Fertility Appointments and Beyond: Electric Boogaloo

[thislittlebird]

Hit capacity on the old thread, will tag you in!

Oh gosh @jeaniej that is such a lot of money. How long ago was it? Hopefully you will see improvement soon.

@thislittlebird can I ask why you chose The Lister? Had a chat with Access and am still no clearer on which clinic to choose.
How much are you estimating as add on costs - drugs etc.

DP is stressing out hugely re money. Feels like it's IVF or house move for us and if we come out of this with no baby, no money and we still can't move... Stressful!

@Particularprick we also might have mentioned the £6k with Ramsay. NHS said they’ll remove DH’s, he’s waiting for a scan and apparently it won’t be a long wait because it’s a teaching hospital. Either way, I’m not sure if it’ll help and may just set us back further. Not sure what to think really. I’m so tired of it all and feeling like there’s no end. I’m feeling more resigned to this not ever working for us, and like you I can’t see us using donors.

For me the lister was expensive enough and I couldn’t have justified the more pricey ones. I had seen them before and liked a particular doctor but she retired. I like my current doctor too, I just think the biggest issue is us and our gametes and bodies now and not the clinic, if that makes sense. Unfortunately our last round went badly, that was our first lister one and I think it was a shock to us and them. They basically followed the “winning” formula the nhs used for us where we got a few embryos but bumped up the dose for my meds, added in clexane and antibiotics and it was dire (not because of the additions). I don’t know if higher doses will be the answer for me with the next Lister round tbh, but that’s the route all clinics except Create will take, especially at our age. DH’s sperm is a huge hurdle for us right now and I don’t see an end point where it improves. He needs a wisdom tooth out, he possibly needs a varicocele op. We’re looking at autumn before we can try again probably.

Allow about £1500-2000 for drugs I’d say. I didn’t find the Lister pharmacy that much more expensive than the cheaper suppliers tbh.

We can’t afford to move either with IVF. Also can’t justify leaving London where the clinics are. I’m fed up.

DH’s hormone tests results came back. They’re all normal. I should be pleased, but it feels like another avenue with a potential solution in it shut off to us.

@thithislittlebird I'm sorry. But it is good news. And great news the NHS can do the op for your DP. It can't hurt and could make a great difference.
Thank you for your thoughts on The Lister

@thislittlebird that is good about his tests.
How long do you think you'll need to wait for his scan & potential embolisation?

@Particularprick my DH got his embolisation in September. Dr Ramsay said we should start seeing results in as little as 4 months, but usually around the 6 month mark.

We'll be at around 6 months by the time he needs to provide his sample for the cycle.

We did a standard SA in early Jan & his morphology dropped (was normal before). We haven't retested for the DNA frag, but it was 37% before the embolisation. DH wants to think of the SA test as a blip ...and maybe he's right? He's always more optimistic than me.
We're rolling the dice with this ICSI cycle coming up for sure ... I'm very scared we won't get any embryos.

xx

Hi ladies! How are you all?

I'm also between clinics. I had a chat with the new clinic in Plymouth recently and it was interesting how little they would change my protocol from my current clinic in Exeter.

Essentially they would give me the same doses, but maybe try a synthetic medicine instead of a natural one. They would use the same trigger too. They would give me more progesterone to better support my LP though which is good. They also said that they wouldn't have fresh transferred my only day 5 embryo in my last cycle because I was already bleeding and clearly my hormones weren't in the right place to accept an embryo.

Interestingly the doctor said he didn't think less eggs means better quality. He said our bodies prepare 1000s of eggs for ovulation each month, but only one makes it and the rest are discarded. All they do with IVF is make more of those eggs available. So he wasn't concerned about my 20+ eggs collected.

He also said that with my low doses I'm essentially on IVF lite which means both clinics are costing me be about the same.

I have a follow up appointment with the Exeter clinic on 28th Feb, so I'll make a decision in early March.

@Particularprick I’m worried about how long the nhs will take but Guys assured us it isn’t a long wait because the fellows get to train on these sorts of procedures so hopefully that will be true. We’ll chase the scan next week and see what the next SA says.

What clinic are you leaning towards? The london women’s clinic do seem pretty reasonable, they keep plugging their ads at me on Facebook.

@Kay00 Did your clinics discuss any extras? Like immunes etc. I’m not sure everyone does them. I really want to move but worried about losing access to the London clinics, because there’s so many. Although Create is one I’m considering for the future and I know they’re in Bristol. It’s all just so far away from Cornwall, so I can’t see us moving until we give up on it all. It’s frustrating.

Whats the synthetic and what’s the natural? I feel like Menopur (?) is natural and Gonal F is artificial. Seems like sound advice to not have transferred that last one.

Fewer eggs meant worse quality for me so far. It all seems like throwing a dice, and at my age and with his sperm the more the better. I’m hoping the higher dose meds do the trick but if they don’t the next attempt will probably be lower dose meds because I will have tried higher doses twice now.

Got a pregnancy announcement today. Just feel like it’ll never work for us tbh. Seems like something that happens to other people. I wish we could try again sooner but we can’t. Autumn seems realistic at this stage, feel like I need to try to pretend none of this is happening because the waiting is so hard.

*facebook? My brain just defaulted to that for some reason. I meant on Instagram, but same company so 🤷‍♀️

@thislittlebird you're right, I think it is just like throwing a dice. Gonal F is a synthetic drug, and the Meriofert I took in my first two cycles is a natural drug. I don't think the doctor thought there would be much difference, just it was worth a try.

I think if you moved to Cornwall your closest clinics would be Plymouth CRGW (which I'm considering), and Exeter, which I have already used. I can't see that either so immune screening 🫤 you could call and ask I guess.

@Kay00 I’ve heard meriofert is better for older women so I’ll probably be on some of it next time.

So we have a weird situation. DH had a wisdom tooth out and the resulting fever and bad sperm seem to have ruined our November cycle. We have another paid for, it's now been over 3 months since then and we got and SA back and DH's sperm numbers are very good but as usual motility and vitality are low, morphology is normal. We need to do another DNA fragmentation test and we've asked our clinic if they can do a private test and assess the movement of the sperm because they were only "occasionally twitching" in November. We want to know if any are moving forward.

DH now needs another wisdom tooth out, and maybe a varicocele removed. He's booked in for the tooth at the end of Feb but if he goes ahead with it that potentially takes us until September when we can try again and I'm 40 in May. I'll assume the varicocele embolisation would be even later than Feb.

I need to get some NK cells tests done, and I need to probably take myself to urgent care to assess an ongoing stomach pain (maybe gallstones, unclear). I have a GP appointment for this that's two weeks away but it's only a phone call and I don't really want to wait to find out what's going on what with ivf timing to consider, it's already been off and on for weeks as it is.

But if my tests at urgent care are ok and his sperm DNA and movement are ok, do you think it makes sense to do the paid for round before the tooth and possible varicocele embolisation? Both of those will set us back months and months, and we haven't even had the varicocele scan letter through yet. We managed to make 4 good quality embryos on our first round and only one didn't survive the thaw, our second round went to shit because of the fever afaik.

I don't want to rush into things, although we would make sure to test his sperm before the cycle this time, and I might have meds for immune issues, who nows. I don't know how I can just sit here doing nothing until September knowing I'm wasting crucial months, it's very confusing.

@thislittlebird it sounds like you have a lot to think about.

I can only speak to the varicocele stuff. We were told that ideally you need to wait 6-9 months post embolisation to see optimum results. So ideally you'd want to get it done in the next month or so for a Sept ICSI cycle.

I know there's alot to weigh up and the sperm is only one piece of the puzzle.

xx

@thislittlebird that's a difficult one, and I obviously can't decide for you, but if it were me I think I'd push to get a cycle done before you have the tooth extractions/varicocele removed/stomach investigations. But then my eggs are at the rubbish end of the scale so feel like any extra age isn't helping. Whatever you choose it sounds you'll be taking a bit of a break from the IVF for a while soon, and that might be liberating whilst you focus on improving your health x

@ththislittlebird I'm sorry, I don't have any advice but that seems a lot to consider! I really do think so much of this is down to luck, or lack thereof

How's everyone doing?

I'm due to start my cycle next week and have come down with a cold 😷🙄. It's not too bad, so I'm hoping DH doesn't get it.

I'm not sure how I should feel about this cycle. It's my first one, so I should feel hopeful, but I'm resigned to thinking this won't be our only cycle.

Anyone have any advice on how to stay sane during the cycle?
I'm gonna work through it & try stay as normal with my routine as possible. Might avoid the office so I can stay as germ free as possible.
I'd like to keep up my running, but I've read conflicting stuff online. What did you guys do?
xx

Hi @thislittlebird hope you're doing ok. It sounds like you have a very difficult decision to manage but if the dna fragmentation comes back ok, then sounds like it might be worth doing a round now? Or would you consider egg freezing for this round until his sperm is in better shape and you have had the immune testing? Like you say, Sept is a long time to wait, esp when you're turning 40 in the meantime. And though there seem to be lots of people who have no issues having babies well into their early 40s and no clinic would say it isn't possible, it might become more difficult. I still live by the mantra of the nurse after my first embryo transfer : try not to do anything you might regret. If you think you might look back and regret not doing a round now, with all the "what ifs" there could be, then I'd do it now (in some shape or form, whether a full round or egg freezing). But at the same time, given how unhappy you were with how the last round went, you might need to think about how you'll feel if you get a similar outcome if you go ahead now and the sperm issues are not yet resolved. Sorry, i know this is going round in circles a bit - really hope you figure out what will be best for you. Sending hugs xxx

@JeanieJ it's exciting that you will be starting your first cycle soon ☺️

My top tips: plan some nice (non strenuous) things for you and your OH to do, maybe long walks on the beach or a local mini break as you will be dealing with a lot physically and emotionally.

Don't forget your fluffy socks for the egg extraction and egg transfer.

My mum bought us a tray of chocolates and we had one each after each injection, that made them slightly more fun to do.

Be super organized and set alarms for all the pills you take/injections you do.

Go running if you like, but my ovaries felt massive in the days before egg collection and running would have hurt, so I'd recommend nice walks instead xx

@Kay00 thank you for your advice, it's super helpful 💕
I've got some nice weekend plans in place to keep me distracted & im working throughout the cycle.
Hope everyone is ok this week xx

Hi Jeanie. That sounds great! How are you doing? Have you started stims yet?

@Kay00 nope, not yet.AF due tomorrow-ish & I start on day 2.
I'm starting to feel nervous now.
The gonal F seems really cold in the fridge ... is it a bit chilly in the injection? xx

Hey @JeanieJ how exciting!! I kept ovaleap in the fridge and there was no difference to any of my room temperature injections :) my only other tip would be a hot (but not too hot!) Water bottle on your belly every evening (or whenever), to keep your womb warm abd promote blood flow, and try and keep your feet warm too :) oh, and eat/drink ALL the protein, I read somewhere once that eggs make eggs 🤣 x x x

@beckyCarlos aww thanks for the tip 🙂
I love a hot water bottle & any excuse to eat eggs 😂
Hope you're doing ok xx

@Kay00 we're leaning towards doing a cycle if we can. Age is very much not on our side, can't really believe how much time has passed.

My private clinic gave me the grippy socks and told me to wear them when I went down to theatre but they were HUGE lol.

@JeanieJ we're unlikely to be able to get it done in a month, got some tests to do and then have to see how long the appointment is.

I'm sure a cold won't do any harm to your cycle, it's only really fevers in men that seems to be an issue. I also second the protein advice from @beckyCarlos and maybe use a cold pack for injections.

@99pctpractice I'm kind of ok but never really, it just never ends. So he did the DNA frag test today so we're waiting a few weeks for results now. We're leaning towards doing a round in the Spring if we can, knowing full well we might throw another £7k down the drain. I just don't think we have time to waste at my age.

They also prepped his sperm today as if they were doing IVF and the person (embryologist?) called him to say his count is good (as usual) but only a tiny number of sperm are normal and not clumping, and they think he has antisperm antibodies! That's a new one on us, I've heard of it but it's the first time someone has said it. Always feels like there's another hurdle and I don't know if there's even a solution for it.

@thislittlebird I've never heard of Anti-sperm antibodies either, have they given you any indication of what causes it and what the cure might be?

@JeanieJ I never noticed any difference with my chilled injections either. Some let you bring them up to room temperature first, but I never did and it was always fine.

I have my WTF appointment tomorrow with my clinic following from our Dec 22 cycle. I'm hoping to get something hopeful out of it... We'll see.

@Kay00 keep us posted on how the follow up goes. I hate those meetings.

Sounds like various potential causes including but not limited to varicocele, mumps and trauma, he’s had all three at some stage over the last 40 years. Sigh.

There’s no cure, just more ICSI. Although the clinic did say they will have to prep the sperm quickly and use it straight away because the antibodies attack the sperm, I think they can wash them too to remove the antibodies. I’ve been reading up tonight and the internet suggests prednisolone could (or could not) improve matters and high dose vitamin c. We’ll discuss some of this with the clinic, I’ll probably book in with the immunes specialist there at some stage, maybe after the results are in. The other thing is that I can also develop antisperm antibodies 🙄. I’ll ask them if I also need to be tested for it, I’m going in for an immunes panel tomorrow anyway, getting NK cell bloods done.

@JeanieJ good luck with your cycle. I wouldn't run because there is a small risk of ovarian torsion if your ovaries become quite enlarged. I just wouldn't risk it. Walks will be good!

Nothing going on here and I still lurk now and then. I'm seeing a reproductive immunologist soon before my next transfer