Low dose IVF - any experience?

[Scottishgirl85]

I'm about to embark on IVF treatment abroad (Reprofit) for severe MFI. We're awaiting the protocol from the clinic, and I have asked them about low dose/low stimulation IVF. They have the option available and aim to colect 2-6 eggs, I'm waiting to hear their thoughts on this for our specific situation. I just wondered in the meantime if anyone has any experience of this? From Reprofit results, success rate for standard IVF is up to 40% per cycle, low dose is 25-35%, so I'd be reducing our chances, but I'm starting to worry about long-term health implications of high dose hormones. I guess I'm just getting cold feet as the cycle approaches...

For info, I'm 31, checked out ok and have had a previous (miracle) baby. So our issue is just severe MFI.

Thanks in advance for any experience shared.

Hi OP. Have you asked the doctors about these long-term health impacts? I'm just about to start IVF and they can dose me up all they like as long as I get a child. They wouldn't be able to do IVF if it had serious health implications. A friend has had IVF and she's very healthy. If your on high dose of hormones indefinitely but IVF is for 6 weeks on the long protocol. IMO if your desperate for another child, do it. If your paying privately I wouldn't reduce your chances over ifs and buts

Hi OP, I have been in your position, got cold feet many times about 'all the drugs' however after going round in circles a few times, I have just had my first round of IVF and I'm pretty glad I didn't go for the low dose option. We have male factor too and I needed all the eggs they could get! They collected 14 eggs, 9 of which fertilised but by the time we got to day 5 we only had 4 embryos left. I've got a feeling this would have been a lot lower if we'd only had a few eggs in the first place. We were told before we started our cycle that in normal ivf you would expect about 50% of the eggs collected to fertilise but with male factor to expect it to be more like a third. Our cycle unfortunately didn't work, they put two of the embryos back as they advised that due to high sperm DNA fragmentation, there would be a higher chance of the embryos being chromosmally abnormal. Unfortunately neither of ours made it but we have 2 frozen for another go later in the year.

I don't mean to try and put you off low dose if that's what you want to do, but you may find you need more rounds on a low dose and therefore will end up exposing yourself to the same amount of drugs in the long term anyway.

The high dose drugs also bothered me, OP. I ended up doing two natural and two mild ivf cycles to get our daughter.

My cycles went

Natural, 2 eggs, 1 mature, 1 embryo for transfer, pregnant but miscarried
Started natural cycle but added in low dose stims as first scan showed multiple follicles trying to grow, 3 eggs, 2 low quality embryos for transfer, bfn
Natural, 1 egg, 1 embryo back, bfn
Mild stims, 4 eggs but only 1 slow dividing embryo to go back, bfp - now a toddler

We went with Create, which specialises in these types of cycles.

Thank you for your helpful replies.

Closephine - I'm a lurker on a few of the threads on this board (too scared to join properly), and was absolutely gutted to read that your cycle didn't work. Keeping everything crossed for you. I'm leaning towards your way of thinking that if I want the best chance of it working, then we need more eggs, rather than doing low stim and having to do multiple rounds perhaps.

Eurochick - You're helping me to sway the other way again as you had success on low stim! Although I'm keen to avoid multiple rounds as we're going abroad for treatment and I think I'll quickly run out of holiday allowance taking a week each time!

I have no idea how I'm going to decide. Should hear back about my protocol this week and the doctor at the clinic is aware that I'm nervous about high dose hormones. Maybe they could do me a mid-dose protocol!

Thanks again, it's given me food for thought...

Hi Scottishgirl. I am in exactly the same boat. I've been dithering for the last few months between normal IVF with CRGH or mild stimulation with Create or just keeping on trying naturally. We've been TTC since November 2015 - no fertility issues identified other than age (I am 40 and DH is 47) and we both have 2 kids each from previous marriages. We've done 5 IUIs with CRGH (3 unmedicated and 2 medicated) which seem to have been a waste of time and next step is IVF. Just can't bring myself to take the plunge.

I've compared what would happen at both CRGH and Create as some threads on here suggested that Create would give same level of drugs as normal IVF but just do a short protocol. From what I have gleaned, they don't - the drugs at Create would be the dosage and they aim for around 8 eggs whereas CRGH aim for far more. I hate the idea of loads of drugs and have been trying to persuade my consultant at CRGH to give me fewer but he won't - in his words "either you stiumulate or you don't". The success rate (LBR) for my age at CRGH is 23% and only 14% at Create so I guess that really speaks for itself. Not sure it's worth all the upset and hassle for only 14%. That said, i am just not convinced IVF is safe. I've read as much as I can and they cannot rule out that it increases the risk of ovarian cancer by a small but insignificant amount. I've just had a cancer scare and would hate to have another one and then the added torture that i had increased my risks. I don't think it's to be taken lightly. That said, I think with Create you could end up doing a lot of cycles to get the same result so you may end up with the same, or more drugs, anyway.

Keep us posted and good luck!

Sorry, littered with typos. I meant to say the dosage at Create seems to be half the amount that CRGH give you. So there is a marked difference.

I also can't get Create to return any of my calls so the decision may have been made for me!

I think I've chickened out... Got my low dose protocol from the clinic, drug quotes coming in at £170 so very tempting! But can't shake the feeling we wouldn't be giving it our all. So asked clinic for a standard protocol and received it today. Now to decide which drugs to order! Clinic are leaving it up to me to decide. I'm trying to stay removed from it all. I'm a pharmacologist and hubby is a cancer research scientist, so we naturally over research things and delve in to the science and health risks! Thinking we're going to give it our all and go standard dose, although the clinic success rates for low dose are actually very good. I'm just blocking out the risks tbh. The risk to my mental health if I don't go through with it is far greater. Whatever we decide we're starting in may, which is approaching faster than I'd hoped! Loads of good luck to you xx

Crikey, had my consultation yesterday to start my preparation month and went through what happens after embryo transfer. Apparently it's pregosterone 4 different ways (2 lots of pessaries and 2 injections, one with a massive needle in the bum!). Told the nurse I had to think about it. Does anyone know if this much progesterone is definitely necessary? Really not sure if I can go ahead.