Should I change clinics?

[Gillian84]

Hi everyone I have had 2 failed rounds in my local clinic and am hoping to start a new round however my current clinic haven't suggested changing anything particularly. I have just turned 37 with an amh of 7 with male factor fertility. I had 4 eggs followed by 5 eggs collected in the second round with a double 3dt on round 1 and single 2dt on round 2. I have looked at another clinic which is about 5 hour drive away but they have said they will change things such as offer Imsi and increase my Fsh to 450 and they take the embryo to blastocyst. The treatment itself is around £2000 more expensive and then there will be travel/hotels on top. Which I'm willing to consider but my OH is dubious about Imsi due to the lack of research and I have heard that increasing FSH to that much can actually lead to damaging the eggs. Has anyone had a positive experience of either changing to IMSI or having their FSH increased this high? Apologies for the long post but I really don't know what choice to make as not only is it a lot of extra money its potentially our last try. Thank you so much in advance xx

[leo1980]

Hi Gillian84,

What is your male factor issue? Did you see a urologist? My husband has 1% morphology, so only 99% of the sperm are abnormal in appearance and 30% fragmentation. The latter can be improved the former cannot.

We had IMSI on one of our rounds and really it made no difference. IMSI is just a stronger microscope they use to identify good speed. Referring to the way it looks rather than the DNA integrity.

Depends on what your issue is - it can be helpful but it was not for us.

I am 40 but have always used 300 FSH and 150 LH. But my eggs are old and poor quality so it’s more like that than the effect of the drugs.

Would you consider a long protocol?

[Gillian84 in reply to leo1980]

Hi Leo1980 thanks for you reply. We have been told my OH has a concentration of less than 2 million with 0% normal forms we have had Icsi so far and it's only since having a consultation with this new clinic has an andrologist been mentioned which we have now been referred to. I have always been on 300 fsh before but the new clinic want to increase to 450 if we move where as my current clinic have said they won't go that high but with no reason as to why not other than they don't think it makes a difference.

[XOXO13 in reply to Gillian84]

A year ago my husband was told he had 1% sperm morphology, meaning 99% abnormal in shape for both midi-piece and head. He started proxeed twice daily alongside FertilitySmart supplements and recently repeated his tests. He’s sperm morphology has improved to 3-4% which is still a little under where they want it to be but it’s a stark improvement. Just something for your husband to try if he hasn’t already as we both believe it’s what has helped him.

My husband also cut back on drinking, reduced high intensity exercise down significantly (for example, he’d box 5x a week and reduced that to 1x/2x week), had cooler showers and cotton only boxers (to help with temperature control). Just a few things our doctor advised for us.

I was 30 when I had my first transfer (31 now), and my AMH is 9.73 (or was) which is low for someone of my age and we collected seven eggs. We used ICSI and 6 survived to blastocysts which I can only put down to the use of ICSI (and maybe my age). Sadly three transfers haven’t worked so we decided to move clinics and try again… i pulled the trigger last night so I can’t tell you if it’s been better for me but I feel mentally better for changing clinics and trying something new - it’s given me new energy and hope. We also started again with all tests and explored further tests and we have done everything so different to the first time in terms of how we are being monitored really. Sometimes change is good so if you’re thinking about it, it may be the right thing to do.

Wishing you lots of luck xx

[Gillian84 in reply to leo1980]

Sorry, yes I would consider long protocol but neither clinic have suggested it. I wasn't sure if that was because my amh is lower

[Running79]

Hi

We had unexplained infertility, because my husband was mid 50’s when we started he had a DNA fragmentation test straight away, which confirmed his slightly lower morphology I think he was 3 or 4%

So ICSI was recommended, as already suggest IMSI is only a stronger microscope, they still use ICSI for the actual procedure.

We didn’t change clinics, mainly because our clinic does everything and also we knew that it could take a couple of rounds to maybe be successful.

Rounds 1 and 2 we changed consultants, although we stayed on a short protocol our stims medication changed

Out of the two rounds we had 5 embryos which made it to day 5 blasts.

Out of those we had, 1 BFP which ended in MC before 7 weeks. 2 failed to implant and two were PGTA tested and found to be chromosomally abnormal.

I’m an older lady at 41, so those rounds were process of elimination. We went with a known donor for round 3 which was my youngest sister, she with my husbands sample, achieved 3, 5 day blasts the first one transferred we are 17 weeks + 3.

So what I’m pointing out is instead on moving clinic

Does yours offer everything that’s needed?

Could you change consultant who could have a second opinion?

Are there any other tests you might need that have been overlooked?

[Gillian84 in reply to Running79]

Hi running79 thanks for your reply. I'm at a small clinic in Plymouth and they only have 2 consultants but only one decides protocols. They don't do IMSI here and they don't do any PGTA testing.My OH has had an appointment with an andrologist on the advice of the clinic in London so he is waiting for additional tests now.

I just feel like the clinic in London have been trying to look at other options where as plymouth don't seem to change much or add additional tests but expect a different outcome.

The price in London is going to be around £15000 plus travel whereas plymouth is £7000. If we go to London this will have to be our last round whereas plymouth we could do 2 but like I say they seem to just repeat the same and then expect a different outcome

[Running79 in reply to Gillian84]

I’m at a London Clinic - I won’t mention it here, if you want to know which one let me know and I’ll PM you.

3 rounds has cost us £40,000 - they did say we could do another round with my eggs and we might get lucky as my AMH was good for my age, but as I said no point if they are blowing dust so went straight to donor then, which for us was the right decision as this was our last round.

There will be clinics closer to you, who are equally as good, it’s a case of finding them, which you. An look at on the hfea website.

It certainly sounds like your clinic doesn’t think outside the box which doesn’t help!

[Gillian84 in reply to Running79]

Yes please I would love the name of it please? It's just so hard with to know what to do. I'm going to look at any clinics in Bristol as well and see anything else they offer. Thank you 😊 x

[FoxKinder]

HeyI had 2 failed cycles at my local nhs clinic and decided for our 3rd go to try another clinic about 30 minutes away from where I live.

My old clinic were not planning on changing anything and as this was going to be our last go I felt like I wanted a different opinion.

It was the best decision I made. My old clinic got my amh at 5.4, the new clinic 13.9. This meant they reduced my drig dosage and this allowed me to get better quality embryos.

I had 2 put back in, in april and I am currently 14 weeks pregnant with one baby and have 6 embies in the freezer.

I would say it is deffo worth considering having conversations with other clinics x x

[Beclp]

Hey GillianI recently changed clinics and I’m glad we did.

I felt alot of doubt with our FS and just putting me on the same protocol each time.

I’m just about to start my first cycle with the new clinic on a high dose FSH so hopefully it goes well.

Changing gave us a new perspective on the process and even if it doesn’t work out at the new place I feel more at peace that we changed.

If we had stayed where we were and it didn’t work I would have always wondered.

Unfortunately there are no guarantees on this IVF journey.

I believe in following your instincts and if that means spending a bit more $$ it may be worth it.

Best of luck 🤞 💕

[gianna83]

Hi Gillian84!I specifically asked for IMSI at the clinic i went to and they said yes,as long as i was paying for it. I had 14 eggs and got 3 5 day blasts and 4 4 day blasts.Third transfer worked and had my son. I would change clinics,it's such a drag to go to the same place again and again,with no results.It drains your soul a little bit,doesn't it?

I also had to travel as i live in Crete and the clinic was in Athens.