Create Fertility - Experiences

[Sunflower360]

Hi 👋

I was hoping for people's experiences and thoughts on Create Fertility? I am considering them, so any thoughts would be much appreciated.

I am currently going through a short protocol with high stims with another clinic, baseline scan showed 4-5 follicles (expected that as I have low AMH/low ovarian reserves) but through my high stimulation am only showing 1, maybe 2 follicles that are growing...so cycle is not looking great.

So I wanted to consider Create as they specialise in natural modified and mild IVF, but would appreciate feedback on people's experiences as we would be going in multi cycle with my low AFC/AMH and want to ensure it's the best decision in those circumstances.

Thanks!

@Sunflower360 your situation sounds almost identical to mine. I did a couple of high dose short protocol cycles which didn't work (low AMH/low AFC/poor responder) so I moved to Create, just to try something different in all honesty. Turns out natural modified IVF suited me much better and resulted in my DS.

Thanks @Bubblemachine0 do you mind me asking what your circumstances were? I'm 37, AMH around 6, and OH has low morphology, but otherwise all else is ok. What were the protocol/meds in your Create cycle and number of eggs/follicles? Sorry for the questions! Any tips/advice I can get would be greatly appreciated 😊

I was 39, untreated endometriosis, no male factor, AMH 2, AFC varied 3-5. I was on 125 of Bemfola but with natural modified IVF they start stimming a few days later in the cycle compared to short protocol. Did 3 cycles and eggs collected varied between 2 and 6 (which was better than I responded to short protocol). I found their lab were excellent at explaining, they called with all the stats of how DH's sample looked on the day and answered any questions I had with the embryo updates.

Thanks @Bubblemachine0 that is really positive to hear! Were you able to do back to back treatments with natural modified or did you require a 1 month break in between (withdrawal and then period to re start a cycle)?

I was able to do back to back if I wished but I chose to spread them out a bit

Thanks @Bubblemachine0 that has been really helpful 😊

A friend was with Create st Paul's and thoroughly recommends.

We found Create very poor for male factor so I’d advise you to ask lots of questions about that side of your issues. We raised it a lot and they weren’t particularly interested then after each egg collection they made a massive deal of how poor the sperm quality was! They just didn’t seem equipped to deal with it. Sounds like your male factor is less severe though so they might be fine for you. Good luck.

Thanks @b0zza1 Good to hear it's gone well for your friends.

Thanks, @GreyZebra. We would push for ICSI with the male factor low morphology, but thanks for the tip, though, in case any further investigations were needed. What treatments did you have, and what were the results like?

We had ICSI but Create don’t do any add-ons like AOA. Results were shocking (0% fertilisation from two egg collections) but I don’t want to give the impression that was all Create’s fault. It’s difficult to tell because they just wrap up the IVF and IVF&ICSI stats together and I got a very sales-pitchy answer when I asked about their ICSI experience and competence. I’m sure they have success with ICSI in more straightforward cases, they just didn’t seem used to the severity of our male factor.

Thanks @GreyZebra If you don't mind me asking what is AOA and ehat is that used for? Good to know just in case!

Artificial Oocyte Activation. It has definitely helped our fertilisation rate but not necessarily useful for everyone but it was the right decision for us to move on from Create to a clinic that offered this.

Hi @GreyZebra, I was wondering if you had any advice to help ref your initial fertilsation rates. We've had our first egg collection and unfortunately encountered zero fertilization and been advised that ICSI would be advised next time round. If you don't mind me asking, what reason did you need to use the AOR? Just wanted to understand more about that

Hi @Bubblemachine0 as you may see in my previous message, our cycle did not work out this time. 4 eggs of which 2 were mature, one did not progress at all and the other was classed as 'failed fertilisation' (so it did attempt it but did not work out), hence ICSI being advised now.

Could I please ask a question... if I am trying to understand how it is possible to get more than 1 or 2 eggs in a natural modified cycle? Only reason I ask is because the webinar on the Create website talks about natural modified focussing on 1 or the most 2 eggs being collected. Any advice would be greatly appreciated as they would be our next port of call and I'm trying to work out if mild or natural modified would be better in my circumstances with low AMH/AFC levels

Hi @Sunflower360 I am really sorry to hear about your latest cycle. What happened in my case was that on the cycle where I had 5 follices at the baseline scan, all those follicles grew and a further 2 more appeared during stimulation and I got 6 eggs (the 7th was in an awkward position and they couldn't retrieve it). I didn't respond so well on the other cycles unfortunately but that was because my follice count was only 2 at baseline on those months.

Thanks @Bubblemachine0 that is really helpful. I was on 450 IU stims for this cycle, and I am trying to get my head round how the lower stims would get follicle response if that makes sense? I definitely prefer the idea, but it does appear some Dr's tend to shut down mild or natural modified IVF as not being good, but feedback that I have heard and research, would suggest otherwise for those with low ovarian reserves

@Sunflower360 I was on 450 before too (menopur). I think with natural modified IVF they sort of ride on the back on your natural cycle which is why they leave it a few more days before they start stimulation. The most eggs I got on the 450 was 4 so I had a better response on the lower dose/bemfola. It's all a bit of a gamble but I decided it was worth a try as short protocol wasn't working for me.

Thanks @Bubblemachine0 that is really helpful. My current Consultant has talked about recruiting follicles early on with a high dose of stims, vrazy how they have such differing views on it ...but I have to say after this cycle I'm not convinced about high stims. Feels like natural modified is the way forward for me

Hi @Sunflower360, I’m so sorry to hear about your cycle. I’ve been there a couple of times so know how devastating it is. We have severe male factor so it was always ICSI for us. We had pretty poor fertilisation rates (25% of mature eggs for two egg collections) so our embryologist suggested AOA as the only thing that might help. It felt like a Hail Mary really and he wasn’t at all convinced. We decided to change tack entirely and go for natural modified at Create where we did two cycles with 0% fertilisation. After that we changed clinic again to one that does AOA and last cycle had 100% fertilisation so it does seem to have helped for us. If you have a follow up at your current clinic it would be worth asking them if they think you’d benefit and why to see if they have anything more definitive to say than my clinic who basically said it helps for some couples but not others and they’re not sure why. It’s rated amber with HFEA but that seems to be because there’s not enough evidence to support using it rather than any ill effects. Our view was why not, it wouldn’t do any harm and it might just help and it seems it did so I wouldn’t do another cycle without it. However, if you want to do natural modified, Create is probably your best option and therefore AOA won’t be an option.

Thanks @GreyZebra It is difficult to tell at this stage if it AOR would be needed as only 2 eggs were attempted to be fertilised. Suppose a cycle of ICSI would work out if that works or not

Hi, I have been advised by the current Consultant to take DHEA (as part of the follow up following our failed IVF cycle with them)... does anyone know what Create's view is on DHEA? I was considering taking it sooner rather than later to see how it works as we'd like to commence the next cycle in August, if it was recommended, but I have read that you're meant to get tested for levels first (Consultant didn't even mention this)?

@Sunflower360 yes my previous clinic advised me to take it but Create told me to stop. I had an unsuccessful cycle while taking it at the previous clinic (with untested levels).

Same for me. Previous clinic advised me to take it, Create told me to stop. I’m not sure whether it helped or not.

Thanks @Bubblemachine0 @GreyZebra that is really helpful and good to know. Did Create explain at all why not to take it? Reading so many different things on it 🤯

@Sunflower360 I don't think I asked them for a detailed answer as to why. I know some people do have success with it but I'm annoyed that my levels were never checked because I might not have been a suitable candidate to start with. It's the only cycle I had where some follicles were empty at collection so I was happy to take Create's advice to stop it