Decision

Dear wandidrant - first of all, Merry Christmas 🎄💓!!!

The answer to your question is, of course, massively influenced by our own experiences ... but I'll start!

First of all, your AMH is still really good - but that's only a statement about the egg reserve and not about the quality!

I was actually at a similar point at your age - but from today's perspective we made the wrong decision !!!

I also had a miscarriage in the 10th week of pregnancy when I was 40. We had the embryo examined and there were two chromosomal abnormalities!

We then had a consultation with a human geneticist. As a result, she said that statistically there are still healthy eggs in a 40-year-old, but that you have to look for them!!!

And then we went in the wrong direction!!! We tried to look for healthy eggs using polar body diagnostics (that's all we can do here). We stimulated for several months in succession and collected egg cells. The polar bodies were then analyzed and the result of the analysis was 1:10... one euploid embryo and 10 uneuploid embryos. However, the "healthy" embryo did not implant either!

Of course, polar body diagnostics is also a tool and today I also say it's a load of crap!!!

What we should have done differently back then:

After the miscarriage we should have gone straight abroad and "searched" for the healthy eggs or embryos there by means of a proper genetic analysis.

All that money would have been well spent there, but definitely not here in Germany!!!!!

Abroad, you should have chosen the "right clinic" where the egg donation would be convincing if there were no genetically healthy embryos left!!!

I was 43 when I realized - ok, that's not going to happen with my own eggs and only then was I ready for egg donation. I had to have exhausted everything for myself before I could get involved!!! And other European countries (and not Germany) could have helped me much better!

The bottom line: look for a competent clinic abroad... do one or two IVFs there and importantly... make sure you have a genetic test... this is the only way to know what's going on with your eggs (assuming the spermiogram is normal) !!!!

If it then turns out that there are only genetically abnormal embryos, the only remaining option is embryo transfer... But you've tried everything you can !!!!!!!

I would have liked to have gone down this path ☺️!!!

My first EZS has now worked and I am now at 12+6🤗 - this shows me that my eggs have not been in order for a long time, or never have been!!!

All the best for your journey!!!

Dear patient.

If you are considering a new icsi, the next one should definitely be with PGTa (pre-implantation genetic diagnosis).

Best wishes and happy holidays.

Dr. Izquierdo

Hello wandidrant,
considering your age, it would be advisable to do an ICSI with PGT-A. Statistically, only about 1 in 4 embryos you have will be euploid (chromosomally normal). To avoid negative transfers or miscarriages, it is therefore recommended to perform a 100% PGT-A with a new ICSI.
As far as the decision for another ICSI or egg donation is concerned, the previous cycles would have to be reviewed very carefully in order to be able to make a recommendation with criteria for a change in treatment. It is possible that the quality of the eggs is not quite as good, but the number of mature eggs, the fertilization, the quality of the blastocysts, the sperm analysis, etc. must be evaluated. In this way, we can assess whether there is an opportunity for improvement by performing a technique in the laboratory such as sperm selection with microfluidics, calcium ionophore if fertilization was not good, etc.
If you would like to know what your options are, please do not hesitate to contact us.

With best regards,

Dr. Alejandra García-Villalba