Going through IVF at 40+ with bmi of 39

[stardust82 11]

Hi, All - Tomorrow is my first egg retrieval day and I am disappointed, to say the least, that I did not respond well to the meds (300 IU of gonal rediject and 300 IU of menopur) and they are only expecting to retrieve 2 eggs. I have pcos and have been taking 50 mg of spironolactone. I was told I no longer needed metformin a few years ago after losing 100 lbs (that I was no longer pre-diabetic) but I've read that some women took it and that it helped with weight loss and getting pregnant. So I'm going to look into that. I've also been told to look into taking Wegovy through a local medical weight loss program that is run as a part of that particular hospital's bariatric surgery program. has anyone done something similar? basically, i was told losing weight could yield me a better response to the meds.

I will be 41 in February and the quality of eggs goes down even further by then. I am told that I can do 2 more cycles before then and am fortunate to have decent health insurance that covers a big chunk of the expense up to 8 times if i am only doing the egg freezing part (though the cost still comes out to about $2000 a cycle). any advice would be much appreciated now from women who have gone through ivf. I was sad enough about not having found a life partner yet at 40. now the thought of not being able to have even one biological child on top of that is devastating.

[kaylee50 61]

I went through 2 rounds of IVF while I had PCOS and obesity. They are supposed to carefully calculate the meds based on your weight, medications, and other factors. Maybe look into having the retrieval with a different clinic, if the second round is similarly disappointing. Reproductive endocrinology is more of an art than a science; it's not even about the most experienced -- some docs just have a spooky talent for it.

But here's what I really want to tell you: take heart, because the technology has advance so far already since I did this (my kid is now 11 years old). Back when I was undergoing IVF, preimplantation genetic diagnosis was relatively uncommon. Nowadays, even if you only have a handful of embryos, you can figure out in advance which ones are viable. For anyone over 35, this is absolutely necessary. So imagine how much better it will be when you are ready to have that baby?

Also, consider whether you want to get donor sperm because embryos are far more likely to survive cryopreservation, compared to ova. One of my single friends did half and half, because she could not make up her mind whether she wanted a biological child without having the idealized nuclear family. In the end she decided she just wanted to have a child, found the smartest and best looking donor she could, went ahead with the transfer, and had a beautiful baby boy on her own. And then she met the man of her dreams (wouldn't you know it...lol).

[stardust82 11]

12 minutes ago, kaylee50 said:

I went through 2 rounds of IVF while I had PCOS and obesity. They are supposed to carefully calculate the meds based on your weight, medications, and other factors. Maybe look into having the retrieval with a different clinic, if the second round is similarly disappointing. Reproductive endocrinology is more of an art than a science; it's not even about the most experienced -- some docs just have a spooky talent for it.

But here's what I really want to tell you: take heart, because the technology has advance so far already since I did this (my kid is now 11 years old). Back when I was undergoing IVF, preimplantation genetic diagnosis was relatively uncommon. Nowadays, even if you only have a handful of embryos, you can figure out in advance which ones are viable. For anyone over 35, this is absolutely necessary. So imagine how much better it will be when you are ready to have that baby?

Also, consider whether you want to get donor sperm because embryos are far more likely to survive cryopreservation, compared to ova. One of my single friends did half and half, because she could not make up her mind whether she wanted a biological child without having the idealized nuclear family. In the end she decided she just wanted to have a child, found the smartest and best looking donor she could, went ahead with the transfer, and had a beautiful baby boy on her own. And then she met the man of her dreams (wouldn't you know it...lol).

thanks for your response, kaylee. did your doctor predict the right # of eggs for you? mine said that she was only expecting 4 eggs based on the # of antral follicles that i had. i have 2 that are the "right" size but the other 2 are too small/grew too slowly. my doctor did not adjust my meds at all, sadly, during the course of this first round. i'm going to look into some who know more about working with women with pcos to see if they can offer any more advice. and also work like hell to lose as much as i can in the next 6 weeks before starting this again!

[stardust82 11]

I ended up not having any mature eggs ☹️😧

[kaylee50 61]

Oh gosh, I am so sorry stardust82! I am sending you virtual hugs, cups of tea, and reassurance. Don't lose hope. "Persistence and determination alone are omnipotent."

You know, I looked up what meds they put me on. Like you, no embryo transfer was scheduled after the retrieval, so they were free to be pretty aggressive with the meds. I mean, it's not like you need to carry a pregnancy right after, right? I told them please go for it. The reproductive endocrinologist had me on: Follistim 300ui, then increased to 900ui; Menopur 75ui x 28 days; then Ganirelix 250. I weighed about 200 lbs at that time. They monitored me closely. Not gonna lie, I was basically in PMS 24/7 for a while there. But it was worth it, in my opinion.

I agree with your decision to find an RE with experience in PCOS, and it does not hurt to tell them to overstim you if needed because you aren't planning to carry a pregnancy immediately thereafter. Best of luck to you and keep me posted!

[stardust82 11]

2 minutes ago, kaylee50 said:

Oh gosh, I am so sorry stardust82! I am sending you virtual hugs, cups of tea, and reassurance. Don't lose hope. "Persistence and determination alone are omnipotent."

You know, I looked up what meds they put me on. Like you, no embryo transfer was scheduled after the retrieval, so they were free to be pretty aggressive with the meds. I mean, it's not like you need to carry a pregnancy right after, right? I told them please go for it. The reproductive endocrinologist had me on: Follistim 300ui, then increased to 900ui; Menopur 75ui x 28 days; then Ganirelix 250. I weighed about 200 lbs at that time. They monitored me closely. Not gonna lie, I was basically in PMS 24/7 for a while there. But it was worth it, in my opinion.

I agree with your decision to find an RE with experience in PCOS, and it does not hurt to tell them to overstim you if needed because you aren't planning to carry a pregnancy immediately thereafter. Best of luck to you and keep me posted!

you took menopur for 28 days? I was on the injections for 12 days. I was slower to respond but had 4 eggs growing. I wonder if a lower dose but longer course of treatment would work for me too!

[kaylee50 61]

3 minutes ago, stardust82 said:

you took menopur for 28 days? I was on the injections for 12 days. I was slower to respond but had 4 eggs growing. I wonder if a lower dose but longer course of treatment would work for me too!

I cannot actually remember my protocol, but I searched my old files for the prescription and it did say #28 for Menopur. This was over 10 years ago, so maybe the science has advanced since then for PCOS patients.