Natural modified IVF

[Cloclo93]

Small break down
1 failed ivf cycle 4 eggs. zero fertilization
1 failed icis cycle 2 eggs. 2 fertilized stopped growing at day 4.
Low AMH of 3.
31 years old
I've come to the conclusion I should explore natural modified ivf rather then been on the highest dose of injections focus on quality because I never get quantity anyway!
These 2 cycles were both in Ireland so I am looking to go abroad for natural ivf, can anyone please give me advice on clinics you would recommend for this? And to hear your success stories would be lovely as I am so upset atm fertility issues are so mentally exhausting and upsetting 💔

Anyone? Bump 🥺

@Cloclo93 sorry to hear about your experience to date.

I have had natural modified IVF and would strongly be an advocate for it, clinic I went with is Create Fertility who specialise in low amh and natural/mild IVF. My amh was around 4 pmol, so it was low and I'm 38.

My journey so far...

Cycle 1: NHS cycle (not Create): high stims, short protocol: 4 eggs, 2 mature, zero fertilisation. Despite asking for ICSI they said on the day sperm sample was good so they did conventional IVF, they admitted next time ICSI would be adviseable whatever the sample result.

Started with Create on a 3 Cycle ICSI natural modified package. Plan was to freeze anything retrieved then transfer at the end of the 3 cycles.

Cycle 2 with Create: 5 eggs, 4 mature, 3 fertilised. 1 blastocyst frozen, 1 day 3 frozen.

Cycle 3 with Create: 2 eggs, both mature and fertilised. 1 blastocyst suitable for freezing.

Cycle 4 with Create, tried mild IVF as response was good on natural modified: 7 eggs, 7 mature, all fertilised, 5 blastocysts frozen.

In total 8 embryos frozen.

I've had 3 FETs and had 5 embryos transferred over those FETs and am currently 8 weeks pregnant with one of them, but still got a way to go as the 3 month point is the reassurance bit, but hopefully that gives you some hope.

Long and short of it is, it's a long road and trial and error. If you can, stick with it and find a Dr/ clinic that is on the same page as you.

Hope that helps.

Hi @Cloclo93 are you on COQ10, vitamin d etc.? I think the going down the lower vol / better quality route may be a good one, but make sure you're doing all you can re. Egg and sperm quality first. Try impryl for you're partner (if male)

@Cloclo93
I hope you don't mind me jumping in.
I was wondering if you had any luck with finding somewhere that does natural ivf?
I've just finished my 9th conventional ivf with no blastocysts forming and was wondering on my last go is natural ivf worth it more than another round of the same thing.

To give a brief overview:
34, low AMH, unexplained fertility. Did ovarian PRP a few months ago but it hasn't made any difference to this cycle.
I had a little boy on my second attempt 4 years ago. And since then have done 7 further attempts with no success. All high dose 375iu ovaleap on long protocol.

@Sunflower360 Hi - I've also been recommended the same treatment plan as you by Create in Wimbledon.
Can I ask if you did all egg collections back to back? (I'm not actually sure if this is possible! we've only just had our treatment plan through) And how long did the whole process take from the first collection to transfer? Can you do them back to back? Sorry lots of questions, i hope you don't mind!

@Ru19 no problem. I did back to back with natural modified as that is possible but if you respond really well i.e. produce more than 3 eggs then it may be best to have a month break between each. I ended up going back to back for the first 2 cycles and then had to abandon the 3rd due to low response (likely due to me needing a break) I had a break of 1 month to recommence that 3rd cycle. Reason being I was getting more follicles than is normally expected for natural modified despite my low AMH (I was getting 5-7 follicles of decent size when usually it is meant to be 1-2 follicles). This is why the 3rd cycle ended up as a mild as the response was better than they anticipated. Mild as standard has a 1 month break and its not advised to do back to back

I did however develop a polyp due to my response (high estrogen causes these which makes sense as my estrogen was unusually high due to the stimulation and because I had back to back initially my hormones did not get chance to settle). This delayed things in terms of transfer so after the 3rd collection (when I was due to have my 1st fresh transfer) I had to do a freeze all and sort the polyp out as it can affect implantation. I had a Hysteroscopy a month later privately to sort that out and then had the transfer a month after that.

Inclusive of all egg collections, abandoned cycle, Hysteroscopy from start to first transfer, it took 6 months.

My advice would be to not rush things if you do respond well as there is a risk of polyps which can delay things. Luckily I had private health insurance to cover that Hysteroscopy procedure but if I didn't it would have meant waiting on the NHS list to get it done (not sure how much time that would have added) but if you go private it can cost £3k so it is a sizeable cost. You also want to be physically in the best state to receive the embryo. This was my 3rd transfer before achieving pregnancy, but then that could be genetic issues with the previous embryos as I am 38. 1 in 4 tend to be normal my age which would make sense as I had 4 embryos transferred over the 3 FETs as my last one was a double transfer

I can Recommend create AMH was 4 then dropped to 1.8. I had 4 failed ICSI with one or two poor quality day 2 transfers.

At create natural modified age 36
Cycle 1 - zero fertilisation
Cycle 2 - 1 x day 3 frozen
Cycle 3- 2 x blast

My son was the best quality blast from cycle 2 success on first frozen transfer.

We also had male factor but went on to naturally conceive a lock down baby age 39.

@Sunflower360 sorry for the slow reply, but thank you so much for coming back to me in so much detail. Really good to know regarding the risk of polyps, so will definitely bring it up if i do end up responding well.

Ours/our doctors plan currently is to do 3 back to back, but will be reviewing after each cycle to see if a break is needed. Starting stims next week and feeling both excited and nervous to get started.
Hope all is going well with your pregnancy too - congrats!!

Hey, I have been advised to start a natural modified cycle. Did everyone use tamoxifen on this protocol

thank you

@Cloclo93
Sorry to hear about your situation.

I've had a similar experience. I am 30 with AMH of 5.4.
1st cycle: short protocol with high stims and ICSI. 2 eggs total fertilization failure
2nd cycle: short protocol with high stims and ICSI. 11 eggs (only 3 mature) total fertilization failure

My consultant has told me there is likely a problem with my egg quality with so is hard to hear as I am only 30 and have been taking COQ10 600mg for 6 months.

I'm also looking into private mild IVF, have you managed to get seen yet?x

@Sunflower360
Hi sorry to jump on your post!

So sorry to hear about your poor experience with high stims.
I am 30 with AMH 5.4 and had 2 NHS short protocol high stims cycles with total fertilization failure with ICSI both times. They have said they will do 1 last round but try long protocol but have fully advised they don't think it will work and to not bother going private.

My consultant has told me that low stims won't produce enough eggs and said there must be issues with my egg quality which is so hard to hear but reading your post has given me so much hope.

Can I please ask how you have found create to deal with as I've been looking into booking a consultation with them. Do they have much of a waiting list and are they easy to contact etc.? Just our nearest Create clinic is Leeds which is 1.5 hours away so it's going to be a hassle if we do go down this route but hopefully will be worth it

Thanks in advance :)

I had one cycle of mild IVF after 3 failed conventional rounds with a quality problem. The difference was night and day in terms of fertilisation rate (from 20% to 100%) and I had 3 high quality embryos and two babies (not at the same time).

@WokeMarxistPope
Hi sorry to jump on your reply

That's great to hear that mild worked for you :) My (NHS) consultant keeps telling me that mild won't get enough eggs.

Would you mind if I asked what your AMH was and what clinic you went with?

Sorry no idea any more, my youngest is seven. We went abroad but the clinic is no longer there. My AMH was decent for my age I think.
I got exactly the same number of eggs in every cycle, it’s just that the medications were knackering the ones I did get.
The next step would have been natural cycle ivf.

@Catmom25Hi, all went well, not long had DC. So I would strongly advise speaking to Create and see what you think. They specialise in low amh and low stim ivf. Be cautious about their communication though-it is a call centre; its hit and miss and was a lot of chasing/checking but the medical care was good I found and if you get a key contact the admin gets better. I was at the clinic every month for almost a year so I got to know the staff.

Be mindful about travel too... with low stim ivf there can be more monitoring, sometimes I would have 4 scans spread out every other day before an egg collection, just depends how you respond as everyone is different.

@Sunflower360
Thank you so much for your reply

Huge congratulations on DC! Hope you and baby are well.

It's great to know there is hope after failed fertilization. Did they advise you that your failed fertilisation could have been due to stims or could they not say until they saw how you responded to lower doses?

We aren't sure if we should just do 1 cycle to say we've tried incase there is genuinely an issue with my eggs but would you recommend the 3 cycle package? Do they literally just give you back to back stims/ EC/ freeze them them put them back at the end?

Do you know if all the scans are last minute or if they give you a schedule in advance? Are they upfront with all the costs etc. as my initial quote was around 21k for 3 cycle ICSI package and I don't even think that included medication!

@Catmom25They didn't really comment on stims as my high stims cycle was NHS via another hospital. I came to the conclusion I didnt respond well to high stims as I had much better results on lower stims taking a slow and steady approach.

21k should include meds if it's mild IVF, best to double check the invoice as it does break it down

Did create do DET ? When I wanted to do a transfer of 2 they said absolutely no they only wanted to do SET and it would have made the cost so much higher for us ( and I’m 41 so I really argued my case after having 2 failed cycles )

@Catmom25sorry just realised you had other questions. I would suggest 3 cycles mainly as you're embryo banking, you could also PGTA them if you wanted to ensure they were euploid (although euploid still does not guarantee success).

Regarding schedules.....IVF unfortunately very rarely runs to schedules, there can be a curve ball at any point! On some occasions I came in for a scan every other day, on the odd occasion next day if follicles were close to the required measurements....bearing in mind I did natural modified for 2 of cycles so that is closer monitoring and other times there can be 3 days between scans

@Catmom25also back to back is not advised with mild as you need to wait for a period between cycles. So you're looking at every other month for a cycle, bear in mind there could be other delays if your body takes longer to recover or you need further investigations. My advice would be to not necessarily rush it as the i investigations and letting your body rest a but can be beneficial. I ended up with a polyp as I did the stimms quite quick between each collection, that then led to a delay in doing a FET as I needed as a hysteroscopy...so it is worth pacing yourself

@asdreportFirst 2 transfers were single. Create refused my requests for double transfers for the 2nd FET after the 1st failed FET but they did say OK for the 3rd FET which is the transfer my DC was from. They appear very cautious and explained issues could be uterine environment in which case you could lose both embryos regardless of them being normal.

@Sunflower360
Thank you so much for all the time you have taken to help answer those questions :)