Saturday, June 27, 2009

How Many IVF Cycles at 42 years old?

Questioner: Lisa
Subject: How Many IVF Cycles

Hi Dr Ramirez, I am 42, FSH 6. I have failed 2 cycles of IVF.
First cycle got 6 eggs, second cycle got 10 eggs. 3 were fertilized each time with quality being from poor to good. I am about to start my third cycle of IVF. How many cycles should I try with my own eggs before giving up? Is there a point when my efforts are considered futile?


How long you continue will depend on you; How long can you tolerate the failures and how many times you can afford. Since the pregnancy rates at your age are around 25% per attempt, that means that there is a chance of getting pregnant. The problem you are facing is overcoming the age effects on your eggs. As long as your ovaries still stimulate, then you have a chance. The most cycles I have ever seen was in a patient that tried with her own eggs for 13 tries. She finally got pregnant and delivered healthy twins, and she was your age. After 42, however, pregnancies are rare so in general we do not recommend them. At that point you should go to donor eggs.

If you don't want to keep trying with your own eggs, or you've reached the end based on answers to the above two questions, then your best bet is donor eggs. I recently had a patient your age who tried with her own eggs for three tries. We had one chemical pregnancy. She then, because of financial restrictions, decided to try one last time with donor eggs. She was successful in that first try and is currently pregnant with twins.

The point where things are "futile" is if your ovaries no longer respond, and/or your egg/embryo quality is poor. At that point, you should no longer try with your own eggs. Until then, miracles can happen.

I hope this helps,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

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