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Does my wife need IVF?

Q: My wife is 41 years old. We got married 7 years ago. She had a myomectomy for fibroids 4 years back. After the blockage of the tubes was removed, she conceived under the medication Letrozole but it turned out to be a vesicular mole. Then IUI was tried for 6 times with Clomid and Pregnyl. There was no result. We have been advised IVF as the next option. Here is the myomectomy report 4 years back. Uterus Abnormal Fibroids Tube Left Right Cornua Healthy Healthy Isthumus Normal Normal Ampulla Normal Normal Fimbria Normal Normal Adhesions Present Present Ovary Size Normal Normal Surface Healthy Healthy Follicle Absent Absent C.luteum Absent Absent Adhesions Present Present POD Adhesions U.V Peritoneum Normal Tube Right Blocked Tube Left Blocked Ovulation Absent Fundal and anterior wall fibroid 10x8 cms. There is a posterior wall fibroid 4x3 cms. Bilateral tubal occlusion cornual. The blockage of tubes was removed. Uterus cavity appears normal in contour and capacity. No evidence of abnormal filling defect. Fallopian tubes appear normal in calibre with free spillage of contrast in to the peritoneum on both sides. Impression: Tubes appear patient on both sides. I want to know if it will be safe to go for IVF ICSI. Will there be any life threatening complication during IVF procedure and during pregnancy in case she conceives?I am really confused. Please help.

A:At 41 years of age, the pregnancy chances are naturally very low and hence IVF should be the best option because after a year, pregnancy with her own eggs may become rather difficult. On the other hand, vesicular molar pregnancy has a tendency to repeat itself and donor eggs may have to be used. Therefore, if on IVF, the clinician finds that your wife is not making enough eggs, donor eggs would be a good option to have a healthy pregnancy in your case.

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