4th round IVF, new clinic not prescri... - Fertility Network UK

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4th round IVF, new clinic not prescribing same (or any) treatments for thin lining.

emma_g87 profile image
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TL;DR: I have a phonecall with the Medical Director of my new IVF clinic today. Looking for advice on treatments have you had for thin lining, particulalry those used during a fresh cycle. My new clinic refusing to prescribe Viagra/Sildenafil even though I have had during previous rounds.

Hi, I'm in the process of arranging my 4th round of IVF, following two miscarriages and one unsuccessful implantation.

A bit of background context. My first three rounds of treatment were in Scotland (at the GRI (ACS), a very well respected NHS unit in a large hospital). I've since had to move south to Oxfordshire because my husband is in the military - we had no choice about the timing of this move. So, even though we were happy with our previous clinic and would have paid for private treatment there if we could have stayed in Scotland, we have had to find a new clinic now that we have relocated to the other end of the country.

During previous rounds the persistent problem I have had has been with achieving a thick enough lining for transfer. My previous consultant prescribed me with viagra (sildenafil) pessaries in order to help with this. It did seem to have some effect, particularly during my final FET there, when we reached 7.2mm.

However, my new clinic is saying that they do not prescribe viagra at all. This came as a disappointment as my preference would be to take the learning/data that has been gained from previous cycles and build from there. They are also saying that the maximum dose of stims they can give me is lower than what I received at the clinic in Scotland.

While I understand that not all medicines are used across different clinics, it did come as a surprise to me that the clinic do not intend to do anything at all to help thicken my endometrium during the planned fresh cycle. Their preferred approach is to 'see what happens' during the fresh cycle and if the lining is not thick enough, freeze any embryos and try again during an FET. This seems really unsatisfactory to me. Particularly as my history clearly shows that we have only ever managed to get one embryo from each cycle (sometimes 2 or 3 fertilised but each time only one survived beyond that). My concern is that this history is being ignored and the chances are massively increased of us either (i) having to go forward with a sub-optimal transfer with a thin lining or (ii) losing the embryo before its possible to freeze them.

I know that the evidence on what works to achieve an optimal lining is mixed. But am wondering what treatments others have received to support with this, and what the outcome was? (also whether your nurse/ consultant commented on how widespread/accepted these treatments were). I'd like to speak to the Med Director having done some degree of prep on what things might be considered. E.g. I have seen there is some good evidence out there on the use of Vitamin E supplements - although the amount of available research is quite limited.

Thanks in advance!!

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Endofitall profile image
Endofitall

are you committed now to use this clinic or could you go elsewhere? I’d be very unhappy to use a place that wasn’t going to use the learning from my previous cycles. If viagra has worked for you, and you’ve needed a particular stims dose before, seems bizarre to ignore that.

emma_g87 profile image
emma_g87 in reply toEndofitall

Thanks. No, not 100% committed but as I live a bit more remote now the options are limited. My conversation with the medical director today is a last ditch attempt before I put time and effort into trying to find a new clinic).

Endofitall profile image
Endofitall in reply toemma_g87

I understand. I’ve had vaginal viagra which worked well in fresh cycles for me in past. Natural/modified natural FETs worked better for me but I only get to 7mms max often 6.5mm.

However medicated FETs were terrible for me (barely getting to 4-5mm and often lining disintegrating on higher doses oestrogen patches pills pessaries). Also had clexane during stims which can help but I was on it for APS anyway.

I really hope they listen.

I recently replied to someone about all the things I’ve tried for my thin lining issues herehealthunlocked.com/fertilit...

I do think it can be quite cycle dependent though! As I do all the same things each time to boost it and sometimes it can get to decent enough and other times it doesn’t 🤷🏻‍♀️

editing to add that viagra prescribed by consultant in a CARE clinic and they also did NHS treatment so not a weird niche private clinic thing.

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