Different clinics - whats the real difference?

[Fishface199]

I am all in a tizz and would appreciate advice from ladies who have cycled with different clinics.

I am about to embark on my first IVF. I am 40 and been told IVF would be best after one mc and 6 months of ttc would no luck. However my DH insists we should go to a local clinic (less hassle and so he can support me and attend all appointments). But the problem is my local clinic has a poor success rate for my age group (12%). I worked out 3 cycles would only give me slightly better odds than 5 cycles of trying naturally (5%) as both would take the same amount of time.

I don't think I could afford ARGC but am looking at clinics elsewhere where the success is more 17% and 3 cycles would lead to a much higher cumulative success rate.

However I have received advice that your first cycle is always a trial (seeing how you respond ) so you can try first in a local clinic and then if unsuccessful move on.

Also some ppl have suggested that ARGC aside, most clinics have very similar protocols and similar success rates which vary according to individual differences.

I am confused and flitting from wanting to go to London to the best clinics I can find, to thinking that trying naturally would be less stressful!

Any advice would be appreciated!

You don't have time on your side so my advice would be go to the best place you can afford and go there for your first round.
I personally did one nhs cycle which was a total bomb and then moved to argc - now have twins from a frozen cycle after miscarriage from the fresh cycle. Other clinics that tailor to your needs are zita west (dr George) and crgh I don't know anything about them but someone will come along and advise. I'm also think they are a lot less expensive than argc.

How far are you from London?
It is a tricky one. Those few percent do seem a lot when you cumulate them. But the thing is, you have your own personal chance of achieving a pregnancy. Each clinic's % rate is made up of the people that sadly only have a 1 or 2% chance each cycle, and those that have a 25 or 30% chance and have just been super unlucky so far (or have a problem that is totally fixed by IVF, like blocked tubes and no other issues). It might be that your personal chance is not affected much by which clinic you go to. But it might be, if ARGC offers something that your local clinic does not.

Yes I agree about the first cycle. Both clinics would be working off exactly the same info so going local for the first one could be a good plan.

Don't underestimate the benefits of having your cycle locally, especially for a fresh cycle. It is great having your partner there for support for some of the appointments. it also means less time off work if that is an issue; an hour maybe for a scan as opposed to a whole or half day. Plus some of the appointments have to be moved around sometimes at the last minute so can play havoc with work. When we had our fresh cycle we lived about 30-40 min drive away from our clinic (an hour in rush hour), which I thought was pretty good; we've since moved and now our clinic is 8 mins drive from home, and directly on my route to work too, so it is ridiculously convenient and that has really contributed to us being able to have 4 FETs since August!

oh FYI, Excel tells me that 3 cycles at 12% success rate gives you a 31.8% probability of success, 5 cycles at 5% gives you a 22.6% chance. So I would say that is a noticeable increase. And actually, your personal success rate at IVF will probably increase slightly for each cycle as you learn more, whereas it won't for just bashing away naturally :-)

Oh another thing is, remember the % success cover everyone who starts a cycle. Unfortunately some cycles are abandoned at each stage of the process which is awful, of course; however if you do manage to jump each hurdle then your % success is going up at each step. As an example I was 32 when we did ours and my age range had a 33% success rate IIRC; we were very lucky with our treatment and by the time we got to embryo transfer with a single 5 day blastocyst our consultant quoted us a 60% chance of success (it did work :-). On the other hand, the % rates given are for achieving clinical pregnancy (a heartbeat at 7 weeks) and of course some people who get a BFP will get bad news at the viability scan.

if I were you (and I'm not!), I think I would probably go local for the first one. after that you will have a much better idea of what the cycles entail and whether you can manage it long distance with work and everything. Are you going to go through the NHS or self fund?

Hi, due to my age I was told NHS would not fund, so its self funded.

I live about 1.5 hrs away from London by train luckily I live near a station. Door to door probably be 2 hours.

I've turned into a mathematician overnight, all these probabilities! I know the London clinic I am interested in is about 80% more expensive than my local clinic price and treats many more women (about 400 as opposed to 60) and many women with low AMH too.

Local clinic was very positive about my odds (perhaps too positive) but part of me thinks cos of my fairly limited fertility history both will have fairly standard protocols for my first round.

Thanks Moggle for your number crunching!!

Well I am ready to be carted off! More confusions!

Found another London clinic with a success rate of 22% (CRGH). But also found clinics under the same banner "Care...." with wildly differing results across the country (from 10% to 30% in my age group).

Am feeling a more nutty than a bag of KPs.

i went locally as thought easier ,after2failed we went abroad,so def more travel

but higher sucess rate and 5th ivf =my5w daughter snoring in the corner of the room

Congratulations Blondes! I was a longtime lurker and have been following your story! What a lovely lovely conclusion!

Thank you @fishface

Hope you get success

And totally understand the sc

That when our ivf failed df was still a dad

We're only about to have our first cycle and spent ages considering the pros and cons of different clinics in the UK and abroad. On the ARGC front, I found that they seem to have a lot of twin pregnancies suggesting to me that some of their high success rates are down to putting 2 embryos back a lot more often than others. I also found them very impersonal. Going abroad I would find too stressful for me, and the most local clinics seemed to have poor success rates. In the end, we've decided to go with Zita West - so far they have been professional and friendly + we've received excellent nutrition advice. I find the clinic a pleasant environment to be in and combined with the holistic approach and high success rates it was the best choice for us. We didn't really think about money too much - we figured that 1-2 cycles with excellent rates will still be less of a financial, emotional and health burden than a lot more cycles in a less successful clinic. Also, my little sister is just studying medicine and has done some research for me - e.g. The solution that embryos are put it can have a huge impact - in some solutions, 25% fewer embryos make it to blasts than in others... We figured we didn't want to take risks with a clinic that seem to have been getting a lot wrong and having poor success rates.

I have to add about ARGC they do have good success rates but are picky about their patients. Not only about FSH but my friend has a heart murmur and they refused to treat her but Zita West did.

I have stumbled on a few real surprises Care Sheffield don't treat too many patients but have a brilliant success rate for ladies over 40! Its a real learning curve!

I always wonder what the success rates really mean as the clinc we used for ivf markets heavily to lesbians, who have a much better success rate as they don't necessarily have fertility problems and use optimized donor sperm. Their success rates are super high, but if you aren't exactly the same as the other patients, they might not give you much information about your chances.

It all depends on you. Are you using your own fresh eggs or frozen? Do you have a problem with your eggs/dh's sperm? Donor eggs? Donor sperm?

Women without fertility problems who use fresh donor eggs/sperm often have a better chance of producing a live baby than anyone else, regardless of age. You really have to go through the numbers and see if it's worthwhile for you.

Thats a very good point James.

My colleague has an AMH OF 22.1 as she was nearing 40, this was an excellent reserve. Yet her clinic recommended IVF, not IUI at first or any other treatment. She was single so was not like she had any fertility problem. IVF worked and she has a beautiful daughter. But I did think perhaps she may not have needed it and she went through such expense to help bump up their figures. Maybe I am being cynical.

I will be planning to use my own eggs.

I wonder if with your friend, it could be the case that given her age, the clinic suspected a lot of the eggs might not be great and decided she had a better chance if they retrieved a few rather than trying IUI which is only marginally better than trying naturally...

It may have been the case because of her age but I did wonder if they could have offered alternatives (I know they suggested IVF even before her AMH was known). But either way it worked so I suppose they did get it right!

The stats should show

Own eggs fresh
Own eggs frozen
Donor eggs fresh
Donor egg frozen

And then the above 4 in age groups

Plus then have stats for preg

And live births

The live birth is Obv a lot lower :(

Where do they have pregnancy stats on the HFEA site Blondes?

My advice, in principle, would be to consider how much success means to you and your DH, and agree whether you're going to throw whatever it takes at it. Without knowing what your fertility issue(s) is of course i'm generalising wildly, but at 40 you don't really have time for a half-hearted approach.

I was in a similar situation to you, in being 40 and my OH wanting to go self-funded at the local NHS unit. (Reasons of cost and he wanted to help fund public-sector research.) Being told there was a 10-week wait for a routine pre-treatment scan, and their poor results, changed our minds.
After unsuccessful treatment at a satellite dr (whose main service was not fertility treatment) attached to one of the 'big-name' providers, we went to the Lister. This is actually quite well-known for treating older women. They do have someone who specialises in immunes etc problems, but certainly don't ram the gamut at you as routine (we only found out by chance - be warned that each consultant IME tends to act fairly independently, with their own ideas).

The reason I say "in principle " is that our circs (OH retired, me fairly flexible job, live in london), meant that the london clinics were our local ones. There were also times I might have quite welcomed doing the consultation by myself (DP is forthright but not always knowledgeable .) Realise of course that each person's situation is different.

Lister was actually the clinic I was thinking of in London.
Seeing how consultants move from clinic to clinic does make me think how much difference there will be in service. I have found a big name clinic with a satellite in my city I may try that for my first go. They seem to have better success rates than the local clinic but satellites I presume have their own issues!

This is really interesting to me and am struggling with a similar decision. We've had 3 failed rounds with Guys. Donor sperm but am a poor responder with lowish AMH. We've pretty much decided on one more round and no more but can't decide between Guys (who are lovely but don't really seem to have a plan beyond 'try again') or trying Lister who I think have an outpost near where I work but am not sure about doing one round only with them. The ability to do appointments without taking official time off work is really important but not quite as important as succeeding- no idea what to do at the moment!

Try this link and put in your clinic

guide.hfea.gov.uk/guide/SuccessRate.aspx?code=88&s=l&&nav=2

Scroll down to the bottom and will say stats and live births etc

guide.hfea.gov.uk/guide/HeadlineData.aspx?code=88&s=l&&nav=2&rate=i&rate_sub=FSO

Hopefully this will work

You literally have to put in clinic and then scroll to bottom and put in stats of age - if own eggs - etc