When is it too soon for IVF

[Strawberryicecream281]

Hello!

I'm 29, TTC since 2023 but probably 13/14 months in total) I have low AMH (it was 5pmnol in 2021, dread to think what it is now) and endometriosis. My partner also has had performance anxiety so I know that some of the months we've TTC have been poorly timed/missed it completely and we've only managed to try once.

The consultant we've seen has suggested IVF as soon as possible and has ordered blood tests and an ultrasound. Obviously this is all really good but there has been no mention of a Hycosy or anything to check if my tubes are blocked. I had endometriosis on one of my fallopian tubes found during my lap. I'm worried about jumping too soon to IVF as I know low AMH means people don't always respond well and also, I'm wondering if maybe a Hycosy would be more useful at this stage. I think I just didn't expect to be referred to the fertility clinic and the first appointment be immediately about IVF, I thought there were other things to possibly try and that would come later.

I left the appointment feeling like IVF we had no hope of conceiving naturally, but I just don't know if that's true.

Thank you for any insight

Just to add we recently had a break from TTC whilst waiting for the referral so I could try a hormonal contraception and get a break from my endo symptoms

Personally, if you’ve been recommended it, I’d go for it. One thing I’ve learnt is IVF is not always a quick fix so I wish I’d started sooner

Perhaps you could start down the road of IVF, as it does take a while and if they are offering it wouldn't be a bad thing to be on the list, but I'd say definitely get a hycosy to check tubes open and saline scan to check anything going on in the uterus - or even a hysteroscopy which is the gold standard. I think its mad they don't check these pre ivf, as if it was a case of your tubes needing a flush out that might fix your issue and avoid the whole thing!

Ditto if you have anything structural going on in your uterus it would be good to know before you start IVF - I say this as someone with scarring and I've just had a failed transfer, so I'm having ti have yet another look into this

Also, at 29 you have age on your side. Another reason I did IVF is to embryo bank for best chances now and future, I'm 38.

So I'd not say no to IVF, but push for other investigations first or alongside! And hope you won't need it

With low AMH, the sooner you start the better. It’s not going to increase.

Thank you for your reply, that makes complete sense and it's a good point

Hi, thank you for such a detailed reply! These are my thoughts I'm worried there isn't something wrong structurally and that I'm not going to find out going straight to IVF!

Thanks, I will definitely ask about a hycosy at least when I have another appointment. I should have asked the first appointment but I was a bit bewildered!

Thank you, this is true and something I definitely need to think about

I felt the same after an NHS consultant appt - to go from trying naturally to IVF just seemed like a massive leap and surely there's something in between to be trying!

If they have ordered blood tests, does that mean you haven't yet had all those results? Surely they are needed to get the full picture.

I've had a private consultation online (sharing my NHS tests results with them in advance) and feel that I now have 2 things to try before the jump to IVF.

Thank you for your reply! That's it, it feels like such a jump. I wasn't expecting it really.

I've had the blood tests (AMH and Day 2-5) but they said I won't be sent the results, it would just be discussed in my next appointment after my scheduled ultrasound.

Taking your results to a private consultation is a good idea, and I'm glad you have some new things to try, I wish you all the best!

We’ve been ttc for 18 months and starting IVF end of the month. I’m also wondering sometimes if we are rushing it but I am pushing myself to forget about these thoughts. I was referred to the NHS fertility clinic in the summer but haven’t heard back yet as the queue is massive. I looked for advice from different private clinics, the first told us to go down IVF straightaway due to my husband’s low morphology. My AMH is also low but I have regular cycles. The clinic I am with now suggested I do 6 Letrozole rounds to release multiple eggs each month. The treatment went well but I didn’t get pregnant. I’ve had a hycosy done too. I appreciated this clinic not rushing us to have IVF and saying that despite the low morphology, my husband’s other parameters are way above average and make up for this issue so they couldn’t pin down why we never had a single positive pregnancy test. They never pushed us to start IVF although advised that with my AMH, we shouldn’t leave it too long and that it’s a sensible next step as we could keep looking for a reason and spending time and money on other fertility tests that aren’t very reliable. Some clinics just sell IVF and really push you which isn’t nice. However, I think that the NHS wouldn’t push you to do such a costly treatment unless they genuinely think it’s the best option for you. It must be hard to experience this issue at such a young age and having to make such tough decisions! I wish you the best x

I'd recommend asking for a print out of all your blood test results so you have all the details. My NHS consultant just said 'fine' then when I spoke to the private guy he pointed out a few things like my TSH was the highest of 'normal' at 5.6 but optimal for fertility is 2.5. Also my testosterone is low.

Good luck to you too ❤️

Thank you so much! Your experience so far is really interesting, I'm sorry it hasn't worked out but I wish you the best of luck with IVF.

I also wondered about things like Letrozole.

Thanka again x

Nhs waits for hyfosy is often months

Private one is 515 gbp
We did that

They will do structural checks as part of the process for IVF. I have adenoymyosis and my clinic did several scans, including a saline balloon scan, to check the womb cavity was clear before proceeding with IVF. It delayed my treatment by about 2 months for the checks they were doing as often had to wait to be on my period. They nearly did a hyscopy but decided I didn't need it.

If they are referring you now, go for it, especially as you will be able to have these checks for free as part of the process.

Personally I would avoid hormone contraception - as an adenoymyosis suffer I totally appreciate why you want to go back on it.

My clinic put me on a long protocol which means you have drugs to 'down regulate' your body and it helped with symptoms.

Good luck.

Id go for it! I had IVF in my 20’s with endometriosis after years of denial thinking i’d fall pregnant naturally. IVF is daunting but i didnt actually find the whole process that hard, i responded well to it and got pregnant on my first cycle. My only regret is not doing it sooner 😊

Did the doctor explain their point of view? You can also ask your doctor for information on IVF and natural conception—how long it might take you to conceive and what the success rates are. It’s possible the doctor may explain that your chances of natural conception are nearly zero, helping you understand why IVF is necessary. Additionally, seeking a second medical opinion can help you make a well-informed decision