I am excited to share that I am writing a book for women trying to conceive with advanced maternal age! It is a Kindle book and available for pre-order now! It is not completed quite yet, but it is full of information on the proper supplements and dosages to take for cellular and mitochondrial support. It will include a chapter exclusively about Red Light Therapy’s ability to increase mitochondrial health and systemic blood, as well as which light specifications are needed for treating infertility and how to use it. I will talk about which initial testing is important to get done for you and/or your partner, if one applies. In addition to all of that, I will include a chapter on the most current IVF protocols and therapies showing promise for women with AMA. Honestly, there will be so much more inside! Read book description here!
Each purchase of this e-book brings us a baby-step closer to our child, and I do not take this unique opportunity lightly. I am in the thick of it with you, and I know exactly how it feels to think you have no control over the fate of your fertility, to be told that you have less than 5% chance of ever conceiving naturally, or without IVF. I know what that feels like.
I am a 43 year old, womb-less mother of four wonderful children, and we are starting on an own-embryo gestational carrier journey this year because my ability to carry another child was taken from us by chance… fate, if you will. The struggle to conceive is filled with anguish and trauma, despair like no other… but there is still hope. It sounds like bullshit, but believe me when I tell you that there is still some damn hope!
It is the need to share the hope alive in me with others on this journey that has me giving you my very best. I am working tirelessly to deliver the most pertinent information available, supported by the most current research, to women trying to conceive over 35, and yes, even well over 40! Above all, I want you to succeed. I want you to create that life you so desperately yearn to nurture and love. I want this for all of you out there suffering with AMA, and I want it for myself, my husband, and my family.
The information that will pour into your mind from the pages of this book changed my life, and the lives of many, many other women fighting the same war against AMA:
Most embryo transfers are performed by artificially mimicking a woman’s natural cycle via hormones. The predictability of artificial cycles (AC) is preferable to clinicians because it is slightly more convenient, but at what cost? Recent studies reveal that frozen embryo transfers (FET) that use an artificial protocol have a reduced clinical pregnancy rate (CPR) and live birth rate (LBR) compared with modified natural cycle (mNC) FETs and stimulated cycles (SC) FETs.
Fresh transfers usually take place only days after a retrieval has been performed. The typical transfer occurs when the subsequent, fresh embryos are transferred back into the womb of the same person who underwent the retrieval. Sometimes the embryo(s) can be transferred into a surrogate. During the stimulation phase of treatment, the body is exposed to intense levels of hormones. This exposure can result in a less favorable womb environment.
A frozen embryo transfer (FET) happens when a frozen embryo is thawed and then transferred into a receptive womb that has typically not been exposed to intense stimulation medications. In addition to being convenient, FETs provide a more optimal uterine environment than fresh transfers because the body is exposed to significantly less hormones.
Why aren’t more women doing modified natural cycle (mNC) or stimulated cycle (SC) FETs if it means drastically less hormones, no daily, painful injections, and a greater chance of getting pregnant and giving birth? Quite curious, indeed!
Abbreviations and Definitions
| FET – Frozen embryo transfer (FET) | LBR – Live birth rate (LBR) |
| CL – Corpus luteum (CL) | HCG – human chorionic gonadotrophin (HCG) |
| FSH – Follicle-stimulating hormone (FSH) | CPR – clinical pregnancy rate (CPR) |
| EMT – endometrial thickness (EMT) | IVF – In vitro fertilization (IVF) |
| ICSI – Intracytoplasmic Sperm Injection (ICSI) | PCOS – Polycystic Ovary Syndrome (PCOS) |
The three most common protocols for preparing the endometrium for FET are the following:
- Artificial cycle (AC) – exogenous hormones, such as Estrogen and Progesterone, are administered to mimic the menstrual cycle, i.e. thicken the endometrium and support the pregnancy in place of a corpus luteum (CL)
- Modified natural cycle (mNC) – ovulation is triggered by an HCG injection. The CL supports the pregnancy as it would in a natural cycle. Progesterone therapy may be given after trigger.
- Stimulated cycle (SC) – follicles are stimulated with ovarian stimulation drugs such as Letrozole and/or FSH, followed by an HCG injection. The CL(s) supports the pregnancy as it would in a natural cycle. Progesterone therapy may be given after trigger.
Study Details
Wang and colleagues conducted a retrospective study in which they analyzed and compared pregnancy outcomes using the three most popular protocols for endometrial preparation AC, mNC, and SC. An impressive total of 16,946 cycles undergoing IVF or ICSI, who had cryopreserved embryos, were evaluated.
Results
FETs that used an AC protocol had significantly thinner endometrial thickness (EMT) than mNC and SC groups (10.10mm vs 10.53 and 10mm vs 10.63, respectively). ACs had significantly lower live birth rate (LBR) than mNC and SC groups (40% vs 43.3% and 40.9 vs 46.5%, respectively). In fact, ACs were associated with the lowest LBR, whereas after matching and adjustments, mNCs and SCs had a comparable rate.
In the model used by Wang and colleagues, there was a higher association of abnormal implantation in AC FETs compared to both SCs and mNCs FETs. Clinical pregnancy rate (CPR) was also significantly lower in the AC FET group than in the SC FET group (50.7% vs. 54.7%). CPR was also significantly lower in the mNC FET group than the SC FET group (52.8% vs 55.8%), though it was still slightly higher than in AC FETs.
Discussion
Using artificial means to prepare the endometrium for FET is convenient for both practitioner and patient because it can reduce the need for repeated office visits; however, if your menstrual cycle is regular, and you are undergoing FET, I implore you to listen to the research. Start asking the correct questions: “Why has my RE not mentioned this?” and “Does my RE keep up with current research?” How about, “Why has no one mentioned that there was another way to do a transfer that has better success rates and requires very few injections?”
If you menstruate regularly, your best chance of success is by using a mNC or SC protocol for your FET lining prep. Out of the three main protocols for endometrial preparation for FETs, AC protocols have the lowest number of clinical pregnancies and live births. In addition, AC FETs are associated with the thinnest EMTs and the highest number of abnormal implantation. To summarize, AC FETs are hurting your chances of becoming, and staying, pregnant.
Wrap Up
If you have regular cycles, you have no reason to be pumping your body full of exogenous hormones to prepare your lining and support a pregnancy. Even during transfer cycles, your body’s own CL should be used to support a transferred embryo(s), thus making painful, daily progesterone injections irrelevant. If your RE will not offer you mNC, nor SC, then it’s time to find one that will. This is not fun and games here, this is your life, your family, your future. You have a say in your healthcare, and don’t you ever forget it!
Having said that, AC FET has its place in medicine. In addition to its convenience, it is an effective protocol for preparing the endometrium of patients with irregular cycles. Women with PCOS, especially, may benefit from not having to trigger ovulation at a specific time.
There will be further discussion on this topic in my e-book Create Your Miracle: Preventing and Treating Age-Related Infertility available for pre-order now.
Thank you for being here
TTC, advanced maternal age, ATP, BioPQQ TTC, Diminished Ovarian Reserve, dor, low amh, early ovulation, early progesterone rise, Getting Pregnant After 40 Statistics, Getting Pregnant Over 35, how long after positive opk did you ovulate, Improve Egg Quality, IVF over 40, IVF, IUI, egg donor, embryo donor, Male Infertility, Mitochondria, premature ovulation, ovulating too soon, Ovulation Over 40, Pregnancy After 40 Success, Pregnancy over 40, Red Light Therapy, Infertility, Signs of Bad Egg Quality, FET protocols, modified natural FET, stimulated FET
<3 BK
Please head over to No Trigger Warnings Facebook Group to discuss blog posts and podcast episodes, and of course all things TTC with advanced maternal age!
