Not sure when to move onto IVF

[Nessie2395]

Bit of background, sorry this is long!

I'm 28, have endometriosis and very low AMH. I found out I had very low AMH when I was 25 so my partner and I froze 4 embryos. We hadn't tried to conceive yet as we weren't ready at that point. I'm aware I'm very lucky to have those embryos! I had surgery for endometriosis in November 2023. I hoped it would help me conceive but it hasn't.

We've now been trying to conceive for about a year.

I'm not sure when to move onto a FET. The endometriosis consultant I see said that the NHS may not fund IVF for me due to my AMH and if they did they would likely suggest donor eggs. I'm not sure they would fund anything for me now as I had the embryos frozen privately (perhaps in haste but I panicked tbh). Nonetheless I'm on the waiting list for th NHS fertility clinic and can expect a phone call around September 2025 apparently.

On one hand, I'm only young so I could keep trying naturally for longer. I have no idea what my AMH is now. I do want a hycosy and was hoping I could get one of these from the NHS but won't know until I get an appointment next year.

On the other my partner is a decade older than me so is worried about his age.

I don't know whether to wait for the NHS call with the fertility clinic next September or move onto a FET beforehand. Having a FET would definitely rule out any NHS help. At the moment I'm unsure if I would get help from them. My care board says you can't get NHS IVF funding if you have had a private cycle. I don't know if freezing embryos (with no transfer) counts as a cycle - it probably does!

I thought maybe it was worth paying for a hycosy before anything else but I can't afford one of those and a FET.

Just lost and unsure what to do. Would you keep trying naturally until I heard from the NHS? Even though I'm probably not eligible for help?

Thank you x

Why don't you find out if having the embryos already in the freezer rules you out for NHS help? That way you can move forward with a decision and you won't need to wait until next September (I can't believe they've said that as a date! almost a year?!)

Hello! Thanks for the reply 🙂 yes I was referred in September, the waiting list is 12+ months in my area just for an initial phone call with the fertility clinic! I've asked my GP and the consultant I had and neither know. Wondering where else I can find out for sure? It's a good idea thank you I'll look into it!!

That part I'm not sure about but there must be someone who can give you an answer - at least then you have the information and can make a decision? If you know where the clinic is (part of your local hospital?) then couldn't you call them?

https://www.nhs.uk/conditions/ivf/availability/

Under the age of 40 you aren't eligible until 2 years of TTC in any case - so that rules you out at this stage, but you may be falling into that category by next year around this time if you've had no luck.

Hi, thanks for your reply! I will try and call that hospital department, maybe someone will know who I should talk to.

I think the time spent TTC depends on your ICB. Mine says for couples/single women where there is a known reproductive condition, it's only one year that you need to have been trying for. It's two years of you don't have a reproductive condition (I do unfortunately!). But doesn't really matter as you said by next September it's be two years unless we get lucky 🙂

Thanks again!

Hi @Nessie2395 - I had a similar situation a few years ago. At 30 years I found out I had a very low AMH and MFI on top, we started trying immediately. I monitored my AMH and after 6 months it dropped again so we looked to freeze privately. We did 2 freeze rounds privately and got 1 embryo from each. We then went to the NHS after a year of trying as the policy was 1 year + another problem or 2 years without a problem. Our care board doesn’t count low ovarian reserve as an infertility marker, so we qualified with 1 year because of my partner. In our first consultation I mentioned the private freezes. Our NHS policy was that we could have 3 rounds of fresh IVF but the 2 freeze rounds disqualified us from 2 of those. I asked if they’d at least fund putting them back if our 1 fresh round was unsuccessful and the consultant said something like “hmm, it’s an interesting one, I think it’d be one for a letter from me to the care board explaining the circumstances”.

We managed to get some more embryos on our 1 full fresh round so are slowly putting those back in first. So I haven’t had to cross that bridge, but a heads up that it wasn’t clear if we could do that or not. Good luck!

Sorry you are in that situation

As said above, start enquiring if you can have an nhs round first - as I suppose at this point you are deliberating over a decision where you don't even know if the option exists yet.

We bypassed the 2 year wait, we had a known condition (male factor) so we didn't need to have a ttc period. Even without a ttc period, it still took us 18 months to get started.

If nhs is available, wait, and obviously keep trying naturally while you wait. If not available, I'd move forward with private, and I wouldn't postpone (assuming you are in position too) even private can come with multiple delays.

Ivf doesn't necessarily stop you from trying naturally (only when on the meds).

Only thing I'm sure on though is that I wouldn't wait till next September to find out if you can have nhs input, as even from there you could still be looking at several months from that point. There must be a way of finding out if it's even an option first.

Hello thanks so much for your reply, that's a very similar situation. I'm glad you have managed to get some NHS funding. My ICB only offers one round on the NHS so by that logic I won't be entitled to anything now. I will have to find out - just no idea how to do that, communicating with that hospital has so far been a complete nightmare for everything I've had so far. Thanks again and good luck x

Hi thanks for your reply! This is really helpful, you're right IVF doesn't mean I can't try naturally. We could always do a FET and then try naturally again afterwards if necessary.

I need to find out if I'm entitled to help. I will start by calling them and hopefully they can direct me to the right person

You could try reach out to the PALS team at your hospital. I moved areas and got put to the back of the queue for my new area and the PALS team sorted it out for me. I wrote quite a personal letter to explain my low ovarian reserve situation and time matters etc. It might be worth a try for you.

Hi @Nessie2395 definitely go for the hysteroscopy to clear any scaring from your endo, then maybe ttc for a few months if noting happens look into a frozen transfer! Goodluck ✨️

PALS is a great idea thank you 🙂

Thank you, much appreciated! Currently saving for the procedure, I had endo on one of my fallopian tubes which is why I think it might be relevant