Choosing between 2-cycle package and 3-cycle

[Klmno]

I am really stuck deciding between a 2-cycle package for IVF/ICSI or a 3-cycle package. With Access Fertility.

Either way I don't think we'll pay the extra for the refundable one.

I have amh of 37, I'm 35 years old. We have male factor so would be having isci.

I know nobody can decide for me but interested to know how others decided what to do?

It's 8900 for the 2-cycle, 10950 for 3-cycle.
Plus the meds which ofc can get expensive.
So 2k difference for an extra round...but we'll be kicking ourselves if we get super lucky and only need one or two! Is it just being naive/unrealistic hoping we will be that lucky though!?!

Hi, I remember being in this exact same boat trying to decide between the various IVF with ICSI packages looking at Access fertility and Assured- we went with Assured in the end but they are all very similar so I don’t think the company makes a massive difference. My partner is a big fan of a spreadsheet nerd which he used for pros/cons and cost comparison!

We went with the 2 cycle but mostly because I’d already had one NHS funded cycle and I was thinking that 3 rounds would probably be my personal limit of what I’m willing to put myself through. We’ve just had the second Assured cycle after we didn’t get any good quality embryos that survived to the transfer the first time and currently halfway through the 2 week wait so we’ll see what happens!

Even if this one doesn’t work out I don’t regret only choosing the two- but funnily after the failed first Assured funded round I found myself exhausted at the thought of having to go through it again because it was part of the plan. Obviously I got over it after taking a few months break but there was a point where I thought I wouldn’t be doing it if it wasn’t already paid for which is crazy when I think back to it now!

If you’re confident that you know you have it in you to continue doing whatever it takes if you get right down to the 3rd cycle, then that one could be right for you- we also though about how bitter we’d be if it worked first time but I think the excitement of a successful pregnancy would outweigh it, and it’s money that is already out the door- that always softens the blow a bit for me!

I hope that ramble makes sense, and very best of luck with your decision and the IVF.

We had a failed nhs round then a two cycle package and it worked on the first one. We didn’t feel annoyed that we’d paid extra, in the scheme of things it’s not a life changing amount and we were just so happy to have our baby. It’s like an insurance policy, you hope you don’t need the second (or third) round but are glad that you do if you need it. If you don’t need it happy days, you’re pregnant.

In my clinic, I signed up for 1-cycle package at first and then after it was done, i upgraded to 3-cycle package and i only paid the price difference, so it all worked out. Ask you clinic if they can do the same, let's say if you sign up for 2-cycle package but then after 2 you can upgrade to 3 and just pay the difference after.

there's no way to tell how many you will need otherwise. all my numbers were fine and i ended up doing 3, i know someone with exactly the same numbers and age and they got pregnant after 1. it's a lottery.

Thank you so much for the replies!
It's a really good point that if we got pregnant we would be so delighted we probably wouldn't give two hoots about the extra 2k (although it feels like a lot right now, when forking out so much money all at once, and with no certainty we will get a positive outcome).
My partner is more tempted by the 2 rounds but I don't know if he's just less aware of how IVF isn't a guarantee!
Unfortunately we have decided to forgo our NHS round due to huge wait, so kind of going in blind.

Good luck to those of you still having treatment!

I have very low amh, when I read your number I was like.. that’s possible?! I’m on a three cycle package, but because a “round” of ivf is literally just stims and if I’m v lucky one transfer. If I had loads of eggs I would for sure reconsider the three cycles (I’ve already had two nhs ones) and I feel a little dread looking into my ivf future (one down two more to go). I suppose you’ve got the option to think about siblings…

oh also, because of the amount of meds I need, and needing icsi. Our price is coming close to 24k. We had no idea we were quoted 15 when we began. Took out a big loan for it. So your situation sounds quite good (in an ivf context) to me!

It's many years since I had my IVF and we bought a 3-round package. The first round the NHS paid for the drugs but we had to pay for the other two. I didn't respond well to the drugs the first time and produced very few eggs. This resulted in only two viable embryos but the transfer didn't work. They told me I'd have to have an increased dose of drugs next time and the amount was eye watering. What I hadn't taken on board also was that I had a 12 month period to use the three attempts (may be different now). We were stressed to the eyeballs wondering how we'd afford the next drugs, and what we'd do if the second attempt didn't work. In the end a miracle occurred and I got pregnant naturally between tries - having been told the chance of that happening was almost impossible! Naturally they wouldn't refund us any money we'd paid for the unused attempts, but we had a healthy baby, so that took the sting off.

I wish you well for whatever you decide OP and hope you're successful early on.

we Nearly went with Redia (sister company to access) and they were lovely to deal with. Their testing to get accepted wasn’t crazy but I was under a tight deadline as was 39 and my 40th birthday was approaching so time was a factor. I had some concerns around if I didn’t like the clinic and had concerns (I don’t believe it would be possible to change that so please do research where you go) and the timing of getting the process complete to starting cycle and also that you need to transfer all embryos before starting the next cycle. Thankfully my second cycle (first self funded) worked and I had a BFP just before my 40th birthday. It works for a lot of people and I found Redia not to be pushy and also they do various refund packages depending on age but sometimes it’s good to trust your gut x

How severe is the male factor and how many children do you ideally want?

Thank you so much for the replies
Lovely to hear of some success stories and good luck to those of you still ongoing treatment.
I really appreciate your help and takes on things

@sirensong we have had three semen analysis, one was normal but low end of normal, one showed low motility and one showed low morphology (nothing dire, but low). We then got a DNA fragmentation test which shows fragmentation (not severe).
I used to always dream of 3 children but have accepted this is probably unrealistic now. I'm not sure that makes a difference to the access packages though as they end when you get a life birth? So I couldn't used subsequent rounds for siblings.

@Nosejug that's reassuring to hear my numbers are good, tbh I'm a bit confused as it was 29 in Nov and I didn't think it could go up?!! I have stopped working nightshifts though which were definitely killing me so maybe it's that?!

Huh… going up by that much is quite unusual, I think it’s a thing for pcos. Mine went up too heh, 2.7 - 3.8, bot quite the same jump! There’s a small amount of fluctuation depending on variabilities but I think it’s usually small. Was it flagged at all?

I also dreamed of three…💐

Hm I've had one NHS scan and two private scans and all were described as normal ovary appearance, with our latest consultation the consultant mentioned it's a fairly decent number and said sometimes PCOS causes it but that I don't have PCOS. I also paid for a hormone panel like testosterone etc and that was normal. So I'm a bit stumped! But I guess it's a good thing so very grateful it's a decent number even though I don't know why on earth it's changed!

@Nosejug it's so hard when you feel like your dreams are disappearing, isn't it 💐 xx

I’d love mine to suddenly go up by ten! In any case you know it’s high, and so will not have a problem making eggs. Best of luck with your treatment, I hope it all goes well :)

Thank you. Really hope you get there soon 🤞🏻

It's so hard to advise as it's impossible to know how your round will go.
It might go absolutely amazing and it might only take 1 round or , it may fail. Every women and every round is different. Its a roll of the dice. Nobody knows how many rounds they will need.
Most women with a higher amh respond really well. However, On my first cycle ( we did icsi) my amh was 62 they told me I would be a high responder and a ohss risk but I only produced 7 eggs. We only had 3 fertilised eggs got all got to blast which my consultant said is very good and doesn't usually happen and we have a son now from our first ever go. My amh and follicle count really don't correlate.
We're currently on round number 2 and we had the option for a single cycle or mutil cycle. In the end , we've decided to just pay per round. our consultant advised us its a risk and Unfortunately for us , the money is too much of a gamble. I think the question untimely is , if you do a multi cycle, say pay for 3 rounds and it works , are you going to be OK with having lost all that money ? And if it doesn't work, can you afford another round?

@Klmno despite normal androgen levels it's worth testing your insulin resistance. Fasting glucose and insulin and a HbA1C test.