Tell me what to do.. ABC fertility and beyond!

[Piapea]

Hi everyone,
I need some advise please.

My partner and I are trying to put a plan in place to take the next step towards IVF. He has low morphology and a low sperm count, I've had a baseline scan and everything looked fine with my ovaries and follicles. I'm 37 and he is 33. I had a consultation with ABC fertility yesterday. This is a cheaper IVF clinic as it's nurse led instead of consultant led. They offer mild stimulation in the hope of getting a few good eggs. The nurse I spoke to said that they try to get one good blastocyst and not worry about having anything to freeze. I am 37 and thought that it was probably a good idea to at least try to get a couple of embryos in the freezer. I would ideally like more than one child (although would be so happy just to get one), and I like the idea of using the eggs I have now.. let's face it, they're not going to improve with time. Anyway, I wonder if we should just go for full IVF to get more eggs and have a better chance to get something to put in the freezer. I also understand I could get nothing in either situation but I need to start with a bit of hope!

We have also been refered for treatment on the NHS but due to some nonsense with my GP I never received a booking letter. I have finally chased this up and have made a booking for an initial consultation.. but it's not until May. Who knows how long it will take after that for treatment to start. I can see it taking 6 months or more.
I also got in touch with Access fertility to see if that would be a good option for us.

If we jump the gun and don't wait for our NHS referral, I just have no idea what the smart choice would be. I think everyone would like to think that one round will do the trick but it could take 2 or more, or not work at all. My partner likes the idea of the refund program on Access fertility. He has zero confidence in this working, where I'm more positive and think (stupidly, I know) it will work the first time.

So thank you for getting this far! If anyone out there had learned anything at all from experience please, please send a little wisdom my way. I feel a bit paralysed in taking the next step.
Thank you 🙂

Hi OP. I was with ABC and I had one good blastocyst. My follicles were slow to grow and I really only had 3 decent sized eggs on the low dose stimulation. The blastocyst looked great though and was a 4AA, unfortunately it ended in miscarriage. Because of that we are now doing PGTA and an Access 2 cycle 50% refund package with Lister.

Both clinics are excellent but Lister is able to alter the protocol more easily. The standard with ABC is 150 Bemfola and they don’t alter it readily.

I am glad I went to AB for my first round though as I learnt a lot. We were ‘unexplained’ but we saw that my follicles were very slow to grow in that first round and they have also been in the second round I’m now on. But this time we’ve doubled the dose which in my case seems to have helped the growth significantly.

So my advice would be to do one round with ABC and if you get a poor response like I did move onto an Access package. From my research ABC and Access are the most reasonable options available in terms of costs. Good luck!

Hi OP, I can only comment on ABC. I started treatment in September with my first round of IVF and am now 25 weeks pregnant and have 3 embryos in the freezer. I was 36, almost 37.

I remember being disappointed with the number of eggs I got (I don't know why as I should've expected a small number given their mild approach) but they kept telling me it was quality over quantity. It turned out to be true for me with 4 top quality blasts on day 5.

The problem is, unless you try it, you never know how well you will react to the stims etc and therefore whether you need a higher dose than that provided by ABC.

We had looked into other clinics too prior to coming across ABC and we were planning on using Access Fertility and spending £12,000 on one of their packages. So we thought we might as well take a punt with ABC first to see how it went. In the end we only spent £2250 plus the cost of egg freezing (can remember how much that was). I fee very fortunate that we got a good result. It's so hard to know what to do for the best! Wishing you lots of luck, whatever you decide to do.

Hi OP

I looked at ABC but in the end went with NHS.

Firstly, I would check your CCG rules as some let you have 1 or 2 private rounds before your NHS one. If you are lucky enough to have a child through a private round though you do of course lose your NHS entitlement.

I’d also put a call in to whichever NHS clinic you’ll be with and ask what their current wait time/timeline is as many clinics are now catching up after Covid and the wait isn’t as long as it was.

Consider too that as you’re male factor ABC (like most clinics) charge extra for ICSI. I think this is about £1000 from memory but not totally sure on that and then as PP has said extra again for embryo freezing/storage if you do happen to have any left over.

In terms of the chances of success everyone is different but as a blanket rule the stats are usually around 30% per cycle so while you absolutely may have a baby with your first transfer it’s not a guarantee. So I think it’s totally reasonable to want to get something to freeze if you can, especially if you think about 9 months of pregnancy + whatever age you’d like your first child to be before you try for a second.

FWIW we are ‘unexplained’ and I had just turned 36 with a fairly good AMH/AFC (both about 23 I think) when I had my NHS cycle.
I was on my clinic’s standard stims dose of 225 and ended up with 6 good blastocysts which my consultant said was a very good response/outcome - I think she was actually a little surprised tbh!
I’m now 27 weeks with my 2nd transfer (after a miscarriage with my 1st).

It’s an absolute minefield figuring out what to do for the best but I wish you all of the luck whether that be with ABC, NHS or somewhere else.

I'd bear in mind that ABC have an age cut off of 37 I think - you can't be older than that and be accepted for treatment so depending on how far ash you are from age 38 you may not have a lot of time consider your options

As a previous poster said lots of women get more than 1 blastocyst at ABC - it's called mild dose but many "normal" IVF clinics don't proscribe much more than 150ml Bemfola depending on your AMH levels for the first cycle so you could end up paying a lot more somewhere else for essentially a very similar drug protocol

Hi all, I'm just considering going through ABC for IVF and have seen that the package starts at £2,750 but then it says the initial consultation with the scan is about £400. So that puts it to over £3000. Are there any other hidden costs like that I need to consider?

Thank you so much for all the feedback @FloatOnBytheStorms, @RiverRiot* and @loulou2021*.
I know everyone's experience is different but sometimes you just need to hear real stories.

@loulou2021.. you seem to have gotten exactly what I want from ABC, so good to know that mild IVF can produce good results.

@RiverRiot.. it's definitely a minefield! ICSI has been recommended in our situation so I've factored that into the costs. Did you ever come any closer to getting an explanation for 'unexplained' infertility? When my partners most recent SA came back with poor results I was almost relieved that I had some explanation. Although we have been TTC for 2 years and his SA from last year was fine and I still didn't get pregnant so there may be something else underlying on my side.

@twinsetandpearl.. that is really interesting about the medication protocols, I had no idea, its so hard to know the right questions to ask when talking to the fertility nurses! Also I had my consultation this week and she said as long as you put the booking deposited down before turning 38, they will treat you.

@FloatOnBytheStorms.. thanks for all of that info! I completely understand that for most people the first round is almost exploratory, especially with unexplained infertility. Maybe that is what is giving me decision paralysis though, thinking that maybe we'll be writing the first round off. Then I think of the Access program, then back to @loulou2021's experience, and here we are back with me being completely ridiculous and not being able to make a decision!

@Tinkerbell098.. as a previous poster said, ICSI is about £1000 more expensive. The good thing about ABC is that an medication is included. Have a look at the website and there should be an ad for a 1 hour induction zoom seminar. I joined this and they were doing a 50% discount on the initial tests.. it might be a regular thing. The other thing that may cost is a frozen embryo transfer if they are unable to do a fresh transfer. This would be due to OHSS . This would cost about £1000 ish more.

Thanks again to everyone who got back to me and good luck with the test of your pregnancy @loulou2021 and @RiverRiot 🍀

Hi @Piapea. I went with ABC as met their criteria, and liked the idea of the low doses (and the price!). Was 35 at the time, and now 36. I ended up doing two rounds and still don’t have a baby. I ended up with one excellent blast to transfer on my first round that resulted in a BFN and then an early blast on my second round that also resulted in a BFN. Ended up with three Day 6 fair/poor blasts frozen.

I am now doing the multi-cycle package with Access Fertility at the LWC where I will be on higher doses and a different protocol.

IVF is very much a numbers game, and the Access package appeals to me because you get transfers and two rounds included (excluding meds). If I had transferred my extra blasts with ABC, it would have really added up, and I wanted to see if I could get better results with standard IVF. I have since looked into mild IVF a bit more, and it does have lower success rates. Some women are lucky, but others will need multiple rounds to achieve success. I’m also not sure in hindsight whether I put much stock by the ‘less eggs, better quality’ thing. Most clinics don’t seem to believe in it. Also, note that you have about a 30% chance of an untested blast taking, then factor in that the cost of transfers is not included with ABC.

I felt I wasn’t getting answers from ABC about why my results were poorer than they should have been. They just said that most women only get one blast, so my result was good. 8 eggs > two poor quality blasts is not good. I also didn’t get to speak to a Dr at all, which would have been helpful.

So, if you can afford the Access package, I would consider it. I would, however, have a consultation with ABC.

If I had been successful, I would probably have written a very different post!