Time between cycles - unnecessary delay?

[Borerora]

Hi,

I'd love to get some insights into the typical time frames between conclusion of an IVF cycle with negative outcome and commencement of a new one.

Our first cycle failed and we had no embryos suitable for freezing. Obviously this is upsetting but by no means unexpected. The clinic's process is to have a consultation with us following their own internal review meeting. I've been told that this consultation with ourselves will take place 6 weeks after the internal review meeting (which is almost 2 weeks after the negative pregnancy test). It will only be at that point that new treatment dates can be scheduled.

I know I am in a highly emotional state at present but this seems like an unnecessarily long time to wait for just a consultation, with who knows how long of a delay before commencement of a new cycle. Is this typical? What sort of reasonable expectations should I have in terms of timelines for repeat cycles?

Thank you x

[AnnieStar12]

Sorry to hear that. I am in a similar position - our first cycle has failed and we have nothing frozen. Today is my official test day, which is negative so my cycle has sadly completed without success. So I sympathise with how emotional this time is.

My clinic already did their clinical review meeting on Monday and discussed my next steps in case it was a negative outcome, and I have my consultation on Saturday to talk it all through with the consultant about what we do next. I told them I would be keen to move quickly if this first round failed, so I was probably putting pressure on getting things moving and to be fair they have been accommodating. It's a small private clinic so it's probably easier for them to be flexible.

It is a really emotional time, and making you wait almost 2 months just to discuss next steps feels unfair. I'm sorry that's what you're dealing with, I would also be upset. Are you with the NHS, or private? I am sadly not entitled to NHS as this is a secondary infertility issue, but I do know friends on the NHS have had long waits in between appointments. Have you pushed for them to move quicker?

[2mumlife]

Hey. We paid privately, but our clinics stance was there should always be at least 1 natural cycle between medicated cycles. So after a negative result, you'd have a bleed, and then they would want you to have no medication for that cycle, until you bleed again. That was the fastest we ever had between cycles. Sometimes there was more of a delay though due to how busy they were, or if there was things that needed discussed, different forms to sign etc between cycles.

It may be your clinic want to run additional tests between cycles to give you a better chance next time. In the meantime, some people find it useful to use the break between cycles to focus on healthy lifestyle / supplements / alternative therapies like acupuncture etc to try to boost fertility for the next cycle.

Best of luck for your next cycle

[blahblahetc]

Hi there - if you are a private patient, you should demand an earlier appointment slot. I was with Create and I couldn't wait the 3 weeks they had initially booked me in for; their excuse was the doctor was on holiday so I asked to see someone else, which they obliged to in the end. The stand-in doctor just had to get herself up to speed with my notes.

There is sometimes a mandatory wait time between cycles to ensure your body isn't too strained with the hormones overload, think OHSS etc. But completely reasonable to want a consultation ASAP to understand what went wrong / what should be done different next time.

I'm sorry for your failed cycle, the first one unfortunately can be hit or miss as they are just waiting to see how your body responds. I was in a hurry to get on with it (failed transfer with NHS) and in hindsight, wish I did more research before going with the private clinic (Create).

I recommend you look into options abroad; they are a lot more efficient and less expensive.

[Natty2]

Hi OP I'm sorry your first cycle failed.
I had my first egg collection this January, which only resulted in 1 viable embryo. As we ended up on a freeze all due to high progesterone levels, we decided to do another round of egg collection (just for better odds and a future sibling)
Although the first round was funded by the NHS the treatment was done under a private clinic. We had a follow up 3 weeks later
The clinics policy is to wait for the withdrawal bleed first and then another 2 natural periods- which is longer than most!
We heard there was no evidence to suggest there would be a difference in waiting that long so they allowed us a day 1 scan on my first natural period after the withdrawal bleed (which I think is normal for other clinics) to check for any cysts and then I was able to proceed
I just had EC 61days after my first.
Sadly on another freeze all and again they want 3 bleeds before we can put one back in!

I completely feel the pain of waiting and I hope you can speed up your consultation. Once we had a plan in place it helped relieve some of the anxiety.
Good luck

[Borerora]

Thank you so much for your replies. I've calmed slightly and contacted the clinic and they undertook some manoeuvres to slot me in in a fortnight's time, which is better but still a bit longer than I'd like.

@AnnieStar12 I'm so sorry about the outcome of your cycle. I hope you will be able to move quickly once you meet your consultant and wishing you the very best for the next cycle. I'm also a private patient.

@2mumlife That's helpful to hear about your clinic's policy of requiring an interval of at least one natural cycle. I think mine might be the same although it's a little bit shrouded in mystery!

@blahblahetc It sounds like a similar situation to mine in that the delay was partly explained by a doctor's planned leave. I wasn't aware we had to deal with one doctor only. I thought they worked in a cooperative manner, with patients dealt with by next available doctor. I think that will be something I keep in mind in the future, to request to be seen by someone else if it makes it more timely. I need to look into overseas options, it's not something I've thought about till now but it's something that's in my interests to be informed about.

I think what's annoyed me about this is that I see the consultation appointment as somewhat of an admin step and a barrier to getting on with it, because treatment dates can't be set until it's completed.

The reality is that if protocol changes are suggested we're going to just accept them and we are also going to confirm that yes, we do want to proceed to another cycle. If additional testing is needed, that's fine too but surely that could just be communicated following the internal meeting if needed and progressed. It seems so inefficient in the context of a time sensitive process and that is mightily frustrating!!

Thank you all again for your replies, it's really helpful to get advice from others when you're not sure what's normal and what's not, especially when not feeling in the best of form. Xxx

[Borerora]

@Natty2

Hi OP I'm sorry your first cycle failed.
I had my first egg collection this January, which only resulted in 1 viable embryo. As we ended up on a freeze all due to high progesterone levels, we decided to do another round of egg collection (just for better odds and a future sibling)
Although the first round was funded by the NHS the treatment was done under a private clinic. We had a follow up 3 weeks later
The clinics policy is to wait for the withdrawal bleed first and then another 2 natural periods- which is longer than most!
We heard there was no evidence to suggest there would be a difference in waiting that long so they allowed us a day 1 scan on my first natural period after the withdrawal bleed (which I think is normal for other clinics) to check for any cysts and then I was able to proceed
I just had EC 61days after my first.
Sadly on another freeze all and again they want 3 bleeds before we can put one back in!

I completely feel the pain of waiting and I hope you can speed up your consultation. Once we had a plan in place it helped relieve some of the anxiety.
Good luck

@Natty2 I'm sorry, I just missed your message in my initial reply! I hope you will be able to have your transfer soon, wishing you lots of luck. The waiting is so tough to deal with. It's interesting to hear that your clinic has a different policy on intervals. It seems like the evidence base for those rules is flimsy! You are right though, having a plan in place eases anxiety.

[Btowngirl]

Like you I was keen to go back to back if possible. Initially had 2 failed IUI cycles. After my last I wanted to press ahead with IVF asap but due to when my period fell and their Christmas closures, I ended up waiting almost 3 months for my suitable day 1. It was super frustrating and felt really unfair (which this whole process is just that really, unfair). When I had the IVF I asked how soon I could go again if it didn’t work and they said I would need that bleed and the next day 1 would be my new cycles day 1, hope that helps.