IVF Package vs. Single Round

[Hoping43]

Hi All

we are looking at doing IVF after TTC our third for 18 months (no issues conceiving the first two naturally).

I am stuck between going straight in for a three cycle package or paying for a single round.

we’ve never done IVF before so part of me thinks what if we hate it, can’t handle it and decide this isn’t for us after we’ve paid for a package. On the other hand, if we need more than one round I know it could save us money.

does anyone have any advice please?

I wasn't eligible for ABC but they are cheaper because it's nurse led rather consultant albeit the collection and transfer is done at their more expensive sister clinic create

Also it's very much one size fits all hence the strict eligibility criteria so low dose drugs

@toooldtodate thanks. I wondered why it is cheaper. What does it mean by nurse led? And do you not see a consultant?

also, how does the low drug thing work? My AMH is 18.6 but my FSH is on the high side of normal so I’m worried it may be an egg quality issue for me

@Hoping43

No you don't see a consultant but they do sign off on the protocol etc just all appointments scans etc are done by nurses

Your AMH is good so low dose would be fine for you

I understand the main reason why ABC is cheaper is because it's nurse led rather than doctor led. This meant that most of my monitoring was done by fertility nurses. However there were a couple of times when they brought a doctor in, so I felt that although I wasn't seen by a doctor every time, the nurses did "escalate" my case as and when they needed to. The egg collection was done by a consultant doctor (as was the transfer). I felt that I got a very good level of care. However I expect ABC can work well for straightforward cases but probably less well for more complex ones. They have strict criteria around age, follicle numbers and BMI. - take a look at the website. I was 36 when I had treatment and I had it at the Manchester clinic. We were unexplained infertility. My DH did have one sample that suggested slightly low motility but all subsequent samples came back normal.

@loulou2021 ah okay thanks. I’m in Halifax anyway so it would be Leeds or Manchester. When you say follicle numbers do you mean AMH or do they look at follicle counts too? My follicle count was 13 but AMH 18.6 but it’s my FSH that worries me although no consultant I’ve ever seen things that FSH is worth worrying about apparently

Also @toooldtodate and @loulou2021 how many times would you normally see a consultant during the IVF process? I don’t know anything about it but I know whilst I’ve been on ovulation induction drugs, it’s always been nurses that have scanned me and I’ve been charged extra if I’ve spoken to the consultant even for 10 mins!

I guess I don’t know how complicated or straight forward my case is because of not knowing the underlying cause x

@Hoping43

To be honest I was with create and maybe saw the consultant once or twice per round (I did several) so if I could have saved money by going with ABC and being nurse led I don't think I'd have noticed the difference

They seemed to focus on follicle numbers but I think if you're borderline on follicles then they'd look at AMH.

@toooldtodate thank you for the info. If it’s “mild ivf” I feel a bit apprehensive as I’ve read it doesn’t have great success. I know create is mild but not sure on ABC.

did you have success in the end with yours?

ABC's ethos seemed to be quality over quantity, so they were very clear with me that I should expect less eggs compared to standard IVF. I think they're of the view that if the medication to stimulate is too high, it damages quality. I've no idea if that's actually true, but it seemed to work well for me. Also with lower dose meds, I found that I didn't have side effects from the stimming - I felt completely normal, which was another advantage.

@Hoping43

Yes I had twins 🤩

Thanks ladies @loulou2021 . @toooldtodate wow twins! that’s the ultimate dream surely for everyone experiencing infertility!!

it’s so hard to know what to do isn’t it. I don’t know what we will do. Im taking letrozole at the moment (I ovulate naturally, it was a last shot before IVF) and not having the best response to that so my current worry is I won’t respond to IVF drugs either. Everything seems to be a constant worry!

@loulou2021 sorry I have thought of another question… did you have to pay for testing to find out if you were eligible or not?

Yes, you have to have a scan and then consultation. From memory I paid about £250 for this in total.

Hi @toooldtodate @loulou2021 @Longbin (I think you said you were with ABC). Is it mild IVF? What happens if you don’t respond to their drugs protocol? Do they increase it as per conventional IVF? So sorry for all the questions. I might start a thread about it and see if I can get some more thoughts. It’s certainly got me thinking about options!

No need to apologise for asking questions - happy to help! Yes I think it is classed as mild. They set your meds based on your follicle count/AMH I think - so I was initially set at 125 bemfola. However my follicles weren't growing as quickly as much as expected, so they did move me up to 150 bemfola during the stimming phase. However I think they have a set amount that they'd go up to, and I'm not sure if that amount would be as much as traditional IVF (as I've only done it with ABC so I don't really know about other protocols). The medication is included in the price that ABC charge for the treatment.

@loulou2021 thank you so much. I just don’t know what to do about anything. My head is all over the place but all I know is I’m
desperate to have a third baby and I know I won’t rest until I’ve tried everything I can.

the problem is that nothing I try seems to work. Some girls on MN had success with letrozole for unexplained infertility so I tried that and it couldn’t have been any more of a disaster. So I just want to make sure i am making the best choices going forward. But it’s impossible to know isn’t it

@Hoping43 yes it is mild ivf to reduce the risk of over stimulation, which I did manage to get anyway, so the drugs can't be that mild! I think the best thing to do is book a consultation and speak to them about it as there are a lot of steps in the process

Hello, we’ve had 3 rounds of IVF, first 2 were NHS funded (unsuccessful). Then we opted to go for a package at a private clinic. We chose a package because we had already had 2 failed rounds and didn’t expect it to work again and so wanted a sort of insurance policy. The 3rd round at the private clinic was successful and so we didn’t end up having to use the spare go, however I often think of the money we could have saved doing a single round, but then now I have my babies I wouldn’t change a thing. The only thing is with the refund packages, the criteria is really high and they don’t accept all applicants, we were rejected and had to chose a different type of package.

Make sure you have all fertility tests before deciding, including male factor!

Best of luck x

I think 150ml is the max ABC do but then again I had a decent response on that level with an AMH lower than yours so don't write it off just yet

Thanks @toooldtodate im sure I saw someone else on a different thread say they had gone to 225. I don’t know. I haven’t even responded to letrozole so I am concerned that it’s an egg quality issue

Wow this sounds exactly like me now !! 2 dc conceived naturally. But now after 4 years i haven't had a bfp at all . Results show low amh 2.6 at age 35.

Ive had my baseline scan today they saw 6 follicles in total so i think mild ivf if the approach but it’s costing around £7/8 k with create for single cycle .

But around £16/17k with meds 3 multipack but that’s only embryo freezing each cycle with 1 fresh or frozen transfer only! It’s not 3 ivf transfer cycles which i thought.

and then If it failed i would have to pay another £2795 for fet and pay extra for meds so around £20/21k for 1 fresh transfer and 1 frozen ?

Whereas i could do 2 single fresh transfers (£16k) with any extra embryos frozen for 2 years at £1240 each cycle then pay the £2795 for fet at later date and see if i can do double transfer when i can afford it again . Roughly around £20/22k same as multi but with more changes to transfer this way ? If i’m making sense .

Obv it may be bit more but i just think 2 fresh cycles and 1 or 2 fet would give decent chance especially as this would be last baby . It’s first time i’ve had to do this and already having mental breakdown looking at the prices ! My heart goes out to any couple struggling ttc with ivf . Now i understand the mental impact it has on individuals . Xx