QuestionHi Dr Ramirez, I am 42 y/o, my fsh is 6. I had 1 failed IVF cycle in 2/09. I
am on my second cycle now. I have 15 follicles to be retrieved in 2 days. If
my second cycle fails, how many more cycles should I try? Does doing more
cycles increase your chances of pregnancy? My RE tells me after 2-3 cycles,
she does not want to try again with my own eggs as the chances of
pregnancy becomes extremely unlikely, does this seem reasonable?thank
you, Lisa from Anaheim, CA.
AnswerHello,
I'm actually originally from Mission Viejo.
How many cycles to try depends on several things: (1) how good you stimulate, (2) how is the egg and embryo quality and (3) how much money you want to spend.
You have a good FSH level, which is an indication that your ovaries are still working pretty well, and you are stimulating very well (as evidenced by 15 follicles). How many eggs are retrieved is a key and how good the embryos are at transfer is even more important. I think that if you have good quality embryos to transfer, and have at least three good quality embryos, then there is not reason you cannot keep trying with your own eggs. Keep in mind, however, that since we cannot know if the embryos are perfect, because that technology doesn't exist, you chances are still only 20-25% per cycle based on your egg. The most I have had a patient try is 6 times but she ended up having twins after the sixth try. She was 41 years old. When I was younger, I did take care of and deliver a woman who was 42 and got pregnant on her 13th attempt. She was determined to have a genetic child.
You also have to decide how important it is to have a genetic child, and whether or not you can bear the cost of continuing to try. That is the major factor for most couples. If you can afford to keep trying, and you have the above criteria, then you can keep trying by all means. However, if you can't afford more attempts and/or your embryo quality is not good, then donor eggs would be best. With donor eggs you would have a 50%+ chance per cycle, so less attempts would be required (usually only one).
I don't dictate to patients what they should do. I counsel them as clearly and extensively as I can. Then, I leave it up to them to decide and will abide by their decision.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
