ABC - FET due to oestrogen levels

[StarryHannah]

Hi everyone
I have been chatting in another ABC thread but don't want to take over the chat with this new query I have.

I'm just coming to the end of my stims (trigger tonight) and having egg collection on Monday. My oestrogen levels have shot up and I have to have a frozen transfer (nurse said if it wasn't for covid I could have had fresh but they have lower thresholds in place at the moment).

My questions are basically about the process. We obviously paid the £2500 inclusive price. We had already paid an extra £995 for freezing embryos with the hope we get some for future use, we now have to pay £1050 extra for the frozen transfer plus we have to pay for more meds (nurse said tablets) anyone had to do this and can tell me what they paid so I have an idea please?

I'm assuming we can go ahead with the FET my next cycle? Can anyone give me any insight into the process/procedure/timescales please? I'm unfortunately one of those people who like a clear plan in their head.

Thank you
Hannah

Hi @StarryHannah, I can relate! I'm also one of those who like to have a clear plan in mind beforehand, and I know sometimes getting the right info can be a bit of a struggle with ABC...

I can't answer the part about costs in your situation, but re: the last question in your post about timing, after my fresh (failed) cycle at ABC, they had advised me to wait for 2 cycles (AF) to pass before we resume IVF/attempt an FET cycle. They said it was to give the body some time "calm down" first since a lot of key readings are at a slightly elevated level right after all the injections.

It's also worth noting that depending on which ABC clinic you go to, the protocol seems to differ some times, so my situation might not apply in your case. Hope that helps give you a sense of timing all the same!

@indigocloud that is so helpful. Thank you. I've got mild OHSS so grateful they wanted to plan a fet. My nurse said i will have this bleed and they'll start my treatment on the period after. Sounds similar to what you said. I hope everything is going okay with you x

Hi. I'm in the exact same situation as you! When did you start FET? And which clinic are you with? I'm with Harley street.

Hi @Mellow89

I have had to have FET due to high AMH causing high oestrogen levels, and I'm glad as I did develop mild ohss and was quite poorly even though only mild. It was £2500 for standard ivf, £995 for freezing of embryos for two years.

I had egg retrieval last Monday and have just finished my last injection... i had a weeks worth of cetrotide injection and a weeks worth of another injection to prevent blood clots in case I developed ohss.

Patient coordinator phoned me today and confirmed I will have a reduced FET price of £1050 and I have to pay £50 extra for meds. I had my egg retrieval last Monday, my embryos were frozen on Saturday which was day 5, and I had detailed treatment summary emailed to me today with my embryo grades etc. My period also came Saturday which was just 5 days after retrieval. My nurse is allowing me to start the meds ready for FET on my next period. The patient coordinator has told me to phone about two weeks before my expected period date, they will then book me in for online appt with the nurse a week before my period is due. Following this online appt my patient coordinator will call to take payment and then my meds will be sent to me. No injections this time around. Tablets start on day two of period and I will have a couple of scans to check how my womb is doing. I'm with ABC in Cardiff but had to go to Bristol for egg retrieval and will go there again for FET. Let me know if you have any further questions x

Thank you so much for replying! This is exactly what I wanted to know. I'm with ABC London but they have said I have a withdrawal bleed and then 2 bleeds before I can start the FET process. Did they ever mention that protocol to you? It sounds like they counted your withdrawal bleed as your natural period which i hopes they would do for me. So happy you are able to get going! I have my retrieval tomorrow...nervous is the word!

Hi @StarryHannah, how are you doing? Did you receive your embryo grades? I'm clueless about what is good quality. I had 9 eggs fertilised today morning. They said they will freeze
Some on day 3. Still trying for them to the do the FET after my next period after withdrawal period! They keep saying the withdrawal does not count. Just getting so Impatient - every step there is a different hurdle :-(

Hiya @Mellow89

I'm so sorry i didn't get a notification about the message you sent yesterday. How are you feeling?

I had ten eggs and 6 fertilised on day 1. Day 3 i had four good embryos (three x grade 1, one x grade 2, one x grade 3 and a four cell they couldn't grade). On day 3 grade 1 is the best and grade 2 are very good. As there were four strong embryos they decided to let them all continue developing to day 5.

Day 5 grading is different .... 5 is the best as it's a hatching blast, 3 and 4 are expanding blasts, grade 1 is an early blast. Then they are followed by two letters ... A being the best. The first letter is to do with cells and something like how compact they are within embryo (this is the most important part of the grade) The second letter is something to do with placenta.

I have a 3AA, a 3BA and a 1 (no letters given to this one as early blast) frozen.

Hopefully this makes sense.

My nurse has told me I can start on the period which follows my withdrawal bleed. It's silly how each clinic has different protocols xxx

Thank you! You are more informative than the clinic. Fingers crossed! Do you know your estrogen numbers by any chance? Mine was 5900 on the last scan and that's why she put me on a freeze all cycle. I was annoyed to be paying the extra cost as I am feeling fine and don't think I have OHSS.I am more annoyed that their FET protocol differs between clinics! I've just sent them an email why this is the case. I'm sure it's safe after 1st natural cycle

That's all i know was on my first scan it was 2020, my second scan it was 4200 and was told if it reached 8000 i had to have FET, and my third scan they just phoned to say it had shot right up and i had to have FET. Apparently they've had to bring threshold down due to covid as they're not allowed to risk putting strain on nhs (it's a deal clinics had to make to stay open)
I felt fine until after the retrieval but then became quite poorly. My body wouldn't have been fully strong to receive the transfer so I'm glad now x

Thanks for the messages @StarryHannah! Hope you're getting on well.
I've talked to ABC and they said if my ovaries
Have shrunk to normal size I could start on the next period which they will check on day of my period. Really hoping they say it's all . Day 3 I had 8 fertilised with 7 of them at grade 1 and the other in grade 3. Had my egg retrieval on Tuesday and I'm still waiting for my withdrawal period still. Did you have Busserelin as the trigger? When did yours come ?

Do you know if they just give us oestrogen tablets and progesterone before embryo transfer?

Sorry for the lots of questions. I'm just like you and want to know exactly what to expect

@Mellow89 fantastic news with your embryos.
My retrieval was on the Monday and my period came the Saturday morning. Yes i had busserlin (supracar) trigger too. The tablets they take from day day 2 of our period are the same ones as they sent us ready for transfer with all our meds. I haven't had a look in the box but i think they are pessaries x

Thank you for your reply. Please if you can keep me posted when your period comes. Looks like you're about a week ahead. So nice to talk to someone who is doing the exact same thing as me. Wishing you so much positivity. I know with all this waiting we will be happy soon :-)

@Mellow89 of course . It's nice to chat with you too. Hope today hasn't been too much of a difficult day for you xxx

Hey @StarryHannah. How are you getting on? I'm just keeping busy. Got my withdrawal bleed 5 days after egg collection like you. Got my embryo grades - they look good. I have my FET treatment consultation next week just incase I'm ready to start in the next cycle. I wish this next cycle will start- I'm hearing it could shift by 10 days.. I'll be tracking by the ovulation sticks so hopefully I might get an indication. Will your nurse see you before the transfer for a scan to check your OHSS has gone? Or they will just allow you take the tablets from day 2 and check your lining further down?

@Mellow89 Hiya. I emailed our patient coordinator yesterday to say period ''due' in two weeks and asking her to call my husband so he could book our online consultation and pay. She phoned him yesterday afternoon so all paid now and booked in for our online consultation with nurse Monday afternoon. I will keep you updated. I think as my nurse checked me when i had OHSS and then called me every day until i was better she has judged i will be ready to start tablets on day 2 (we will find out Monday anyway)

Turns out the extra meds were only 25 pounds and are tablets (not pessaries as coordinator told me on the phone last time)

Congratulations on your embryo grades 😊 xxx

Good luck tomorrow. @StarryHannah. Thank you for the information. Have you used ovulation sticks to find out when you ovulated or will ovulate ?

@Mellow89 I've used them in the past when trying to conceive but haven't used them this month. I didn't want to be stressing about when i could be expecting my period (I know what I'm like as I'm a big overthinker and worrier 🙈) so I'm just going to go with the flow and see it as an exciting surprise when it arrives 😂

Are you using the sticks? Xxx

Hey @StarryHannah. It's probably better not to use ovulation sticks but I probably will just to see the shift in ovulation and period lol. I'm just so impatient I feel like I have to be doing something. Also I have some cheap sticks left might aswell use them and dispose them. . Is the consultation 1 hour long? I think they defo push for the medicated cycle which I don't mind to be honest.

@Mellow89 i wasn't offered a choice so assumed for everyone they go by when natural cycle starts the use meds. It's an online consultation so I don't think it'll be that long. I'll let you know tomorrow how long it was xxx

Thank you @StarryHannah

@Mellow89 online FET treatment consultation was less than 10 mins. So I'm starting this period... call or email in on day 1 then start tablets three times a day on day 2. Around day 10 will have a scan and if it looks triple lined and no follicles i will take pessaries for 5 days before the FET xx

Thanks for letting me know. Aaah that sounds straight forward. Was it with a nurse at your clinic?Looks like it's about 2 weeks from day 1 of cycle which isn't too long of a wait . Are you feeling excited? I just read frozen have a slightly better chance than fresh cycles so fingers crossed for us. . Did they tell if you need to take a the day off after transfer?

@Mellow89 yes it was a nurse from my clinic who i had consultation with.

I'm feeling excited again now 😊 And your little message about frozen transfers being slightly more successful gave me butterflies in my belly.

She didn't say anything about time off and I didn't ask sorry. I didn't think too ask because in my head I'm going to take sick days on the transfer day and the day after (I haven't told work about the Ivf at all and I think a couple of days away from what can be stressful (secondary school teaching) will be a wise idea xxx

@StarryHannah oh so sorry I never got a notification for this message, I had my FET consultation yesterday and she did say that frozen does have a better chance so fingers crossed! I had to decide which embryo to put back in as I had one frozen on day 3 which was doing better than all of them so they will culture this to day 5 and then transfer that if it survives. If it doesn't survive they said they will take the other day 5s.

Taking some time off is definitely a good idea - I will probably take 2 days off aswell. I haven't told anyone just my boss who is mega understanding. I didn't wanna tell family as I just didn't want any pressure on how it went and I want some elements of surprise left. I feel excited now.. just a waiting game now. Trying to say positive among all this waiting!

@Mellow89 well turns out the £25 I paid was just for the prescription. If this happens to you be sure to chase prescription up until you get it! Mine arrived yesterday and I took it to a pharmacy in a big asda who thankfully had the meds in stock. They cost £14.60 and I'm just glad to have them ready when my period arrives. I was starting to worry as I was told I was having meds delivered directly, then I find out it's a prescription and had no idea where I could take it to. Asda told me they usually have to order them in, most can be special next day delivery, but some take 5 working days and I was risking not making it if my period comes on time. Thankfully this wasn't the case though and they were in stock.

What are your next steps? Xxx