IVF vs. Monitored cycles (controversial question)

[TayceOnToast]

Hi all

I’m 36 years old, TTC ~3 years, low AMH

Planning to take the plunge and go balls to the wall with an expensive London clinic, initial consultation booked and paid for. (As a couple we aren’t eligible for IVF on the NHS.)

HOWEVER, last week I went to a private gynaecologist and now I feel like my plan of action may be shifting. The clinician at my most recent fertility assessment told me to see my GP about spotting between periods before going forward with IVF assessments. I decided to go private to speed things along/hope for a better service.

The gynaecologist was very informative, very matter-of-fact but friendly and I felt he was trustworthy. He was (annoyed? Horrified?) that 1 year into fertility assessments no one had checked my tubes or my FSH levels. He said that “it’s not hard” to determine a couples fertility’s and made no secret that he was disappointed with the way the NHS and IVF clinics go about things. He recommended that I have the above things checked, as well as a “monitored cycle” to really see what’s going on with my body. It didn’t feel like a sales pitch (which our consultations with some IVF clinics have felt like.)

So my question is - has anyone else got any experience of having monitored cycles instead of or as a pre-curser to IVF? Or even just considered this as an option?? Until last week I didn’t even know this was a potential route to take, I thought it was IVF or nothing. Now I’m seeing stories of women who thought they were infertile becoming pregnant naturally after one or two monitored cycles.

And my controversial question is this: Are fertility clinics sometimes encouraging us to have IVF when we might not necessarily need it?? 😬

Any viewpoints welcomed xxx

hi OP,

If you have unexplained infertility I think it is fairly standard to do some monitored cycles and maybe even try IUI. Low AMH on its own isn’t infertility. I went straight to IVF as we had MFI as well as low AMH but my friends who had unexplained infertility did several monitored rounds first.

When I went through the NHS my gp checked my FSH etc almost immediately via a blood test and then I also got a HyCoSy to check my tubes & uterus within ~6 months so I think your consultant has a point.

The biggest factor for you is age vs time, as over 35 your ovarian reserve and quality diminishes quickly. So you’d have to weigh up how long you would be willing to spend on other methods before you move to IVF.

good luck with whatever you chose.

Thanks, yes this is what I’m weighing up now - whether I have enough time to monitor cycles etc if I’m just going to end up doing IVF anyway. That’s really interesting you got FSH levels and HyCosy done on NHS. Feel like I’ve been let down somewhat with the lack of testing but can’t change that now. Maybe my GP and the fertility clinic jumped straight to suggesting IVF because of my age. Thanks for your reply x