When does it feel like the right time to go for IVF?

[Klmno]

Ttc 18 months
I turned 35 in Feb, my partner is 36.
We believe we have mild male factor infertility and some sperm DNA damage (again mild).

We are very very fortunate we have some savings and could afford the three cycle package with Access- so I think it would cost £1200 for three rounds, plus medication which I believe often comes to around £1700 per round (please correct me if I'm wrong).

We were referred for NHS IVF in June but it is likely to take months and months to get started... we'd also only get 1 round in my area. So kind of feels crazy to wait ages when the first round is unlikely to work anyway!
(Thought I'd also mention if we do go private we'd lose the NHS round)

Has anyone been in vaguely similar situation and felt like they knew when to go for it?

I struggled with TTC from about month 4 onwards when it wasn't happening, so don't feel in a great place mentally lately, and I feel like I really can't cope much longer not changing anything.... but I also know IVF isn't the magic fix necessarily and is very gruelling in itself.

But I kind of feel like I just want to get going, see how our first round goes and at least get an idea of our prognosis - how many embryos we get, essentially, even if it's not successful it might give me more of a picture of what kind of road we are on.

If NHS offered us our round very soon it would be a no-brainer to me to just do it, but even though we can afford it the thought of that much money does sting a lot.

I would love to hear people's feelings about how they felt it was the right time to go for it xx

Hi @Klmno have you spoken to someone in the NHS fertility clinic? I also thought it would take ages but when I spoke directly to someone in the clinic we chose I was advised the wait was usually 3-6 months. Obviously not as quick as private but could probably use the wait time to be healthy/ make lifestyle changes etc? Having said this, we ended up doing it privately because we didn’t qualify with NHS. We found that my AMH was too low for the liking of our local regulatory board.

In my opinion, if the wait is less than 6 months I will wait for the NHS round if you are eligible for it. If you do decide to go private, also factor in the cost of preliminary blood tests and investigations, potential referral to a private urologist if you have male factor, etc. My meds cost at least 2k per round but that was mainly because I have low amh so needed higher dosing. Good luck OP whatever you decide.

If you have the money I’d go for it to be honest. full transparency, I am in a different situation as am in a same sex couple so not eligible for funding. However we did try 2 rounds of IUI first and when we moved over to IVF, getting more specific info and answers to previously unanswered questions really helped my spirit. Knowledge is power in my opinion and like with keep trying, the IUI felt clouded in mystery as we didn’t know how good my eggs were as no one had viewed them under a microscope. As PP said though, if you’re able to call nhs and confirm wait time, if it’s really soon I guess it’s worth going down that avenue first. But I wouldn’t just wait indefinitely!

Go for it now. I suspect this is the answer you want… by which I mean that when you know you know - and I reckon you know? It is gruelling but I have found struggling with infertility without taking any action to move things forward the hardest of all. Best of luck!

Thank you all for the replies, I really appreciate the different perspectives. Magpie I think you're right that I think I do know I want to do it. I guess there's just the little whisper that says 'what if' though, and the fear of spending all the money and it not working. But as Btowngirl points out, knowledge is power and I guess even if it doesn't work it might shed some light so even if we then have to save for another round(s) at least we might be further along and learn things from failed rounds. Unfortunately friends have recently gone through it at same NHS clinic and it's been 10 months but that is a good idea to phone them just to double check the actual wait time.

I think you want to go for it so go for it. We went for ivf privately after 12 months ttc but I was 39 so I felt I had no time to waste.

Are you sure about your costings? £1200 for 3 rounds sounds massively off, unless you're missing a zero 😉

£1700 for medications per round should be fine. I spent around £2500 per round but I was on a high dose and had expensive human growth hormone as an add on.

Then you have the cost of transfer(s) on top of that.

Haha oops yes I was missing a zero!! If I meant what I wrote it would be a no brainer to go for that bargain 😂 the package includes all transfers fortunately.

I am glad that people are generally saying go for it....I think part of me wondered if 18 months TTC is too soon but it doesn't seem like it appears I'm rushing things from what you have all said

It really has been agony emotionally (I'm a midwife which doesn't help) and I think I might be better off going for it while I still have an ounce of mental strength than leaving it much longer when I'm at breaking point.

Having done one NHS round that was near-enough a complete failure, I would say to try and utilise that if you can bear to wait. I didn’t have to wait too long, but when I asked about waiting times my GP wouldn’t/couldn’t give me an answer. As each round is a bit of an experiment, I think it’s a shame to miss a chance to have a free go. Then when you go into private treatment, you are armed with all the information. We had things done through the NHS which we now don’t have to pay for again (and aren’t included with access) for example, it’s £140 just for a blood test.

However, I completely understand the desire to just get on with it. You have to do what will suit you best. Good luck :)

Reading some of the replies has prompted me to mention, it’s worth asking your GP to do some of the bloods etc for you. I took a list from the clinic & my GP was happy to do them and give me the results to pass on to my clinic.

I have friends and family who have used NHS rounds & the care was completely incomparable to our experience & those of friends who have also gone private. It seemed the NHS didn’t have as good access to lots of alterations to treatment. Also didn’t offer ICSI which shocked me as my friend has a complete failed round which could have been saved by switching to ICSI from IVF. Also look into embryo glu. I’ll never know but feel it contributed to our success.

Good luck OP, must be such a strug delivering babies every day xx

I wanted to know exactly why we weren't getting pregnant pre IVF, so we could address that in treatment. We started after 2 years TTC and in that time we found endometriosis, got that excised in a laparoscopy which also found adenomyosis, then found out I had high NK cells and cytokines, found I had thyroid issues which I started medication for, found low morphology and then extremely high DNA frag for my husband.

All of that informed what kind of treatment we would seek, which actually landed us abroad in Spain specifically for a clinic that would address all of that. We're from Ireland and the clinics here just aren't equipped for dual factor like this. We're in the middle of embryo banking so not at the finish line yet, but knowing our issues allowed us to push for ICSI with zymot and then a downregulation prior to FET to suppress my endo / adeno, followed by an immune protocol for FET. This process is so so brutal, but I feel blessed to at least have a good understanding of why we haven't conceived naturally that we are able to address with the right doctor and the right treatment. I would be a million times more anxious, stressed and depressed if it took me 3+ failed cycles to land at these diagnoses.

@wonderingwonderingwondering sometimes you never find out why though. I don’t know why I couldn’t get pregnant. The first cycle of ivf worked though. I did have hsg scan and amh checked which were good and my dhs sperm was normal. But these things are generally checked as a work up for ivf anyway in a lot of clinics.

Very true. And of course there's no guarantees no matter what you do. And I will say, since starting IVF everything takes so long and AMA is such a factor that I do wish we had started earlier.

I guess I was just very invested in root cause and felt we had so many disappointing appointments with clinics where we didn't feel cared for, that I wanted one that wouldn't shove a cookie cutter treatment plan at us and we'd end up no better off months/ years later

Thanks again for all the thoughts and advice, it really is so appreciated!

That's a good point that IVF can help you figure some stuff out about why it's not working. But also agree it's frustrating that 'unexplained' is also the case sometimes. Maybe one day they'll discover more reasons/causes of infertility.

I must say we've already spent a few hundred trying to get to the bottom of why it's not working as I didn't want to accept 'unexplained' without delving deeper.

So far we've had

• USS (I have some fibroids but none intrude into my womb lining)

-hycosy (clear)

• progesterone tests show I ovulate.

-sperm analysis for my partner which were all 3 borderline but okay

• sperm DNA fragmentation showed slightly high fragmentation
• he had a testicular ultrasound which was normal
• I got my vit D checked which is normal

-One of my thyroid tests came back slightly high (not out of range but suboptimal for fertility) however the next one was pretty good, so not sure what's going on there and why it fluctuated a lot. -nhs have run a test on his sperm to check infection isn't causing the fragmentation, but we are still waiting on the results

Do you think there's anything glaringly obvious we haven't checked out yet? Or is it likely to be sperm DNA fragmentation so hopefully overcome by isci and zymot?
(Or something 'unexplained' that scientists just don't know of yet).

We are both really healthy, eat very nutritional food, have never smoked, both exercise, barely drunk alcohol since we've started trying, my partner doesn't use saunas or tight boxers or cycle....he's started on Impryl too. It's so frustrating that we work so hard at being healthy but I think I do just need to accept that fertility is often plain bad luck!

I do think it's a shame NHS don't investigate further.
My partner did the sperm DNA test private, but our GP agreed to refer him to an NHS urologist. The urologist was like 'yes, sperm fragmentation is associated with infertility and miscarriage and failed IVF but most people wouldn't have done this test at this stage of your journey'....I think it's mad the NHS don't test it as we'd have been recommended straightforward IVF rather than ISCI based on the normal analysis alone!

Hey, I can really feel how much you're carrying with the uncertainty, the waiting, the emotional toll of TTC, and now this big decision hanging over you.
I don’t think there’s ever a perfect time to start, but from what you've shared, it sounds like you’re reaching a point where doing something might feel better than continuing in limbo. That’s really valid too — mental health plays a huge role in all this which is important to consider.
If you haven’t come across it yet, Fertility Mapper webpage has reviews from UK patients about different clinics — including things like how supported they felt emotionally and whether the clinic felt transparent about costs. Might be helpful if you do decide to go the private route and want to call someone not at a clinic.
Sending lots of good luck for whichever path you choose💛

@Klmno unfortunately many general urologists are quite dismissive when it comes to these things. I would strongly suggest seeing a urologist specialising in male fertility, you may have to do this privately so you can choose a doctor. We did and thought it was well worth it. If you’re in London, I recommend Mr Tet Yap. He didn’t leave any stone unturned when investigating my husband’s slightly high dna fragmentation although he was convinced it was mainly due to his varicoceles. He ran lots of tests, all refused by our GP who insisted that they don’t take recommendations from private doctors so we had to pay for all of them. Some are quite pricey but we do think all was worth it. Dr Jonathan Ramsey is highly recommended also but sometimes he has a long wait list.