K G P, 30 years had one cycle of IUI in another center. Her tubes were not blocked, uterus was normal and egg count was 20. She was diagnosed to have PCOS. We did another 2 cycles of IUI but without success.
She was advised IVF and she readily agreed. She had her treatment in June and December 2010 which was unsuccessful. In December 2011, she had another cycle of IVF. 4 weeks later, two pregnancy sacs with fetal heart was seen. She was excited and extremely happy. However, 2 weeks later, only one fetal heart was seen. She was advised that in twin pregnancy, 20% will have vanishing 2nd twin. Her pregnancy progress normally and she delivered a healthy baby girl weighing 3.1kg.
In 2014, she came back and planned to have a second child. IVF cycle was started in April and embryo transfer was done on 2nd May 2014. 7 weeks later, 2 pregnancy sacs with fetal heart were seen. She was delighted to hear the news; twin pregnancy. Her twin pregnancy progress well and she delivered on 28th december 2014 a set of healthy twin, one boy and one girl. She and her husband were satisfied and happy to a family of one boy and two girls. Another happy news for her; she still has frozen embryo for future treatment cycle.
Getting Pregnant Over The Age of 40
A woman is born with all the eggs she will ever have in her lifetime. Unlike a man’s gamete, the sperm which can be regenerated, the woman’s egg reserve is finite and decreases as she ages. Apart from the lower number of egg reserve, the eggs will also age which results in the quality of the egg to decline. This is why women at older age are at risk of miscarriage and genetically abnormal child births. Statistically, a woman has less than 5% chance of getting pregnant when she reaches 40, and almost zero as she approaches menopause (no more eggs).
Is It Possible To Conceive Over 40 Using Own Eggs?
There are 3 known cases worldwide, where women are able to conceive using their own eggs at the maximum age of 46 in Fertility Care Orlando USA, Create Fertility London UK, and Metro IVF Malaysia. With the help of IVF, pregnancy can be achieved.
It was in 2012 when Pn. Lina, a local Malaysian, came to Metro IVF for her first fertility visit. She planned to get pregnant when she was 45. Physical and medical examination showed she had poor ovarian reserve and it would take a miracle for the IVF laboratory to achieve pregnancy for her. During the consultation, she was also informed by the consultant and the fertility counsellor that her chance of getting pregnant is less than 1%. Furthermore there is increased risk of miscarriage of over 20%, risk of abnormal baby and also the risk of hypertention, diabetes, and other medical illneses. She decided to seek other fertility opinions. In 2013, Pn Lina came back and requested to proceed with IVF treatment. She was further counselled on the low chance of achieving pregnancy and other risks.The fertility team worked hard and together with the embryologist and andrologist had a long discussion before proceeding with the case. It was decided that the best stimulation protocol for her would be short IVF protocol (Flare-up) She had 2 follicles and 1 egg. ICSI was done for the single egg to ensure fertilisation. The inseminated egg was then cultured in a mint incubator with mixed gasses and media to ensure optimal progress. The following day, fertilisation was confirmed by the embryologist that there was 2 pro-nucleus and 2 polar bodies. The team knew they have made the right decision.
On the second day, the embryo had divided into 4 cells. The fertility team collectively decided to transfer the 4 cell embryo instead of culturing it further (Although the standard procedure requires cultivation to 3 days or 5 days). In-vitro is better than in-vivo. The embryo transfer was then performed by the most senior and experienced clinician and senior embryologist. The embryo transfer went through smoothly and was placed 1cm from the fundus. The team was relieved as the embryo was placed at the best position. After the transfer, it was decided that Lina should have adequate luteal support to ensure implantation. She was given both progesterone injection and vaginal progesterone. During the three weeks that follow, she was regularly supported by the team of fertility counsellors. 3 weeks later, Pn. Lina was confirmed pregnant and a healthy baby was delivered at term via lower segment cesarean section (LSCS) .
At last, the team of clinicians, embryologists, counsellors at Metro IVF were delighted that all their hard work and time spent was not in vain. It would have taken a few hundred cycles on average to achieve 1 such pregnancy. To date, this is the oldest successful IVF woman to conceive and deliver a healthy baby using her own egg in Malaysia.
F.E.H., 35 years was married for 9 years and had been trying to conceive for the past 8 years. Her husband, is a Dutch IT consultant. They visited Metro IVF on 16-02-2010 seeking assistance to get pregnant. Our initial investigations showed that her uterus was normal sized and her hormone were normal. Her antral follicle count was good, at 15. However her husband Semen analysis showed severe sperm count.
The couple was explained on severe male factor as the cause for their infertility. She was advised IVF instead of IUI. She commenced ivf treatment using long protocol. 14 eggs were retrieved in May 2010 and 3 embryo was transferred 2 days later. The cycle was unsuccessful. 3 months later, patient on her request was referred to Netherlands for her subsequent treatment. She had her 2nd ivf cycle in Netherlands under Dr Cam in Oct 2010 and had similar result.
The following year, She came back to Metro IVF and started her 3rd IVF cycle in March 2011. 18 eggs were retrieved on 21st march 2011 and embryo transfer was done 3 days later. 12 days later her blood bHCG was 127iu/l. At last F.E.H. is pregnant!!!. At 7 weeks of gestation a single intrauterine sac was seen with fetal present. Detailed scan of the baby was done on 16th August 2011 and a healthy baby girl was noted.
On 15th October 2011, F.E.H. delivered a baby girl weighing 2.7kg.
3 years later, the couple planned for a 2nd child. They returned to Metro IVF and F.E.H. was started on long protocol in November 2014. 10 eggs were retrieved on 9th December 2014 and 3 days later 3 embryo were transferred. She had excess embryos for freezing.
On 29th January 2015, a single pregnancy sac with fetal heart was seen. F.E.H. is pregnant again!!! Her pregnancy progressed normally and she delivered on 26th August 2015, a healthy baby girl also weighed 2.7kg. The couple was very happy to have the pair of girls and decided their family is completed.