IVF at Create Fertility - process and timeline?

[ohsheglows]

Hello all, I used to post on the conception thread but I think it's time I now moved to the infertility section instead.

I've been trying for over a year now and have decided to go down the IVF route. I have low AMH and low antral follicle count (3) and I'm 32 years old. After so many days of feeling down and crying, I now feel like I need to get into gear and try to be more positive about it!

Is anyone on here currently with Create Fertility for their IVF or have been in the past? Can someone give me an idea of costs, general timeline and the process?

Thank you all 🙏

@Sunflower360 I think my af will be due around 5 December, so hoping they'll let me start then, egg collection should be a week before Christmas I think. I've not seen anything about Christmas closing but I've seen another create clinic on Facebook and I think they're just closed on Christmas day.

That's good @VenusStarr hopefully it will be ok, and I suppose you can always double check in the consultation call 😊

@VenusStarr @Sunflower360 yes it’s been a crap year and I’m feeling very despondent and not hopeful at all.

i think my consultation will hopefully clarify what my thinking is. It’s just soo much money we spent approximately £15-17k on the last two rounds of conventional IVF.

i do think if I don’t try this clinic I’ll always be wondering what if especially as they specialise in low AMH but I worry my quality may never improve even with all the supplements diet and lifestyle changes.

I’ll keep you both posted on how my consultation goes on Friday. Please let me know how you’re both getting on, I find talking to you both so much easier than trawling on other threads and Facebook posts to get answers. Thank you so much to you both xx

No problem at all @Hopesandsunshine and hope your consultation goes ok on Friday. If you had any questions at all at any point please do post! I have found Mumsnet really helpful through my journey so far

Hope today goes well @Hopesandsunshine I'm with you on that wondering what if. I feel like I need to do this to allow me to draw a line under everything. The money we've spent makes me feel a bit sick though.

Time is going so fast, not long before I have my consultation now. Hope you're OK @Sunflower360 you've reminded ne I need to write my list of questions, will start now seeing as I'm awake. The clocks changing has thrown my body clock off x

Thanks @Sunflower360 got a follow up with the consultant before restarting but hopefully that goes ok. I've been advised I'd need a day 2 scan to be sure the residual follicles had all gone before I could restart anyway, so could find it's after Christmas I start back up if their still there

@VenusStarr @Sunflower360 thank you for all your well wishes. We had our consultation this morning and the doctor has advised the three cycle natural modified package. It’ll cost about 12-13k including medication. No idea what our decision will be… he seemed very confident and thinks I’ve had bad luck and it’s a case of keep trying till we get there.

There are so many things running through my mind, it’s a lot of money, what will the impact be on us etc but will I then have regrets if I don’t try? But why hasn’t it happened at the previous clinic so far? @Sunflower360 @VenusStarr would you both say start sooner rather than later if I have low AMH or wait until my cycles return to normal? What would you do in my situation?

If I say yes we can get one cycle in this year and the other two starting in January…

xxx

@Hopesandsunshine it is a lot of money, but time is something you cannot put a price on and in our position we went ahead as we didn't want to have any regrets, but I can appreciate there is a lot consider.

If all your tests are clear and the Dr is in support my advice would be to proceed, if you're happy you've made all the adjustments you'd like to do before a cycle (if you had wanted to that this of course), like diet/supplements etc bearing in mind they can take up to 3 months to get in your system.

I had a chemical pregnancy just before starting the first cycle (natural in between cycles), Dr initially said to have a break but I said I didn't want to waste a month as the chemical is such an early miscarriage. So they said as long as the 1st scan was ok and showed no tissue from a miscarriage I could proceed (very slim chance anyway with a chemical), all was good and I proceeded. So far that was the best cycle as we got 2 embryos a day 3 and 5, frozen. So I would say if you feel up to it and have got the Drs advice to proceed then may as well.

How are you doing @Hopesandsunshine thats great that the consultant was optimistic about it working.
What's going on with your cycles at the moment? I'm in the frame of mind now that I just want to crack on, I feel ready now after a long break. But there's no harm in waiting a bit longer, if you need more time?
What supplements are you and your partner on? Its very overwhelming though ❤️

How are you @Sunflower360 ?

We got my dh's sperm dna fragmentation results today, pleasantly surprised that they've slightly improved, its 14.5% from 16.4% so taking that as a small win. Was expecting it to be awful as his sperm analysis was so poor. Hes back in impryl now too (these results were on wellman conception) So hopefully with icsi, we'll have a good chance.
My consultation for my protocol is Monday. Feeling a bit more optimistic about our chances now. I'm ready to start. Af is due this week. Really hoping we can start in December, will check on Monday. X

Hi @VenusStarr I'm ok thanks, just waiting for AF, hopefully will arrive before the end of the month. Then I'll need a day 2 scan to ensure the residual follicles have all gone...if not then will have to wait until the new year, so all a bit of waiting at the moment!

Hope you are ok, this results sound better. What will happen from here for you?

Fingers crossed things go smoothly for you this cycle and you get the go ahead @Sunflower360

Once I've got my protocol, I'll hopefully get a rough timeline. I heard today that my clinic might not be open for egg collections in December so need to check when we can start. Apparently the last FET is 3 December. Although they let me do the baseline scan a couple of weeks ago. I've got my head ready now, so hope we don't have to delay until January 🙏

@VenusStarr when I have they said you would need to start your stimulation by? I was advised by 30th Nov

That is for an egg collection before Christmas

I definitely don't think my period will be here at the end of November @Sunflower360 I'll check next week. We'd originally said november cycle but its taken longer to get all the test results back. I'm glad I know now, so I don't get my hopes up x

@VenusStarr I was wondering if you had any advice as I recall you saying you had immunity issues...basically I've tested high for anti thyroid peroxidase levels, and will be on Prednisolone from stims in readines for transfer in my next cycle. My TSH levels are currently under 2.5, which is good but high anti TPO could mean possible thyroid issues and maybe miscarriage (I had a chemical in August hence testing). What was your experience and levels like in this situation?

Hi @Sunflower360 I have low level thyroid issues so am on 75mcg levothyroxine to keep it under 2. My TPO are fine though.
I've got positive ana antibodies which could indicate an autoimmune condition but I've also got very overactive nk cells so they think they kick into action when I'm pregnant. I'm also on immune modulators (hydroxychloroquine and intralipids).

I've had normal issues with the steroids other than I tend to get moon face quite quickly. What dose would you be on and for how long? It can impact your sleep so take them early just after breakfast.

Thanks @VenusStarr I'll be on 5mg twice a day from when stims start (hopefully end of this month), so not sure I'll be able to avoid taking it later in the day but I can ask the Dr perhaps, is your TSH stable now?

It seems to be fairly stable @Sunflower360 but it'll then fluctuate. The last time it did I was really stressed when dh was sick and it went to over 4 on the levothyroxine (50mcg) so it was put up and seems alright at the moment on the higher dose.
Hopefully the steroids will keep everything in check. I'd recommend testing your thyroid and TPO Again with a bfp. They usually recommend upping levothyroxine so I'm not sure what they'd suggest about the steroids but if you check it might give reassurance or identify you need to continue steroids x

@VenusStarr @Sunflower360 sorry I’ve been so MIA from the recent posts…funny story I’m in my TWW (two week wait) from trying naturally and was silly enough to convince myself that it had worked this time because I has so many of the symptoms but it turns out I don’t think I am. I feel so stupid for even believing for a second that I could be or that my body was able to do this.

We are now waiting for meds to be delivered and then waiting for my period to arrive to then start, hoping it comes soon so I feel like I’m doing something. Not sure if I feel hopeful but we will see.

@VenusStarr glad your husbands dna fragmentation test came back better than your hoped. Where are you upto now? my husband just did a speak analysis and no fragmentation test, wondering if he should have done that? What is covered in the dna fragmentation test?

@Sunflower360sorry to hear about your high tpo antibodies, I don’t have this issue but glad your TSH is stable and hope the medicine they prescribe resolves it. What happens now? Do they need it to be under control? I’d read somewhere that TPO antibodies can’t be controlled but i really don’t know enough in this area.

thanks again ladies, you’ve been in my thoughts this week but not going to lie, this week has felt pretty heavy xxx

@Hopesandsunshine don't feel stupid, there is every possibility it could happen. I had a chemical pregnancy (had a HCG test after the FRER which confirmed it) the month before we started the IVF cycle with Create, but it turned negative within a week, so barely got to 5 weeks. So it can be possible.

TPO antibodies is basically an indication that I'm likely to get Hashimoto's (underactive thyroid) in the future as those antibodies attack the thyroid gland and there are triggers like stress, pregnancy that can make it worse, hence the advice to have steroids to suppress the immune system to try and control the response and to avoid it causing an issue for the embryo in early implantation/pregnancy (whether it works is yet to be seen but then it could not work due to the embryo itself, so difficult to tell). The Dr advised he has treated women with high TPO that have gone on to have live births so that is something I suppose. If anything, it has given me a flag to monitor my thryoid over the years and maintain my diet/lifestyle if only for my own health. Could be a number of years before it was to develop as my current thyroid levels are within the levels advised.

Hope your cycle goes ok with Create, any questions please do ask here as the first cycle can lead to a lot of emotions!

@Sunflower360 thank you I’m day 25 and the test is negative so I think I’m out. But at least I have some hope left eh?!

So were your TPO antibodies really high? Sounds like the doctor knows what he’s doing which is really reassuring when coming across situations like this, so what’s next now for you?

Thank you here is to fresh beginnings and round 3 of ivf and trying Create. I’ll keep you updated on how my cycles go as this first cycle like you’ve said can be a bit full on emotionally and is always considered a test run. My protocol for natural modified is 150g-f and then cetro- 0.25, I’ll be interested to see if it helps me in any way and then trigger with Ovitrelle. Is this similar to yours?

@Hopesandsunshine TPO to be negative is under 34, anything above that is deemed as positive and an indicator of Hashimoto's now or in the future (even if thyroid levels are normal without meds at this time). So I'll be on Prednisolone 10mg a day from stimulation as we're transferring on this 3rd cycle, and that will be the case until either a negative pregnancy test or a scan if it was positive.

Your natural modified cycle sounds same as mine, as I was on the same meds/doses. I also had 2 x Ovitrelle pens

@Sunflower360 ahhh okay gotcha, glad it’s been found sooner rather than later at least now something can be done about it. Is prednisolone a steroid then to calm the antibodies? Sounds positive that they’ll keep you on them for some time…I’ll have everything crossed for you 😊

can I ask if you chose to do ICSI on any of the rounds? We don’t have male factor but given the poor fertilisation of the last two cycles I’m just wondering if it’s worth trying. But apparently it can worsen the outcome is what I was told in the consultation?

@Hopesandsunshine yep it is a steroid and thoughts are it would supress the immune system...will see how it goes.

We had ICSI, mainly because we have failed fertilisation in our 1 NHS cycle. DP has good sperm parameters, it was just morphology that was low in our NHS cycle (2%) but they still did not do ICSI(despite me asking them to, they just said they would see on the day depending on the sample...was so annoyed when in the follow up they said next time we'll try ICSI-and at that point decided Create were the best way forward).

DP had another SA with Create and morphology had improved to normal levels (4%), but Create advised ICSI based on the failed fertilisation in the ICSI cycle which we were happy with. I would advise ICSI but that is just from personal experience which has been as follows:

• 1st cycle: 5 eggs collected, 4 eggs mature, 3 fertilised with ICSI (the 4th degenerated likely due to egg quality), 3 were going well on day 3 so a day 3 was frozen (standard Create protocol so there's one frozen at least), by day 5 the other 2 reached blastocyst, 1 day 5 was frozen, the other kept on to day 6 but did not make the cut to freeze so discarded

• 2nd cycle: 2 eggs collected, both fertilised, day 3 one was lagging behind but the other was doing well, by day 5 one was frozen and the other was kept to day 6 but it did not make it so discarded

I daren't think what would have happened if we had standard IVF after our NHS cycle. In my opinion it is good that they pick the strongest looking sperm-gives it the best chance possible, but I understand some people prefer natural selection with IVF where possible. We just didn't want to take that chance again after the NHS cycle

@Sunflower360 ahhh okay sounds promising!

Well it hasn’t been recommended but these were my results at the other clinic doing long protocol with down regulation and conventional IVF:

first cycle: 3 eggs collected and 2 were mature but only 1 fertilised.

second cycle: 4 eggs collected and again 2 were mature and only 1 fertilised again.

my partners sperm analysis has been really positive, so likely an egg issue but equally I’m scared to take the risk of just going with conventional again and have the same thing happen again.

But during our consultation the doctor thought ICSI wasn’t needed due to these results and in the videos you watch before you sign the consent forms with create the video was saying that ICSI can lead to more problems in terms of birth defects so that’s also at the back of my mind.

But it seems like you’ve got really good results, just confused on what to do…@VenusStarr when you’ve done IVF previously did you do ICSI or conventional IVF?