Thursday 5 May 2011

Let's give a few examples:

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). However this couple was only interested in having a child from their own sperm and eggs. We placed her on a program of mini-IVF back to back cycles to store up embryos by vitrification over the next year. We were only able to attain one egg (and one embryo, therefore) with each cycle. After four embryos were finally stored up, we transferred two thawed embryos at a time in subsequent months, and with the second embryo transfer, at age 44, she became pregnant with her own eggs and delivered a healthy baby boy.

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. 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. But they were definitely not interested in their son's sibling having a different maternal DNA origin than his. 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. One half year later we thawed that single embryo and transferred it to her uterus. She became pregnant and delivered a healthy baby at age 44 without having to resort to donor eggs.

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. So they were recommended to use donor eggs for her next (fourth) cycle, but they were just not ready for this option. In desperation they underwent three back to back cycles of mini-IVF with us (at about one fifth of what she spent in her previous IVF's), obtaining two eggs each time, resulting in six stored up frozen embryos [video]. We transferred two at a time the next year, and she finally got pregnant with her final embryo transfer, with her own eggs, and delivered her own healthy baby.

Some women lose most of their eggs earlier in life, like in their early 30's or late 20's, just as though their ovaries were that of a 40 year old. For them the news is even harsher when an IVF clinic tells them they will need to use donor eggs. One such couple we treated with back-to-back mini-IVF cycles had immigrated to the U.S. 12 years ago. 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. They had started expensive stimulation protocols for IVF at several clinics and each time the cycle was cancelled because "there were too few follicles."

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. All three of these cycles cost less than they had spent for just one standard cancelled cycle elsewhere. 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.

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. Each cycle produced only one or two poor quality embryos and no pregnancy. Now at age 43, we put her through one cycle of mini-IVF, and she produced 5 high quality embryos and is pregnant. Too much FSH stimulation produces poorer quality eggs, especially in older women.

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. Finally, we transferred 4 embryos (because her eggs were so old, and as expected, she did not become pregnant. 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. 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.

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