Over 43 years old, trying to conceive for six years, and experiencing six miscarriages—would you reject the idea of using donor eggs if you were determined to become a mother but kept facing failure?

In specialized clinics for recurrent implantation failure or repeated miscarriages, the most common cases involve individuals over 43 with "immune rejection or thrombosis problems" still hoping to conceive with their own eggs. But what are the real rate of success?

At 44 years old, the mother successfully graduated after two rounds of embryo transfer, achieving her dream of becoming a mother.

The cover story of iVie Issue 51 features a mother from Hong Kong, known as the mom of "Baby Cuttlefish." With a clear goal of having a child, she knew at 44 that her egg quality was poor, so she opted for donor eggs. She implanted a high-quality blastocyst (D5/5AA, chromosomally normal) at the right time (ERA 131), but unfortunately, it failed. Who is the murderer? Low progesterone levels. After adjusting her medication, she underwent a second transfer with a D5/5AB blastocyst—and finally graduated.

Implanting a PGS-tested blastocyst at the correct implantaion time (ERA-guided) is known as "IVF3.0 plus" at Stork Fertility Center—a personalized and precise IVF treatment. But if the process is so scientific, why does failure still happen?

Believe in science to identify the murderer.

There is always a reason behind every outcome. Out of curiosity, we analyzed 54 cases who did the first transfer of IVF3.0+ resulted in fail, chemical pregnancy, or involved a degenerated blastocyst in 2023. The findings were striking:

Baby Cuttlefish’s mother experienced two episodes of heavy bleeding during her first embryo transfer. This was a symptom of low progesterone, one of the easiest issues to manage—unfortunately, she was in Hong Kong at the time and couldn’t get an immediate diagnosis or intervention.

Low progesterone can be caused by poor absorption or rapid metabolism. To prevent such issues, doctors typically adopt a dual approach to supplementation, such as:

• Oral progesterone + Crinone (progesterone gel)

• Oral progesterone + Progesterone in oil (intramuscular injection)

This combination ensures more stable progesterone levels, improving the chances of successful implantation and pregnancy maintenance.

During the critical period from embryo transfer to fetal heartbeat detection, bleeding can commonly be attributed to five main causes:

1. Low estrogen levels

2. Low progesterone levels

3. Immune rejection

4. Excessively high blood clotting

5. Excessively low blood clotting

At Stork Fertility Center, blood tests are conducted first to pinpoint the exact cause. We won’t attribute the bleeding to the anti-clot injection; sometimes, it happens because we inject too little.

With over a decade of experience and thousands of cases involving recurrent implantation failure and recurrent miscarriage, Stork has gathered valuable clinical insights. However, it remains unfortunate that, to date, no medical team worldwide has published evidence-based research on this critical topic.

The Superwoman List features those who broke away from the formula and succeeded in becoming mothers.  

At Stork Fertility Center, the patient education iPad features a page called the “Superwoman List.” The “Superwomen” are those who, like Wonder Woman, have fought through extraordinary fertility challenges. Every woman on this list represents a case where the standard SOP approach failed, requiring personalized strategies to succeed.

Some of these women spent up to ten years trying, with one even undergoing three rounds of donor egg matching before finally graduating. One mother finally held her baby at age 54.

These five women were the most extreme cases out of hundreds—the toughest of the tough. Without customized treatments or the courage to break away from SOP protocols, they would never have had the chance to become mothers.

For a first-time patient at the age of 43, I would offer three options:

1. Self-egg with a preset stop-loss period of six months

2. Direct egg donation

3. Mixed approach— Which means you can try 3-4 months cycle of egg retrival while waiting the verification period of goverment. 

However, if the patient has issues like immune rejection or thrombosis, I would firmly recommend direct egg donation. The reason is that, even if we have collected precious embryos, facing immune and thrombosis issues will likely result in a failed attempt, making the effort almost futile. I would strongly advise not to waste resources and money fighting a losing battle.