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fertility treatments after miscarriage?

I hope to hear your opinion. I am almost 46 and few months ago became pregnant without fertility treatments after a few months of trying to conceive. We married late in life. Neither of us has children or has tried to conceive before. My initial HCG levels were strong. We saw a heartbeat at the 6-week ultrasound. My progesterone, however, went from 21 to 24 to 17 to 15 despite progesterone suppositories. At the 9 1/2 week ultrasound, the heartbeat was no longer there. I had a D&C. Prior to my getting pregnant naturally, the RE said my only real option was donor eggs. At the time of the missed miscarriage, he said he would be willing to try fertility treatments once I had had 2 normal cycles. The RE said he would NOT do IVF on a woman my age using my own eggs. I guess we are talking about drugs/IUI. But I’m not sure. We’ll see him next week to find out. Friends are telling me that IUI does not work as well as IVF. So I’m not sure why the RE would think non-IVF routes would have a better chance of success. It’s just seems to me it’s too early to think about donor eggs… I think we still have treatments to try. My husband and I don’t have lots of money… Using donor eggs is pretty expensive in US. So donor eggs aren't really an option for us financially this year. I know we can(and we probably will if there’s a need) go abroad for de ivf. Only this way we’ll be able to afford it. Still insurance does not cover de ivf. We’ll have to find money somewhere. I don’t want to think about it now. I have full insurance coverage on other fertility treatments. That's a major factor in trying the fertility treatments right now. Could drugs/IUI actually work on a woman my age given my recent pregnancy? I’ll appreciate your responses.

3 Answers • 5 months ago


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It is highly unlikely that either IVF or IUI will work at age 46. Regarding IVF, I am aware of three studies looking at IVF in women of advanced reproductive age. One, from Cornell, showed a 3.1% live born rate in 45 year olds with IVF, and 3/4 of all positive beta-HCGs end in miscarriage. There were no pregnancies beyond age 45. Two other studies, one from the UK and one from Israel, showed even more discouraging results - 0% pregnancy rates in women aged 44 and older. Even if you are fortunate enough to get pregnant at age 46, 75%-80% of the time the pregnancy ends in miscarriage. It is likely that, even though you saw a heartbeat with your miscarriage, that the pregnancy was genetically abnormal - probably a trisomy. Thus, I would not recommend IVF. IUI is, I believe, equally futile - just cheaper. Sorry to be so pessimistic. I would not recommend IVF with your own eggs or IUI. By far your best bets for a family are adoption or donor egg. I hope I didn’t upset you. I hope you’ll find the best decision which will suit your family. You’re absolutely right about going abroad for donor eggs IVF. Prices for this procedure in Europe are much lower. Nowadays many couples who struggle with infertility go there. European clinics have high success rates even though services are cheaper.

3 months ago


Hi, I don’t know about the success rates with woman over 40, but what I do know is that with IVF you get something you won’t with IUI. Im from Spain and here they test your embryos before inserting them for chromosomal abnormalities, giving you the highest chance possible to conceive a healthy baby and therefore have a healthy pregnancy.
If you have every other fertility treatment covered by your insurance I would say it’s worth giving it a shot. But think that time is not in your favor, and maybe stepping towards IVF in a different country is a better idea than just trying a bunch of IUI rounds without success.
There is a clinic in Spain called IVI : https://ivi.es/ (It’s like 7500 euros for the more specialized IVF procedures and 5000 for regular IVF.)
I know the link is in spanish but it will give you an idea of treatments and prices. I’m not affiliated with the clinic by no means, but I do know some success cases.

3 months ago


Hello. I'm sorry for your loss. I'm in a similar situation. We have had two pregnancies both end in miscarriage. The most recent was lost a 7 weeks and we never saw a heartbeat. We have been going to see a fertility specialist as well. Initially they told me that at my age (41) most likely donor eggs would be the best option. I'm wondering if you had a fertility work up done to test hormones. They will measure a hormone called AMH which can tell you the "health" of your eggs. If you know that number is less than 1, that can confirm that you likely will not be able to conceive a healthy baby using your own eggs. My AMH was 3.5 which is considered normal, so we are continuing to try on our own before going down the IVF route (statistically we should get a good egg at some point). If you are ovulating on your own (also ask to have FSH:LH tested on CD3 and progesterone at CD21), and AMH is good i think it's worth continuing to try on your own or consider IUI before moving to IVF. Also have you had your husband's sperm tested? That will tell you your likelihood of success with IUI. But since you are like me, and have been pregnant just cannot sustain pregnancy, it is likely that his sperm (like my DH) are perfectly normal. There is also an expensive test you can have done on sperm to check for DNA damage (but i haven't yet figured our where and how to have this done). If chromosomes are your problem, do everything you can to improve eggs and sperm if you're trying on your own. I suggest myo-inositol/D-chrio and DHEA (these were recommended by my fertility specialist) for you and an antioxidant supplement for DH (to minimize DNA fractionation). You can ask your specialist to test you for DHEA to see if you need supplementation and how much before you start (i recommend this because too much can cause cystic acne and unwanted hair growth). The myo-inosital/D-chrio seems well tolerated by most. I also take pre-natal, fish oil, B12, B6, calcium, magnesium, vitex, and low dose aspirin (after O also recommended by my doctor). Of course watch your diet and exposure to environmental toxins around you. It can take up to 3 months for the supplements to take effect so you will likely have to keep trying for a few more months to see improvement. That's just my advice, so please take it for what it's worth. Of course, going IVF with genetic testing for the embryos greatly improves your chances of implanting a healthy bean from the start (it is so expensive and our insurance does not cover any of it). I'm not a doctor just wanted to share my experience with you since we are in similar situations. Good luck to you and i hope you get your healthy baby at the end of this journey!

3 months ago


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