Higher age does NOT always mean Donor-Egg-IVF.
This couple came to us from Asansol. The husband's age is 44 years, wife's age 40 years. The lady became pregnant 3 times. First pregnancy was 21 years ago, resulting in a male baby. The second pregnancy was terminated as they were not ready for that. In the third pregnancy, she delivered a female baby, 7 years ago. All of them were spontaneous pregnancies without any problems or complications.
Unfortunately, the boy died at 18 years of age after an accident. After becoming little "stabilized", they were desperately looking for another baby, because the baby girl was looking for a sibling. They visited different places and she was advised to have IVF with egg donation, because of her age.
When they presented to us with broken heart, we explained them the risks to the mother and the baby as a result of pregnancy at advanced age. They agreed to take the risks. We evaluated her cardiac, renal condition and blood sugar. All routine tests like Thalassemia Screening and Rubella Testing were done.
They did all Fertility Investigations outside, so we did NOT have to do any tests. The reports showed she had low AMH. The first day, they visited us, was the day-4 of her period, so, we checked her AFC (Antral Follicular Count- the number if eggs in the ovaries) by TVS (Trans Vaginal Scan) and found it was low.
We asked them "What to you think?" The reply was, "We want to try for baby from self-eggs, if necessary by IVF. If this fails, only then, we will consider Donor-Egg-IVF".
We respected their decision and asked, "When you are planning for IVF with self eggs?" They said, "Probably after March, because if financial year ending".
They asked, "Could you give any medicine to increase the chance of pregnancy, in the meantime?" We explained that the chance of pregnancy after taking medicines for Ovulation Induction (OI) at this age is extremely low. Still they insisted.
Following their requests, we started OI with Clomiphene Citrate and advised her to come for Follicular Study (by TVS) for 3 days. We found that there was ovulation (rupture of the eggs) after taking the medicine. They said, they will try it in February and March and then will return for IVF in April.
But fortunately, they got the good news after the first month.