ABC IVF for beginners please

[fsr111]

Hi all,

My DH and I have decided now is the time to book our initial ultrasound scan with ABC IVF in Bristol, I have a couple of questions for anyone that might know - is there a better point in the cycle to have this, or doesn't it matter? And I haven't had any AMH tests on the NHS, will they do that as part of the initial appointment and if I don't meet their criteria, I guess that's that on our journey with them?

Feeling a bit out of my depth, but guessing it all gets explained as we go along...?!

Hello :) I am currently going through this process with abc. I had an amh blood test as part of my baseline scan/assessment. I don’t think it matters where in your cycle you are for the scan, because they will be looking at your scan in the context of where you are in the cycle, if that makes sense! Mine was on day 8 I think and the consultant was saying things like “this is fine/normal for day 8” etc. They are looking at your uterus lining and the number of follicles you have in the scans, which you can look at wherever you are in the cycle.

if you don’t meet the abc criteria they do have a sister company called Create, all the same building/clinicians etc, who they might refer you to. Abc is nurse led and use a particular protocol that is supposed to suit the patients within their criteria, whereas Create is consultant led and therefore more expensive but perhaps a little more bespoke! I hope that is helpful. Good luck!

Thank you so much @Quickdraw23 - that's so helpful!

One other question, if you don't mind, what sort of time frame is it from having the initial scan to starting the process proper?

Good luck with it all, what stage are you at?

It depends on the outcome of the scan, where in your cycle you are and when you’re wanting to get started I think! By the time we had finalised our treatment plans and paid I was on literally day 1 of my cycle so we had to wait a whole month after that to get started. They say if there is a period of more than 3 months after the baseline scan you need to get another, so generally working in quite small windows. Once we had finalised everything and done all the paperwork it went pretty quick. Everything has been very efficient and reliable for us so far!

ive got egg collection tomorrow, feeling quite ready after 8 days of stims!

A time period of three months I mean, rather than a menstrual period lasting three months 😂

Do just think about all your options - abc cheapest on paper (and cheapest if you get pregnant on first cycle!) but you are unlikely to get multiple embryos to store - if you are planning 2 kids/mid to late 30s probably best to do cycles where you freeze plenty down as will only get harder to get decent embryos later on (and you don’t know how many transfers it will take). Also FET has much fewer appointments and is a lot easier to work into your schedule compared to a stimulated cycle which is quite disruptive (I can only speak for natural cycle FET). I don’t think I would be able to cope logistically doing repeated stimulated cycles which is what you may end up doing with abc

Also we were incorrectly advised to have ICSI by abc (which cost more) - they even said we would have to sign to say we were going against their advice if we turned it down
Got second opinion from a fertility expert and was not recommended at all
Ended up with 6 very good quality blastocysts from one full stimulated (not mild) cycle elsewhere - no ICSI
Aged 34 at the time, amh 14

agree with above poster of course, best to look around and read up - obviously don’t know OPs individual circumstances

@Harryateacroissant, thanks for this, that's really helpful. It's such a minefield of terminology, I read it all but it's difficult to understand what that means in the real world.
We have a DC already, so I'm not massively concerned about freezing eggs for later down the line.
I suppose your point about the type of process you have leads me to another question - with ABC, is it a one approach fits all? Or will it differ depending on circumstances / results of the initial consultation? Guessing you didn't proceed with them, did you have the initial call and then decide to go elsewhere?
Eesh, I don't know if I'm being dim or just overwhelmed by information! 🤣

It will be a one size fits all with abc as is nurse led and managed so will be very protocolised. So if you don’t respond well then they will be able to increase dose of meds for example - as per protocol, but if there is something more complex and specialised it will be difficult to discuss.

We had the consultation and they had said that my husband 2% normal morphology necessitated ICSI. we did some reading (actually mumsnet was the most helpful!) and essentially we learnt that given his other numbers are twice the normal range this shouldn’t matter - ie if you have double normal number of sperm and normal morphology is half of normal range you still have same number of sperm with normal morphology! We went to a fertility expert we knew was highly regarded and he said the same thing and actually said that ICSI would actually lower our chances, because when you do ICSI you are selecting sperm based on how they look under microscope, and actually normal fertilisation means they are selected based on how they work - so you only do it when you really need to. Also, the morphology measurement is only a snapshot of a tiny area of a huge sample.

I think at that stage we had lost faith and we went elsewhere. We went to an nhs unit but self funded - this generally works out a bit cheaper.
Also meant the staff weren’t money driven - they didn’t have a clue whenever we asked them about cost of things at various points and we would always have to check with admin - which weirdly I found reassuring!

Also make sure you pick a clinic that has an anaesthetist for the sedation - ideally profile as it just feels like GA. We were told that abc does have this at the time.

As I’ve said before - do have a think about number of appointments (if it matters to you and your lifestyle/work etc). With my most recent stimulated cycle, I had a baseline scan, then 5/6 further scans to determine best time to trigger ovulation, then you are out of action all day of egg collection, then embryo transfer. With my frozen natural cycle FET I had baseline scan, 2/3 scans to decide when to trigger ovulation and then the transfer. The transfer doesnt need medication so you can go straight back to work afterwards. If you end up needing loads of transfers it’s a lot of appointments and time out for multiple medicated cycles.

Propofol for the sedation that should say
Not profile!

Just re read your post and I think you were asking for a simpler reply that I have given!

To sum up, you can do ABC, but it will mean that you won’t get many embryos. It will also mean that you are on a protocol rather than having a specialist consultant in charge of your care. Stimulated cycles are when you are given drugs to make you release lots of eggs and then they are collected (and an embryo is implanted 5 days later). A frozen transfer is when a frozen embryo is implanted - a simpler process with less appointments and much fewer drugs. So if you do conventional IVF, you would likely get more embryos than mild IVF with ABC. This means that if the first transfer is not successful, you can then go through a simpler process to put a second embryo in. If you got lots of embryos in the stimulated cycle, it would mean that you could do this process many times before having to go back to do the full stimulated cycle. My experience is that the stimulated cycle is pretty heavy going and quite disruptive for work commitments etc

Hope that helps!

Ultimately OP if you go for a consultation and you don’t feel like your questions are being adequately answered you aren’t obliged to go with that particular clinic and can seek a second opinion.

@Harryateacroissant I totally appreciate you are sharing your own experience here, and I’m really sorry to hear you felt a lack of trust with abc, and also pleased to hear that you had a good experience elsewhere.

However, I really don’t think without knowing the OPs personal clinical circumstances it can be said that they’re unlikely to get multiple embryos to freeze from a mild cycle. We really can’t know that. It is possible to have several embryos from a mild cycle to attempt FETs with if needed, just as it is possible to have poor outcomes and have one or none with a full cycle. There are also other risks that can be increased with a full stimulated cycle - I would have been very likely to overstimulate on a full cycle and potentially be quite poorly.

@fsr111 I had 8 eggs collected today, obviously it remains to be seen how many fertilise and make it to day 3/5. The woman next door to me on the same protocol had 13 collected, so it’s not necessarily the case of very low numbers on mild protocols. It really is individual and dependent on what is appropriate for you based on your clinical situation, which is why it’s worth getting a couple of opinions if you’re not sure!

I do agree with above poster! Not entirely against abc and is a good option for some people - eg those at risk of overstimulation, very straightforward cases where specialist advice unlikely to be needed - just make sure you take more than one opinion if you are going down the abc route to ensure you are being given good advice! The above (believe it or not!) is a summary and we were told other incorrect things at our initial consultation.

Also do ask the clinics about refunds etc if cycle is cancelled due to medical reason or transfer has to be postponed due to medical reason. At our clinic we had the transfer included when it had to be postponed after egg collection and didn’t have to pay a separate fee - a lot of clinics (including abc) do not do this and it’s another big chunk of money to pay.

I am currently going through the ABC process and have found them fantastic. I managed to go from first appointment to starting treatment in 2.5 weeks, which I thought was very impressive! Everyone has been very responsive to emails etc.

I do think it is probably true that ABC works best for simple cases. I am young and can actually fall pregnant very easily… but I have recurrent ectopic pregnancies due to some damage near the ovaries which has left me with no functional tubes :( so an ‘easy’ problem to fix, which may not be the case for complex hormonal issues.

Re light stims… as someone with a very high natural count I actually found it reassuring as it lowers the risk of OHSS!

@Superstorefan123

Hi, I know this post was a long time ago. However I am looking into abc ivf and I am glad I stumbled across your comment.

Sorry to hear about your previous ectopics. I have suffered 3 ectopics in the last year and only have one tube. I am currently 29 and can obviously get pregnant as although they were ectopic, we have still been pregnant 3 times within a year; which is why I am hoping this would be a good route for us to take.

please can I ask if ivf at abc was successful for you?

Hi @Ttckate sorry to hear about your ectopics. ABC ivf was successful for me. My first transfer unfortunately ended in a miscarriage but my second transfer stuck and I am now cuddling my newborn son :) I also have some embryos in the freezer for no2 if we wanted. They were really great during my miscarriage and helped me work out what was going wrong (I needed blood thinners - I actually had to transfer to their sister clinic create for this but they basically operate as 1 so no hassle) so cannot recommend enough!

best of luck any questions let me know xx

Also note - it is still possible to overstimulate on mini ivf - I did and ended up collecting 27 eggs! (6 embryos in the end)

@Superstorefan123 aw congratulations on your baby boy! That’s wonderful! And thank you for replying to my comment! I have signed up for this q&a session with them so will hopefully get lots of info there - then if happy arrange to book an initial scan and consultation! Thanks again!

Hey, I've sadly had 2 ectopic pregnancies and both of my tubes removed so we have to go through IVF. Im wondering if you qualified for NHS funding? Also, what was the consultation process like with ABC, did you reach out to them or Create? I've been looking at both and I'm unsure who to go with.

Congratulations on your little bundle of joy!

Thanks!

Hi @sansansansan - I did qualify for NHS funding but was inpatient so went private (my NHS trust only worked with Homerton hospital with a long waitlist) . You can only access funding through create with a very limited number of NHS trusts.

ABC actually didn’t work for me - I ended up miscarrying due to some complex medical issues so had to move to Create who could offer a more specialised set of medication - this worked and I have a 4 month old son :)

however consultation very easy with both centres and I had a positive experience :) feel free to message me any questions!

I’m look at starting my ivf journey with ABC. I’ve booked my initial scsn and consultation . Can someone tell me, do they only transfer one embryo even if you’re over 35? And would they allow embryo testing by their sister company create? Thanks