IVF or Natural / Natural Modified

[Sian7919]

Hi everyone, unfortunately I just had a failed round of IVF. I had 7 AF and only 3 eggs collected, AMH 3.12. I was hoping for more and previously had a much higher AF count of 14 on a previous scan, so not sure if I just had a lower number that month and it may be higher on another month. I was on Menapur 450IU and Cetrotide. 1 egg fertilised but the shell was damaged and it was not viable. Now we will have to pay and are in the Manchester area.

Does anyone have any advice on whether we should try again with the same regime or try natural IVF. I've heard Create do a package with egg collection and embryo freezing x 3 for approx £10200 for natural modified. We have a consultation next Thurs with St Marys to discuss next steps, but worried they might be too slow and not enough monitoring if we go with them again, as two of my eggs went over before collection.

Any advice, I feel really confused?

Hi all. I’ve been wrestling with this decision having initially had a consultation with Care before speaking to MF a couple of weeks ago. Neither consultant was a fan of the natural/modified thou MF seemed to see merit in the argument. His view was still very much that you should try standard IVF first to see how you respond (it’s a numbers game etc). He seemed to feel that Create had monetised natural IVF too early before the science had been fully explored and there still wasn’t enough evidence.
It’s a minefield! I’m having a couple of monitored Clomid cycles first and then if still no luck will do an IVF cycle with max dose to see what results I get.
It’s an expensive guessing game for sure!!! x

@Kitte321 expensive for sure ! I think that’s the issue . If it was a couple of grand a try It would be no issue to try every suggestion out there , when you only have money for a couple of goes though ..
@Weswoo Best of luck with the transfer 🤞

I had my appointment with Manchester Fertility and I think we will try two rounds with them. I have booked onto the Create webinar for this evening. The Consultant said my chances are only 5%, my partner feels like it's already game over and started talking about donor eggs, but I don't like the idea of it and it's not something I want to even consider right now :(

Hey @Sian7919 - sending hugs. Are you going to do a multi-cycle package (the Access Fertility deal)? I'm just wondering if that's why you've mentioned doing two rounds.

We had our consultation with MF this morning, with a similar outcome. The consultant said our chance is 10% or lower.

Basically, everything is fine EXCEPT my ovarian reserve (my AMH is low, as expected; which correlates with the high FSH and low AFC).

And unfortunately, that's the one thing they can't fix; and also the thing which makes IVF unlikely to work.

Natural conception is still possible, but could take ages - and we don't have the luxury of time. We don't want this to dominate our lives forever. For the same reason, we're keeping it strictly between ourselves.

At present, we think we'll try a round of standard IVF at the start of next year, as a trial to see how my body reacts. Then decide to do either more standard IVF or natural modified. The bottom line is that no one knows for sure how someone will respond to IVF until they try it, as the test results merely give a statistical indication.

It's unlikely we'd do more than three rounds. Probably not more than two, if my body doesn't respond well.

In the meantime, we want to carry on trying naturally (as it's not impossible - and we've only been trying for 9 months) and do a lot of thinking about how MUCH we want this, versus the costs and expense.

They did say I'd have a good chance with donor eggs, as my body seems to be in good shape for carrying a baby (normal womb etc.). But while it's an amazing thing, we don't think we want a baby who's 50% of us, instead of 100% of us. a good chance with donor eggs, as my body seems to be in good shape for carrying a baby (normal womb etc.). But while it's an amazing thing, we don't think we want a baby who's 50% of us, instead of 100% of us.

PS - Weird repetition in that last section there, sorry!

@CC81 thanks for the update and it sounds like a good plan. I think we will go ahead with MF this year, if the first round doesn’t work or has similar results to my nhs funded round I might suggest a more natural approach and see what they say. Otherwise will try Create after the two short protocols. It’s nit just how it physically takes it out of you, it’s more the emotional side of things. It really is a struggle x

@Sian7919 - I agree, I'm wary of putting myself through something that makes me feel dreadful.

Did you make contact with Create? What's your general impression of what they offer? Is there a waiting list?

We're awaiting our results and treatment plan from MF, so we can establish costs etc. Then we'll probably approach Create for a comparison.

Part of me wants to go straight for natural modified, as my cycles are still regular at present and it should be a less invasive process. Then if it doesn't work, 'upgrade' to conventional IVF - but probably only once, just to confirm the predicted poor response.

I wish there weren't so many things to decide! x

Hi @Sian7919, how are you getting on?

And @Weswoo?

@CC81 hey Hun, We haven’t fully decided yet. I don’t know whether to go with MF and do a cycle this month or contact Create and do the three cycle package. I wish I knew. Did you contact Create? Xx

Hi @Sian7919 - I have a scan and consultation with Create next week.

But we're currently at least 60% sure we won't do treatment. It'll be interesting to see if Create convinces us otherwise.

The message we got from Manchester Fertility was that they can try conventional IVF, but our chances are low. It's unlikely they'll get enough eggs (if any!). Plus it's so expensive per cycle (although we're awaiting a quote - did you get one?).

At least with natural modified IVF it's cheaper and you get three 'goes' (three months) for a similar fee, from what I've heard. So three months to see if your body can do better each time.

We can also keep trying naturally. But with all options, with low egg supply there's a higher risk of problems, so I'm bearing that in mind, too.

We were thinking about the access fertility package which is £9250 for us including meds for two goes at MF. I never poked an appointment with Create. Pls let me know how it goes. I thought I had decided but as time has gone on, I have just felt a bit weary and just not sure what to do. Also had another setback with my autoimmune disease and had to come off my meds last week, back on them again but lower dose as of yesterday... so just feeling a bit done in! Also my partner thinks it’s just not going to work and is a waste of money so I feel a bit like if we do it and it doesn’t work I will be blamed, which is shit. Hope your consultation goes well. Let me know how goes will you x

Oh and it was nearly the same price for one go with MF and didn’t cover subsequent frozen transfers so financially access is much, much better X

Hi all, another option to consider is Lister. I had a consult with them yesterday about my case (poor responder and generally everything is a bit weird!!) I let the consultant talk through my case and see what he proposed and he said either the natural modified approach or a flare protocol which uses my own natural hormones. He said he would be in favour of trying flare first and embryo banking with it. Overall I was very impressed with them.

I have a consult with create next week but I am already leaning toward Lister as if we do a cycle of say modified or flare and get nowhere we could then do a normal cycle with same clinic.

Has anyone heard much about them? Not much chat about them on these threads but they seem to be highly regarded.

@Sian7919 - It's such a tough decision. My mind changes daily!

Have you discussed any of this with a fertility counsellor? I've had one session and found it helpful to start sorting my thoughts out.

Re: MF - Really interested to hear that two cycles via Access is below £10k. I wonder if we'll be offered similar. We asked a few medical Qs after our consultation, so once we've got answers we'll be asking for the financials.

I just wonder how refunds work, if both cycles got cancelled for poor response?

Re: Create - Scan and consultation are this week. I'll be glad to get it out of the way! Then we can finalise all our info and make a decision.

I'm also getting my tubes checked by NHS, as it's the only thing remaining. If they're ok, we officially have no physical barriers to natural conception.

Just my pesky low egg supply, which unfortunately makes IVF unlikely to work.

Recently we've been swaying in the direction of doing no treatment. My biggest challenge is that I keep comparing us to other families, which is unhelpful but hard to stop.

@Likeafriendivealwaysknown - Is the Lister a London clinic?

I'm up north (and I think @Sian7919 is too).

Do you also have low ovarian reserve? My AMH is 0.9 and AFC is 5 (on last count). I'm 39.

Hi @CC81 yes it’s in London. I am in Ireland so looking at Uk as a whole.

We decided to go ahead with Lister. I can actually do all scans at a local clinic here and just fly over for egg collection so if you were interested in them you could see if that would work for you too linking in with a local clinic.

I have diminishing ovarian reserve and although my AMH was 23 when we started this 3 years ago it’s now 8 so a big drop and regardless of my AMH I always respond like someone with low AMH getting around 2-4 eggs in each of my 3 cycles. He said I am a complicated case.

I had a consult with create in Manchester too but they said they wouldn’t actually recommend the natural modified for me... said they would recommend a short protocol with low dose Stims of 150. They were very knowledgeable and I was impressed with them but I could get the same as what they were offering from my current Irish clinic so it’s a no go for me. The doctor who did the consult was lovely though.

I’ve heard Lister are experts at low AMH. My sisters friend went into early menopause and her AMH was so low the Irish clinics wouldn’t accept her but she got her baby with Lister. I’m doing the cycle now in about two weeks so I can let you know how I get on if it would be useful.

@Likeafriendivealwaysknown - Yes, it'd be good to hear how you get on, thank you

It's all so complicated! I'm a complete newbie.

So far we've only talked to Manchester Fertility. They basically said 'yeah, you can do IVF, but you probably won't respond well'. No details yet about protocol etc, but I think we'll get that with the costing plan. It's taken AGES - I'm trying not to get cross with them.

My Create scan is today, then consultation tomorrow. It'll be good to get a different view.

I don't think we'd want to travel for treatment. For us, doing IVF would be mostly to tick the box that we've tried, rather than something we expect to work. But also, our first child is a toddler and we don't want IVF to dominate our lives.

There's still a chance we can conceive naturally (though unlikely) - so we may simply leave it up to nature.

It's so hard to decide these things!

@CC81 good luck with create. To be honest if you already have a child I would consider whether to get on the ivf rollercoaster. I come from a big family and always wanted 4 kids but after all we’ve been through so far we now agree if we have one child we will be delighted and would be reluctant to go through it all again for another as it has completely taken over our lives for the past : years!!

Hi all, bit of an update from me!

I'll summarise as neatly as possible, in case it's useful to others (especially @Sian7919).

CREATE

Had my scan and our consultation last week and it was really useful. A three-cycle package of Natural Modified would be £11.7k.

The doctor made me feel SO much better about myself, which in itself was helpful. He pointed out that I have a lot more going for me than not. He used to work in conventional IVF, but stopped because he didn't believe it was right for everyone - simply whipping the body harder to see what it can do.

He explained their approach very clearly and was honest that it won't work miracles - but it might help to speed things along, by making sure that the egg and sperm meet, then seeing what happens, what the quality is like, etc. Rather than simply wondering. But it would only give us a three-month snapshot.

He also emphasised that if I can stop feeling stressed about my low AMH, I may well conceive naturally anyway, as lots of people do (many of whom never know they have a low egg reserve).

MANCHESTER FERTILTY

This clinic has been much slower with the whole process and less reassuring. A single cycle of conventional IVF would be £5.9k, or two cycles via their funding provider (Access) for £9.2k.

Our consultation was more about statistical chances, rather than the approach they'd take and their ethos. We've been given a 10-15% chance and told to expect a poor response to drug stimulation.

They said usually with my test results they wouldn't advise it at all, but as I'm 'young' (39!) and everything else is working, it could be worth a shot.

OR DOING NOTHING

This is our third option. I'm very tempted by it... simply to forget all the clinic stuff, stop feeling stressed and accept what we have. Then we might have natural success anyway, although unlikely.

And honestly, we are happy as a family of three. I think my feelings are confused by all the medical stuff.

But there's that bit of me that would always wonder. I'm hoping my fertility counsellor will help me figure it out...

@CC81 thanks for the update. I’ve decided to go with Create. The 3 cycle package they quoted me was £13500 including meds and the package for bloods/Us. Did yours include that as it’s a bit different in price. Good luck in whatever decision you make x

@Sian7919 - Good to hear you've made a decision - good luck. Did you speak to Dr Tamar Nafee at Create? We need to take a closer look at the details. We decided to take a step back for a couple of months to let everything sink in properly, then will make a decision next year.

@Skdims3 - Did you have a bad experience with Create? If so, which branch? London? We've had a good impression of the Manchester one (and have seen good reports about Birmingham).

@Skdims3 just looking into create now , what was your issue with them ? Thanks x

@CC81I spoke with Dr Lamiya.