Dear Professor Winston,
Firstly, thank-you for the opportunity to raise these questions, it is an incredibly valuable and kind service to people who often find themselves in isolating circumstances.
I am a healthy 44 year old women with a 50 year old, similarly healthy, partner, and we are currently in the midst of our first IVF cycle. We met later in life, and neither of us have any children from previous relationships, not due to any physical difficulties, purely through choice. We are due to marry in the summer and have been attempting to become pregnant since April 2013. The first two pregnancies, commenced in May and November 2013, respectively but sadly ended in early miscarriage, around the 8 week point, both times. Since then we have been attempting to become pregnant naturally and then decided to give IVF an attempt on the advice of our local NHS fertility service. We have undergone the usual tests and there were no factors exposed that signified we might have a problem. We both practice yoga and meditation daily, eat a healthy diet, do not drink alcohol or caffeine and try to keep stress levels at bay, as much as possible.
We were pleased with our IVF progress until Saturday, the day of the embryo transfer. Last Wednesday 8 eggs were collected, and then overnight, 7 were fertilised. The following day, (Day 2), there were 5 embryos remaining, all graded 1, (the top grade for this clinic) which were all at 2 cells each., and we were told to prepare for transfer the next day. When we met the embryologist on Saturday morning however, he advised us the although we had 5 embryos still remaining, with 3 being at Grade 1 and 2 at Grade 2, they had not ‘progressed’ since the previous day and were still at 2 cell level each. Despite this, they decided to transfer the 3 grade 1 embryos, in the hope that they might ‘catch up’. My partner and I were both devastated by the news and still are, as we feel, this must be highly unlikely to develop in to a pregnancy. We are both painfully aware of our ages, especially mine, being at the top of the fertility age spectrum. My question is, do you think we might still have a viable reason to hope this cycle has worked, and if not, is it really worth us considering undertaking another, or will this, given our ages, just be pursuing false hope?
Thank you so much in advance for your time and consideration.
The very cruel fact I am afraid is that, at the age of 44, you are more likely to miscarry than to have a successful implantation with a live birth if you do get pregnant. Regrettably, I know of no evidence which clearly shows that by having IVF you a) improve your chances of either a pregnancy or b) reduce the chance of miscarriage. As you will see from this website and previous answers, grading of embryos is not a particularly good indicator of outcome. I suspect that in your case the embryos you had did not survive after IVF because they were chromosomally abnormal and this risk is more likely if you take the powerful drugs to induce ovulation.
My advice would be not to go through IVF again, but try to conceive naturally on the off-chance that enjoyable sex in the right setting may be your best chance of having a child.