To change IVF clinics

Medication wise

Cycles 1 & 2 - 225ml Bemfola daily plus double trigger

Cycles 3-5 - 75ml Bemfola every OTHER day plus tamoxifen tablets plus double trigger

Cycle 1 and 2 I got a total of 28 eggs but less than 30% fertilised with ICSI and day 3 quality average to poor - blastocysts were all BB grade or lower

Cycle 2-5 - 2 eggs each time 100% fertilised with ICSI all good quality day 3 and 2 grade AA blastocysts and then my twins which were a day 5 BB and day 6 BB/BC

@naomimn

I guess it was a psychological choice to work backwards in terms of quality

Cycle 1 short protocol - I did 2 transfers of average blastocysts, first transfer was a BFN and the second was a ruptured ectopic (my second ectopic and I lost my last tube)

Cycle 2 short protocol - this was the one I PGTA on - 2 average blastocysts neither came back normal but they agreed to transfer a low level mosaic but that was a BFN

So cycles 3-5 I did back to back natural modified egg collections and embryo banking and got 4 blastocysts and didn't PGTA

I'd decided by this point this was the end and I didn't want to do any more egg collections / the toll on family life became too much - it becomes addictive doing IVF and I felt my eldest was suffering from my lack of focus, couldn't take holidays or book anything in case I was mid cycle etc. Also I'd spent £40k - remortgaged house and took a loan out. And I was ready to stop emotionally as I knew I'd given it my absolute all and I'd have no regrets that I could/should have tried something else

Anyway psychologically I felt if I put the best back in first and it didn't work then I'd lose hope. If I put the "worst" back in first then I knew I still had the best frozen!

My worst 2 stuck and i had twins 😅

Having done a fair amount of IVF and also TTC naturally supplements made zero difference to my egg quality - the only thing which did was changing protocol and focussing on far fewer follicles

In cycle 1 and 2 on short protocol I had fertilisation rates of less than 30% PGTA 2 embryos on the second cycle neither came back euplojd - changed to natural modified - got 50% fewer eggs but fertilisation went up to 100% and transferred the 2 lowest quality without PGTA testing and had twins and still have the top quality ones still frozen

Did you have a c section with your first child? I did and that was ultimately the reason why I ended up needing IVF so a lot can change post birth in those 2 years and if you breastfed as well it can take a few months for your cycles to return properly - so if you breastfed say see the recommended 6 months you are only just likely to be having your cycles back to normal?

It depends on your clinic how receptive they are really - some won't let you have any input at all

I was with Create Birmingham and found them very amenable and I was able to - not dictate - but certainly have a lot of say in my treatment and even which embryos to put back

I chose Create because I only wanted to do short protocol and wanted to cycle as quick as possible with the minimum possible impact on my older child who was around 2 when I started IVF (I'd had multiple miscarriages and also lost a tube to repented ectopic)

I also didn't want to take a lot of drugs - in the end I paired it back even further and after 2 initial failed short protocol cycles with Create changed to natural modified - able to cycle back to back embryo banking and that gave me my twins

So it's a personal thing really - I would say read read read be prepared research and question everything - the more informed you are the more you can push your clinic

It's the high dose it damages the eggs, have a consultation with create fertility, they use lower doses that doesn't damage the egg quality. Also agree with ICSI to get max fertilisation.

Your update sounds like you have a good number fertilised so fingers crossed for this round.

Oh and the follicle size - sorry forgot to reply on that - statistically you want follicles of 14mm and larger on trigger day for the best chance of getting a mature egg from it

I did 5 rounds of IVF....each follicle scan I would write down the follicle numbers and size. Control freak??! Yes but it helped me feel in control. I was then able to monitor growth over the stims - you want to see at least a 2mm growth every other day.

If they say told you you had 20 follicles but lots of them were below 14mm on trigger day that could explain why you only got 7 eggs?

I would ask about ICSI but if the sperm is good quality there is no reason to do it

NK cells - again it's only really something you'd look at if you'd had a high number of chemical or early miscarriages

Have to say also....this is for a second child but you were "only" trying for a year. I know that feels like a long time when you are TTC - I've been there. But Statistically at your age it takes up to 24 months to conceive and you'd only just be in the window for when the NHS would refer you for testing had you not already had a child

I fear that your clinic may be taking advantage here - getting you to pay for PGTA etc - and most decent ethical clinics would have said try a few more months - 6 at least and come back rather than take your money for 2 cycles in quick succession

Long protocol - in the simplest terms is much longer duration of treatment. You take initial medication to switch off your ovaries - called down reg - then the clinic gives the go ahead to start stims - the idea being that all follicles grow at the same rate and apparently creates more follicles. But the process can be 6+ weeks long

Short protocol - your protocol - no down reg. start stims at a certain point in your cycle. Risk is follicles grow different rates

Some clinics don't do long protocol - like Create - their ethos is short low Dose stim cycles. Some clinics will only do long and then everyone else do a mixture of both

Hmm so a few things I would say from your reply - at age 29 home AMH of 13 is pretty low - for context when i started IVF age around 34 my AMH was 13 and that was considered low for my age - that would explain you were on a pretty high dose of stims - 450 is the top dose.

Guessing this was also long protocol?

I'd question why a clinic would want to PGTA - its still not a proven science and most reputable clinics would only suggest it after lots of miscarriages (like in my case) rather than a young woman in their 20s with no obvious reasons for infertility

The Chicago tests are not routinely offered, they were an additional cost of about £2k and were sent over to Chicago for testing - although that was a few years ago so hopefully they have begun the same type of blood testing here.

I’d hold out for now, especially given you already have a child and are having IVF after a relatively short time TTC. Most people I know it’s taken a few rounds.

I needed ICSI because the sperm couldn’t get through my egg outer surface. There was nothing wrong with the sperm, my eggs just didn’t like letting sperm through. We went from 20% fertilised to 90% fertilised meaning we could take more to blastocyst to give us the best chance. ICSI can still be relevant for female issues.

Hopefully this round will have better results for you. Sometimes a change of protocol can make the difference. I did 4 short and 1 long protocol. I think I got more eggs on my long protocol but sadly although most fertilised only 2 were suitable for day 3 transfer and that cycle didn’t work for me.

I ended up doing 6 cycles altogether as we had unexplained infertility and had been trying for 13 years. The first 4 were at our local hospital and for the remaining two we travelled to Glasgow as I felt that my local teaching hospital were quite set in their ways about IVF. I never got pregnant on the first 4 and they said that there was no correlation between high TSH and infertility (there is!). They also didn’t believe in immune issues. My GP phoned an endocrinologist at our local hospital who said I would never get pregnant with my TSH as high as it was (think it was 4.6 and it needs to be below 2.4).

We moved to a clinic in Glasgow and I started on levothyroxine and had a biopsy of my uterine lining and my NK cells were 6.5 and they should be below 5. I was put on steroids and had to inject myself every day with blood thinners after transfer. I got pregnant for the first time ever but my hcg numbers were low and was told that they would continue to drop then I’d miscarry which did happen. For my 6th attempt we went for donor eggs at the same clinic as I was 41 and I got pregnant again and now have a 6 year old.

I would say to stick where you are for now as this is only your second cycle (which may be successful) but if you feel that your not being listened to or they’re not willing to try something else then I’d say to move. Being in London you will have more of a choice on clinics. Wishing you all the best on this difficult journey xx

I never made it to ivf was just about to start and got pregnant so extremely lucky but l had strongly considered going abroad for treatment even my nurse in my Gp surgery went abroad after many failed attempts and got pregnant and really urged me to go abroad, when the clinic I was with found out I got pregnant naturally I was treated horribly I won't go into it but basically no care at all no advice even on medication they had prescribed if I were to fall pregnant naturally as they went making ivf money off of me. I remember sobbing down the phone asking them for a blood test to confirm and they all but hung up on me. (I'm not in the UK btw)

Have a look at (the wait ivf) on Instagram x