IVF add on treatments

[Gillywater]

Sorry if this is repeating previous topics, but I am about to start round 1 of ivf and I was asked about the endo scratch and embryo glue today. It was mentioned before, but we thought we wouldn't try this time (as you can see, I'm already planning ahead....) but now I'm wobbling. I'm almost 38, AMH is ok ish, high ish FSH, endo and OH has variable motility, so we might have ICSI. We're every clinics dream......

This round is NHS funded but additional treatment is obviously extra. I don't mind paying- but also don't see the point if it's not going to work.

I've checked this website: www.hfea.gov.uk/treatments/explore-all-treatments/treatment-add-ons/

Plus, I've read about the recent endo scratch study that basically said the previous studies were poorly designed and it makes no difference to pregnancy or birth rates. Some clinics eg.Bath aren't even recommending it anymore apparently. My clinic is supposed to be one of the best in the area, so I'm wondering why they are still recommending it.

Anyway, would be really useful to hear opinions- both for & against. I also don't like pain, I've just had enough of it due to the endo, so if it hurts- please say so!

[Goandplay]

I saw and read Sir Professor Winston saying these additional treatments have no evidence to support the use of them.

Personally I wouldn’t. I would focus on heathy living, nurturing my body and hold back any additional funds for the future.

On a side note I had 3 cycles. 2 successful. Both successful cycles were with hypnosis. I think it helps to get your mind on boards as much as your body.

Good luck.

[Gillywater]

Oh, and we've also been asked about time lapse imaging for embryos, if we are lucky enough to get that far

[ProfessionalBarren]

If I had no reason to suspect that there would be implantation issues then I would skip this add on, particularly in light of the new study. Good luck with your cycle!

[Gillywater]

Thanks goandplay. I have Robert Winston's book somewhere- will take a look at what he says.

[ProfessionalBarren]

I would however do timelapse. Less disturbing the embryos, more information about their development to help choose the best one and you get a cool video of the embryos developing.

[Gillywater]

Thanks professionalbarren- it's the one treatment I haven't done much reading on, so will look into it some more. I think I remember some posters a while back saying it was useful.

[FizzyFeet]

I wouldn’t do the scratch - my consultant was one of the pioneers and he was disappointed that the early successes they had had didn’t seem to be replicated. And it’s painful! We did do embryo glue but that was mainly to do with known implantation issues. IIRC it was relatively cheap so didn’t mind the money. I don’t remember time lapse being offered but would def look into it. Good luck with your cycle!

[Goandplay]

We asked them to keep our unsuitable/unused embryo to monitor it afte rfor freezing even though they said it was unsuitable. It went to blastocyst which made the 2 weeks wait a tiny bit more bearable.

We froze the embryo. As Zita West says you don’t need all good grade embryos, you need one to go the distance. (Something like that).

[Gillywater]

Thanks FizzyFeet- so helpful to know it's painful! Even the description of the scratch made me wince. Interesting about your Consultant- I wonder why the results were initially so positive. To my knowledge I don't have implantation issues, so think I'll skip it.

Goandplay- it's also really useful to hear about your experience re:timelapse. Although the HFEA doesn't seem convinced, I think I need to look into this more.

[Si1ver]

I had a scratch before my successful (so far) IVF. I opted for it because I read a bmj study on the increased level of success post miscarriage.

For what it's worth I found it uncomfortable but not painful. Who knows if it helped or not, but if I ever have a second round I'll do it again.

[Gillywater]

Thanks S1lver. I've never been pregnant, and my understanding is that the scratch is/was recommended after miscarriage or failed cycles. If I don't need it then I don't see the point, but what if end up needing it in future because there is an implantation problem?! Aaaaarrrgghhhh! Too many choices

[Si1ver]

@Gillywater mine cost me £150 privately, in the big scheme of what I was paying for IVF I thought it was worth it. As someone else said, the most expensive IVF is the one that doesn't work.

[Scottishgirl85]

We had scratch and glue on our successful cycle, following a failure where we did no add ons. No one can tell you if it'll make a difference. I'd ask yourself if you'll regret not doing them if the cycle fails. Ivf is a mind game and you want to know that you did everything that YOU believe will give you the best chance. Good luck xxx

[Gillywater]

That's a very good point Scottishgirl85. I am someone who 'what ifs' a lot. Even though I know the stats for ivf are very much against us, I would also like to give it a good shot.

Thank you everyone for the good luck wishes - we haven't told our families or friends that we are going through treatment, so it's nice to have people who understand wishing us the best

[hoping2018]

Hi @Gillywater ,

I researched this a lot - definitely evidence for embryoscope/time lapse and this added such a huge amount of information to our failed nhs round that the clinic paid for it to be included the second time as they felt it would increase our chance of success so much (lots of fertilised embryos but they unexpectedly weren't making it to day 5). I am used to looking at research (as is my DH) and we wouldn't do ivf without it.

With regards to the scratch - scanty evidence. Interesting you say bath don't recommend it because that's where I had my scratch (recommended by them) just before this current cycle which was successful. We changed a lot so I can't say it was the scratch that helped but for me it was such a small amount of money compared to the rest of it and my biggest fear was having regrets - I just really wanted to know we tried everything possible and I wouldn't be looking back thinking "if I had the scratch maybe I'd be pregnant" but I agree with other posters not much evidence for it.

As it is I am currently 18/40 and in the future when have FET wouldn't do it without the scratch (why change what worked for us)

Good luck x

[Gillywater]

Hi hoping2018

Thanks for posting. I have some knowledge regarding research, but this is when having a research background comes into its own I think.

I'm pretty convinced by time lapse, and although my clinic don't offer the embryoscope, I think I will go for the embryoglue.

I looked into the recruiting sites for the recent large study scratch trial, and Bath was one of the sites. There is an updated page from mid July stating the clinic position & they have removed it from their treatment list- so you may have been in the last lot of people to receive it there. I just find it fascinating it's changed so rapidly since the research was published: https://bathfertility.com/recent-studies-show-no-benefit-from-endometrial-scratching/

On balance I will probably end up having it, simply because I don't want to have regrets. I do wonder if it will be routinely offered in future though.

Congrats & glad your cycle worked. All the best

[hoping2018]

Hi @Gillywater , I'm 18/40 now so I probably just snuck in with the scratch! We changed a lot of other variables (surgically removed the sperm second time round) so that probably made more of a difference. I'll be interested to see when I go back for number 2 what they say about the scratch!

Best of luck!

[Ripasso]

I had the scratch with an unsuccessful fresh ivf cycle. I did not have it for my frozen cycle which was six months later and was successful. It was uncomfortable but not awful though I would not bother having it with hindsight.

[Gillywater]

Hi Ripasso, that's interesting. I'm curious, did you decide not to go for it on your FET because you'd already had it, and the effect is supposed to last? (Assuming the theories as to why a scratch might work are true) or because it didn't work and therefore didn't seem worth it?

[Blondiecub0109]

I had a scratch in order to check for immune issues after a failure and a CP (self referred) was advised to go ahead with a FET straight after and it stuck. Embryologist at my clinic advised embryo glue only really useful if there is repeated implantation failure as i’d Had a previous CP they say no.

[Ripasso]

I did not have it again as I felt it had no effect. I did not think the scratch lasted longer than a few months so did not think it would still be there for the FET. I’m not sure how long the scratch is supposed to last.

[Trying2bemum]

I had no extras with my IVF cycle and got BFN. I had scratch and glue with private ICSI and got BFN.

Currently weighing up what to do with our third cycle. I don't think I'll bother with the scratch - partly because I'd like to try naturally the month before our cycle. We're unexplained so I still hope that we might conceive naturally. Despite trying for close to three years now!

[AniSL]

I asked my clinic for a scratch and they were absolutely against it, said that sometimes it cam do more harm than good

[Gillywater]

Thanks for your responses everyone. It seems like such a lottery in relation to what clinics recommend/suggest. It's difficult having to make a choice when so much of this treatment is new or unknown.

I think we are going to go for the add ons, because we may only do one cycle & don't want to have regrets. I appreciate this isn't for everyone though.

[RubyBoots7]

Its such a tricky one as there's so much emotion involved in these decisions. I guess at a population level the stats might say one thing, but do they break it down any further, on the basis on age, cycle number, fertility factors etc? And then what about all the things not controlled for in the study or factors you dont knwo about your own fertility? I've not personally researched the effectiveness so I really don't know the answers to any of these.
We were NHS funded and we had the scratch as part of our funded treatment on the successful round (but not for the unsuccessful ones). However there are numerous factors that may have made a difference and in our case I think our success on the later cycle probably had more to do with better graded blastocysts and more post transfer progesterone (I was rattling with it). The problem is we'll never know what made the difference as it's all still such a vague science compared to other areas of medicine. Do you get more than one funded cycle as that would poss influence my decision.
Oh if you do decide to have a scratch I didn't find it too bad pain wise. its so quixk. I'd rather have another scratch than a Hollywood wax.