IVF newbie (question about lister and mental health)

[PenpalLdn]

Hello,

I had a negative this cycle, my 3rd letrozole + trigger + progesterone cycle, it all seemed to look great, two follicles at 25 mm. I haven't felt this low in a while, overall mental health has been low last 15 months we are trying.

We tried naturally always. I've been pregnant 3 times last year and all ended in early miscarriages. I have a nearly 3 year old little boy, he is my sunshine, and I want to give him a sibling. I've been through many tests, and it seems I have a few conditions to do with blood clotting, so I am to go on progesterone, heparin and aspirin as soon as positive test. But that positive which seemed to come every few months last year, stopped since August. To be fair, we didn't try Aug-Nov. So it has been only 4 cycles. BUT while testing at recurrent miscarriage clinic, I also found out about low ovarian reserve (AMH at measly 1.75 pmol/l and 9 AFC), so I constantly feel panic, desperation and like time is slipping away.

So we decided yesterday to do IVF. I set up initial consultation at Lister, as it seems non selective (hence somewhat lower success rate but I liked that they are not super selective) and deals well with low ovarian reserve? Does anyone have any experience with Lister? Any other London clinics to recommend?

IVF was not something we were going to do as a lot of doctors said just keep trying as I seemed to be able to get pregnant. But I want to try IVF earlier than later. Do you need to have good mental health to start IVF? Is it really difficult? I fear I'm a bit weak mentally ATM with the whole history of the last 15 months. Feeling a bit negative. Worried I'm not ready for it. This is one of the reasons I didn't go for the ARGW, CRGH or the highly successful clinics that have very regimented approach.

If anyone wants to reach out to give advice, please do. Feeling the lowest and loneliest I felt in a long while...

[DianeArnold Partner Nurse Fertility Network UK]

Hi PenpalLdn. Perhaps this me to have a little break and concentrate on you for a few months. I realise you’re probably worried about your age, but you are important, and hopefully you will get some satisfaction treatment. Any one replying with clinic names, please do so by PM. Thanke. Diane

[raverg]

The first IVF cycle is a car crash for everyone as you don’t know what to expect, plus there’s lots of hormones flying around and a lot of waiting around for phone calls to learn how many more embryos you lost from day to day. It’s rough.

So I recommend taking 3-4 months to focus on yourself and re-balance yourself. Your body can wait for 3-4 months, especially as you can think of that phase as prep for IVF and getting yourself in a good place mentally and physically too. After all, it takes about 3 months for eggs and sperm to generate, so taking a break and focusing on your wellbeing (self-care, meditation, fun projects), diet (Mediterranean, lots of fruit and veg and nuts, and cut processed foods, alcohol and sweets), exercise (improved blood flow in your body and your uterus, helps relieve anxiety too) is actually time well spent. Both for you and your husband. Make sure to take high quality supplements too, like Proceive Max.

Read “It starts with an egg” - while I don’t follow it religiously, I have taken lots of pointers from it. Also take this time to do acupuncture if you can afford it. It’s helped me relax so much and I can see how it will help me cope with the next cycle much better. Plus every clinic will offer you counselling sessions as part of your package so make sure to take advantage of those.

But while working on all this, do set up initial appointments with a couple of clinics, who might suggest further investigations for both you and your husband (and do check your husband’s parameters too as so many doctors ignore that half of the equation) and for some of those, results might take weeks to come back or it might take weeks to get an appointment with a urologist for example. So that’s another good use of those 3-4 months.

As for clinics, I think that women with low AMH tend to go on milder stim cycles but I may be mistaking. Check Create, that’s what they recommend on their website at least.

Good luck! Xx

[PenpalLdn in reply to raverg]

Hi, thank you for responding. Would you say it is possible to keep trying with letrozole (medicated) while waiting for IVF or would this interfere with initial tests? I believe at some clinics, the initial tests are just viral ones, hoping I can recycle the million tests on hormones and scan I've done in the last 6 months.

Also would you advise to approach more than 1 clinic at the start? The initial consultations are 200-250£ in London, which are affordable for me, if it is worthwhile finding the right one. I am more of a "put all eggs in one basket" kind of person - no puns intended 😂, but if shopping around is advisable at the start, I shall do that.

[PenpalLdn in reply to PenpalLdn]

And also I do need to make some changes to diet and exercise, and stress. I am hoping at least starting the process for IVF will give me that relief that there will be a time when I have an option to try something else. Still keen to keep going but only if I don't interfere with IVF, because that would be defeating the point.

[raverg in reply to PenpalLdn]

I'm not familiar with letrozole and what it is for, I'm sorry, so it's best to ask the doctors prescribing it, or ask in the initial IVF consultation. But while I'm getting ready for the next IVF cycle with all the steps I've mentioned above, we are trying naturally too. So if letrozole fits into that, definitely keep doing it.

Before our first IVF cycle, which for most people is mainly to get a baseline and understand how you respond to treatment, you just do the usual STI tests for both, semen analysis for the male partner, and hormone / AMH / AFC for the female partner, you're right.

But, especially when you go private, and if you have started to accumulate miscarriages and repeated failures, a good doctor should probably start investigating a bit more to understand what's going on beneath the surface. In my case, I had a bigger panel of blood tests done looking at deficiencies too, whereas my husband had to do a karyotype test and was sent to a urologist for his varicocele, and was recommended a varicocelectomy (spoiler alert: that one requires about 6 months recovery time, so we're going to take our chances and do one ICSI cycle now, varicocelectomy right after, and then if we still need to, another ICSI cycle next year). DNA fragmentation tests are also pretty popular for the man. I'm not as familiar with the more in-depth tests for women, but I'm doing a vaginal microbiome test outside of the IVF clinic at the moment as I had a case of thrush before my previous FET and want to make sure that's gone before the next transfer.

So with this being your first IVF cycle, it's up to you whether you want to see how it goes with this new strategy, or whether you want to look deeper and make sure you're going into the IVF cycle with all the information and the right treatment. Both options are valid at this stage I reckon.

You can probably go by recommendations and reputation to pick one clinic, and if you don't like the vibe or their recommendations in the initial consultation, maybe then see if there's other clinics out there. Maybe start by asking on this forum, or searching in previous posts, where other people in a similar situation to yours have gone, and how they feel about it. No need to interview every clinic, I shouldn't have given you that impression, apologies.

"emmatheembryologist" is doing a run on instagram at the moment about how to select a clinic, which may help. Also, she's done a webinar with The Fertility Suite about how to get yourself IVF ready (which I haven't watched yet, but here it is: youtu.be/oaQLqny8tX4?si=GQN...(Not working as expected?) )

Hopefully this all helps! I'm sorry you're going through all of this; it sounds like a particularly tough situation and it's very common in this process to feel alone and hopeless. I constantly feel frustrated by how little doctors seem to actually know about fertility and how much it is a game of numbers and stats. So over and over I feel it keeps coming down to me and my decisions on whether this whole damn thing will work or not, despite dealing with a medical and scientific endeavour that should have more guarantees for the amount of time these people have done it for or gone to medical school for, and how much money you're throwing at it. It's hard, and I struggle with it too, but once I have decided the plan for the next 3-4 months (which clinic, when the next cycle is, how I'm going to prepare for it), it does become easier to just follow the plan and focus on myself. Best of luck! xx

[BlahBlah55]

I'm in a similar position to you - have a 2.5 year old, have been trying for a sibling for 15 months. Have had 2 pregnancies in that time both ended in miscarriage. Also have recently found I've got an AMH of 1.7 - snap, same as you! I technically know it's possible to get pregnant but also very aware time is running out.

I am currently at a clinic in London who I would recommend, if you DM me I can give you the name, they don't do mild IVF but have pushed me to get the max eggs - which is certainly what I wanted. I have done 3 Letrozole cycles with them so far, and one ICSI cycle (got 3 eggs, 1 day 5 blast but BFN sadly). I am now doing a second ICSI cycle with them.

[PenpalLdn in reply to BlahBlah55]

I'll send you a DM. But yes we are in similar position 💚 I have everything crossed things work out the second time.

[Myshh]

Hi I had my IVF in Lister currently 13 weeks pregnant.