Questions from an IVF newbie

[lostindreams]

Just had a fertility check up and waiting for my first consultation to explain the results which won't be for another two weeks. Have started reading up on the IVF process but it's all very confusing!

• How long do all the pre-treatment tests take? Have already done a blood test for my AMH and an ultrasound scan.
• For the STD check ups, can you do those via the NHS and give them the results?
• I have irregular periods - they're everymonth but the date it starts always changes, could be a few days early or late. In thatcase, will I be more likely to be put on the pill so they can control when my period starts? How long will this be for? 2 weeks or a month? And does that mean I can start taking the pill to suppress my natural cycle whenever I'm ready to start treatment?
• In terms of the time scale for fresh v frozen embryo transfers, what day of the cycle do these happen?
• Am I more likely to be told to go for frozen as I'm over 40?

Lots of questions! Any info would be much appreciated. Thank you.

I’ll number the questions to make it easier and I’m guessing you are a private patient so things might be different if I have made a wrong assumption there. 1. I’m afraid it’s variable (especially at the moment) and depends on what clinic you are with but sounds like your partner still needs a semen analysis done before you move on to the next stage.

1. I’m not sure but I would assume so. Another question for the clinic on whether they would accept them but I think the nhs would allow you to do tests with them.
2. I had super irregular periods like 2 in a month then none for 6 months. They put me on either letrozole or norethisterone. I have also had metformin and menopur. There are a lot of drugs used in ivf unless you go the unmedicated route. They shouldn’t describe what they are putting you on as the pill or contraceptive pill. They don’t do it to control when your period starts but rather to make you bleed or stop your bleeding to get eggs to grow to the right size but also lining to the right thickness. How long each med is taken will be based on your assigned protocol ( most common are long and short variant 1 but there are lots of these protocols) and you shouldn’t take things unless advised before your ivf to suppress a cycle but again you could ask them. There are lots of scans and bloods done throughout the process and this sometimes means your time of taking any drugs could be extended or cut based on what your body does. Main checkpoints that are cast in stone are phoning on first day of your period (whether natural or forced) and a day 21 blood check.
3. I honestly can’t remember sorry despite having 1 attempted fresh and 3 frozen but the egg collection is what you should think about first. A fresh is normally done 3 to 5 days after the egg collection depending on how well embryos are progressing. A frozen collection may or may not be on the next again cycle depending on what’s happened in your circumstances, so a gap month may be needed to reset.
4. Not sure as not in that age bracket but it would remove the issue about potential OHSS which would be more worrying the older you get

1 - not that long unlike on the NHS you can get them all done at the same time whereas the NHS often does them separately

2 - yes but depends on when you get them done. I don't actually remember having to have these done for my private clinic. But they expire quite quick I believe

3 - depends how irregular is irregular. Some clinics won't bother with the pill. If you don't have a period at all or there are months in between then that's different and they likely would

4 - fresh and frozen are transferred the same day - ie 3 or 5 days after egg collection or 5 days after you ovulate naturally

5 - not necessarily depends on the clinic - if your embryos don't make blastocyst until day 6 it's better to freeze and then do a day 5 transfer, also if you have OHSS then you'll need to do a frozen transfer

Thank you both for your answers - very helpful.

So the medication to suppress my period, do I start this whenever I'm ready to start treatment or do I have to wait for a certain time after my natural cycle?

Completely depends on the protocol the consultant determines.

I didn't down reg at all (short protocol). I simply rang my clinic the day my period started and went in the next day for a scan and to start injections.

I'm not sure how open evenings run by clinics are being run at the moment, but I can not recommend them highly enough!!

The vast majority of your questions would be answered there or are highly individualised to you and can only be answered by your treatment team.

Thanks physicskate. I've booked myself in for a few virtual open days so hopefully can get some of these answered then. Guess I will just have to wait and see what they say at my first consultation although I don't think I'm going to stay with that clinic for my treatment. Booked and paid for my fertility treatment pre-corona and then everything got delayed.