Overwhelmed - suggestions for ICSI at a London based clinic

[PeachFinch]

I’m feeling really lost and overwhelmed in choosing a clinic to re-start my IVF journey…. If anyone can recommend a London or even Surrey/Middlesex based clinic for ICSI treatment I’d be grateful

A bit about our journey…
I’m 36 and live in London, initially had fertility tests with CRGH (then known as Gennet City Fertility) about 5/6 years ago I think, results came back ok for me apart from low AMH, for my husband low motility and morphology so ICSI is needed.

I ended up getting cold feet so we didn’t go ahead with ICSI at Gennet/CRGH, fast forward to last summer we plucked up the courage to start the process with Create. I really valued their approach, (natural approach, less medication etc) so went with one modified cycle with 5 eggs collected, one made to blastocyst and implanted but was not successful.

We didn’t go for another cycle via Create as my gut is telling me we need a different approach more tailored to treating male-factor with ICSI. Does anyone have any similar experiences to share?

I have given myself migraines in trying to find a clinic, really overwhelmed and feel time is running out.

This will probably be our final shot at this as financially we simply can’t keep doing this. So I really want to give it everything to try and get as many eggs as possible so we have greater chances!!

Thanks for reading

Yeah it is stressful looking at clinics in London as there are just so many. I did tones of research too, and even had spreadsheets to compare all the clinics different approaches/prices/results etc! I did a few consultations with different clinics. It is very personal and everyone will find a different clinic that suits them.

I can recommend Bridge clinic in Kings Cross. They do conventional IVF rather than the Create mild approach, so the focus on maximising your chances by getting lots of eggs. They don't charge any extra for doing ICSI (where most other clinics charge £1k extra). They are small and very personal and the prices are relatively low. If you have low AMH, and a limited budget, then you will be able to do more rounds there than with the more expensive clinics such as CRGH.

Kings Fertility in South London is also highly recommended. It's not so central so I didn't go with them in the end as being in easy reach was a big consideration for me as I didn't want to be endlessly travelling about London for appointments. If you're in easy reach I think they are worth checking out.

Good luck!

We also have male factor. I did 2 rounds with Gennet City fertility (both ended in losses) and then switched to Aria Fertility in Marylebone (after doing absolutely tons of research) where I’ve had a really fantastic experience. They will work with you on a treatment plan that is tailored to you and your needs, they have a state of the art lab + embryology team and the costs are comparable to other top clinics like CRGH or Lister. Feel free to DM me.

As a side note, has your husband done a DNA fragmentation test? If his only issues are motility/morphology it’s worth trying to improve those parameters via diet/lifestyle changes, there’s a chance you might not need ICSI if that approach is fruitful.

Thanks @AnnieStar12!
I hadn’t considered the Bridge clinic before, tempted by the low cost and surprised they do not charge extra for ICSI.

I think it’s maybe a curse and a blessing that they are a smaller clinic, probably likely to be more personable and less transactional but the stats on success rates worry me as they have not carried out many transfers.

Can I ask whether you had treatment with the Bridge clinic and how you found it?

Thank you!

@giraffesauce Can I ask, what is it that Aria does different to your first clinic? I know someone else who has just started treatment there. And I wonder if my current cycle doesn't work whether I might try somewhere else just to see if another approach changes anything, although I do like my current clinic. But interested to hear if others really rate other clinics whether to check them out.

Thank you @giraffesauce, looking into Aria and no, no DNA fragmentation has been carried out yet, so maybe this is the next step to understand what the root cause is…

Lots of lifestyle changes made but the big struggle is coping with stress as not only is this process chipping away at us, but his job is stressful too. Also I reckon I could’ve bought myself a really nice handbag with the amount of money we have spent on fertility supplements over the years!!

@PeachFinch yes, you're right being such a new and small clinic means they haven't done enough treatment cycles yet to get the years of results which is what most people want to see when picking a clinic. But the flip side is they really need it to work so they are certainly very invested in us getting pregnant!
Being a new clinic without years of data was a concern for us initially as I was drilling down in to all the different clinics results so was frustrating not to be able to do that with Bridge.
But we did research in to the staff and we went and met them all and have been working with them since September - initially did 3 rounds of IUI (one of which was successful but miscarried) and now on my second ICSI round. I also recommended a friend there who just had a better-than-expected egg collection.

@PeachFinch
Context: I did 2 rounds of IVF and 2 transfers (untested embryos) with Gennet which both ended in losses for chromosomal abnormalities.

Transferred to Aria in Sep 2022 and have since done 1 round of PGTA, several investigations and 3 frozen transfers. First two transfers failed, I’m currently 26w pregnant from the 3rd one. So I’ve had quite a few “touchpoints” with them.

Here’s what’s impressed me:

• They were recommended by Mr. Jonathan Ramsay (whom we saw for the MFI) alongside CRGH and Lister. CRGH and Lister are huge clinics so we went with Aria hoping to feel less like a number there
• Extremely knowledgeable embryology team and top notch technology. Their head embryologist is incredibly passionate about his job and personally addressed some of the questions we had in great detail
• They’re happy to try some more experimental techniques for MFI. We did both IMSI and Zymot with them, I think Zymot in particular really helped our blast numbers. Not all clinics have this available
• Consultants are esteemed in their field and always gave very sensible, balanced advice based on the latest research. Good bedside manner. They’re open to trying different protocols and hear your thoughts on what may be right for you. Not one size fits all which lots of clinics do
• All the nurses are very capable and incredibly warm and caring
• I was never made to wait for an appointment (and believe me I had MANY). That was a regular occurrence with Gennet
• They’re generally very well run and on top of your case (from nurses to admin/accounts)
• They’re not cheap, but no more expensive than the other top clinics

I hope this doesn’t sound like I work for them, I definitely don’t!! I haven’t had a live birth yet but they did get me pregnant with an (apparently, so far) healthy embryo. My points above are factual and apply whatever the outcome of my pregnancy.

I did have a couple of blips with them, things were not always 100% smooth and flawless. But they always addressed them promptly and offered reasonable solutions.

Be aware that the success rates on their website are based on 2021 data ( 2022 data isn’t out yet) which was a very small sample as they had just started operating, so the stats are a bit all over the place. I wouldn’t give them too much weight.

Also @PeachFinch you're right about trying a different approach if this is your last shot. With MFI you're likely to see a big drop off during embryo development so mild IVF doesn’t make sense, ideally you should try to get as many eggs as possible and use techniques that overcome poor sperm parameters and improve fertilization and blastulation rates.

Thank you both, finally making tracks now, progress feels good! 😊 I’m going to speak with both Aria and the Bridge along with Lister and go from there. Also now looking at Assured Fertility multicycle packages to see if our money can stretch to two rounds….!

Good luck doing your research! I am using Assured fertility, have a 3 cycle package with them. Found them really helpful. Feel free to ask any questions that come up as you do your research.

We did ICSI with Kings Fertility in South London. It's the only clinic we have used, but I found them really good. Very modern facilities and caring staff.

Hi everyone, on the same boat researching the best clinic for us. I am not eligible for nhs because of low amh of 3.5 pmol. I’m 36 y/o. I think i am also not eligible for Access (to be confirmed) because of my amh and so looking into Assured programme. @PeachFinch have you decided yet - I’m considering Lister and Bridge too. Leaning towards Lister as I read on here that they specialise in low AMH. @AnnieStar12 how are you getting on? @mayihavesomecakeplease I also considered king’s but it’s a bit inconvenient for us to get to. Good luck to us all. It’s a difficult journey but these threads have saved my sanity so far. Xx

Sorry @Pep1952 just seen this, I’ve been trying to stay offline these past few months to keep my anxiety in check and am only now re-entering civilisation lol

Have you started treatment anywhere?
I did end up going with the Bridge Clinic, using a 2 cycle package with Assured Fertility, and am just over 12 weeks - it still feels surreal to be pregnant and im just keeping my fingers and toes crossed everything goes ok. Thank you @AnnieStar12 for taking the time to respond and recommend the clinic! ❤️

I thought the experience through both Assured Fertility and Bridge was great,
using a 2 cycle package has taken some stress away and the team at Bridge were super caring and professional. It was a nicer experience than I had with Create previously. I chose Bridge Clinic over the other clinics as I got a good feeling from the team throughout the consultations, I like the stripped back approach as they weren’t going to try to upsell me add-ons that aren’t proven to work and price played a part too.

Good luck to you, let me know if you have any Qs at all ❤️

@PeachFinch wow, congrats! So pleased it worked out for you at Bridge :)
I also got lucky and am almost 17 weeks pregnant from my second cycle with Bridge despite only getting one egg.
So that’s definitely a good sign about the clinic!

@Pep1952 goodluck! Which clinic did you decide to go to in the end?

I have had a very good experience with Lister. They were my third clinic and so far one live birth and pregnant with second. This was after years of failures at other clinics. I did consults with other clinics and thought they seemed the most proactive. I never felt that I was in a ‘big’ clinic. My treatment was very personalised and I was happy that the lab and embryologists were top quality.

Ahh that’s wonderful news @AnnieStar12 congratulations!!!

Thanks @AnnieStar12, i went with lister although currently just on ovulation induction. I’m on cycle 2. We originally planned to do 3 cycles but tempted to just go straight to ivf next month!
Thanks and congratulations @PeachFinch i can’t wait for my turn!!
Hi @Dochas12111 I’m considering to do ivf next month, currently with lister for ovulation induction. Can i ask what your issues were? I have low amh 3.5, never been pregnant, 36 y/o. My husband’s test ok so far! Congrats on your pregnancy. I hope i get successful too.

@AnnieStar12 i misread your post and just realised you’re currently pregnant too! Congrats!! Wow i’m so inspired by these success stories xx

@Pep1952 low AMH and poor sperm quality - high DNA frag low count etc. also a very poor responder to Stims. I was always on the max dose. Lister added in Letrozole alongside Stims to my protocol and this did help. I think Lister are good with low AMH. That’s partly why we chose them.

@Dochas12111 that is so good to hear. So pleased for you. Can i please ask what your age is and if you have been pregnant prior to this? Thank you so much.

@Pep1952 this is my second pregnancy. First was also from Lister. I started ttc at 31, first round of IVF at 32 , three clinics and 6 rounds of IVF later I finally got pregnant at 36 and am now 38 nearly 39. But both embryos were from when I was 36.

I think Aria are very good too. I actually didn't have the majority of my treatment there as I was already with someone else, but did have some consultations.
Sent a friend there, who had twins after several failures at Lister. Another 2 friends have seen Amanda someoneorother pre/post when she started Aria.

Hi @AnnieStar12, would you be ok with sharing that spreadsheet at all? No worries of course if not! Have one of our own and we are finding it incredibly difficult to knock clinics off our sheet. Might be you have sleuthed and found out some information which will help us make our choice. London is fantastic for clinics but the choice is overwhelming!