Private ivf after over a year ttc?

[Ceramic272]

We’ve been trying for almost a year now and no luck so far. Ive been tracking throughout, timing around regular LH spikes (and now BBT too), everything is like clockwork in terms of spikes and cycles etc but each month is another bfn.
I did get one positive after about 6 months of trying but it ended in a mc (didn’t grow past 5-6 weeks and miscarried at 9).

We both did some testing early on and it showed everything normal with the scan and ovarian reserve etc, although after the MC they did mention there were some cysts on my ovaries, and I also just had a smear which said I have one of the high risk hpvs (though no abnormal cells) :/.

I know people can try for ages before it works but I can’t shake the gut feeling that somethings not right and it just isn’t going to happen naturally. The doctors I saw for testing and mc have seemed so convinced that I’ll conceive quickly, but it’s not happening and something just feels off. I can’t really put my finger on it. We are both 33 and ideally want 2 kids (none so far) so obviously have time but does feel like it’s slipping by somehow

Ive found the whole process very isolating tbh and I’m dreading facing a new year of repeating all of this (especially the mc). So I’ve mentally bargained with myself that if it hasn’t worked by the new year, we will look into doing ivf or isci(?) privately. We are lucky that we could afford a round of private treatment I think, but am I being a bit crazy or have others done this too? Does anyone have any good recommendations around London? I wonder if I’m just setting myself up for more disappointment by just assuming that this would solve it :(

Sorry for the emotional dump but it would be good to hear how others in a similar boat have approached this!

Are you in the UK? Even if you have the funds for private I’d personally start off seeing your GP and you should be entitled to NHS treatment in a lot of cases (age/whether either of you already have kids can impact this).

They can also prescribe Clomid as a pre IVF treatment that can be successful for a lot of people and is much less stressful so it’s worth investing first rather than jumping to private where they’ll no doubt put you straight on IVF.

We did two rounds after 5 years ttc. Our logic was, there's a finite window of opportunity before it's off the tables. If we don't try it, then we'd always wonder "what if?".

As it turned out, IVF didn't work and, after giving up completely we were astonished it happened all by itself. So, happy ending! I hope it works for you.

Did you have a HSG? If not get one.
Cysts on the ovary or in the ovary? Endo ylcysts can cause blockages and prevent the egg from meeting the sperm. Best to get that looked into first. Sometimes the same ovary will ovukate and if that is the one with cysts it might be the issue.
No way of knowing until they do a HSG and MRI/Lapro. You can have Endo without symptoms.
They should investigate what these cysts are.

I wouldn't go straight for private treatment as you will certainly be entitled to at least one round on the NHS depending on where you live. I know it doesn't feel like it, but you have time. And I agree that Clomid can be really successful before you get to the IVF stage- worked for me.

Also you mention the tests you had but did your partner have a sperm analysis? The GP can do this too I think. If you are wanting to fast track things then fertility clinics all do fertility MOTs which would highlight any issues for both of you

Thank you, these responses are really helpful! I should clarify - we did both have a private fertility MOT early on, so did the sperm analysis and the ultrasound etc. All was fine there, they didn’t say there were any cysts. However, after I had the MC, the NHS EPU did a scan and they commented there were some cysts (I think on both ovaries)- but given my periods were regular and no other symptoms they didn’t think these were a sign for concern/PCOS/etc. I was taken aback that the private place hadn’t picked this up though.

I am not sure about HSG - I don’t think I’ve had that; I remember the private place saying the one thing they hadn’t checked was fallopian tubes.

Honestly it hasn’t occurred to me that the GP might offer some alternatives here - I assumed they’d just tell me to keep trying for another year and then come back! I will definitely make an appointment with them. What would they test to prescribe Clomid for example?

OP it sounds like you have a good plan here. I would be asking the gp to run the blood tests - at a minimum day 3 and day 21 to check hormone levels as well as b12, iron, androgens and testosterone. I am older than you and have irregular periods hence the gp ordered these tests among others to rule out any obvious cause - PCOS, deficiencies etc. Have you read ‘it starts with the egg’ ? I appreciate you are under 35 but even so there is lots you can do to optimise conception. If it is the case that you have PCOS (very common) there are lots of diet and lifestyle changes that can make a big difference. Androgen blood test would be helpful to exclude PCOS. Not sure at what sage nhs offer hsg, suspect it is once you have been referred to fertility.

I'd speak to GP first about other options and also what you are eligible for on the NHS in terms of IVF. I would only consider IVF as an absolute last resort, it's not guaranteed to work and it's gruelling.

OP it sounds like you need a referral from your GP to your local NHS fertility service. They run all the tests described below as part of the initial workup and then they will offer treatment options (often Clomid is the first thing they will try). You've been trying for a year so you can be referred.