IVF next steps

[Sunflowerrain]

Hi everyone,

I’m really stuck with what direction to go in next. A bit of backstory I’ve been trying for a number of years now with my husband. I’m 34 he’s 47. At 20 I was diagnosed with PCOS due to raised testosterone and irregular periods. My cycles have always been irregular sometimes no period for 6 months or so, something every 35 days.

When I started this journey my BMI was high over 40. I’ve been reducing this over the last two years naturally and it’s now at 33.5. As I’m over the NHS cut off I can’t get any support or a referral until it’s been under 30 for 6 months.

Over 18 months ago I started working with a private fertility doctor, we found out my AMH levels were very low for my age at 5.1. We tried letrozole for 6 months with no success then in September 24 we did our first IVF round which was the short protocol. I seemed to react well to it with 8 good follicles, however they only collected 3 eggs, two fertilised and then 1 made it to a low quality day 6 blastocyst. I had a FET which failed two weeks ago.

I wanted to move straight into another round with my doctor however my husband is really stressed about money. This next round will wipe us out of any savings we’ve ever had, obviously we’ve just spent a huge amount to even get here. The financial pressure this is putting us under is huge and it means when it didn’t work I was so stressed about it not working but also about losing us all this money.

We had our consult about another round and my husband ended up getting very frustrated with the clinic about extra costs he felt weren’t clear. It was his mistake not understanding them, although they did bill us wrong at one point which adds to the confusion but my doctor was quite defensive on the call with him and really put him off working with them again. I ended up sobbing on the call feeling distraught and stuck in the middle. I feel really conflicted though as I do like her and I think she’s very good and the thought of starting again with someone else and having to wait months before seeing someone makes me really sad. She said I could do the long or short protocol this time, my husband wants to try the long as he said try something different and my doctor was ok with that when I pushed her she said well she’d probably pick the short if it was her as it worked well last time but even trying to decide things like that I hate being asked to decide on it. I feel like I can’t cope not having a plan. I had all my hopes just pinned on going again straight away but now I have no idea what to do.

One option is to considering swapping clinics but there’s a couple of month wait if I wanted to see a specific doctor who I’ve read positive things about and I’m worried about seeing any doctor. The plus is we could also use access fertility if we used them directly, the other is to try and get my BMI down further but it delays treatment for the time to lose it and 6 months after, which with my low AHM I worry if it gets worse I’ll always regret it.

Honestly I feel like I’m stuck in a nightmare trying to balance decisions with no insight. Any words of wisdom on how to make these decisions would be so helpful. My husband just doesn’t understand why I feel so time pressured and I feel so alone in this all.

[Millbanks]

Hello lovely,

I'm sorry to hear of your situation - it's a very tricky thing to navigate.

I found that I was desperate to move on to the next cycle each time one failed - and that sense of urgency is hard to quell - but you are still young. I know you have low AMH but there are so many people out there having success with that and being much older. Try to take a breath and talk through your options with your husband before you get yourself in a pickle.

I would say definitely think about moving clinics if you're not happy. There will be a little extra cost as the new clinic will charge for an initial consultation and probably ask to do all the initial checks again too - but it might well be worth it if you're not happy.

Be open with your husband about how you feel - I found that I kept a lot from mine because I found it hard to talk about, and it made everything so much worse and harder to deal with, when all along he was on my side. We've done a lot of talking post-IVF and I realised I was trying to protect him and myself but it didn't really work - he just felt left out.

I know you'll be feeling very defeated after the BFN - it's hard not to be - but you might get a better response next time and it might work

I would highly recommend starting (if you're not already) an anti-oxident diet. This involves basically limited processed foods, lots of antioxident foods and start taking Ubiquinol 600mg a day and NAC 1200mg a day - this really helps with egg quality. There is a book called "It starts with the Egg" by Rebecca Fett - there a lot of info in there and it can be a bit overwhelming so I just picked a few things that I felt I could change and went with that

xx

[Sunflowerrain in reply to Millbanks]

Thanks so much for your reply, I think that’s it you feel like so much time is slipping away it gives you a real sense of urgency that other people don’t always get. I thinking taking a breather is a good plan. I think I’m going to hold out for this appointment I want at the new clinic, perhaps another one and then make a decision. I read some of these comments out to my husband which I think helped he doesn’t always get it, he’s a lot more practical in his approach. I have read the book actually but then felt a bit overwhelmed so perhaps I’ll read it again. Xx

[Christianbaby]

It sounds like you're juggling a lot of uncertainty right now, and it's okay to take a step back and give yourself the space to breathe. There's no right or wrong answer in this situation, just what feels best for you and your family. It might help to talk to your husband about the emotional side of this process, explaining how much the time pressure means to you, and how difficult it is to feel like you don’t have a clear plan.

As for the clinic and treatment choices, I know it’s tough. Sometimes, waiting for the right doctor can feel daunting, but it might also give you more peace of mind in the long run if it means working with someone you truly trust. On the other hand, if you’re feeling more comfortable with your current doctor despite the challenges, it could be worth sticking with them, even if the next steps feel uncertain.

This journey is emotional, and it’s okay to not have everything figured out right now. Take one step at a time. Sending you strength and wishing you clarity in whatever you choose. xx

[Sunflowerrain in reply to Christianbaby]

I think you’re right, your comment helped me work out I really do need to wait for the right doctor or I’ll always be thinking what if with this round. I’m going to wait and get a second opinion I think and then take it from there to decide between my current one or a new one xx

[Christianbaby in reply to Sunflowerrain]

I wish you all the best. xx

[DianeArnold Partner Nurse Fertility Network UK]

Hi well you’ve certainly been trying so hard I’ve read your post, but forgive me if I miss buts out. Huge well done with the weight loss. Keep going then you may get NHS treatment.you might even anage with medication, I don’t know. We do have a weight loss group and support groups on our website, so do have a look. If you would like to speak to myself or Janet, details are on the support pages. There is an excellent counselling charity called the British Infertility Counselling Association bica.net who cover all aspects of fertility, including relationships. There is a charge, but have a look. I wish you both well with your next move. Diane

[Twiglet2]

I normally say make sure you are in it together but it’s you that has to go through all the hard part with IVF physically at the clinic so if you are comfortable at this clinic then I would stand your ground with your husband and tell him to back off! And if he can’t be civil on consults don’t take him on. That must have been so embarrassing for you! I would move quickly to the next round but at the same time continue to try and lose weight in case you need the nhs at some point in the future too (amazing what you’ve achieved so far you are nearly there!!). The first round is often a learning round so if your clinic would keep to short protocol I would probably listen to them unless there is a reason you have to live to long (other than ‘try something different’ comment from the hubby) How is the sperm did that contribute to any drop off is there anything your husband needs to do/supplements he can take to help as well?

Just a thought/ It also sounds a bit like he isn’t as sure or committed to the IVF process if he is so stressed about the money. Is there something holding him back? Me and my other half rarely agree about money but for IVF it’s the one thing in all the 7-8 years we have been doing it and wiping out our savings and maxing credit cards that we never disagree on and see as an investment, yes it puts financial pressures elsewhere but there’s no point arguing or stressing over it! Set a limit ie if someone told you it would cost you £40k to have a baby would you pay it? What about £60k? Find that ‘top’ figure and have that as your maximum spend and anything less than that is a discount/bargain is how we looked at it in case that helps! Best of luck for your next round xx

[Sunflowerrain in reply to Twiglet2]

I do agree with your comments that I’m going through it so should have more of a say. Yes it was really embarrassing but to be fair my doctor was going no if he wants to ask these questions let him he needs to understand as well so they were both kind of letting it happen even though they could clearly see me getting upset and that they were not communicating well together but I was feeling very sensitive I guess so I just would rather have not had that conversation then.

My husband was always way more of a it will happen when it happens person so the last few years have been a bit of an eye opening shock to him and I feel like he’s still navigating that expectation change whereas I always knew it would be hard for me due to absent and irregular periods.

He sees it much more black and white ie any doctor will give us good advice so it’s tricky getting him to understand how much more I’ve researched this and how much complexity there is to treatment. In fairness he’s got health issues and feels the same about his own treatment even though I would love him to push his doctors more for support so we do just have different approaches.

I think your advice to think of a total and then work up to it might help take some of the pressure off so it’s a good tip thank you ☺️ Xx

[Lou-5656]

hi would you consider a clinic abroad? I had IVF in Spain which was abit cheaper but I know other countries can be a lot cheaper. The Spanish clinic was recommended to us which was why we went there.

[hoping_for_our_time]

After multiple failed rounds in the UK I have switched to a clinic in the Czech Republic- wish I'd moved years ago, much better technology, service and much more affordable. I would highly recommend. PM me if you'd like more information xx

[Passby2024]

Hi, if money is the issue, I would also highly recommend overseas clinics. We recently switched to a clinic in Greece and did one cycle with them. We have collected as many embryos from this cycle as from all the previous 5 cycles in the UK combined. Cost of doing one IVF treatment there is about 1/3 to 1/2 of that in the UK. So in a way, it worked out to be only less than 10% of the cost in the UK. I am already 44 and my AMH is 1.16. Switching to them took me 1.5 month. PM me if you want to know more.

[Avocado007]

Sorry to hear you are going through this, Take each day as it comes. I think once things have settled I would recommend putting a plan in place for next steps. After failed IVFs in the UK I went to Spain (treatment was cheaper and the level of care was outstanding) . I had treatment with Instituto Bernardo in Alicante and have a beautiful baby boy …I think learning to advocate for yourself is key too, I also read the book is your body baby friendly by Alan Bear is an eye opener….Don’t loose hope x

[Sunflowerrain]

Thanks for all the recommendations re abroad. I’m open to going abroad, my husband is more nervous about it. He doesn’t particularly enjoy travelling anyway so I think the combination of not just ivf about adding travel into it would be tricky, but we’ve not ruled it out. We might do a consult with a clinic abroad as well so he can start to consider it. Xx