Questions to ask at initial IVF consultation?

[CC81]

We have our first consultation with our private clinic next week and I'm SCARED TO DEATH about it. It's via video call, due to coronavirus, so I want to make sure we don't mess it up and waste the opportunity.

What questions would you advise that we ask?

Our clinic offers both standard IVF and natural modified.

We've both had tests done - we know some results already, but not all. My FSH and follicle count suggested I have a low egg supply, but no other problems. I ovulate monthly and have no abnormalities. Awaiting AMH, but expecting it to be low. My husband's SA is normal.

I reckon the doctor will say to us either:

1. Your egg supply is crap and your results suggest it isn't worth bothering with IVF. Or:
2. You have a low egg supply, so you'd better crack on with IVF ASAP - but the chances of it working are super-small.

Either way, it'll probably make me feel crap - but I want to make sure we have the right information to make a decision about next steps.

For context: I'm nearly 39 and we have one child already, conceived naturally three years ago (straight away). For all I know, I may have had low egg supply then, too (as apparently it doesn't mean much for natural conception - but it's not ideal for IVF).

Hi, I'd be very interested to hear people's suggestions on this too. I have low AMH and had my consultation over the phone last week. Was not ideal. Feel like i was in shock due to my low AMH that I didn't ask any important questions. They told me to start IVF but when I got of the phone and started googling AMH I found out it is not good for IVF. So i was very confused. I have told myself that it only takes one good egg and one good sperm and they wouldn't recommend it if there was no chance of it working.

My plan is to try regular IVF on my NHS covered cycle and then depending how i respond to that first cycle potentially go private for natural or natural modified. I have heard some good things about CARE Fertility for women with low egg supply.

I hope your consultation goes well!

Hi @Jane1284 :)

I've had a similar experience to you, so far. Google can be very intimidating! But I can't ignore what it revealed. The important thing, as you say, is to remember that it only takes one good egg! So low supply isn't necessarily the deciding factor.

My NHS results showed high FSH, and then a private scan showed a low antral follicle count - both of which generated doom-and-gloom Google results - so I'm expecting my AMH to be low (we'll find out at the consultation). And also for them to tell me that my chances are limited.

The high FSH was a shock and it's taken me weeks to come to terms with it. My other results have all been normal (I still apparently ovulate monthly) and my scan showed that my womb is normal, with no problems.

I'm not eligible for NHS IVF, as we already have one child - hence going straight to private. So we may have a big financial decision to make very soon! It's so bloody stressful.

Google can find you multiple answers to the same question. It's so hard to know what is right sometimes!

Sounds like we are in a similar boat. I ovulate monthly and my womb is normal. I haven't had a FSH test. No idea why. But my AFC was very low so can imagine my FSH would be rubbish too. With my low AMH and low AFC I am not sure how IVF will go for me. They still seemed to think they could get some eggs so we will see. Hoping the eggs they get are good quality but I guess I won't know until I try.

I understand how much of a shock it can be. I am still processing it. My older sister is currently pregnant with her second and conceived twice immediately. So to find out i have a dwindling supply of eggs and need IVF ASAP was a slap to the face.

Good luck with your decision making. I'd be interested to hear what clinic you decide. If you conceived straight away 3 years ago your eggs sound like they were in great shape. Hopefully your eggs are still in good shape and you can conceive naturally!

Further confusion for me!

I've been referred to the NHS Fertility team (even though I can't get IVF on the NHS, due to having a child already).

Had my consultation today and they said that while I don't appear to have any other problems, my high FSH (which usually correlates with low AMH) means I wouldn't be a great candidate for IVF - which is what I suspected.

However, they said it's important to discuss it with a private clinic, as they're the experts and deal with lots of people with low ovarian reserve.

She also agreed with what my GP has said, which is that low ovarian reserve doesn't necessarily stop natural conception - it's just a bit problematic for IVF.

But also that until you try IVF, you don't know, because everyone responds differently. The tests beforehand are simply an indication of how you MIGHT respond. Not a guarantee either way.

So... it WAS helpful to speak to them, because I now feel better-prepared (mentally) for the private consultation on Tuesday. But also unsure if I want to undergo the expense and stress of IVF if I'm not a good candidate for it.

@Jane1284 - Are you trying to conceive your first child? What's your age, if you don't mind me asking?

Glad it was helpful! It's good to get some info and start thinking about it even if you're still getting your head around it all. Have you done any research on potential private clinics that are aimed at women with lower egg reserves? If you look at Care Fertility they say there is no cut-off point for AMH or FSH results. My plan is to see how IVF goes with Kings and then potentially go to them if i do not respond.

I am 35 and trying to conceive my first child. Looking like I will be starting my first IVF cycle in November all going to plan. I initially wanted to keep trying naturally but decided it was worth seeing how i responded to the IVF treatment sooner rather than later.

I hope Tuesday goes well and you have some more clarity!

Hi OP. Did you get your AMH result? If it is above the cut off point (which I think is 12) look at ABC IVF. They offer low cost IVF (£2.5k a round) if you meet the criteria. They use low dose drugs which tends to be better I believe for those who may respond poorly to traditional IVF. If not, I agree with the suggestion of Create and natural/modified IVF. Best of luck! X

ABC IVF don't take anyone over 37 but yes they look like an option for people who do fit their criteria.

@CC81 people can be an excellent or a terrible candidate for IVF on paper and then respond in a completely opposite way to what is expected, you really won't know until you try.

Ah yes of course, sorry!

Hi @lawandgin - thanks for your reply, but unfortunately I'm nearly 39!

My AMH is rubbish (low egg supply), so I'm not an ideal candidate for IVF.

It's frustrating, as physically (internally) I'm fine - everything is normal and works the way it's supposed to.

My first pregnancy was very uncomplicated! We may decide to accept being a single-child family, rather than go through the stress, expense and medical discomfort of IVF. But it's such a tough choice!

Quick update to this thread - we ended up conceiving naturally, to our shock!

Story here: www.mumsnet.com/Talk/infertility/4290062-Update-Low-AMH-success-story-hope-it-helps