Should I proceed to egg collection?

[crystalrock]

Hi all, looking for advice. I’m 43 and have just started my third round of mild IVF at create (3 cycle package) and unsure about whether to proceed to egg collection or not.

First round I got x5 eggs = x1 day 3 & x1 5BC

Second round I got x3 eggs = x1 4BB.

It’s looking likely that I’ll only have x1 mature egg for this third round (few smaller but think unlikely to yield much) so unsure whether to proceed to EC, or wait and try again next month. I did have x1 NHS cycle at the end of last year where I also only got x1 mature egg and did get pregnant with that (6BB), though miscarried at 8/9 weeks. So I know x1 egg can ‘work’ (to an extent!) but equally I got more out of a later round when I had more eggs (x5).

Very hard to hedge bets when it’s against the complete unknown of my next cycle which could be better, or even worse! Any thoughts appreciated

@crystalrock hi, hope you are ok. I am with Create too doing the 3 round cycle you mentioned- they advised me to cancel my last round (cycle 3) as the follicles were either too big or too small by the time I was due for egg collection. In hindsight even though I was upset at the time I think I preferred this than going through EC and coming out with nothing (I had a bad cycle 2 though too- got 4 mature eggs that all fertilised but none lasted to day 5). Has your consultant given you any advice?

Hi @LF82 sorry to hear you've had a rough time, it's no fun is it! At this point they've advised me to up meds a little and see how I get on for another couple of days, but my feeling is this looks like a one egg cycle....my x2 small ones are only 6mm (on day 5) so have a lot of catching up to do!

Hi @crystalrock 👋 I unfortunately do not have any personal experience in this instance, but as you say it only takes one and sounds like you were close first time round.

I would be interested to know what you decide to do and how to approach it, as I'm also considering Create on a 3 cycle package. May I ask whether you have done Mild or Natural Modified and how you have found Create? How would they manage it if you decided not to proceed with it being a pre paid multi cycle package? Mainly asking as I had low numbers in my first and currently only NHS cycle, so anticipating that could happen again.

Hi @Sunflower360 - yes sure, i'll let you know how I get on. I'm doing mild at create - think they recommend mild if your AFC is around 5/6 or higher. Mine is usually somewhere around 6-8. I've found Create really good on the clinical side and the clinic itself (I'm at st Pauls) is clean, professional and friendly and you never have to wait more than 10/15 mins for appointments. They're not great on the admin side though and I'm often having to chase for my medicaiton deliveries/sitting on hold trying to sort things which can be a real pain - but on balance the clinical side is the most important aspect. If I decide not to proceed with this cycle I can just roll over the egg collection/embryology (the really expensive bit) to the next cycle (you have up to a year to complete the 3 cycles), but I would have to pay for the medication I've used do far. I don't think i'd have to pay for the scans/blood tests I've had so far but not actually sure!

@crystalrock how are you getting on? Hope its all going ok

Hi @Sunflower360 , nice to hear from you. I'm getting on OK thanks. I decided to proceed to egg collection in the end (after x2 rounds I just wanted to get on with it really...) - ended up getting x1 mature egg (as expected) which made it to a decent quality 5 day blast (4BB), but unfortunately it didn't take. So I'm now moving onto my first frozen transfer this Saturday. They'll culture the day 3 I have to day 5, and then transfer whichever looks to be the best of the 2-3 I'll have by that stage....
How are you getting on? Have you decided to go for the x3 cycle package at Create? One bit of advice I have (from where I'm standing now, in retrospect) is that I wish now that I'd just done full single cycles, back to back if needed. The x3 cycle package is a good idea if you want to PGD your embryos but I was never keen on this (given I'm unlikely to get many embryos so would rather not take the risks associated with this). My main thought was I could get all the 'hard work' of stimming/egg collections out the way, then move to the transfer stage, starting with my best grade embryo and then working my way through them (as necessary). However, what i've realised in retrospect is that I've actually just wasted time by not transferring after each EC, and now have to spend potentially months on that aspect. I also think I thought it would be more cost effective to do the x3 cycle package, but actually, if you end up needing anything more than the single transfer this includes, you'll end up spending either the same (if x3 cycle package + 1 extra transfer), or even more if you need to move to a third transfer. Doing single cycles also means of course that if the first or second of these works, you'd save considerable money overall. So in short, if you're keen on PGD, then x3 cycle package makes sense, but personally if I did it all again (and my current embryo's all fail and i decide to try again), I'd move to single cycles. Let me know what you decide!

@crystalrock sorry to hear it didn't take, did they give any feedback or advice on relation to that? Hope the next transfer works out.

I'm having 3 x natural modified IVF due to my low AMH; starting end of this month. If I was having Mild IVF I would consider single cycles but with natural modified the aim is to collect one, maybe at the most 2 eggs, so 3 cycles back to back is usually advised in that instance due to the low numbers. Thanks for the advice though!

Hi @Sunflower360 , sorry for the delay in getting back to you. Re my last transfer, no they didn't give any advice (embryo looked good, lining was good) so highly likely it was just the usual reason of being genetically unviable. I had another transfer last Sat but it's a chemical unfortunately (got a faint positive on fri but an even fainter one y'day so am certain it's a chemical). Only have a very low quality one left now (day 6 4BC) so trying to decide whether to transfer that, or save the time & money and move to another cycle. Going to ask to speak to an embryologist for their honest opinion on that.

I'm def going to move to natural modified now as for me there is no point trying to force more eggs - in fact, I got my 'best' quality embryo's the x2 cycles where I only got x1 mature egg each time, and my 'worst' quality (the one I have left) when I got my highest no of eggs (5)!

I'm going to move to single cycles now as I'd prefer to just transfer whatever I get as I go - I no longer see the point of waiting till the end. All that approach has achieved for me is time wasted. But it's a very personal thing and I understand the appeal of wanting to get the 'hard work' of ECs over, and then moving to the transfer stage. Really hope it all goes well for you and feel free to ask me any Q's as you go, I have racked up a fair bit of experience now! x

Thanks @crystalrock and hope all goes well with your embryo if you decide to transfer