Would you advice another IVF cycle?
3 Replies
Zippy - August 6

Hello, Dr. Jacobs.
My husband's (41) sperm has low motility and low count, so we've done 3 IVFs with his sperm without success. Actually, we get a lot of eggs fertilized (some 15-18 each time) and many go to blast with excellent grades (we had 10 to freeze last time), and after all transfers my first and second HcG levels are always superb (like 400, then 800, etc.), but I always seem to miscarry them spontaneously at around 5.5 weeks.

So, anyway, I'm 44 y.o. now and we've been at this 4 years. My husband wants to try one more shot at my eggs but with donor sperm this time. He's convinced all the steroids he took in college and all the PVC plastics in the plants he's worked at for decades have ruined his sperm and that he's the problem. We have had his DNA fragmentation tested and it came out to 21 (which was in the middle of good and bad) and we have also had his sperm karyotype tested and it came back normal. But he's had 3 long term relationships through his 20s and 30s and they could never conceive either, so he's still not convinced he's not the problem.

So, with that being said, would you advise at my age yet another shot at IVF with my fresh eggs and a donor's sperm? My FSH levels continue to test low (at 4 and 6 last two times), so at least that's one thing going for us.

We want to try this last ditch effort because everything else (donor eggs, surrogacy, adoption) are all in the tens of thousands of dollars that insurance doesn't cover one penny of, while IVF is fully covered.

Thank you in advance for your expert opinion!


B. Jacobs, M. D. - August 7

According to published data, at he age of 44, your chance of a live born in an IVF cycle is 6.4%. After the age of 45, your chance is 0.2%. Please use an egg donor. It is age of egg that is the issue.
Good luck.


Zippy - August 7

Ah, so low FSH levels isn't really an indicator as to egg quality, then? (What is it an indicator of, and why do REs place so much importance on it?)

Also, hypothetically, if the results with a donor's eggs turn out to be the same as with my eggs, then would you say it's the sperm? Or just bad luck?


B. Jacobs, M. D. - August 7

FSH is an indirect measure of the number of eggs remaining and has nothing to do with quality. As eggs get older, they are more likely to have an abnormal number of chromosomes. Eggs from a younger woman (under the age of 30) will provide a much better chance of a good pregnancy. There is, of cource, the remote possibility that your husband has a chromosome rearrangement, and increase the risk of miscarriage. That is not likely, but the possibility can be determined by a chromosome analysis on his blood.
Good luck.



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