King's IVF vs IUI

[tryingtogetmypercy]

Hey -
We are finally getting traction with King's Fertility after the covid delays. My partner has azoospermia. I've been told to select sperm and then call them when done so to book an appointment for IVF. Im incredibly overwhelmed..

I don't know why IUI hasn't been suggested as an option for us. (32, PCOS, but regular periods and okay FSH and LH levels).

We have not had a great experience with Kings', and I know if I call back tomorrow to ask the millions of questions I have about IUI and sperm donation, that I won't be able to speak to a doctor for a couple of weeks.

Has anyone has experience with sperm donation and IUI or IVF at Kings?

Thanks x

I am going with Kings at the moment. We had our initial consultation with blood test and scan and talked about iui and IVF. We were there for about an hour and the doctor had plenty of time to talk. Have you had that consultation yet? We did that before looking at sperm.

@Zibidee Thanks for replying. Yeah I have had a few consultations because we have been with them for a year whilst waiting for my partners microTESE. Doctor called last week and was not forthcoming with any info about IVF, I felt I needed to ask all the questions. Just disappointing really. Then get an email from them saying go and get sperm and let us know when you have. Maybe that's just their normal process and I am finding it too overwhelming.
Are you NHS or private?
Would you be happy to chat privately about the sperm selection process and all the feelings around that?

I'm with Kings too for iui with a donor. Just starting our second cycle. Finding a donor was definitely overwhelming. Have you seen a counsellor yet?

Hey @Okdaisy. We are seeing a counsellor next Wednesday which I’m think will help a lot. Just so many feelings around it, mainly around the future.
How long did it take you to find a donor?
Fingers crossed for your second cycle 🤞

@tryingtogetmypercy that's good your talking to a counsellor. Hopefully that will help, we definitely found it helpful. To be honest it didn't take us long at all to decide. We wanted a donor similar to my husband, so by the time we'd narrowed the potential donors down there were something like 4 to choose from. So it was pretty limited choice which probably made it easier! There was one who ticked the boxes and we were both happy with. Good luck with it.

@tryingtogetmypercy good luck with your meetings. I do t have experience of Kings, but IVF has a much higher success rate compared with IUI. Personally I'm going for iui as it is less invasive and I have no fertility issues, although high AMH. Odds are still only 20% for ivf think the odds are closer to 50% that may be why they have suggested straight to ivf for you?

Also with choosing a donor, look also at out of stock ones. My donor bank is ESB they are really helpful in chat and can tell you if a specific donor will be back in stock soon or when a donor that meets your criteria may be in stock. There is a bit of a shortage at the moment, so I would look and order sperm asap, even if you haven't decided between ivf and iui, you can normally get it stored at the bank and ESB gives 14 days free cancellation.

Hope all goes well for you and your husband.

After a consultation this week with King's, they are now saying that even though I don't have any fertility problems, because of my age (39) they recommend going straight for IVF instead of IUI.
They said the success rate at my age for IUI is only 10% and for IVF around 30%.
If that similar to what you have been told?
The first doctor we said said IUI was worth doing, so now very confused.

Also I am very confused about the order of events to start treatment. The guy from Embryology has given me one version, the doctor another, and a different doctor, another again!

This is what the embryology guy, Jose said:

Purchase treatment cycle
Have implications counselling (he says this is a requirement, but the doctor says it isn't)
Inform Jose we are ready to order sperm and give info on the bank and donor being ordered.
Order sperm, the bank will then coordinate with Jose for importation.
Nurse consent appointment
Book appointment to start treatment (at what point of the cycle do we do this?)

The doctor says we should order sperm now ad that bit takes the longest but Jose says you can't order sperm until you've purchase a cycle and had implications counselling.

I would've thought consents should happen first before anything else.

confused!

Implications counselling is essential so I'd definitely do that first. We did that once we had agreed the treatment plan (we hadn't actually paid anything or officially bought a cycle of treatment). You could start looking at donors at the same time, as that decision is something you could discuss with the counsellor. After that we ordered the sperm and the rest just followed from there. Once it arrived at the clinic they got us booked in for the consent appointments etc. Consents are done just before each cycle I think so are done quite late on. So I'd just take it once step at a time and concentrate on the counselling. The counsellor we saw was familiar with the Kings processes too so hopefully you'll find that helpful if you are feeling confused or overwhelmed. Good luck with it

@Zibidee Heya - so I was in the place you are when I started this thread and was totally overwhelmed because of the different info I had received from Jose vs the doctor.
Now I am all settled with it and this is the process I have completed. (I'm on NHS, so this might be different for private)

Firstly we had to decide for ourselves whether we have IVF or IUI. The doctor will not make this decision for you, unless there are medical reasons you cannot have one or the other. I'm 32 and have decided to go straight for IVF, mainly because of the success rates and the cost of sperm vials.

Next, choose sperm donor from the banks on the email Jose would have sent you, the more you look the more simpler this process will be in your mind until you find the one. (when I first looked I had no clue what I was supposed to be doing, but it got easier). Once you put in filters such as 'UK', 'ethnicity', 'MOT20' (or whatever MOT you need) you will be left with very few donors if any from each bank.

Book the counselling at the same time as you are doing the above process (choosing donor), neither one has to come first. This is a requirement by King's, they go through a form with you which King's require. I went with Claude Rennert who we found wonderful (but I'm sure the other two are just as good).

Once your sperm is chosen then drop Jose a message to let him know to expect your bank to be in contact with him. Im using Xytex USA and they have been brilliant. I nudge Jose and Xytex from time to time to check that the process of paperwork is happening.

If you haven't been booked in already, call King's and book your blood test and your nurse consultation. (My doctor told me he would arrange for these to be booked in, that never happened, so I called up and Oliver booked them for me there and then). The sperm has to be at King's before you have your nurse consultation. My nurse consultation is at the end of this month, but my sperm has not been shipped to King's yet as I only purchase a couple of weeks ago, however I will be chasing the bank and Jose to make sure that it is shipped in time (It takes 2 days to ship and the paperwork process takes about two weeks).

The nurse consultation is to run through the treatment plan, the timings, when to book appointment to start treatment etc.

What I am saying above, might not be fact, but that's what the process has been for me, and is someone had told me this a month ago, I would have been in a lot better mental place than I was when I first started.

Feel free to PM me if you have any questions. Good luck! x

@tryingtogetmypercy that is really helpful, thank you!
They really need a treatment coordinator who figures out the order of things and takes you through it all! The amount i'm paying for private they could easily afford to hire one!

So did you have a choice of counsellors? How did you book that, through admin? I don't have any issues around sperm donors, we are a lesbian couple so we need it and I think I fully understand all the legalities around it. But if its a requirement I guess we should just get on with it.

I was hoping to be ready for mid June ovulation but now that seems a bit unachievable. What do you think?

@Zibidee I totally agree. Helpful tip, if when you call and Oliver answers, then you are onto a winner. If he doesn’t know the answer he makes sure you get an answer.

I would totally be put off Kings if I had to go private (but hopefully my one chance on the NHS is a success)

You have to choose between the 3 counsellors they have. They might be on their website, or call on Monday and they will send the details to you. You just choose one and call them up and book (and mention you are from Kings). It’s a little different for you then as you always knew you would need a sperm donor, where as ours was a shock and so counselling really helped.
You get the counselling as part of you NHS or private package.

You start treatment on day 1 or 2 of your cycle, so I guess for you that would be early June if you are ovulating mid June. I don’t think you will make that, unless you found a sperm donor in the next day or two and Kings process the paperwork efficiently. But you know what they are like..

Yes I had doubts about using Kings but they had one of the best reviews on the HFEA website and they were considerably cheaper than the other few clinics with good reviews. Plus very near to my work and home which I thought would make treatment easier. So I will persevere.
Onto lots of phone calls tomorrow then!

For having rushed into IVF (1.5 years without conceiving, 2 cycles IVF failed) and then getting pregnant naturally 3 times I really recommend exploring all options before IVF. The probability metric always felt like a marketing tool for me which made it so much harder when it failed. IVF was incredibly difficult and I think I am pretty resilient in general. of course it is personal and this is only my point of view and advice I would have given myself.

@Steeeevie that’s so great! Wonderful to hear. Did you have a partner with azoospermia or is yours a different story?

@tryingtogetmypercy yes he did, can't remember the figures but they were very low. No room for misinterpretation.

@Steeeevie do you mind me asking..so he was diagnosed with azoospermia and told he wouldn’t be able to have genetic children, and then it just happened one day? Did you do any other treatment? Acupuncture or anything?

@tryingtogetmypercy yes definitely treatments (medication) to improve sperm count. Diet as well. Other than that not really. I do think the medication I was on for IVF really stimulated my ovaries as well.

They never said he couldn't have genetic children but said should go straight to IVF.

We are starting IVF with donor sperm soon. The sperm is in the clinic and I have the consents appointment with the nurse booked for next week. But I feel like so far, we have been given lots of conflicting info about the order of things, lots of delays, despite paying privately, and now, even though I have had 2 scans already to check everything is in working order, I now have to have another scan to check again at the start of the cycle.
Is that similar to other's experiences?
We went with kings because of high ratings on the hfea website, plus they are very near home and my work for ease of appointments. But definitely not happy with the service so far.

And today discovered the baseline scan was booked in on the wrong day of my cycle. Plus the doctor had made decisions about the amount of medications without any discussion or our agreement. Furious with Kings! But no choice but to carry on with them no we have paid for everything.
Just trying to keep the bigger picture in my mind.

I had 2 cycles of ivf with donor sperm on NHS- husband also azoospermic. I’d had iui with donor sperm and fallen pregnant but miscarried. Never worked again and ivf at kings didn’t work for us either so we moved on to double donation and have a son now.