freeze all cycle? When do we prepare for transfer (private ivf)

[Ivf223]

Hello i have been told today i will need to have a freeze all not a fresh transfer monday is my egg collection . I really want to do my embryo transfer straight away as i hate having to induce my period with pcos . And then pumping my body again. . If on the basis i feel fine and i dont develop ohss the bleed that i get after this ivf cycle can we prepare for the ivf? Is this possible? Has anyone else done this?

[Luce_16]

hello and good luck for your egg collection!

I have PCOS and during my successful cycle we went for a freeze all one (to avoid risk of OHSS). To give you an idea of my timelines:

- I collected my eggs at the end of April

- Had the post collection bleeding 14 days after

- Went on the pill for one month

- Transferred after the induced period - end of June.

I can totally understand why you don’t want to “pump your body” with hormones once more before transferring and tbh I am not sure whether it’s possible or not to transfer after the post egg collection bleeding - all I know is that my clinic suggested I had one more period before transferring.

I hope this helps and good luck again 🥰🥰

[Twiglet2]

our clinic don’t class your bleed after egg collection as a period that you can phone up to start treatment on. They call it a withdrawal bleed. The bleed after that you can call up to start next treatment. It’s so your hormones and cycle has a chance to recover, which is frustrating but given my cycles after egg collection can be a little weird or out of rhythm it makes some kind of sense. I know other clinics start some treatments from withdrawal bleeds though so one to discuss with your clinic what their specific timelines are. The FET itself timelines will depend on whether you have a down regulated one or not so again varies by clinic and protocol so one for your clinic to answer your questions on. Good luck for Monday 🤗💜 xx

[MrsOrangejuice]

Normally clinics will ask you to wait for a minimum until your next period after the withdrawal bleed and often one more again (especially the NHS). My private clinic was happy for me to start rounds or frozen transfers on the next period. It gives your body a chance to reset. Do you have periods naturally and fairly regularly? If so, you could ask about going off your next natural period and not having to induce it - that's what we did for FETs. Don't be disheartened about a freeze all either - FETs have a slightly better success rate than fresh and especially if you have PCOS and/or at risk of OHSS, your body may not be in the best state post collection. I found FETs much easier and gentler. Plus I had three fresh transfers, all of which ended in losses whereas my first FET worked and I would always opt to freeze now if I did another round. There can also be the option of natural FETs (no meds at all) or natural modified FETs (sometimes involving a trigger and/or progesterone support) which would be less or no meds and these tend to have better or at least similiar outcomes to medicated FETs. But they aren't suitable for everybody and clinics can be reluctant as they're difficult to control and schedule.

[Eloquentia]

Hi! I understand how you feel. I felt the same way when they strongly recommended a freeze all on the day of my egg collection due to the risk of OHSS. Like you, I have PCOS and they collected 32 follicles. I insisted we try a fresh transfer regardless and sure enough, on the day of the planned transfer, I developed OHSS. They could see it on the ultrasound and we did go for a freeze all. My consultant also explained that even if you haven't yet developed OHSS by day 5 after egg collection, you are still at a high risk of developing it with a successful pregnancy due to the doubling of the HCG every two days. This risk goes away once your period/post-IVF withdrawal bleed comes. So we did a freeze all and I have no regrets. Light/moderate OHSS is horrible enough, I can't imagine how awful the severe one must be. Also, I think my body really benefitted from the time to recover after stimulations and was in a much better state for the FET. The drugs for the FET are much easier on the body and I felt that FET rounds were on the whole much less demanding. My clinic allowed me to start preparations for my first FET after the post-IVF withdrawal bleed and then the first natural period after that. So with an egg collection in May, I started preparation for FET in July and the FET itself was in August. My clinic recommended a protein-rich diet to help avoid and later on deal with OHSS, including a few protein shakes or protein yoghurts per day. Apparently protein helps absorb the excess liquid that collects from the OHSS. Very best of luck!

[LittleMissWorrier]

I wish I had gone frozen vs having a fresh transfer.. which resulted in a loss. With my FET (which has so far been successful 🤞🏻) I felt I had time to recover, prepare my body, get into a really good and relaxed head space and it’s been such a better experience. I felt quite sore after egg collection, even on the day of transfer and I wish I hadn’t felt impatient and so irrational. I’ve been more relaxed with this FET, it wasn’t straight after the rollercoaster of getting to collection and as a result my overall wellbeing has been much better. With my FET my lining and progesterone levels were double what they were before my fresh transfer so I know not only my mind but my body was 100% in a better place and ready to help me make this happen ✨

[Tnthketnf]

It's up to your clinic and you. The NHS clinic would delay about 2-3 months. So if you had your retrieval and withdrawal bleed in June, They would allow you to phone up with July's period to book to start with August's period. And if that was a constructed cycle it meant prostap on day 21 of August's period and transfer another few weeks after that. On one occasion though they allowed me to start with a withdrawal bleed. For other reasons. The clinic abroad are a little more flexible and work around what I want. So if I wanted to start with the withdrawal bleed they would do it. However Since it's abroad for logistic reasons I never started with my withdrawal bleed.

I don't know if there is a clinical reason to wait after the withdrawal bleed. People say it's better for your body to have a break but I don't know if there is evidence to support this.