#ivfphilosophy

When is enough, enough? This is often brought up as a philosophical question. And I am the first to concur that the emotional, physical and psychological toll that IVF takes on your body, your self and your relationship should be a consideration.

But the truth is, IVF goes beyond the mere emotional, physical and psychological. It is existential. I say this having had one child, the experience of birth is close to an experience of both birth and death at the same time. It is truly primal. And the journey and drivers that take us there, I think we need to acknowledge, run so deep in our psyche as to be beyond conscious, and entering both the subconscious and biological all at once.

This is not at all to say that living a life without children is not just as worthy, I’m simply trying to describe the depth of feeling that accompanies this very active choice we make to have children when that choice is subsequently met with the roadblock of biological reality of age or other bodily interference.

Now, if we accept the idea that IVF is a choice we are making which goes beyond much of what matters in a more material (e.g. as in finances) or even personal (health/wellbeing) sense, then there is maybe a logical lens that we could theoretically apply to deciding WHEN enough is enough. And I think such a lens would be a useful resource to have given how complex IVF and life decision-making can be.

With all that said, here is my own thinking around when enough is enough.

Enough is enough when…the act of continuing would require more time, and provide a less than 1 in 100 chance of live birth. At that point, the most logical act is to move down the line to the next potential treatment.

Important to note I am not taking finances into consideration here other than in suggesting that you stack all well-researched euploidy add ons sooner (those most likely to make a difference). Add ons that I haven’t included here but which you could consider based on blood tests are DHEA, testosterone gel and Ovarian PRP. But would suggest doing those as add ons in a separate cycle after adding the initial ones.

Age 35-39 Cycle 1: Move straight to PICSI as an add on which is noted by the researcher as an add on that should be considered standard treatment for 35+ age cohorts.

Cycle 2 onward if still struggling: Consider all other add ons as per 40+ and then if still struggling move to the 43-45+ option.

Age 40+

All additions as early as possible (Met* and Calcium Ionophore and PICSI)

For the addition of HGH, consider if this is right for you. If you’re already getting 5-6 blasts, may not be needed.

If you improve your euploids, keep going to bank what you need (3 = 93-95% chance of live broth and 5 = 99.98% chance of live birth so if you want two children ideally you’d want 6-10 euploids for the best possible chance at that).

Age 43-45+

Complete a single cycle with all euploidy additions stacked on top of their base protocol.

If no euploids or positive outcome (if doing a day 3 untested transfer), move straight to Ovarian PRP, wait 2-3 months for AMH and follicle improvement (as it usually goes down before it goes up), and then go straight to Maternal Spindle Transfer in Albania which appears to have the best success rates at the moment - able to achieve 91% fertilisation, 50% blast and 66% euploidy up to 60 years of age if you are capable of producing follicles still.