Idiot's guide to ivf please

[Moomin]

further to my posts about my endo being worse and being the suspected cause of my sub-fertility; and then my confusion about whether to geta 2nd opinion or go private, dh and i have come to a decision.
i went to see our lovely gp the other day and burst into tears as i told him all about my woes. he listened really carefully and then offered me a medical opinion, followed by his own honest opinion, which really was the one i wanted as i very much respect him.
firstly he said that, of course i'm entitled to a 2nd opinion on the nhs and of course i can be referred to a private consultant BUT, iho, my consultant was one of the best in the business and was very highly thought of in the medical profession. he then thought for a bit and said that, if he was as unhappy as i seem to be at the moment, when i go back for my follow-up scan in january, to ask my consultant about the possibility of ivf asap. he said the treatment of the endo could take up to another year and why wait any longer? i'd already said to him that i thought money need not be a problem as i'd decided to approach my dad. we wouldn't be entitled to a free go on the nhs as we already have dd, plus this would take up to another year anyway, so after speaking at length to dh 9and the bank of dad!), we've decided this is what we will hopefully do.
can anyone give me a broad idea of the actual processes involved? I've been on some of the websites recommended by other threads but can't seem to find an idiot's guide. dh and i just want some idea of what to expect before we see our consultant in january. thanks xx

basically you have to inject yourself with a variety of things several times a day, or maybe it was only twice but seemed like several? for about two weeks to make you produce lots of eggs. they then harvest these. not sure how, as was at work when they did it to my sister. i think basically witha long needle. once that is done, they mix it in a dish with your dh sperm whcih he has provided. i think he has to abstain from ejaculation for four days before hand.might be five. once the sperm and egg are mixed, they wait for any embryos to form. once made, they will implant them into you. i dont know how that happens, as my sister and her dh never got that far. i know that they chose to have only two implanted to prevent the risk of multiples but thye can implant three or four if you wish.
then you wait and hope that you are pregnant.

hope that helps

(five years ago the drugs cost them about six hundred pounds. obviously the consultation fees and stuff are extra. no idea how much that would cost)

Hi Moomin,

I would suggest you look at the HFEA's website (www.hfea.gov.uk) as this gives lots of info on the IVF process and what you should be aware of emotionally as well as in a physical sense. I would also suggest you read the two publications by Professor Robert Winston called "Infertility" (this gives a detailed account of IVF as a process) and "The IVF Revolation". This gives accounts of women's experiences of IVF treatment.

The thing with endo (one of many I might add) is that you really need to find a gynae who has a speciality/interest in dealing with endometriosis. Not all of them by any means are as knowledgeable. There are what are known as "centres of excellence" with regards to endo and it is unfortunately fair to say that some gynaes are far better at dealing with this disease than others.

I wish you all the luck in the world with your return visit to the cons. in January and I hope he gives the go-shead for IVF. It can be an option for some endo cases. Never forget though that you can go for a second opinion at any time and I would keep this option on the back burner.

You could always contact the NES (www.endo.org.uk) for more advice should you so wish.

With best wishes

Meerkats

Hi there. I've been through IVF twice now. The details of treatment protocols do vary between clinics but the 'stages' are as follows:

1. down-regulation - you take drugs which 'switch off' your normal cycle, basically putting you in to a menopause-like state. For me this involved sniffing a drug twice a day for several weeks. you have a scan to check that this has worked.
2. Stimulation - you have injections daily for about two weeks to grow eggs. I did these myself. There are scans to check how this is going.
3. There is a final injection to 'ripen' the follicles.
4. Egg collection - I had this under sedation rather than general anaesthetic. The eggs are harvested using a fine needle inserted through the vagina. Its not as awful as it sounds but is teh most physically invasive part of the procedure. On the same day your partner produces his sample (we weren't given any instructions about abstention but I think its expected that you won't be having sex in the middle of the cycle)
5. Fertilisation - you phone up to find whether you have embryos
6. Embryo transfer - this can occur 1-3 or more days after egg collection ,depending on the clinic. The embryos are transferred through the cervix, its a bit like having a smear in terms of the level of invasiveness. There are stricter guidelines about numbers now and usually two are transferred.
7. About 2 weeks after embryo transfer you have a pregnancy test - some clinics give you a blood test, others just ask you to do a home test. I always did my own anyway! If the test is positive you have a scan a few weeks later.

Physically I didn't find it too bad but emotionally it was pretty tough going. All the very best of luck to you. I'm not sure how endometriosis might affect the details of treatment for you, that't something you'd have to discuss with the consultant.

I suggest you have a further look on the web for bulletin boards that might be helpful to you - I believe the CARE clinic in Nottingham has a useful website with message boards and information - might be worth looking for that and also searching for other websites of fertility clinics.

I am hoping to start IVF for first time in January. A friend recommended Zita West's book "Conception and Fertility" because it has a chapter on IVF. I didnt buy it for ages (I thought it would just try to convince you to buy expensive multivitamins) but in fact the IVF chapter is really good, simple and straightforward. It is also good for reinforcing the "eat well, relax, get lots of sleep" message.

My local consultant advised us to be very business like in choosing a clinic. Its your money (well your dad's) so approach it the same way you would buy a car, or double glazing. Go to the HFEA and check clinic success rates. The Foresight website has a league table of the results. Then get the literature from say four clinics you are interested in and read and compare them all. Then phone them up and ask what their most recent year's results are likely to be,etc etc.

We have decided to go to ARGC in London even though we dont live in London. The rates for our local clinics were all 29% or so whereas ARGC's rate was more like 45% or so (for women under 38). Even though flights and accomodation will make it more expensive, I prefer these odds (of course nothings guaranteed etc)

Anyway buy the book, do your research, and best of luck!