problems for donor eggs. One 44 year old woman who was turned down by many IVF centers unless she agreed to use donor eggs, underwent two mini-IVF cycles at our center in which we were able to retrieve 4 eggs each time, resulting remarkably in 4 embryos each time, which were frozen by vitrification and stored for eventual transfer.
We celebrated with our amazing two-month-old twin baby girls and we wanted to extend our sincerest gratitude for helping us realize our dream to become parents. The next month another mini-IVF cycle yielded 3 eggs, which resulted in two more beautiful embryos which we also froze. She already now has two babies (with her own eggs) and still has four more frozen embryos with which she can try for a third baby despite now being almost 50 years old. But with this mini-IVF approach of storing up vitrified embryos month by month in older women, we have a remarkable pregnancy rate even in women over 42 years of age of over 50%, and this year thus far 67%. Most IVF centers will turn these women down if they do not agree to donor eggs, or else string them along with tests and meager treatments that are doomed to fail, until they finally agree to donor eggs.
The advantage of mini-IVF is that we can get better quality embryos at a much lower cost per cycle, store them up safely with vitrification, and spend less than the conventional IVF cycles would cost. They also have substantially lower success rates with fertility treatments including in vitro fertilization (IVF). With treatments such as IVF, the issue that holds back success potential is both egg quality and egg quantity. With IVF treatment we hope to get multiple embryos so we can choose the best ones from a group for transfer back to the uterus. The rate of chromosomal abnormalities in eggs (and therefore also in embryos) increases significantly with advancing female age.
However, when going through a fertility treatment such as IVF, the quantity of eggs remaining influences response to ovarian stimulating medications.
Louis, is just the right approach for older women or women with low ovarian reserve who still want to use their own rather than donor eggs. We placed her on a program of mini-IVF back to back cycles to store up embryos by vitrification over the next year. Her first embryo transfer here resulted in no pregnancy, but with her second single blastocyst transfer she became pregnant and delivered a healthy baby boy, with her own eggs, never having to resort to donor eggs.
However, six months later we thawed and transferred 4 more embryos, but this time she became pregnant and delivered a healthy baby with her own eggs at the age of 46. With mini-IVF and ICSI we managed to get 3 eggs, all good quality, inject them with his few sperm, obtain 3 good quality embryos resulting in a healthy baby boy nine months later.
We transferred one thawed embryo of her 6 that were frozen from her own eggs, and one embryo derived from her donor eggs (at her request). Indeed we found a few sperm in him with TESE that were quite good quality, and with mini-IVF, obtained 3 eggs from her very deficient ovaries. He had had a vasectomy 20 years earlier as a young man, and had not decided till this late age finally, after 12 years of happy marriage, that they both really wanted a child. These cases of women over 46 getting pregnant with their own eggs are unusual, but it is nonetheless quite possible if donor eggs are not an option for them. But it takes a great deal of patience on the part of the patient to retrieve just a few eggs at a time every month until enough embryos are banked to warrant thawing and transfer. The misery this brave and beautiful young woman had to go through, being told by everyone that she could never have her own children, and her determination not to be swayed by the naysayers was truly inspirational. Nonetheless, some women simply will not have any viable eggs of her own, and then donor eggs becomes the only remaining option.
We have been offering donor egg IVF for over 24 years, and therefore have had a chance to follow these children and their parents for a almost a quarter century. It takes advantage of your own natural FSH elevation with an ingeniously simple protocol that strives for smaller numbers of better quality eggs.

So we put her through two cycles of mini-IVF back to back, and stored up three embryos retrieved from her own eggs, only one of which looked viable.
She still has 6 more frozen embryos remaining, and so it is possible she could even have a second child in a few years, before she is 50, to be a sibling for this miracle baby she had from mini-IVF with her own eggs at age 46.
She wound up delivering healthy twins, one from the donor eggs, but clearly one also from one of her 6 frozen embryos that had resulted from her own eggs. It is just that most people would prefer their own DNA, and for that goal, properly administered mini-IVF with embryo banking is the best alternative for the older woman or for even for the younger woman who suffers from low ovarian reserve. Silber was that good at thinking outside of the box, he could help a healthy 44 year old become a mother.
Silber explained to us the odds of conceiving because of my age, now 43, but he also had a plan to give us a chance. I told them we could easily restore his fertility with a vasectomy reversal or just retrieve his sperm microsurgically, but the problem was her age. She was completely out of eggs and we had managed to retrieve her last remaining eggs in the nick of time.
She went through a total of 6 cycles of IVF just to store up embryos, retrieving only a few eggs at a time, and eventually storing up 10 embryos.
Both the children and the parents are well adjusted and completely happy with their lives as a result of the donor egg IVF.
Instead of massive doses of expensive hormones to try to blast out a few poor quality eggs, it more naturally teases out of the older ovaries their best quality eggs with a carefully devised protocol of minimal stimulation. Both were physicians, only 34 years old, and had been told by several IVF centers they had visited that she had only a few follicles left, was about to go into early premature menopause, and was not a candidate for IVF with her own eggs. So this time, again with mini-IVF, we actually got 6 eggs and 5 good quality embryos, giving them two more children, even at age 43, when every other center would automatically turn them down because the results are normally so poor with conventional IVF in women over 40.
This case exemplifies dramatically that if you can get good quality embryos using mini-IVF from your own eggs, even for patients in their mid-forties, pregnancy is still possible without the need necessarily of donor eggs. After saving up several more embryos, with another cycle of mini-IVF, and another TESE for him, they now had 5 good quality embryos frozen using our advanced vitrification technique. So five months later, at almost 46 years of age, she asked to thaw and transfer all four of her remaining frozen embryos, thinking that from such old eggs, there was very little risk of multiple pregnancy. We finally figured out these doctors were trying to waste enough time to force us into using donor eggs, rather than pursue a plan that would help us try to have our OWN children. I had a very healthy pregnancy and made it to 39 weeks with what my OB described as a pregnancy better than most of her moms carrying ‘singletons’. Secondly, the very clever Japanese approach to minimal stimulation allows us to retrieve just as many (or few) eggs from older women as more expensive massive dosing conventional stimulation protocols, but better quality eggs and at a lower cost.
Although I brought up donor eggs as the surest solution, they insisted on trying with her own eggs.
A half a year later, at age 48, and completely devoid of eggs, we transferred these three beautiful frozen embryos, and she has a healthy pregnancy at age 48. She became pregnant and delivered a healthy baby at age 44 without having to resort to donor eggs. As though this was not enough of a family, they decided at 45 to try once again with her remaining 3 frozen embryos to enlarge her family further and now again has a healthy pregnancy due to deliver when she is 46 years old, all from her own few remaining eggs, and his near zero sperm count. As a result, this unlikely couple now has two healthy babies using the husband’s sperm and the wife’s eggs, and never had to resort to either donor sperm or donor eggs. We realized that using donor eggs is a viable option for some couples but had told each doctor from the beginning that was not what we wanted. Finally, the ability to freeze the embryos with impunity and then transfer in a later cycle where the uterine lining is more perfectly synchronized to the stage of embryo development than during a stimulated cycle, all adds up to better success rates in challenging cases. The reason it is so often misunderstood is that what appears to be ingrained character in a child is in truth, a subtle result of early interaction with parents in the first two or three years of life. In either event, if you are forced by complete lack of any fertile eggs of your own, to use donor eggs instead, in the end you can feel quite comfortable that you can still have a very happy and fulfilling family.
Fortunately, and as expected, her triplet pregnancy spontaneously reduced to twins, and she delivered healthy term twins, with her own eggs.
The character, personality, intelligence, and even coordination motor skills of the child are dependent on that emotional bonding and complex interaction with parents in the first few months and years. Thus, with our new mini-IVF technology, we have to still be cautious not to transfer too many embryos at one time, even with older eggs.
So couples who have to take their second choice, donor eggs, because they have run out of their own eggs, should not be forlorn.

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