Pressured into IVF

[graygoose]

Hi all

DH and I have some issues that will make it hard but not impossible to naturally conceive (endo, adenomyosis, one sluggish tube and zero morphology). On the other hand, my levels are all good, I ovulate and DH has very high count and good motility.

We are both 34 and have been trying for nearly a year, although with this and that we’ve only “tried” properly for 6 months. We’ve had all the check ups and keep hearing conflicting things - one doctor says to keep trying naturally until the end of the year and then consider IVF. Another says it’s hopeless and just to do IVF now.

I don’t know why but the other doctor really upset me. Am I being so naive and stupid as to think there is a chance in hell we could try naturally? I turn 35 next year and I know that’s a bit of a cut off for egg quality etc (we would fund our own IVF as currently aren’t in the U.K.). However, I feel like some doctors have been a bit cavalier in saying to jump to IVF. It’s thousands of pounds and a huge physical and mental toll.

I am resigned to likely having to do it next year, but AIBU to want to keep trying naturally for the rest of the year? Also no one has even mentioned IUI or other potential avenues - it’s very frustrating and I feel condescended to and unheard.

@graygoose IUI is notoriously unsuccessful and would not be recommended as a treatment for you.

It depends on how much of a toll it is taking on you both mentally I suppose? So you have the capacity to keep going month after month without success? Yes you could try for a bit longer but you are going to be up against it without addressing the issues you have - the zero morphology for instance..... that needs to be worked on regardless of IVF or natural conception. How bad is the endo? You could have your AMH tested to get a quick glance at your ovarian reserve although that will not tell you about the quality of your eggs. This will give you a bit more of an idea about timelines. For instance, mine was 10.7, im 33... that was seen as the low for my age and therefore they said whilst we could continue for 6 months and my AMH is unlikely to change in that time, I wouldn't want to keep going beyond that without success (particularly as this was for baby no.1).

If you've been having sex for a year without protection, that is a year of trying, whether you track or not in the eyes of doctors.

If you're self-funding you don't need to worry about waiting times or paperwork pipelines like you do with the NHS, so that is a positive.

Thanks @FlyOnTheWall89. My endo isn’t too bad but I’m getting another opinion tomorrow. I was on birth control for a very long time (since my teens) to stop bleeding as much and slow it down but obviously now I have normal periods again it makes it worse.

DH has been prescribed Proxeed for the morphology which he takes every day. I really don’t know whether it will work or not but it’s only been a couple of weeks. He actually got a girl pregnant a long time ago when he was much younger and she got a termination so he had able swimmers in the past, although that doesn’t necessarily mean anything now.

AMH is 17.3 which is a little on the lower side but the fertility doc we went to never mentioned it being a problem - he was much more focused on the morphology.

I guess I do just need to suck it up with the IVF :(

@graygoose well after 2 months on Proxeed, pycnogenol, omega 3, ubiquinol and Vit D my OH morphology went from 0 to 9% and I'm now pregnant if that gives you any hope.

AMH looks fine then. It's most relevant when going for IVF, but it's good to know in order to build a timeline.

Ye sperm changes all the time so a previous pregnancy a while ago isn't much indication of sorry health now.

His DNA fragmentation may also be low... worth researching.

Hope you get to the bottom of your period pain. It may be that because you both have issues, you'll get there before next year, but it will have just taken a while. We were booked in for IVF, but I fell pregnant 2 months before it was due to begin after 15 months. Good luck xx

@graygoose I think the DR telling you to do IVF is being realistic me and DP have been trying to conceive since 2016 naturally not one inkling of BFP/ I have suspected Endo, his sperm is completely fine. I got my BFP from my second cycle- very early days and extremely scared.
I wish my doctors had pushed for oVF before 35, I got 20 eggs on long protocol but only 3 got to blasts.

My first cycle they got 8 eggs on short protocol and none made it to blasts.

It can work post 35 but it's more difficult.
Look into IVF while continue to try naturally is coming back to the UK an option.

I'll tell anyone the same- don't wait x

I think it's realistic to consider IVF sooner rather than later, given the issues you're facing. But it's also important to realise that in most cases, starting the process of preparing for IVF doesn't mean starting it next week - you may need additional investigations done, or to be on a waiting list. You can also often get some counseling through the IVF clinic to help you get your head round it all. Good luck!

I think it's reasonable to think you'll most likely need IVF to conceive, so in that sense your doctor is not unreasonable ; and IVF does not always work immediately so while you're still young, it makes sense to not waste time.

However, I also think that a few more months are unlikely to make a huge difference, and if you need that time to close the door on natural conception and preparing yourself mentally and physically for IVF, that is fine too.

Has your DH looked at diet adjustments he can make to improve his sperm ?

Fwiw, I don't think IUI will help if your issue is endo/implantation. I had successful IUI myself but I had no fertility issues, and I defied statistics (they struggle to reach a 20% conception rate per cycle on people with no issues apparently). The stats may be much lower when you have endo. So it does make sense to not waste time and money on something that would only slightly improve your chances.