Deciding on a clinic with conflicting advice

[Firsttime2023]

I have had 2 failed rounds of ivf (1 fresh and 1 frozen).
I am looking at clinics abroad to do another round of IVF and potentially some further investigations into unexplained infertility.

i have spoken to two clinics so far in Greece and both have very different approaches to how I should proceed.
The first clinic have recommended I have aqua scan with potential for hysteroscopy depending on findings, endometrial cuts, microbiome testing and a few other things before proceeding with another round. The second clinic has said that if my recent ultrasounds are normal they don’t recommend any further investigations as it is likely an embryo issue (due to my age as I am 39).
I am going to speak to 2 further clinics but I wondered if I could get some opinions on this? My gut is telling me I need further investigations. Although I have only had 2 failed transfers I have been TTC for 3 years and never had a BFP.
But now I don’t know!
Any advice appreciated!!

I can't speak as to which is more suitable for you, but I would be put off by a clinic encouraging you to do more testing before a round of IVF, rather than before a transfer.

Whilst you aren't old, at 39 every month counts. It seems much more sensible to get embryos as soon as possible and then think about further tests - which I agree sound like a good idea if you've never had a positive.

I hadn’t thought about that. Although I don’t think there is much wait, I could pretty much be booked in straight away by the sounds of it and the ivf round would start the following cycle after the investigations they have recommended. I will double check this thank you

It’s so difficult making these decisions. On the one hand you’ve only had two failed transfers, so I’d side with a clinic saying to get more embryos, keep trying. Though you’ve never had a pregnancy, so it’s also possible there’s a problem with something else instead of the embryos. But then being 39, you want to get the embryos asap, as above poster said, testing can always wait.

I did 5 rounds, the last at 39, and for us what worked in the end was a good quality embryo. We were technically unexplained, but they always said my age was a reason. (Nobody thought partners low morphology was clinically significant in terms of ivf, we just did icsi). So for me it really was just getting the right egg and sperm combo. If age is the main driving force behind reduced fertility, then getting eggs asap seems logical. I’d had two spontaneous pregnancies that ended in mc (mmc and ectopic) and as awful as they were, they at least told me my body had the instructions. I can understand how difficult it must be trying to make this decision.

@aLogLadythank you for replying. Sorry to hear you had to through 5 rounds 😫 and for your losses.
The clinic that had suggested some further investigations have said I can have it all done within 3 days and then start stims the next cycle so it really wouldn’t hold me back too much time wise.
It is such a tough decision, one made even harder when you feel like your body is a ticking time bomb and you’re going to run out of time 😫

Well if it’s any comfort, the only proof of a good egg I have was when I was 39! Tried since 35 with no joy, so even those of us who’ve been trying with younger eggs over the years, age isn’t everything. But yes the time bomb feeling is very real.

I tried to make a lot of my difficult decisions based on what I would regret least. The gain from extra tests is that you can score things off a list of unknowns, and it sounds like these are things that are (whether to prove fruitful or not) worth scoring off for your peace of mind. I would look everything up on the hfea rating system that they offer as I imagine testing doesn’t come cheap, but maybe doing it abroad compensates for that.

@aLogLadythats a good way of looking at it. I wasn’t aware of the hfea rating system so thank you I will definitely check that out. The price difference for abroad is huge from what I’ve seen so far!

i was always tempted to go abroad! I actually found the focus of ivf quite psychologically pleasant and I’d have been up for being in another country in exchange for big savings! Hope everything goes really well for you :)

My clinic runs comprehensive testing on both (male and female) before deciding the right treatment and be as least invasive as possible. Rushing to IVF might not be the answer. Depending on what's happening in your body will drive what IVF medication you need to maximise the quality of the embryos you produce. Rushing in for IVF without understanding that might just waste your time, money and emotional investment.

You can try reading the book "it all starts with the egg" by Rebecca Fett which suggests age isn't impacting the egg quality as much as we think. It also proposed what you can do to improve your chances of good quality eggs.

Good luck.