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!

@countrypunk my thoughts are similar to yours. I do wonder with lower AMH how benefical high stims are...I was on 450 IU by the end of the short protocol I did and got 2 mature eggs of which 1 failed to fertilise at all and the other abnormally fertilised. So ICSI next time round and a focus on quality over quantity...Create do appear to be the leaders with lower AMH.

What clinic are you with and what have your AFC/egg collection numbers been like, if you don't mind me asking? Do they do mild IVF?

My other consideration was duo stimulation but Create do not do that. Will see how it goes with Create I think.

@Sunflower360 So interesting. Slash frustrating! I think so often with IVF it's either a one size fits all approach or a total stab in the dark!

For my first round I was on 225 of Ovaleap. I had 13 follicles, 10 eggs, 9 mature, 8 fertilised, 2 blastocysts on day 5. First transfer failed, pregnancy from second, but missed miscarriage at 9.5 weeks. We were expecting it because at our first scan we were told the embryo was developing very slowly, so I suspect it was abnormal. We didn't do any embryo testing and wouldn't again unless by some miracle we got loads of embryos!

I'm with a small clinic in the south west. They're actually a satellite clinic and we'll have all the lab work done by the bigger clinic we were with last time. They only have one clinic so you wouldn't know them unless you live in my area (sorry, I'm trying not to be too outing!)

This time I'm on short protocol with 450 of menopur. I have 8 follicles but 2 are very small. I'm trying to manage my expectations - if we got 2 blastocysts last time from 10 eggs, we may get nothing from 4 or 5 eggs this time. Our current clinic don't advise mild IVF for someone like me because they say it's a numbers game and you want as many eggs as possible, hence blasting my follicles with highest dose!

Already researching what to do for next time! I think we'll definitely have a consultation with our local Create. It's so bloody hard to know what to do.

@countrypunk I'm by no means an expert, but it is odd they upped the stims so high for you as you appeared to respond well on the lower dose first time round. Surely they would just stick with that dose of stims and look at other ways to tweak the protocol to improve things?

Agree with you though - it is hard to know what to do for the best!

@Sunflower360 I think the new clinic were thinking I'd respond even better on loads more meds! But actually it's been the opposite.

I think with fertility knowledge at its current (crap) level, it's complete luck of the draw when a cycle works. You've just got to try lots of different stuff and hope something sticks.

Please keep us posted with how you get on!

@HopefulElle sorry, if possible, would it be ok to know how quick a treatment consultation is booked in at Create (after the scan/consultation) and how quick meds can get ordered/delivered to start treatment? I am estimating from the initial consultation that I may have around 2 weeks until my AF and am keen to start the treatment asap....

Agree with you on that @countrypunk it does feel all a bit trial and error. The last consultant we was with suggested I take DHEA before starting the 2nd cycle but luckily I did reading on it and turns out you should be tested before going on DHEA as it can have the opposite effect and apparently Create are very much against DHEA... the advice varies so much between Consultants.

Will be sure to update, hopefully @HopefulElle you could keep us updated too!

@Sunflower360 you book your scan and consultation at the same time, so you will be able to see that if you go on their website and click through like you’re booking a scan. Depends on availability but I think our consultation was a week or so after the scan. Our was at the end of May, and could have proceeded to treatment more quickly but I opted for thyroid and genetic testing which have added around 5 weeks (to get a blood appointment and to wait for results) onto the timeline. I’m starting 6th July now - so 6-7 weeks after my scan. They do seem to able to move quickly in my experience, but might vary dependent on location too.
I’d really recommend them so far - early for me to say that but so far so good.
If you’re unsure there are some really good DOR groups on Facebook that helped me with making my decision. Wishing you and everyone on here good luck - it’s a crappy group to be in 😟 Xx

Thanks @HopefulElle good luck to you too! Got the scan and consultation booked in, can't book any further though until the consultation which would give me around a 2 week window to start. Have had thyroid tests during my NHS cycle, not sure what the genetic testing though...what is that?

Fingers crossed they can meet your timings, sounds possible! It’s karyotype testing - looking for any chromosome abnormalities that could potentially explain my AMH. Getting the results in the next few days and they did say that for most people, it doesn’t explain anything (my thyroid was totally normal). I wanted to do it anyway because I was so shocked at my results and desperate to try to understand why - particularly if it could help.

I’ll keep you posted, if you’re interested?

That would be really helpful, thanks @HopefulElle And I'll keep you posted on my journey with Create!

@Sunflower360 My costs were similar to @HopefulElle we didn't need ICSI in our case but that would have been more. My predicted odds were also similarly low but it worked.

I only had one usable embryo so we didn't bother with testing.

Good luck everyone x

@Bubblemachine0 congratulations!! And thank you for giving me some hope ❤️

Thanks @Bubblemachine0 !

Hi @Sunflower360 - I wanted to share my experience with Create Fertility with you so you don't make the mistakes I made. I am with the Birmingham branch.

My advice is to read the fine prints and ask lots of questions. It was sold as a package but there were a lot of add-ons along the way. We have spend £12k+ for a mild stimulation cycle and it was sadly, unsuccessful. The majority of the clinicians are experienced but the doctor who did my egg transfer seemed really confused on the day. My biggest complaint is the patient coordinator whose greatest skillset is apologising.

My experience in detail below:

1. Different quotes were provided and this created confusion, perhaps intentional. When we go back to check on the different quotes, we see that the amounts for the same thing are different. So ask lots of questions before you pay.
2. Delivery of the first batch of medication was miscommunicated, I had to call the pharmacy myself to ensure they were being delivered that day. This is a time-sensitive delivery as it had to be available on the second day of my period. I should not need to contact the pharmacy directly as we are paying Create and not Fertility2U. I assume this isn’t branch-related as the main number goes to a call centre, the staff at the call centre need to be trained properly if patients are not provided a direct number to call the branch.
3. We were overcharged by 1 x ovitrelle in the first delivery and was told this would be refunded. I later needed a final Gonal-F equivalent and my husband had to pick that up at the last minute before closing time. He was not informed that that would offset the overbilling of the ovitrelle. We felt that the prices were made up as it was not documented, nor communicated.
4. We had to inform the doctor on egg collection day that we are going down the ICSI route as advised by our doctor. They appeared surprised and said we had not paid for ICSI. Had we had not mentioned this, and ICSI was not done, I don’t know what the fertilisation rate might be (it was low with normal IVF). The bill of course, came very shortly after with no apologies of their oversight.
5. We were not informed that we can delay the medication delivery when we had the treatment consultation (otherwise, once delivered, we cannot get a refund) this includes medications that I may not need should the embryo testing comes back abnormal. Everything was billed upfront, even when we may not need the medication. This is not reasonable, we get the impression that the company is charging their patients whatever they want because of the patients’ desperation to become a parent. Make sure you check the medications are definitely what you need at that point in time.
6. We had the mild stimulation IVF and was advised to do PGT-A, we were charged for a fresh embryo transfer even though we were advised it was going to be a frozen embryo transfer when the PGT-A results came back. They stated the FET would be discounted, and even though it is at a lesser charge that what is advertised on the website, we were still charged for an ET we did not need. I'm not sure if this is standard practice, it just seems unfair.
7. We were lucky to have one euploid for transfer; however, the FET procedure was nerve-wrecking (as compared to the NHS experience, surprisingly). My bladder was beyond full and they pushed against it to get a picture of the embryo being deposited. The doctor who performed the egg transfer seemed doubtful, and gave the impression that she wasn’t sure what to do. We were given an ultrasound photo and when I asked what am I looking at she said “you can’t see it as it’s a bad picture”, so what’s the purpose in giving me the picture?
8. They don’t offer a beta HCG blood test which is surprising for the amount paid. A substandard urine pregnancy test was provided instead.
9. Again, the call centre staff are mostly useless, they don't call you back when they say they will. This is extremely frustrating as you’re essentially having to pay for a NHS-type service.

10. You need to speak to a nurse before speaking to a doctor, the nurses don’t book appointments so it’s back to relying on the patient coordinator to get the appointments booked in. It is impossible to get hold of the patient coordinator and when you do, she claims she wasn't aware that you had tried to call/email her or that she was out of office.

Thank you @VSRCM for sharing. It is really hard to know what to do in these circumstances and sorry you had a rubbish experience 🙁

Hope you don't mind me asking some questions as this is a big decision and any help that can be provided would be really appreciated.

With the meds, can you order each stage at a time? For instance can you order the stims and then more if you need them? And then order Progesterone if you get to transfer stage? For instance I didn't get to transfer stage in my NHS cycle so would not want to waste our money. Also can you use another company to buy the meds if that company you mentioned is not great? I understand Asda and Lloyds are options.

You mentioned the Dr during egg collection was not great....how was the egg collection, were there any issues during the procedure?

With the ICSI, which we will need, would that be stated in the documentation at sign up stage? We would be needing ICSI so we wouldn't want that kind of mishap after egg collection.

Did you go for 3 cycle? If so, how did you find each cycle? Do you think it was affected by the service overall?

Did the Patient Coordinator get appointment bookings wrong, what were the issues? Is there another form of contact if the Patient Coordinator is not great?

Also @VSRCM would it be possible to know your cost breakdown? You mentioned 12k, was not sure if that was for 1 cycle and if so would be useful to understand that a bit more

@Sunflower360 Hello, so for the meds I'm not sure if you can get the prescription and order it somewhere else but definitely ask the question.

The egg collection process was ok, the only problem I had was them not finding my vein but they managed to get 10 eggs (I was expecting 7). What was stressful was by the end of it I had to remind them to do ICSI as I did normal IVF with NHS and the fertilisation rate was not good. I had to insist that was what the doctor advised and I'm happy to pay for it. So that was an oversight on their part.

I did 1 cycle and am now contemplating the 2-cycle upgrade (and also looking at doing if abroad); you should be able to do 1 first and be offered the 2-cycle upgrade if unsucessful. I'm not sure if there's a difference in costs though if you sign up for 3 initially. They did not sell me a 3-cycle plan at the start.

I actually had a follow-up appointment with another doctor just now and have asked for a different patient coordinator. Are you with the Birmingham branch? If so, don't use Justine. Justine just did not get anything right from the start, which made the process even more stressful than it already is. I've been given a different patient coordinator now.

I voiced my concerns re. egg transfer day and this doctor said I can opt in for a sedated one if need be; as stress and anxiety can affect implantation. So obviously I had a bad experience that day that pretty much decided the fate of my euploid :(

That said, I'm still undecided if I want to do the 2-cycle upgrade or go somewhere else. They have my notes and know my case and there are success stories with Create. I am 41 in a couple of months and time is ticking!

My 1-cycle cost:
1 mild IVF (that included a fresh transfer that they know I won't be needing because of PGTA) - 3350
PGTA for 1 embryo - 1350
PGTA subsequent embryos - 350 each x 3
ICSI - 1200
Medication - 1352
Separate medication bill (not sure why but this was the one I didn't need yet) - 100
Support package - 735
Annual storage (I haven't got anything suitable for transfer but they stored it anyway so this is confusing) - 350
Discounted FET - 1050
Discounted FET (separate invoice, disputing this) - 1600

I didn't need progesterone as I had leftover from NHS cycle.

Hope this helps, make sure you check and double check everything before paying and let me know if you have any more questions :)

Thanks @VSRCM I am surprised they did not offer the 3 cycle package in the first instance, which appears better value (if you can call it that!). If you don't mind me asking, what was your AMH/AFC? Perhaps they thought one cycle would be fine in your instance.

@Sunflower360 My AMH is 14.8 which is quite good for my age I think, but the report does state diminishing ovarian reserve.

That is very good, mine is 6! Surprised you have been classified as DOR with that AMH.

Did they indicate what could be improved for next time? Was not sure if they consider investigations to improve outcome next time. Also did they review your NHS notes?

I wanted an appointment this week and this doctor and I discussed that:

• they want to do a further check on my endometrium although the lining is not showing any problems
• I said I was prescribed bromocriptine by NHS last time to manage my prolactin levels and it implanted but I miscarried (didnt do PGTA), they said they don't prescribe that unless absolutely necessary and in my case, not
• I have an inverted uterus so that makes the transfer trickier was also what she said... again, no problem with NHS!

Other than that, I was already on steroids to manage my NK cells and aspirin and clexane to manage sticky blood; and it was a normal embryo so she couldn't tell me what could have gone wrong...

I have another appointment with my actual doctor in 2 weeks time, he is the lead consultant so hoping he can tell me more.

They asked for my NHS notes so they must have reviewed those, although she asked me what my prolactin level was and I couldnt remember!

When do you start treatment?

@VSRCM not got a start date yet, pending the consultation/ investigation appts, but hopefully August!

With Create I think it tends to vary with each clinic but I've read both good and bad experiences from various locations (some good/bad reviews about the same clinic), hopefully you will have a better experience next cycle now you have fedback your experience (should you stay with them).

I am only likely to be interested in a 3 cycle package, it sounds like it may be better overall and with my AMH level a single cycle is unlikely to get closer to a result (if at all).

It's hard to know what to do for the best, but with my AMH/AFC level sticking with Create may be best and I'll keep on top of asking lots of questions!

@Sunflower360 Good luck to us both 🙏
Do let me know how you get on! I will too once I have that discussion with my doctor :)

@VSRCM with communications with Create is it always through the call centre? I am not a patient as yet, but using the support email address, which I have to say, isn't the best... and agree with your point about the call centre too - depends on who you get but it is not the great

Yes, that's part of the problem. You will get a patient coordinator's email address once you get assigned one and even that is a hit or miss.. There is unfortunately no direct number to the clinic.