I am not sure who to whom you are addressing this?
I have one child but here is some information about them both:
As for why one vs the other. I think ZIFT offers the MOST aggressive approach BUT does not guarantee success AND most importantly AGE again is the SINGLE MOST IMPORTANT FACTOR in anticipating success with any approach attempted in women over a certain age. The doctor with whom I spoke at SIRM said that the MOST success was offered in conjunction with PGD: pre-genetic implantation diagnosis. (this adds another 3-5K to the cost) She indicated that when they have older patients that opt out of the PGD and there is failure then they are led to believe that is the AGE OF THE EGGS and the lack of PGD that is impacting the success.
My conversation with SIRM was quite refreshing IN THAT I was told absolutely we are WILLING to try the most aggressive protocol with you even if you are 45 and we are will offer another less aggressive protocol (EZ-STIM) but STILL more aggressive than what most REs will offer.
In the case of EZ STIM there most certainly is vitrification.
BUT with that offered the doctor was very frank in telling me that we can still not make any promises above a 1% success.
So with that said I feel almost as if my already having had two pregnancies AND no other factors determining that I should NOT be able to succeed EXCEPT my age (DOR) I would be just as well off to stick with my local RE, try the medications she will offer and TTC with TI or IUI. I may also see if I can work with another local RE who is willing to try the medication protocol offered by SIRM. Even the good doctor I spoke with at SIRM didn't seem to think this was unwise thing to do in face of the odds. The good thing is that SIRM/New Hope offers the MOST aggressive approaches available for women 43 and up and do not subscribe to these arbitrary cut offs which are currently 43-44 depending on the reproductive center philosophy. (and let's not get me STARTED on these Hutterite data collection analysis, that REALLY boils my BLOOD)
SO because, a) I will not add the inordinate amount of stress to my life by worrying about cost and travel and probable lack of success, AND b) I am limiting the amount of stimulation and invasion to my body based on approach I have decided that I am not going for the MOST aggressive approaches and I am OKAY with that acceptance.
I also have come to realize that I am better off mentally by setting a time frame of how many attempts that I am even willing to make using medicated cycles with or without TI and/or IUI.
Additionally my RE and the SIRM RE have completely different medication protocols. BUT that said I have now spent HOURS culling anecdotal accounts of how women over 40 (with specific interest of how women over 44) achieve pregnancy and what I am finding is that while a) various protocols are successful, there is not ONE that offers a guaranteed success b) there seems to be very little relevant statistics offered by REs for women in this age group as this appears to be a reproductive "no man's land" currently and c) there seem to be just as many women who conceive naturally with success at this point than those who go the route of TTC with ART. In fact I am beginning to think that natural conception at this point offers the most likely route of success in that FORCING the process may often result in a pregnancy which ends in miscarriage for reasons that support the SIRM doctor's advice that the MOST important thing in all of this was to utilize PGD. Which in support of my self created theory means that "catching the good egg means you are catching the GOOD egg".
*please bear in mind that I am making this analysis based off many hours of reading various forums and this is NOT a scientific analysis AND I do believe that right now the whole act of fertility and women in the OVER 43/44 crowd is much more of an art than science at this point. I hope that with places such as New Hope and SIRM willing to dip their toes into the world of the dreaded over 43/44 crowd that we will begin to have more substantial evidence based proof on what will work vs what doesn't work.
Finally with all of this research I have also begun to realize that all doctors involved in fertility and women's health are doing the ENTIRE FEMALE population a disservice by NOT addressing women's fertility earlier in the game. I think women should have better baseline testing done at a much younger age so that they can make more informed decisions when planning their futures. It is heartbreaking for me to read of these very young women in their 20s and 30s who WAITED to reproduce only to fine that they are full of endometriosis or PCOS or have only one functioning tube or a septate uterus etc etc. Why couldn't they have been given more thorough fertility screenings at some point? To me it seems that ob-gyns are FIXATED on us NOT getting pregnant than the reverse. And I wonder what IF ANY impact all the products devised for birth control have in this process. I cannot tell you how many young women on various fertility forums I am visiting discuss things like having very unhealthy menstrual periods and their doctor's first solution is to offer some form of BC versus determining the underlying cause. The mantra seems to be fix the symptom not cause.
Additionally I wonder why my ob-gyn didn't sit down with me after I had my child when I told them at the age of 38 that I didn't think I wanted to have another child, THAT perhaps I might consider egg storage for future planning. Had I done that I might not even be in the position that I am now. But for some reason this is NOT EVEN addressed as far as I can tell in the many conversations I have now had with women. In fact NOTHING like this is addressed at any stage. It is becoming more of a topic of interest now but I have sat and conversed with several female friends who had no idea of the issues of the complexity of fertility. I also think that male infertility is increasing from what REs have been telling me and that this is going to place some new stress to the process in the future. One has to wonder what is causing that increase.
I would also like doctors to be more aggressive with addressing women's hormonal imbalances as they age versus seemingly saying: this is just what happens as you get old. It very obviously has deleterious effects on our health and is important. Why are there NOT more serious approaches to help our bodies maintain our health as impacted by these hormones. I watched a news piece yesterday about women's knee health and the "big" conclusion from this was that they THINK there is a significant link between the drop in estrogen in aging women and arthritis but there have not been any truly effective studies to support this hypothesized link. Jeez, part of me thinks if this were all about men the research dollars would be flowing. I think back to the "days of yore beliefs" about women and heart disease and how doctors just assumed that women didn't have problems and all the research was done on men where we are now left with these misnomers that have women unaware that heart disease is the leading cause of death of American women, killing more than a third of them and more than 200,000 women die each year from heart attacks- five times as many women as breast cancer. (sourcehttp://www.womenheart.org/resources/cvdfactsheet.cfm
) Yet with all the money being dumped into the Susan B Komen breast cancer machine we are all terrified it is our breasts that are going to be the death of us. In fact it is more likely to be heart disease. That ALSO leaves me to wonder how much of that heart disease is due to underlying hormonal imbalances versus environmental factors but WHO is going to push for this cause except Suzanne Somers at this point?
I wish all women here success in whatever avenue that they choose to feel that they are doing the MOST that they can do to achieve a pregnancy.
Sorry for my Sunday morning rant.