Clinics in Birmingham

[BmIVF]

Back story - we are a same sex couple with one DC. Both of us have previously had treatment, with Birmingham Women's Hospital, (what was) Midland Fertility in Tamworth and now at Care Birmingham.

The staff at Care are fantastic, particularly the nurses, but we're not that happy with the way they operate - they only do set procedures on set days, scan appointments are often at really inconvenient times so difficult to fit around work, they're so busy that I've been told a few times that they've had to shorten other people's appointments to fit us in, and we're starting to feel a little like they manipulate their patients' bodies to suit their schedule, rather than trying to work with the body to optimise the chances of getting pregnant.

The main problem is we don't know if this is just how things are now with Covid, or if we moved to a different clinic whether we would end up with the same scenario in unfamiliar surroundings. Of course no one advertises these things on their website so it's difficult to know!

In total we've had 12 rounds of treatment (between us), two positive rounds and one live birth so our patience (and money!) is wearing very thin with the whole thing, which absolutely could be colouring our view. This is very likely to be our last round of IVF, so we feel like we need to be sure of our decision.

Does anyone have any experience with any of the other clinics in the area that they'd be happy to share to help us make our decision?

Have you looked at Nurture? Maybe a bit further for you to travel but they have great results.

I'm pregnant with twins via Create (near Birmingham airport)
They start scans at 730am so fitted in around work and did transfers and collection 7 days a week - whatever was needed
They only do short protocol or natural modified IVF though. But I really liked them

I'll check out Nurture, thanks.

@ivfbeenbusy, congratulations on your pregnancy! I'm not sure how much joy I'd have with more natural IVF. I've had an ever increasing amount of drugs after every failed cycle so stripping all that away seems like a strange prospect. Had you had "standard" IVF before you did a natural cycle?

Hi yes the short protocol IVF I did at Create (2 rounds) was pretty much the same level
Of drugs you'd get at any other clinic it's just with short protocol you don't do the down reg part. After 2 cycles and getting rubbish egg quality we took the gamble to rather than increase drug levels to reduce them and go after far fewer eggs - so I did a 3 cycle package of natural modified IVF- my fertilisation rate went from 30% to 100% and in 2 rounds got the same number of blastocysts as the 2 rounds of short protocol IVF but the quality was massively improved and 2 of these blastocysts are my twins with 2 more even higher quality blastocysts still frozen x

Thats really interesting, thank you. My fertilisation rate was low in my most recent cycle so definitely something I'll look into.

There is also the Priory and Coventry Hospital (can't remember the full name of that one). The Coventry one has very good success rates from what I saw online but as is always the case there are lots of bad reviews as well as good ones

Hiya guys,

Hope you don't mind me jumping on the thread, I have a questions for @ivfbeenbusy in particular.

We are awaiting our consultation at create on Monday, we have had our scans and bloods, all is well.

We have had a previously failed cycle at another clinic, and I had two blastos transferred, I believe this was because the blastos started degrading before they transferred them, although I am unclear to be honest.

Unfortunately the failed cycle (in January 2019) put us under huge financial pressure and this cycle at create will likely be our only one. I am 33 but DH is 52, and is concerned to be getting any older and going through the IVF.

Why did create decide on transferring you two blastos? I am eager to have two transferred again as I know the chances of neither becoming a pregnancy are high, although I am aware of the risks and that clinics don't like to transfer two, generally.

I was wondering what reason they transfered two for you and was just trying to gauge if I would be a likely candidate for another double transfer.

Thanks in advance :) and huge congratulations on your pregnancy. I hope it being happy and healthy, x x

@Ultimateblends
Hi there. Ultimately it was my decision to have 2 put back in. There was some debate with Create as to whether I should be allowed but ultimately they agreed on the basis that

• this was my 4th transfer
• I previously did PGS testing and didn't get any normal embryos - I didn't test these final blastocysts but the odds of one of them let alone both of them sticking were really low
• we'd already spent £35k with Create by that point and literally had no money left. I had 4 embryos from a 3 cycle package of natural modified IVF. We couldn't have afforded to do 4 single transfers and mentally I was done. 4 individual transfers would have prolonged the process by almost a year and I was ready to move on with our lives and the constant stress/pressure/drugs/focus being elsewhere was having a detrimental effect on our older DD
• I am (was!) fit and healthy with no underlying medical conditions that would make a twin pregnancy dangerous
• we can financially (just about!) afford to raise twins
• we agreed not to transfer any grade AA blastocysts together so I actually transferred my 2 lowest grades (a day 5 5BA and a day 6 4BB)
• I'd already had both tubes removed due to ruptured ectopic pregnancies (IVF and especially double transfers can increase risk of ectopics)
• age wise I'm 37 - almost impossible to get a double transfer under the age of 35 - most other clinics like Care are absolutely rigid on this and won't entertain it at all if you are not older than 37

So lots of factors really but I did have the support of Create. I had a good relationship with the doctors and embryologists there having been a regular customer through 5 cycles in 18 months which i think made it easier as I wasn't demanding a double transfer on my first cycle.
I did my transfer 2 weeks after the clinics reopened in June so still in the last lockdown. But i known some clinics now have a blanket ban on double transfers due to covid so I don't know if Create have now brought that in?

Not going to lie though a twin pregnancy is physically brutal. Only do a double if you would honestly be prepared for twins (as much as anyone can be). I've pretty much been on sofa/bed rest since 18 weeks pregnant. If I wasn't working from home I'd be stuffed work wise. I can't walk more than about 100 yards or be on my feet long before my hips/pelvis/bump becomes very painful. My resting heart rate has gone from 67 to 90 odd. Just going up the stairs it rockets to 120

It's true when they say twins have an impact on the NHS so they aren't wrong on that if they try to argue that - I have scans sometimes fortnightly. I also almost had to have them out at 28 weeks - luckily they stopped them coming but both my babies are guaranteed to have to go into NICU for several weeks too

You can obviously ask them but be prepared to get a non committal answer back. They will
Most likely want to wait and see what quality of blastocysts you get as the other argument is that you can actually decrease your chance of success by transferring embryos of vastly different quality - mine were very similar and we used the embryoscope so the embryologist reviewed the footage to pair mine up into the 2 most compatible couples

Oh wow @ivfbeenbusy, ghabk you so much for the detailed response, I wasn't even sure you were going to reply at all, so thank you again.

In all honesty, I think the clinic i was with before knew that my blastos had started to collapse and therefore transferred two knowing that they likely wouldn't work, the decision to transfer two came right at the last minute, I mean, lying in the operating table and "would you be ok with a double transfer" of course I said yes.

The only things I can take in similar situation to you is I have no fallopian tubes (2 x ectopic), fit & healthy, financially able to bring up twins,
My grades were similar to your two lowest, when transfered, which is interesting as in reality they could have become a viable pregnancy, I guess i honestly think my old clinic knew they were non-starters, and that's why the last minute decision to place two.
I'm mid 30s, and as the doctor kept reminding me is 'young' in terms of ivf.

In both rounds I have never had any good enough to freeze.

Thank you again for your detailed response, of course the only outcome I really want is a happy, healthy pregnancy. I am just so nervous of another failed round, and im not convinced mild ivf will give us the take home baby we want, when conventional did not, but my DP has alot of faith in this clinic.

The other question I did have on my mind was that is embryoscope worth it? Obviously in your case it must have been. Its an extra £300 and I've been agonising on if this particular add on is worth it in my case.

Lots of 'food for thought' and thank you for the reply, I of course ultimately just want a happy singleton pregnancy, but you have helped me to unravel why I was given a double transfer last time, and the chances of being given another this round, and you obviously know our clinic very well.

@Ultimateblends

No problem - sleepless night last night so was awake early!

For me I started out on short protocol mild IVF with Create and then stripped it back further to do natural modified so for me the fewer eggs we targeted the better the quality was so changing protocol can have a huge difference to the outcome (I would say it's the only thing that really has an effect on egg quality - not supplements or diets or healthy living etc)

For me the embryoscope was worth it as our final 3 cycles was part of the 3 cycle package at Create so banking embryos/blastocysts. The embryoscope information was then invaluable in being able to decide which two of the four to put back together. I think that also made a big difference to both sticking. If you are only doing one round and likely to only get 1-2 blastocysts anyway of which you'd push to put both back then you may think the embryoscope isn't worth it

I did a lot of research going in to and during IVF as I felt that I was taking some control back over my life that way (I'm a control freak! So struggled with the unknown of IVF and infertility) so I felt like I got the best out of Create because I discussed and challenged a lot of what was going on and also because we had such a long standing relationship (I don't know many people who stuck out 5 rounds with the same clinic)

If you really want 2 put back go in with your argument rehearsed and just be firm but be prepared if they end up Wildly different gradings that you'll have to settle for one

And above all good luck!

Ivfbeenbusy you really are a lovely for talking to me about your journey.

To be honest, im still confused between mild ivf and natural modified, I even looked over the price list last night and struggled to differentiate between the two. I'm sure they will explain all to me on Monday, but if you have the chance and time if you could tell me about you experience between the two I might be able to go in with more knowledge and idea of what would be suitable for me.

Sounds like we had similar outcomes, my first ivf resulted in my DC but I was mid 20s and his father younger, he was the perfect blasto, higest grade and perfect - but the only one. None to freeze.
Second round, me -mid 30s, dp in his 50s - low quality and collapsing by time of transfer, none to freeze.

I'm worried about his happening again, as I seem to make embryos that are low quality with very little choice (eg. None to freeze)
What i mostly want is to choose the protocol that will result in the highest grade (best chance) blastocyst I can get, im not too upset of thats 20 embryos or just two. It only takes one!

I dont feel ive done much research with thus particular clinic, by that, I mean ive done all the googling I can regarding mild ivf etc, and I get so many contradictory opinions- but my DP is adamant he wants to try with this clinic and this way, I have no argument against it to be honest, but it is very helpful and reassuring to hear from someone else who has a similar history to me and went with the exact same clinic.

Well done for sticking it out for 5 rounds! That is incredible, and must have taken you alot of faith to continue with create. I do get the feeling they genuinely care and feel most comfortable with create, the clinic I was with before were unorganised, rushed, lacking in professionalism, we recently found out not long after we had our treatment they had a big shake up and now half the drs and nurses are no longer there, and the company has a new name or owners of some such.

Makes me wonder what was going on behind the scenes and if this was a reason to my failed cycle.

I definitely need to take a leaf out of your book and stand firm and be actively involved in what I want out my cycle. Im very much "let them tell me what to do" - which isn't how it sound be when I'm paying large sums of money.

Thank you also for being realistic with what swayed your chances. Im doing the whole diet/lifestyle/vitamins malarkey, its costing me a fortune! X

There isn't a lot of difference between the 2 protocols but the ethos is very different - with the mild protocol I did 225ml Bemfola stims daily from cycle day 2 with cetrotide as needed to prevent ovulation (no down reg required). I did 2 of these cycles and got 14 eggs each time . But egg quality was rubbish and less than 30% fertilised each time even with ICSI. I got 4 average blastocysts in total. I PGS tested 2 and neither came Back normal.

Natural modified was 150ml Bemfola every OTHER day from cycle day 4-5 with cetrotide as needed and daily tamoxifen tablets (similar effect to clomid). Sometimes bemfola was changed to 75ml and then added in 75ml Luveris. I only got between 2-7 eggs but the quality was much better and fertilisation was 100% with ICSI. As soon as I went back on daily stims quality dropped again. So for me less drugs was much better. I got 4 top quality blastocysts from this 3 cycle package.

There is a bit of a difference between individual Create clinics in that I know St Paul's say natural Modified only goes after 1 egg but I was told at Birmingham that they do aim to get more .

Price wise little difference between them but the drugs are obviously much cheaper as with natural modified you are taking a lot less.

I would ask your previous clinic for more information if possible - did you lose a lot of embryos after day 3 as this is a sign of male factor issues? Obviously your partners age is likely the biggest factor unless there were underlying issues with yourself prior to losing both tubes? My low fertilisation rate indicated poor egg quality? Did you have good fertilisation?

I kept spreadsheets of each of my cycles in terms of follicle numbers and size etc - I'd try and write down as much as you can remember from your previous cycles so you can give this to create? The more they know about how your body and your embryos reacts the better able they are to tailor your treatment as often it takes a couple of cycles for a clinic to really understand and be able to provide individual treatment?