anyone decided NOT to have IVF for unexplained infertility?

[nouveaupauvre]

after 18 months tttc number 2 with no success, we are looking at a diagnosis of unexplained infertility. which means it's IVF, adoption (which neither of us are keen on) or just accept that it's probably not going to happen. we have a three year old already and although we desperately want a sibling for him, am finding myself weirdly hesitant about IVF.
maybe it's having had a couple of close friends go through real turmoil with it - one marriage nearly broke up over it - but am now starting to wonder whether we want to spend money we haven't got on what's probably a wild goose chase (I'm nearly 40 and as nobody knows what our problem actually is, i guess the chances of success are not that great) and potentially putting the family we do have under a lot of strain. i just wonder if we'll regret later not having given it every possible shot.
has anyone been in a similar position and decided not to have IVF but keep trying naturally? or had unsuccessful IVF but wished later they hadn't?

Don't forget that if a patient discovers she really is too old for fertility tx, by using donor eggs you effectively reset your biological age to that of the donor. That's how these older Hollywood stars do it!

Bagofholly, thanks so very much. This is very useful. We are looking at ivf privately in the new year, as both agreed couldn't bear to be childless due to having been too busy! Poor excuse. What is your story? Have you personal experience of the aforementioned institutions? X

I'm 39 now, I was 32 when I met my husband and we married quickly and have never used contraception. By the time I got to 36 I was thinking something odd was going on so started ttc like mad. Nothing. The odd month of symptoms and then a big bleed but that was it. Got to 37, and was going crackers. Had the usual stuff done at the docs, all ok apart from slightly slow sperm. Gave it another few months and decided that the hoops we'd have had to jump via the NHS were not for us, so headed to the clinic with the best success rate - ARGC. I had a load of immune testing done beforehand and am so glad I did as I needed steroids to sort out my hostile endometrium. Had 1 cycle of icsi, it worked and got our fab toddler son! Went back in May for another go and am 23 wks pregnant with twins! ARGC is full on treatment but once it's done it's like it never happened! I'd say go along for a chat, get in the system and get cracking! You only regret the things you never did! X

Bag of Holly: thank you so much. You have been fantastic. Congratulations on your beautiful family. You are an inspiration. We will head straight for the ARGC in the new year. Wot are the waiting times like? And costs? Did the treatments make you mental?

Ooo I've gone all blushy!
I posted at the bottom of page one but I think it's been missed - ARGC is about £8k a cycle all in. There's a short waiting time to get into their system and then once you're in, it all happens quite quick. They do a monitoring cycle to see what your body is like without any interference, and then usually you start as soon as ovulation is confirmed.
Did the drugs make me mental?! Ha, a lot less mental than keeping banging away at it month after month did! I don't remember feeling particularly bonkers although apparently I might have been a tad more emotional than usual! I truely felt relieved to be Doing Something!
Here's the link to the ARGC bit of Fertilityfriends - you can get people's unbiased opinion about it all, and ask as many questions as you like. Some of the histories (in the signatures) are inspirational - mine was relatively straightforward!

www.fertilityfriends.co.uk/forum/index.php?board=210.0

fedupttcnosuccess I have no idea what worked for me to be honest. I did have acupuncture the month I conceived DD but I think I just relaxed about things and it just happened.

Well done! Sorry for being so inquisitive, but I'll try anything. I'm at the end of my tether here! It's so frustrating. Oh well, worst case scenario we'll go down the IVF route in the new year. I've ordered the TCOYF, Zita West and a few others. Can't wait to get my teeth into them. Also joined FF. So fingers crossed... You girls here are fantastic. Wish I'd logged on a long time ago... Still better late than never! X

Londonlottie, that's an excellent way of looking at it - as a course of treatments which you continue until you get the baby, rather than looking at it per cycle. Incidentally, London Women's Clinic offer a 3 for 2 deal on IVF! You pay the lot up front and it covers you for 3 treatments!

Here's my major caveat - I think the approach of starting at a 'less successful' clinic is a good one ONLY if you've got time on your side, or maybe if you're entirely male factor. If you're only just starting out and the wrong side of the magical 37, then I personally think you've got to bring in the big guns straight away.

I found this illustration really useful:

www.in-gender.com/XYU/ART/Cumulative-Odds.aspx

Using the figures on here as a rough and ready reckoner, you'd need at least one more cycle, you'd need three times as many cycles at Guys than you would at ARGC to hit the same cumulative rate. (I'm basing that on a comparison of the live birth results reported for Guys and ARGC for 40 year olds having ICSI, which is 11% and 27% respectively.) So, rounding the figures to the nearest marker on the graph, you'd need 6 cycles at Guys to get to a cumulative success rate of 47%, and only two at ARGC to get to a comparable rate of 44%. So at £4k at Guys, that's £24k, whereas at £8k at ARGC, that's only £16k.

I poured over these like the nerdy statto I am, when we were debating where to go, and when time isn't on your side, the extra few percent can make all the difference!

Just to add, it sounds like I'm a rep for ARGC or something! I'm totally not, and there are defo other really good clinics out there, but we picked them because their results were the best for my age group. I think UCH are the best for younger women.

Fedup, can I nosily ask why you're waiting until the new year?

Not nosey at all! Dad has terminal cancer, progressively getting worse. Mum in law in final stages of degenerative kidney disease with diabetes; prognosis not good for either of them!
Dh and I both in stressful, competitive careers. We're very optimistic that things may have calmed down in the new year. Also we have time off work then.
I am quite certain that it will be the IVF route for us.londonlotty: which option was successful for you, hon?
Very aware of our ages, bagofholly's proposal sounds good, especially with the experience she's had there. However, we do need to look into the clinics more. Brother in law lives in Spain: he's recommended some clinics out there, but don't feel comfortable: especially as am also a sucker for facts and figures. We'll see. Will definitely keep posting on mn in general to report back. It is a fantastic outlet for stress release as well as your words of wisdom. Very grateful that you lovely ladies have taken the time to inform me of all that's out there! Xxxx

Not nosey at all! Dad has terminal cancer, progressively getting worse. Mum in law in final stages of degenerative kidney disease with diabetes; prognosis not good for either of them!
Dh and I both in stressful, competitive careers. We're very optimistic that things may have calmed down in the new year. Also we have time off work then.
I am quite certain that it will be the IVF route for us.londonlotty: which option was successful for you, hon?
Very aware of our ages, bagofholly's proposal sounds good, especially with the experience she's had there. However, we do need to look into the clinics more. Brother in law lives in Spain: he's recommended some clinics out there, but don't feel comfortable: especially as am also a sucker for facts and figures. We'll see. Will definitely keep posting on mn in general to report back. It is a fantastic outlet for stress release as well as your words of wisdom. Very grateful that you lovely ladies have taken the time to inform me of all that's out there! Xxxx

Ooops

Gosh I'm so very sorry to hear that! What a lot of stress and upset! I hope the future brings some calm and you get through the next few months as well as you possibly can! Keep talking! Sending you virtual hugs over t'internet! x

bagofholly:thank you so much for your kind words: your advice re: IVF more appreciated than you'll ever know!Amen to the calm months coming ahead; at the moment can't see the wood for the trees. most days just operating on autopilot.xxx

Just a quick Q for those in the know ... why is it that sometimes IUI and sometimes IVF is recommended?

I'm having problems conceiving #2 and have been told that IUI with Clomid would be our first option [again we have unexplained sub-fertility].

I think IUI is recommended if his sperm count is low/borderline or your cm is hostile. So sperm is washed and then put in. I'm no expert, but that's what I've gathered from the threads here. Hope someone more knowledgeable like mummyabroad or Londonlottie show their heads round the door! X

Whereas IVF : fertilise outside and let you incubate for either unexplained or more serious issues: as I said I think I'm making this up as I go along ! Lol

Lychees, IUI and clomid is cheeeeeeeeap! Cheap as chips. So in many areas the NHS offer 3 cycles of this before moving to IVF, because at least some of their patients will get pregnant anyway. In the feedback given to by healthcare professionals to the last fertility NICE guidelines, there was huge criticism of this approach as the success rates with IUI are so much lower compared with IVF, and in older women this can be very valuable time wasted. Very few private clinics recommend it - most go for IVF if not ICSI as a first line treatment as they're focussed on getting their patients pregnant, rather than cost savings.

From a purely procedural point of view, IUI is where the sperm is 'washed' and then cathetered through the cervix into the uterus at the time of ovulation. The clomid causes ovulation to be more predictable and can also help stimulate the production of progesterone.

IVF is where the ovaries are stimulated, eggs harvested and then mixed with sperm in the lab. The fertilised eggs become embryos and they're replaced at within 5 days, by cathetering them back into the uterus. ICSI is the same procedure but the sperm are individually selected and manually put into the eggs to fertilise them.

Hope that helps explain a bit! x

Thankyou for such a succinct explanation bagofholly! So when we go for our private treatment in the new year, if we are given the option, then which is best icsi or ivf? Obviously interested in a baby at the end of it, so which one, in your educated experience has the greater chances of success?

Well, on the basis of results, ICSI. IVF relies on the sperm knowing what to do and getting in there with the egg, whereas with ICSI, the sperm are individually selected, with the ones that look the best, picked out. Some people feel strongly that they want a 'natural' element and for the sperm to do the fertilization bit itself. I think there's also some studies which show slightly higher rates of congenital defects with ICSI than IVF - personally I've never bought that, as the success rates are so much higher with ICSI than IVF that you have to adjust the overall figures to take this into account. ARGC does over 70% of their treatments as ICSI for example and the breakdown of IVF vs ICSI are all displayed on the HFEA website so you can see the difference in results. We only considered ICSI each time but you can do 'half and half' if you like. You only have to make the decision after egg collection, so if you've only got 2 eggs then ICSI would be the way to go whereas if you've got 20 then you might feel more confident about trying just IVF. I'd say take the advice of the embryologist on the day, to be honest!

Nice one. Yours is truly one of the voices of experience here. Much appreciated hon x

V welcome! Will be crossing everything for you! x