Confronting the likelihood of failure with IVF

IVF forces us to confront one of life’s hardest truths: the likelihood of failure, and our lack of control over it. Why are these two things so hard for us to accept?

Obviously my goal with this Better IVF is to focus on research that relates to euploidy. In a way, my case study is a curation of the most significant of those things (as it relates to a general population of women who are 30-40+) that have been shown to impact euploidy. So I don’t wish these philosophical musings to create a sense of negativity when we are all here to try and flip these odds for ourselves. And my deepest hope is that many of you do.

But even if, with this research applied we DOUBLED this outcome (from 10% cumulative, to 20% cumulative) which would be, frankly, incredible but any scientific research study’s standards—it would still mean that 80 out of every 100 women went home without a baby. It would mean that for the most part, the Better IVF community will be doing more consoling than we will ever do congratulating.

The average >42 year woman walks in to her fertility doctor’s consult rooms for the fist time and can expect a cumulative live birth rate which plateaus after five cycles of a maximum of 9.5%.

Putting this another way:

43 yo woman: “Hi there, I’d very much like to have my own biological child.”

Doctor: “No problem, just so you know, out of every 100 woman I see like you, 90 of them will never create their own biological child.”

This is…frightening. It’s devastating. Especially when before this point we all know how much age is a factor in fertility, but we don’t really get HOW much. Not really. Not in our bones. Deep down our desire is so great, so all consuming that we cannot believe it.

The reason this came up for me today was because I’d just finished pilates at the gym which I do every Sunday morning. I walked out with another woman whom I’d chatted with in passing before and after previous classes. She mentioned how her morning hadn’t been great, she’d had a really heavy period and spent the morning before class, crying.

I wondered if she were older than she looked and might be entering peri-menopause, and so asked after her age. She said she was 35 (so I suspect it was just a heavy period!), and then she asked my age. When I said I was 40, what followed was her pure disbelief.

She said, and I quote (because it really made me laugh), “I thought you were in your late twenties.”

I can assure you, this person is utterly blind.

I look nothing like a person in their late 20’s.

Anyone who is 40+ would be able to easily tell I was 40. I think the eyes of the young sometimes deceive them. Perhaps people think that as soon as you hit forty you look like a husk of your former self, who knows 🤷‍♀️🤣 (sometimes I feel it, that’s for sure).

But guess what, even if I don’t look like someone else’s version of what 40 should look like, my eggs are most definitely 40. The vast majority of the things that I added that improved my euploidy rates did not actually make my eggs younger.

The reason I use this example is because so often I see people in their forties saying things like, “But I’m so healthy, I eat well and I look after my body. But I don’t feel old. All my stats are perfect, I still have a regular period…etc…etc”

Yes, that can all still be true, and yet the mitochondria in your oocytes don’t care about any of that.

So, all I can say is that it Really. F**king. Sucks.

But we need to confront these realities on numbers and likelihood head on—not because they’re depressing, but because they can be made fuel for a fire.

They can be motivators to have these hard conversations we may need to have (like following up and asking “why” when we’re told “No”), or hard decisions we may need to make (like moving clinics or doctors).

The conversations I‘m witnessing all of you having with your doctors and embryology lab managers each day are not easy. They’re hard. They’re overwhelming. And this is why we need that fire.

Because if we can truly sit here and stop wondering if we may be different, or we may be one of the lucky ones, and instead start acting on the basis of that being our starting point, then we CAN potentially change something. Or at the very least, end our journeys knowing we did everything we could.