Choosing a fertility clinic - any experiences or help much appreciated

[worriedmum100]

Hello

Quick back story. Been TTC DC2 for 18 months after no problems conceiving DC1. I am nearly 38 and DP is 43. Had all the tests the NHS provides and nothing seems to be wrong. I ovulate naturally no blocked tubes, fibroids or cysts. DP has a slightly low count but not anything to be concerned about according to consultant. Really good motility etc.

I have recently discovered a cyst on my thyroid which is being investigated but I doubt this is the cause of the unexplained secondary infertility because I don't really have any symptoms to suggest hypothyroidism.

So, we have decided to seriously consider assisted conception which we will have to pay for privately.

I have started to research clinics. I've looked on the HFEA website. I live in the South East and seem to have a wide choice but I don't really know where to start with narrowing it down. Is word of mouth best?

A friend went to the Oxford Fertility Unit and says they were good. Success rates seem about in line with national average. But then I looked at ARGC which seems to have double the success rate for women my age (40% vs 23%). Can this be right?

I don't really know how to choose. Can anyone who has been through this offer any advice. Where did you go? How did you find it? What qualities should I be looking for.

Also I'm finding it hard to estimate a realistic cost. The prices for IVF are listed but I have no idea what will be added on top - blood test, drugs etc. I had a figure of 10k in my head - is that about right?

Many thanks in advance.

[cwtching]

Hello! We are in the same position as you but a little further down the line. My advice would definitely be to book in to at least 3 open evenings at different types of clinics. They are free and will give you a really good idea of what you want out of a clinic. I think it's really important to find a place where you feel comfortable and confident (as well as somewhere with high success rates) and each clinic will feel different for everyone. Please don't be tempted to pay out for an appointment in the first instance, unfortunately we did at a private clinic in buckinghamshire. The experience was truly awful and left us feeling incredibly low (not least because we paid for such an awful experience). So we decided to change tack and booked into open evenings at CRM London (excellent presentation which was incredibly informative about the whole process and very down to earth and friendly), Guys ACU (very good) The Lister (yet to attend) and ARGC (yet to attend). Every evening we go to I feel like we are learning something and are making little decisions about what's important to us in a clinic.

Good luck!!

[MrsCakesPremonition]

I looked at HFEA and I also spoke to friends and friends of friends. They pretty much unanimously suggested Herts & Essex Fertility Centre. I thought the centre looked good on the HFEA website in terms of results, so I decided that I would risk spending a couple of hundred pounds on going for an initial assessment (on the basis it was a small amount compared to the cost of fertility treatment and if I hated them I could still back out). However, I was very impressed with the doctor (friendly, thorough and realistic) and subsequently all the staff were fantastic.
I may be somewhat biased though as I fell pregnant on our first cycle of IVF and Ds is now 5 yo.

[worriedmum100]

Thank you very much for the replies. The open days sound like a good idea. Congrats on your ds mrscakes. cw do you mind if I ask which Buckinghamshire clinic you tried? I ask because I am on the border of Herts and Bucks so may put it on my shortlist without realising! Also, are you able to say why it was such a bad experience?

[Aldwick]

My cousin highly recommends Salisbury

[beginnings]

It's a bit difficult that you have no idea what the problem is as I'd recommend you find a clinic that specialises in your particular issue. If you've had all the tests the NHS offers, it sounds like you've not had the full range of immunology tests that you would have privately. You might hear them referred to as the Chicagos because most clinics literally send the bloods to a lab in Chicago! The lister sends them to a lab in either Esher or Epsom (can't remember) which is better as they get there more quickly. The results of those might help you make a decision. I had some done on the NHS and some at the Lister and paid about £500. The Lister has a good range of consultants with different specialisms - I am biased as I wouldn't have my DD1 without them. Regarding ARGC, the reason their rates are so high is that they tend not to treat women with FSH levels higher than 10. Obviously they are easier to treat. That said, they do have a fabulous reputation. I had high FSH so didn't consider them.

In terms of cost, I had my treatment 2.5 years ago and would say that your estimate is on the high side, particularly if your FSH is in normal ranges. The most expensive drug for me was the stimulatory one, and I needed the highest recommended dose. I also had to be on a blood thinking medication called Clexane throughout the pregnancy but I got my GP to prescribe it so it was free on the NHS.

Happy to talk more about my experience if you want to Pm me. Best of luck!

[beginnings]

Thinking!!!!???

Thinning obviously! My blood doesn't think!

[cwtching]

Hello again! Our terrible appointment was at the Chiltern. I should have been forewarned as everytime I tried to call them nobody answered. Prior to our appointment DH had to have a SA, I organised with them the time I would drop it off in the morning. When I arrived there was nobody there and I waited half an hour for someone to turn up taking us over the hour since the sample was collected, when the nurse finally turned up there was no apology at all, she just seemed harassed and really didn't care about the group of us waiting in a deserted clinic. Then it came to our appointment. It's a small unit which is fine but I was weighed and measured in a corridor full of boxes with a blown lightbulb (so essentially in the dark). During the consultation the consultant didn't look at us, his head was permenantly down looking at his tick list, he talked his way through the list in a monotone, actually ticking his way through!! He didn't refer to our personal circumstances and seemed surprised when we had questions (the appointment only lasted 10 minutes!!). Our problem is male factor infertility, we asked him if there was anything DH could do to improve his fertility prior to IVF and he said no (utter tosh according to all the other clinics) and when we asked for information on pricing he said we'd have to book another (paid for) appointment to find out!! At the end of the appointment they tried to pin us down to booking another appointment, and even though we said we weren't comfortable booking another appointment and wanted to think about things they persisted and were insistent we put a date in the diary to start IVF rolling. We left feeling incredibly depressed about the whole thing. It was our first experience at a clinic and we were hoping to be given lots of information, to have a focus on our individual circumstances and to be given some reassurance about the process by a friendly team. None of which was forthcoming. Our bill was for over £300 (they also did a blood test on me). Thank goodness we've found that the other clinics we have visited since then are NOTHING like this!

Based on our experience I really would not recommend the Chiltern Fertility Clinic. But there are really good places out there which are positive, friendly, competant and informative and choosing the right clinic which will play an integral part in hopefully making your baby and which you can put your faith in during a vulnerable and difficult time is really important... definitely shop around!

[beginnings]

Oh cwtching how horrible! Good luck at the Lister - it's such a supportive environment. DD2 is a BOGOF baby - arriving only 16 months after DD1. At 7 weeks I was a bit worried symptoms were abating and really wanted a scan. I called the Lister and asked if I could just come and have one - I think I phrased it as "would you see an old friend". Of course I had to pay for it but they were delighted to see me - I got a big hug from my consultant when I bumped into her in the corridor, the sonographer I always see was practically dancing a jig for me and was thrilled to put up a photo of DD1 in her office. I had the odd niggle about some of the service I received there and some of things that happened along the way (two fresh cycles, one frozen) but in the main, I have nothing but praise for them.

[worriedmum100]

Thank you all this is so helpful. I have an FSH of 6 and a borderline satisfactory/low fertility AMH so guess ARGC would accept me but wary of the hype. Perhaps I'm over cynical but if it seems too good to be true it usually is!

I'm worried that at the end of the day, the cause is just that I'm older and popping out rubbish eggs and IVF won't help with that :(

I work in London so a London clinic would be doable but not sure I'd want to be working at the same time as treatment that is so time critical. Job is quite stressful so am thinking of taking leave. Not sure if it counts as sick leave?

The Chiltern won't be on my shortlist! Sorry you had that experience.

[ceara]

Definitely second the advice to go to some open evenings to get a general impression of several clinics and where you feel comfortable. It's an emotional roller coaster so feeling supported and trusting those treating you makes a huge difference in getting through it, especially if a cycle isn't successful.

In relation to costs, clinics have different "added extras". Where I went the cost was all inclusive except for drugs, and embryo freezing (if relevant), so the cycle cost under £4,000 all in - £3000 plus the drugs. Freezing our extra blastocysts plus the FET cycle was another £1500 approx. That was all earlier this year.

ARGC get good results but are very much IVF boot camp with very intensive (and costly) monitoring during the cycle, which doesn't suit everyone. I know I couldn't have coped with all the appointments and blood tests.

When looking at quoted success rates make sure you know what a clinic's figures relate to ie positive pregnancy test, clinical pregnancy (sustained to 6-7 weeks), or healthy baby.

For what it's worth I'm 39, unexplained infertility ie all good on paper, and I am pregnant after one straightforward (failed) IVF cycle and an FET. Both times we had a single blastocyst transferred on the advice of the embryologist. We didn't have immunes testing as our consultant didn't advocate it in our situation -just the standard tests which the NHS paid for- though I know immunes testing has helped other people.

Best wishes.

[ceara]

Sorry, I meant to say, your FSH is better than mine was :-) And my ageing ovaries managed 13 eggs and 4 good quality blastocysts after very average drug doses. So don't write your eggs off just yet.

I work in London too and worked through both my cycles except for egg retrieval and embryo transfer days, so I would say it is doable as long as you have enough flexibility to go in a little late on days when you have scans (generally early morning). Work for me was a sanity preserving distraction :-) Also, our consultant advised seeing IVF as a course of 3 cycles and focussing on cumulative success rates, so on that basis I wouldn't have had enough leave not to work through the cycles anyway!

[worriedmum100]

Thanks again. This really is very helpful. I talked to dp about viewing it as a 3 cycle thing but he's not keen on doing it more than once (for financial and emotional) reasons but is open to the idea of freezing and FET (if poss).

I'm a bit torn on the work thing. On the one hand I can see that it might be a distraction but on the other I'm not sure if I could cope with stress on three fronts (work, IVF, caring for ds). My job has time critical elements (court deadlines) so would be difficult if they clashed with treatment days. Will think on it though.

Thanks again for sharing your experiences.

[Buildingamystery]

What is it about these terrible clinics? I had a woeful experience at Create. Rude, ignored calls and in the end I have just given up on them. So disappointing to be back at square one again. Looking at the Bridge or maybe the Lister. I don't know!

[TattyCatty]

If you're looking for positive experiences, can I put in a vote for CRGH (formerly ACU at UCH)? My DD was conceived their via IUI back in 2005, and the staff were wonderful. They were in a really run down building at the back of UCH back then, and I remember feeling a little peeved about the basic facilities given the money we were spending, but the care and expertise easily made up for it!

I had a torrid time in the early stages, as my HcG levels weren't rising fast enough and they were struggling to visualise the pregnancy in my uterus, but all of the medical team were so supportive. When we finally saw a heartbeat at 7 weeks, Paul Serhal, the Clinical Director ran over and gave me the biggest hug, whilst announcing to the entire reception area that "the baby we thought wasn't going to make it is going to be just fine" .

If you do carry on working during treatment, ease of access to the clinic is a big consideration. I was backwards and forwards for scans every couple of days, but was able to go either just before work or during lunch breaks.

I don't have any up to date info on success rates, but from a personal point of view, they are responsible for my DD and my 3 darling nieces, so we're big fans. Good luck!

[TattyCatty]

Gah - there, not their on the first line. Been a long day!

[galwaygirl]

Hi, can't help with clinics but we were up in Scotland and when it came to deciding I went with the stats (since I work with them haha) and it worked fantastically for us. In
Would definitely contact ARGC (not sure if I've arsed that up) and look into their figures.
We were unexplained, I was 31 and we got DD from a fresh ICSI cycle (single blast transferred) and DS two years later from a single FET and we have three more in the freezer.
We had our fresh cycle in 2011 and I'd say it was more like £7,500 all in. We went for ICSI as we were unexplained and didn't want to find out there was an egg wall or sperm issue through a failed fertilisation. It doesn't add much to the cost and could potentially save loads.

Best of luck xx

[Pinkpinot]

We had a very impersonal experience at the Bridge, lots of reading files as we were in the appt, nothing was explained very well, and there was always another test we needed, nothing seemed very organised or thorough

Wouldn't recommend, heard better things about the Lister

[IloveCheese11]

Hi Worried, we have just started with the Lister and I am please with our choice so far. We chose them because of my age (40) as they have a good reputation for success with older women. I have also heard good things about UCH/CRGH

This is our experience to date. Hope it helps.

• We got an appointment pretty quickly and had to fill in lots of forms and send them back beforehand, so quite organised about things. I did it all by email so I could do it at work without anyone knowing.
• At the first appointment I had an ultrasound and day 3 bloods (lucky timing, not deliberate), DP had a SA.
• We saw Dr Parikh who gave us quite a lot of information. Maybe a bit too much to take in if you're new to fertility stuff but I think we got the gist of it and I'd rather have too much than too little. You certainly go away with lots of things to google!!
• Dr Parikh looked at and took copies of all our NHS paperwork and then reviewed our ultrasound and SA then and there. That was great as you wait weeks for that with the NHS.
• I felt she considered our personal circumstances well. We got to ask all our questions and did not feel rushed.
• She gave us forms to take to our GP for all the standard blood tests - thyroid, HIV etc and chlamidya swab. She said that way we could have them on the NHS rather than paying the Lister for them.
• She arranged a telephone appointment to follow up on the bloods and sent us away witha load of information to red (really loads and I still haven't read it).
• The worst part of the experience was handing over my credit card. For the initial appointment, day 3 bloods, SA and ultrasound it cost £680ish. If I could work out how to do smileys, this one would be shocked!

I have now had my follow-up telephone consultation (£145) and we have decided to go ahead with treatment. She was positive but not unrealistic given my poor results. I found her quite lively and energetic which sounds like a weird thing to notice but I was just thinking in contrast to your other experience with Dr Monotone and his tick list.

Re overall cost, I reckon it will be in the £5-6k bracket. Meds could push it up though as I think I will be having high dose.

Good luck with wherever you choose. x

[beginnings]

ilovecheese she is fantastic throughout treatment. Good choice. Pragmatic, caring, very respectful of the rest of the team. She is what a doctor should be.

Good luck - I hope she helps you achieve the same result as she did me.

[wifeofdoom]

I'm at new life in Epsom, they are very professional - specialise in immunity stuff so no surprises when they recommended that after 2 failed cycles there. On the expensive side I think but don't dare count up... It's the cycle cost plus about 8 blood tests at £100 a go and all the drugs. The immunes have been into the thousands before the cycle even starts. They are new so didn't used to have hfea success rates but think they have just published. Lovely facility and I have seen the consultant at every scan, and usually on time. Good luck!

[BranchingOut]

Interesting thread.
I have just had an initial appointment at the Bridge, but we didn't come away feeling entirely convinced. I had gone with quite a few test results (day 3 tests, CD 21, swab, bloods, pelvic ultrasound) from the NHS, plus my husband's results, but the Dr didn't seem to feel that much of this was too helpful and said that we had 'unexplained sub fertility' without being too specific about the options open to us....Wants to book me in for another scan and HYCOSY, plus a whole raft of other bloods at £50 a throw... Is this normal?

[MrsHY1]

Another vote for the Lister here. We saw Alison Taylor and for the first time felt like we were being treated as intelligent, unique individuals rather than generic people on a production line (we were at Kings before). Don't get me wrong, the NHS does a fabulous job with the resources it has but I truly believe it was the immune and blood clotting testing and treatment that the Lister recommended that meant our third FET (having two blasts transferred each time) was the successful one, I'm now 37+2 weeks. Good luck with whatever you decide x

[Dannygirl]

Another vote for ARGC here, they managed a successful outcome with me when another clinic told me it wouldn't be possible (after 4 years of trying). I agree with a few things that have already been said - ARGC is indeed like IVF boot camp, and also you should consider getting your immunes tested if other things look OK. I also found this article which compares the success rates of clinics in an easy to understand way, I hope you find it useful and all the very best of luck xx

understandinguncertainty.org/fertility

[IloveCheese11]

Ooh thank you beginnings, that's very reassuring to hear. Let's hope we do as well as you. Fingers crossed for a BOGOF too!