Just started NHS referral process for IVF / ICSI and looking for some advice

[zbexbj]

My partner (32M) and I (32F) have been trying for a year with no luck. He has been diagnosed with low morphology (1.5-3% over 3 tests). He has a very high count and normal progressive motility and my tests all came back fine, except for a small fibroid which the clinic said wasn’t an issue because of its location and size. I’m now in the middle of the various tests I need to do to get a referral.

I’m realising how long and stressful this process is likely to be and wanted to ask some advice from people who have been through it:

- Can we choose which clinic to go with? I can see there’s a huge variation in success rates so do we have a choice in this?

- Does the NHS fund ICSI or just IVF? Seems with our situation that ICSI might be the better choice but I can’t tell whether the NHS would fund this.

- How long did it take you from referral to embryo transfer?

- Would you recommend telling people that you’re going through the process? I’m in two minds because I think it would be useful to have a support network but also worry it would make it worse if it failed because we’d then have to tell lots of people.

- Anything else you wish you’d known when starting out?

Thanks so much!

[Always_Worried]

Hello

I’m sorry you’re going through this. I have no experience with what the NHS offer but I do know people who have had a couple of cycles and haven’t had a very good experience.

We used Instituto Bernabeu in Alicante and they are absolutely brilliant. We had to have ICSI as we both have fertility issues (I’m 34f and partner 36m) and had our first consultation on 17th July this year. We went to the clinic for my partners tests end of August as it was quoted to be over £1,200 (just for the tests and nothing else) in the UK and only €850 in Alicante. We both went over for it as it was cheaper to both go there with easyJet, stay a couple of nights and come home again but also wanted to visit the clinic and have a look at the area, which was really helpful for us. We went over early October to begin treatment and had the transfer ten days ago so all in all was about 4 months-ish in total.

I did a ton of research on success rates, reviews and costs and it was the best out of all the ones we looked at. We pretty quickly ruled out the Uk. You have your own assistant and doctor so it’s really tailored to you and you don’t have to deal with a ton of different people.

Just for cost reference, we were quoted £12-£15k just for the treatment in the UK and nothing else. We ended up spending that going to Alicante twice, the second time for almost three weeks. That included all meds, flights, hotel and all tests, embryo freezing etc so from a cost perspective it was a no brainier. Of course not everyone has that money to hand and we did have some savings but ended up having help from family but also, please look at Gaia as they offer help for this.

As for your last question, it really is up to you who you want to tell. We only told our parents and nobody else because we didn’t want to have to keep answering questions about what stage we were at and even more so having to tell people if it hadn’t worked or even if it had but then something happened - like not having the 12 week timeframe before telling people like so many people do - but it really is down to the individual. I have found a lot of help in this forum because everyone here is going through their own thing but all know how you feel no matter what the story. If you have a close friend or friends you can trust and want to speak to them please do; I’m only giving my personal opinion on how I’ve found it so far. Happy to give you any more info if you have questions, just shout.

One bit of advice early is to get in touch with a couple you like, some close to home and maybe some like the IB because it’s worth seeing what you each of them say. I ruled one out just after one phone call! Plus it can take a week or two to get an initial consultation so it’s good to have a few lined up.

I wish you all the best in this, it’s the hardest thing we’ve ever had to do but I hope it’s all going to be worth it for you guys x

[Elsidee11]

Hey zbexbj sorry you’re going through fertility problems - I really do wish you success on this journey 🫶🏻

You will be given a list of clinics to chose from from your CCG. I think most will have a few clinics they work with. It’s pretty strict, so you cannot chose outside of their list. I did appeal and it was a strict no.

You can absolutely have ICSI if that’s what they believe will be best. We had ICSI on our second NHS round.

It’s depends on your protocol tbh, but from referral to transfer it can take a couple of months (if there’s no wait times) we were lucky and could proceed following my next bleed, down reg and stims lasted about 4 weeks and then transfer 5 days from retrieval.

In terms of talking to people, it’s very individual but it can help having some close friends/family you can trust. Make sure you and your partner are on the same page with telling people. My husband decided to tell his twin who then told his wife, and so on and so on - this definitely came between us. I really wish some people in my life never knew about our journey. But my best friend and my mum have been my rock. So there’s definitely a balance, but it’s totally up to you.

Wishing you all the luck and success. X

[Rain415]

Hi,

Sorry to hear what you guys are going through, it's a tough ride. My husband had low morphology about 2% (but also had low sperm count) throughout all of the referrals we were told ICSI. On the day of egg collection they said his morphology was normal on the day (5%) so they were going to do ivf not icsi. I was very worried about this. So she rang me back and told me as they collected enough eggs (12) they were going to do half ivf half icsi. I'm so glad they did! We got 3 icsi blastocyst and 1 ivf. My third icsi blast is now my son. Sometimes ivf throws curveball at you but don't be afraid to speak up. I'm so glad I did. Has your husband been to see a urologist? Mine was referred and they found a varicocele which was impacting results and he had this removed via surgery x

[MiniCeeCee]

Hi there, very similar situation to you, male factor infertility driven by 2% morphology, and a small fibroid on my side that they’ve said nothing to worry about. We were tried for a year, then got the call to say we were being transferred for NHS ICSI. That was in July, and have first egg collection tomorrow. So I’d say roughly 4 months is a good guesstimate between getting the referral and then actually going through the treatment (for some areas at least). Feels slow and long, but you’ll get there.

In my area (Bedfordshire), the NHS gave us a choice of 3 clinics to go with. They sort of nodded to which one they recommended, but let us go and do our own research on them and choose. We went with the one they recommended in the end.

Re. telling people, I’d say around 6 / 7 know our side. And that feels quite nice and manageable. Any more and I think it would feel quite exhausting updating people all the time. But I think a few close select few and telling them closer to the time (so in the lead up you don’t have your mum asking you every week what the update is, when there isn’t one!) is a good amount. Telling more or less though might be good for you!

Best of luck with it all, and any other qns… this forum is brilliant for them! x

[GeeGee21]

The NHS does fund ICSI if morphology is under the normal range. Interestingly, this can change over time. For example, my partner had low morphology and the test was repeated three months later. We got the same results. We went through our first IVF cycle as ICSI. In my second cycle, after my egg retrieval, the embryologist came in to say “good news, morphology is in the normal range now” and asked if we wanted to split the fertilization between ICSI and IVF. We did - I am currently 4 weeks pregnant with my IVF baby! Best of luck with your journey.

[HoneyB11]

My husband also had low morphology though I also had a low AMH and for that reason we didn’t qualify for nhs funded treatment so had to go private and had ICSI.

Is he taking any supplements at all? My husband took impryl and his morphology improved to normal level over the course of a year.

We’re currently 6 weeks pregnant from our second round of treatment 🥰

I choose to tell my close friends as have really valued and appreciated their support through it all. This forum has also been a massive help!

Good luck xx

[Eloquentia]

Hello! My husband has low morphology too. Our consultant explained that it is not clear whether and how this affects fertility but they did recommend ICSI and that gave us high fertilisation rate. Our clinic recommended Proxeed supplement for both him and me (there is one for men and another for women), we also took Ubiquinol and Vitamin D spray. I really recommend the book 'It all starts with the egg' - a lot of helpful advice for supplements and lifestyle changes to improve fertility. In response to your questions: you can and absolutely should choose your clinic. Make sure they work with NHS referrals. The NHS funds ICSI - we did ICSI with an NHS referral. It is the only treatment on the HFEA green list other than IVF. The length of time between referral and start of treatment really depends on the clinic and they waiting list. Perhaps something to discuss when choosing a clinic. In terms of telling people, this is very personal. We told very few people - family and closest friends. I found building a support network from people going through IVF or who have been through it was much more helpful than telling friends. Very few people understand what is involved in the process. What I wish I'd known: look at it as a journey and take it one day at a time. You know what the end goal is but you don't know how long it will take to get there, so be hopeful and positive, but try not to attach too high expectations, i.e. that it will work from the first time etc. Be flexible and stay strong. Very best of luck!

[Spicycurry]

Get partner to take all supplements recommended from Rebecca Fett’s It starts with the Egg. I had to abandon my one free cycle of nhs IVF as it was a waste of time. I had to go private but I was 38 then. My husband’s morphology was better when I was 40. I did get pregnant and have a son from cycle I did at 38. However, IMSI worked better than icsi. We were told on nhs if morphology improved to 4% they would not do icsi. But if dna fragmentation is also an issue IMSI is better.