IVF success rates for specific situations (from PCOS to endometriosis, over 40 & more, we break it down)
What IVF success rates mean (& where to focus)
IVF success rates can vary based on age, diagnosis, and treatment approach. And a question we get asked a lot is what really matters when looking at the numbers?
We went live with Dr. Olutunmike Kuyoro (Dr. Tumi) from the Advanced Fertility Center of Chicago, a Prelude Network clinic, to break it all down.
Watch as we cover:
- What patients should focus on when assessing IVF success rates
- Challenges and options for improving IVF success rates over 40
- How mini IVF compares to conventional IVF – and who it’s best for
- IVF success rates for PCOS, unexplained infertility, and after a D&C
- The biggest factors beyond national averages that impact individual success
Looking for expert fertility support? Built by patients, for patients, the Prelude Network is the largest and fastest-growing network of fertility clinics in the United States and Canada, and provides compassionate care throughout every step of your journey. Head here to find your nearest clinic today.
Transcript
Eloise Edington
Hello everyone, I am about to be joined live by Dr. Tumi from the Advanced Fertility Center of Chicago, a Prelude Network Clinic, to discuss IVF success rates for specific situations.
We’re very excited to be answering some great questions that have come in from you guys, and it will be a very informative conversation about IVF success rates for many different scenarios.
Hello to those who are joining — nice to see you today! I’m about to be joined by Dr. Tumi, who is joining me from the Advanced Fertility Center of Chicago. Just going to check she’s here now and we can get started.
Have your questions ready about IVF success rates — anything you want to know, she will be happy to answer. We’ll be talking about success rates after a D&C, over age 40, with a mini-cycle, with PCOS, and much more.
Hello, hello, Dr. Tumi! Lovely to connect with you and go live with you today.
Dr. Tumi
Likewise, it’s good to meet you in person. How are you?
Eloise Edington
I’m very well, thanks. How are you?
Dr. Tumi
Oh, good thank you! Excited for this talk.
Eloise Edington
Absolutely. I’ve just given a brief introduction to what we’re going to be discussing today around IVF success rates for many different types of situations.
So before we begin, if you could please introduce yourself, tell us a little bit about your background, the Advanced Fertility Center of Chicago, and then we can get started on this fantastic topic.
Dr. Tumi
Yes, of course, I would love to. So my name is Tumi Kuyoro. I’m one of the newest physicians at Advanced Fertility Center in Chicago. We are one of the Prelude Network clinics.
We have many — or I should say we have about four offices here in the Chicago area. Excitingly, from next month we’re also opening up our second IVF lab in the downtown Chicago area as well, which is where I’d be primarily based.
Eloise Edington
Okay, amazing! I have invited people to ask questions as we’re talking.
We’ve had some great questions ahead of discussing IVF success rates today. I’m sure you get it every day from patients, so let’s go through.
Dr. Tumi
I love having these conversations.
Eloise Edington
Absolutely. So first of all, I would love to understand: what should patients really focus on when looking at numbers? Because I know things can be misleading online.
Dr. Tumi
Absolutely. So the number one thing — or I would say the first thing — in terms of numbers that any patient or any couple should be thinking about when trying to conceive is, one: the age of the female partner in that couple.
This really determines, one, whether or not they meet criteria for the diagnosis of infertility and if and when they should seek help. And two, age also then determines the success rates for the different types of treatments that may be offered.
And then in terms of success rates, there are really only two numbers that we should hone in on, which are your live birth rate per egg retrieval and live birth rate per embryo transfer.
But it’s very important to be looking at this in the context of age. You want to be comparing — first of all, any clinic that you go to, you want to look at what their success rates are compared to the national average — but hone in on age-specific data.
It’s like comparing apples to oranges if you’re looking at success rates but not looking at success rates specific to the age group that you’re in.
Eloise Edington
That makes complete sense. Do you find you often have patients coming in saying, “Well, I had a friend who got this result, so what does this mean for me?” and they might be concerned about age or where they are in their fertility journey?
Dr. Tumi
Always, the most important thing is really age because that determines — and I’m sure we’ll get into it as we speak more — it determines both egg quality and egg quantity.
However, there are also many other factors: the diagnosis, the reason why they have infertility, that could affect success rates.
So I always caution when comparing one person’s story versus another because this whole issue is very nuanced and very specific, and should be individualized. It cannot always be compared across individuals.
Eloise Edington
Of course, that makes sense. And if anyone has any questions for Dr. Tumi as we’re discussing, please do feel free to drop them in the comment box.
You can also head to our link in bio to find out more about the Prelude Network and to speak to the team directly for personalized treatment, care, and plan.
What would you say are the biggest challenges patients commonly see with IVF success over the age of 40? And what options are out there to help people improve their chances of success?
Dr. Tumi
Love that question, but I’m just going to take it back and talk about how fertility works naturally. So, as women, we’re born with all the eggs we’re ever going to get. We don’t make any more.
Once you start the process of puberty and you start having periods, every month a bunch of those eggs that are contained within the follicles in the ovaries start to develop.
Those follicles start to develop; however, only one of those follicles becomes big enough in order to release the egg that it contains when you ovulate. We call that follicle the dominant follicle.
However, the rest of the follicles that started to develop but did not become the dominant follicle actually degenerate — they die. And this is why, as we get older, the number of eggs that we have starts to decrease — and so — in addition to decreasing quantity of eggs, the other issue that we’re dealing with is also decreased quality of eggs.
And by quality, I mean the genetic material or the number of chromosomes that the eggs contain. As we get older, the eggs start to accumulate a lot of genetic errors, meaning that they just have the wrong number of chromosomes, and the information those chromosomes sometimes contain doesn’t make sense.
Those are two issues that are difficult to circumvent. As we get older, we’re dealing with both decreased quality and decreased quantity. This is why, as women get older, the live birth rate starts to decrease, whereas the rate of miscarriages increases.
So, the one main thing — or the big thing — in terms of any couple who’s, let’s say, in their late 30s or early 40s looking to conceive or contemplating becoming pregnant is early intervention.
If this is something that has crossed your mind, you’re not sure what your options are, you’re not sure what your fertility is, I would urge anyone in such a situation, if feasible, to be seen by a fertility expert — an REI — so that you can do the various testing and go over what options are appropriate and feasible for your specific clinical situation.
But then there are also other things to be considered as well. Like I said, the age and egg age affect both egg quality and quantity, and those are not things that are easily circumvented.
Other things that are within our control that could potentially help success rates are things like lifestyle and health factors. So you want to think about your diet, your nutrition, and generally maintaining a healthy weight, reducing stress where feasible, and then plus or minus some supplements, which may or may not help.
Once you’re plugged into a fertility clinic, you and your doctor want to be talking about specific protocols that meet your specific clinical situation in order to optimize or maximize your ovarian stimulation and potential yields.
In some cases, where there’s only so much that can be done, sometimes that conversation may need to be about potentially using donor eggs.
Eloise Edington
Do you find it’s a common question that patients ask you when they’re about to start a cycle or doing that first consultation — “What does my success rate look like based on my situation?”
Dr. Tumi
Absolutely. The number one predictor is always age. No matter what the diagnosis is, the number one predictor is always age, because the one thing that there’s only so much we can do about is egg quality and egg quantity.
Having said that, like I said, those things that we talk about — like lifestyle, those modifiable factors — may, to some extent, affect those success rates.
And finally, I always say, sometimes we just don’t know until you actually undergo the cycle. I always tell my patients, realistically, in our patients over the age of 40, in order to get to that one genetically normal embryo, that may require multiple IVF cycles.
Sometimes you don’t know until you undergo that first cycle what the optimal protocol is for you and what your response to the medications might be.
Eloise Edington
That’s a very good point that you just brought up, because how many cycles would you say might be average for people to have in order to hopefully have success?
I presume you learn a lot from that initial — or even the first couple — of cycles based on protocol, response, etc.
Dr. Tumi
Absolutely. I wouldn’t say there’s necessarily an average number, but I would say anyone over the age of 40 should expect — to be able to get to an embryo that might result in a live birth — at the very least, two cycles.
Eloise Edington
That’s really helpful to know. If anyone has any questions for Dr. Tumi, please ask, because this is an amazing opportunity to have expert knowledge live.
I also wanted to ask you, how does success rate change for mini IVF compared to conventional IVF? And who might be a good candidate for mini IVF? Would they come to you saying, “This is me,” or do you suggest it? How does that work?
Dr. Tumi
I’m happy to talk about mini IVF — not because I have any specific answers, but I think it’s a conversation worth having.
So, what is mini IVF? Mini IVF is mini-stimulation IVF, and it’s a type of IVF that uses lower doses of fertility medications compared to what we’ll call conventional IVF.
The typical patients who might undergo such a cycle are patients who might be older or patients who have what we call diminished ovarian reserve — so a low egg count.
The evidence for mini IVF protocols, especially for women over the age of 40, is mixed or inconclusive at best.
The most robust studies that we have today still suggest that traditional high-dose ovarian stimulation protocols are still what provide the best outcomes in most cases.
The proposed benefits of mini IVF include potentially better egg quality. The rationale here is that in certain patients, lower doses of the medications we use to stimulate the ovaries might actually lead to better egg quality.
The other thought is that, because we’re using lower doses of those medications, it might mimic what happens naturally, and that may be better for both the quality and maturation of the eggs.
There are other more practical implications as well. By using lower doses, you need less medication, which reduces the cost of a potential IVF cycle. Also, by using lower medication, you reduce the risk of things like ovarian hyperstimulation syndrome, where the ovaries become hyperstimulated.
Having said that, the typical patient population in which we do see mini IVF is not also the population that you might expect to become hyperstimulated — so that’s really something to bear in mind.
It’s also important to talk about the limitations of mini IVF. The goal of any ovarian stimulation cycle or protocol is to end up with at least one genetically normal embryo that could result in a live birth.
One has to bear in mind that by doing a mini stimulation, or using lower doses of medication, you might end up with a lower egg number, which potentially reduces the chance of you ending up with a genetically normal egg — and hence a genetically normal embryo and hence a live birth.
So because of that, you may need to do multiple cycles, which could then nullify any cost benefits in the end. Those are really the two things to bear in mind.
We do these things on an individualized basis. Having said this, we have what studies show in mind, but these are important conversations between the patient and the provider — doing things on an individualized basis and making sure that decisions are made based on informed input.
Everyone involved in the care should be making informed decisions about what’s best for that particular patient.
Eloise Edington
Absolutely. And I presume you see complex cases as well, where people may be looking to switch clinics potentially and look for a second opinion?
Dr. Tumi
Yes, most definitely. For that reason, we mentioned that people, especially over the age of 40, may need multiple cycles — and even in cases in younger patients, they may still need multiple cycles.
Sometimes people get discouraged after not having the outcome they may have wanted in a prior cycle and want to see if something could potentially be offered or done differently in another clinic or environment.
Eloise Edington
Absolutely. We’ve just had a private question come in — so please do send questions in — which was actually going to be my next question to you anyway.
It’s about PCOS and the challenges that present in IVF. How does treatment adapt to improve success rates for your patients who may be struggling with PCOS?
Dr. Tumi
Before I go into PCOS and IVF, I just want to spend some time really quickly talking about what PCOS is.
Eloise Edington
Yes, please.
Dr. Tumi
PCOS stands for polycystic ovarian syndrome. In order to be diagnosed as having PCOS, you need to meet two out of three criteria. What are these criteria?
The first is having signs of what we call hyperandrogenism — either on your blood work or your physical exam. Androgens are hormones in the testosterone family, responsible for things like acne or hair in a male pattern distribution.
So if you’re someone who has acne or male-pattern hair distribution, PCOS might be a diagnosis to be thinking about — in addition to some of the other criteria I’ll mention.
The second criterion is having period irregularities. If you’re someone who has irregular periods in addition to signs of hyperandrogenism, again, this is a diagnosis you should perhaps consider discussing with your doctor.
Last but not least, there’s having polycystic ovaries — something we find on ultrasound. The name “polycystic” is somewhat of a misnomer, because it doesn’t mean having lots of cysts on your ovaries.
What it actually means is that you have tons of follicles. Those follicles are what give the polycystic appearance — not cysts, just the follicles that contain eggs.
I like to think of PCOS almost like a double-edged sword. Because your ovaries are polycystic in nature, it means that potentially, you might actually have a higher number of follicles — and thus a higher number of eggs — than someone within your age group. For that reason, you may be at a slight advantage.
However, what underpins PCOS is a miscommunication or a lack of proper communication between the brain and the ovaries. Those eggs and follicles are not functioning the way they should.
When it comes to treatment, there are two arms. We want to try to get those eggs to function the way they should and also improve the microenvironment within the follicles, because that can affect egg quality.
So whatever form of treatment we offer — IVF or IUI — one of the main things we also want to be thinking about is improving egg quality.
In certain cases, things that could help include lifestyle factors — and I’ll keep mentioning this — like diet, nutrition, and in some cases, medications or supplements. Medications like metformin can help improve the quality of the microenvironment in which the eggs are developing.
When it comes to treatment — and here I’ll speak specifically about IVF — the one thing you really want to bear in mind is that, with patients who have PCOS, because they have this higher-than-average number of eggs, they’re at risk of being hyperstimulated.
So we manage those cycles by using specific types and doses of medications to reduce that risk.
Even during a cycle, we’re making sure we’re doing things that help optimize both the yield and quality of the eggs. Unfortunately, we don’t have any way of testing egg quality directly.
The only way we can extrapolate is based on the age of the female patient. We don’t have a way of knowing the quality of eggs we’re retrieving — we can only make assumptions based on embryo development and what the embryos become.
Eloise Edington
Really insightful. Thank you so much. I’m sure that’s answered the person’s question.
Thank you. And I’ll actually ask you that question in relation to endometriosis and IVF success as well. Would you mind explaining a little more about that, please?
Dr. Tumi
Right. Endometriosis is a very complex gynecological condition. It’s characterized by having tissue that should only be found within the lining of the uterus — but located outside the uterus.
You have these uterine lining implants scattered throughout the pelvis. What it does is cause an environment where there’s a lot of inflammation then reduces the chances of pregnancy.
If that inflammation, or if that uterine tissue, is also found on the ovaries, it might result in something called endometriomas, which are very specific cysts that we find on the ovaries that are related to endometriosis.
In cases with endometriomas, it could affect both egg quality and egg quantity because of the inflammatory environment caused by the endometriosis.
Eloise Edington
Thank you for explaining — that’s really, really helpful.
For anyone joining, we are discussing IVF success rates and the factors that can change that for specific situations. If you have any questions for Dr. Tumi as we’re talking, please feel free to ask. We’ve also linked in the bio to the Prelude Network so you can find out more about personalized care for your needs.
In terms of unexplained infertility — this is obviously a challenging one for people, to not necessarily know why they’re not able to conceive and need reproductive support. How do IVF success rates compare to other situations with unexplained infertility?
Dr. Tumi
Just to give a quick background: unexplained infertility, as the name suggests, is basically infertility where we’re not able to find a reason.
When a couple comes in for a basic workup for infertility, some of the things that we do are to test the fallopian tubes to see if that’s the cause, look at the uterine environment, assess the ovaries, and test the sperm.
If all of our tests reveal that there aren’t any issues in these areas, then we unfortunately use the term “unexplained infertility” because we can’t pinpoint what the cause is.
Having said that, it doesn’t mean there isn’t a reason — it just means that, right now, the technology we have is not able to identify or elucidate the cause of infertility. We know that it’s actually pretty common; about a third of couples who present with infertility will have unexplained infertility.
We do have some theories about what may be causing it, but unfortunately, we don’t have any real ways of testing. One thought is that there is probably a subset of patients who have endometriosis but don’t present in the typical way.
Endometriosis usually presents with very painful periods, but some people have vague symptoms that don’t clearly indicate endometriosis. The only way we suspect it is that, down the line, they have problems conceiving.
Having said that, just because we can’t classify the cause as related to the tubes, the uterus, or sperm, it doesn’t mean that treatment options are different. As with most forms of infertility, the two main treatments are medicated IUI cycles or IVF.
There’s no evidence to suggest that patients with unexplained infertility have different success rates than patients with other causes of infertility. The biggest predictor is the age of the female partner seeking treatment.
Eloise Edington
Really useful to know, thank you so much. Someone just said they are in the IVF process — we hope this works for you as well!
A question, if you have time: what would be the reason why an embryo may not thaw?
Dr. Tumi
I’m not sure what this person means by “thaw,” but I’m going to assume they mean the embryo may not survive the thaw.
There are many reasons. Unfortunately, only a handful we can really tease out. Some of the reasons may include the quality of the embryo itself, which is often reflective of the quality of the eggs that made the embryo.
To a lesser extent, the sperm does matter, although we know that egg quality weighs more significantly than sperm.
Other factors could include the technique that was used in both freezing and thawing the embryos, as well as the environment of the lab in which the embryos were thawed and frozen. All of that could play a part as well.
Unfortunately, we don’t have any way of knowing for sure the quality of the eggs.
The only way we can make assumptions is by testing the embryos that were made from that egg and seeing whether or not they are genetically normal — meaning the embryo has the full complement of chromosomes it should have to be classed as genetically normal.
Eloise Edington
That’s really useful to know. I’m sure that’s answered that person’s question.
We just had another one come in privately: how much sperm is needed for a cycle of IVF?
Dr. Tumi
That’s a great question. Not much sperm, actually. That’s why IVF is often a treatment for male factor infertility — where there might be an issue with either the quality of the sperm, the number of sperm, the movement of the sperm, or the shape of the sperm — because we don’t need that much sperm to fertilize the egg.
One other great part of IVF is that we now have a technology called ICSI, which stands for intracytoplasmic sperm injection. When there are any issues in any of the sperm parameters — number, shape, morphology, or movement — what our embryologists can do is take a single sperm cell and inject it into the egg.
So, because we can isolate single sperm and inject them directly, you don’t actually need that much sperm in order to do IVF.
Of course, certain thresholds still need to be met, but the great thing about IVF is that you don’t need as much sperm as you would to conceive spontaneously.
Eloise Edington
Absolutely. And would you use ICSI with frozen sperm?
Dr. Tumi
Yes. Typically, embryologists would prefer to use ICSI when a sperm sample has been frozen.
Another reason we use ICSI is if there are any issues with the sperm. Certain embryologists may also prefer to use ICSI in cases where the embryos are going to be genetically tested.
Eloise Edington
Okay, that’s really useful to know. There’s another question around sperm, if you’re able or have time to answer. What threshold is needed? This person said, “I know for IUI it’s five million plus, typically — is that right?”
Dr. Tumi
Yes. Typically, you want at least anywhere between five to ten million total motile count — a TMC of between five to ten million.
I would just back up and say that IUI is not a very efficient way of becoming pregnant.
Even in cases where everything is perfect — meaning we can’t find any issues with the sperm, eggs, uterus, or tubes — IUI only offers between a 12 to 18% chance of pregnancy per cycle.
Having said that, you don’t need perfect sperm to do IUIs. You just need to meet certain thresholds, and that’s somewhere between five and ten million total motile count.
Eloise Edington
Thank you — that’s really useful.
Going back to endometriosis, someone just said that Endo is so often missed on imaging at basic provider levels. I think this person may have experienced that.
Going to an RE with their own skilled techs made a world of difference. Would you advise people, if they think they may have endometriosis, to come and get checked out?
Dr. Tumi
Yes — unfortunately, one of the main issues with endometriosis is that it’s a condition that goes undiagnosed for many, many years, for a variety of reasons.
People think that having extremely painful periods is normal. In some cases, we may not be able to find a reason, but endometriosis should be at the top of your differential if you’re someone who has painful periods.
One of the ways we diagnose endometriosis is through ultrasound. However, like this person mentioned, it’s something that sometimes gets missed. One of the hallmarks of endometriosis on an ultrasound is the presence of endometriomas — cysts on the ovaries.
However, in many cases where we don’t see those cysts, endometriosis can be missed. Now, we’re in an age where ultrasound technology has improved.
We’re beginning to pick up signs of endometriosis that are not limited to endometriomas, and people are becoming more familiar with identifying those signs. Hopefully, this will lead to earlier diagnosis.
But I will circle back and say: if you’re having painful periods and haven’t been able to get a diagnosis, I would speak to your provider, your OB-GYN, or your fertility doctor about the potential for endometriosis.
Long-standing endometriosis, if not diagnosed and detected early, can result in infertility.
Eloise Edington
Yes, and there are other symptoms people can look for as well, aren’t there? Would I be right in saying painful sex?
Dr. Tumi
Absolutely, yes. Painful intercourse is one of the hallmarks of endometriosis. Sometimes pain with urination — like bladder spasms — can also be a sign.
As I mentioned, endometriosis involves having uterine tissue scattered all over your pelvis, and one of the places where those implants might be is on the bladder.
So if you’re having spasms when urinating, and providers can’t find a reason from a urine test, one of the things they should perhaps think about is that’s persistent — potentially endometriosis.
And yes, definitely, painful sex is one of the big, big symptoms of endometriosis to account for. Thank you for clarifying.
Eloise Edington
I also wanted to ask you — as we all know, sadly, miscarriages often happen.
After having a D&C, how can that affect IVF success rates? What could be done to improve IVF outcomes?
Dr. Tumi
A D&C stands for dilation and curettage. We use an instrument called a dilator to dilate the cervix, which then allows us to pass a curette into the uterus, which we then use to either remove the contents of the uterus or to take a sample of the uterine lining.
Now, a D&C in and of itself should not affect IVF success rates if done properly.
However, there may be individuals, for one reason or another, who have had to undergo multiple D&Cs.
In those cases, repeated instrumentation on the uterus could affect the integrity of the lining, such that scar tissue starts to build up. We call that Asherman’s Syndrome.
In cases of Asherman’s Syndrome, the lining of the uterus is not vascularized properly — the blood supply to the lining is compromised — and that affects the ability of an embryo to implant successfully into such a lining.
So in cases where it’s suspected that there may be issues with the lining due to repeated D&Cs, having a procedure called a hysteroscopy — where we put a camera into the uterus and look around — may give us an idea of what’s going on.
If we do identify that a patient may have Asherman’s Syndrome at the time of the hysteroscopy, what we can also do is use instruments to take down some of that scar tissue.
Once that scar tissue is taken down, we do things that may help to revascularize the endometrial lining.
One of the exciting studies coming out now is the use of hyaluronic acid to help restore the integrity of the lining. When it comes to a potential embryo transfer cycle, there are different protocols that we can use to help optimize building that lining as much as possible.
It’s also true that some people with thin linings just have thin linings — we may not be able to get to that optimal number. But having said that, many people, even in those cases, are able to have successful implantation and live births, even with suboptimal linings.
Eloise Edington
Is that sometimes the case after a C-section as well, for people with secondary infertility?
Dr. Tumi
It depends on how the C-section was done. Any sort of procedure where the uterine lining has been disrupted in any way — and that could include a C-section — could potentially affect the integrity of the lining.
If, after the C-section, all the products were not removed — if there were some retained products in the uterus that required subsequent procedures to remove — that could also affect the quality of the lining down the line.
Eloise Edington
Okay. So with everything we’ve discussed today — we’ve been through a lot — and obviously there are so many variables when it comes to success rates for IVF. What would you say are the factors that make the biggest difference in individual IVF success?
Dr. Tumi
Beyond the standard protocols — beyond what’s done everywhere — the one thing is really the age of a woman in a couple. That determines both the egg number and egg quality, which is why early intervention is always going to be best.
Like I mentioned at the start of this talk, if at any point you’re in your mid to late 30s and you have any questions about your fertility — regardless of your age — either speak to your OB/GYN or, if you have access, speak to your REI. These conversations are very important to have, and ideally, the earlier the better.
Age, just to wrap up, is always the most significant factor. The age of the female partner is always a significant factor. To a lesser extent, the age of the male partner also plays a part.
Then something I also mentioned is lifestyle and health factors. You really want to try and maintain, as much as you can, a healthy diet. Eat foods rich in antioxidants — these could affect egg quality.
Try to maintain a healthy weight, because weights above a certain threshold have been shown to negatively impact both the success of embryo implantation and also increase the rate of miscarriages.
You want to limit your alcohol intake. You want to limit your tobacco intake. You want to avoid things like chronic stress and poor sleep.
I’m always a bit wary of promoting any supplement over another, but there are some supplements that have tentatively been shown to potentially improve egg quality, such as CoQ10.
Eloise Edington
That’s really great advice. Really, really appreciate your expertise today, Dr. Tumi.
We’ve had a ton of other questions come in privately — including questions around egg freezing as well, which is a bit off-topic today — but I would recommend people head to our link in bio, reach out to your team, and advocate for yourself to get started with some personalized care. Really being able to have a conversation about your personal goals and take it from there.
Really appreciate your time today. Thank you everyone for joining and watching back, and we’ll be speaking to you very soon.
Dr. Tumi
Thank you so much.
Thank you — this was great.
Absolutely. Thanks again. Have a great day.
Eloise Edington
Thanks everyone. Bye.
Bye-bye.
Want to hear more from the experts at The Prelude Network?
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