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  1. #1
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    Default Help Needed - 1st IVF cycle cancelled after EPU. What should i have expected?

    Hi All,

    I am new to the forums. So apologies if I make some errors

    I have just been through my first ivf cycle which was terminated after EPU due to poor quality eggs.
    I have had a very challenging experience with my clinic and after being sent home on Friday after EPU with the only advice being to just rest and no after care advice, I have a few questions.
    I was only told to expect some spotting for up to 36 hours afterwards.
    Its now over 48 hours and I am still spotting and feeling very uncomfortable like i have been pummelled internally. It even hurts to sit.
    Is this normal? How long does it last?

    Also with stimming drugs - can they have that much effect on egg quality?
    I was only provided with one blood test and one ultrasound before EPU. Is this the normal monitoring process?

    The clinic told me not to worry about payment for the moment and they would sort it out later. I have checked my account today and it appears they have taken the remaining payment in full on Saturday without authorisation. If you don't get past EPU, is it expected to still pay for the entire process even if they aren't providing the services?

    Sorry, lots of questions and not a very helpful clinic I'm afraid...

    Thank you@

  2. #2
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    Hey @CanberraHopeful , so sorry to hear you are going through this. I had a similar first cycle. After EPU transfer was cancelled as embryo had abnormal chromosomal count. Such a disappointing cycle.

    Since then I have had 1 more cycle and the two were at different clinics and EPU experience was different both times, first time was a lot worse and my spotting lasted a week. Pain subsided after 2 days. I think anything beyond spotting or a week you should go see your GP or emergency if it is a lot of blood.

    I think really high dosages of stim drugs - Im talking super high can fry your eggs a bit but if it is your first cycle I doubt you were on super high drugs and its hard to say without more info what is causing poor quality eggs, could be a number of reasons including age. That said for any stim cycle you must have stimming drugs so there is no way around that ever.

    I think you should have more monitoring prior to egg pick up, more scans for sure and more bloods. Each cycle I've had about 3 scans and bloods, think this is standard. I also have never been to a low cost clinic so I don't know if you are going part public but each clinic is different. I'm not saying you are going to a lower cost clinic, I just mean some clinics do things differently according to budget.

    You should have a post cycle chat to your doctor and see what they suggest you do next. They need to take all of the money prior to EPU so this is standard that all the money was taken out of your account and your medicare rebate should be back into your account within 2 weeks. They should not charge you for transfer so they may have taken that money and it sits on your file as a credit, if you change clinics make sure you get this money back or they just keep it until you tell them what to do with it.

    I would also consider changing clinics.

    I hope this helps and when you feel better and have more energy you can think about next steps.

    Good luck x

  3. #3
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    @CanberraHopeful that sounds like a terrible experience I'm so sorry you're going through this.

    I had two scans and three blood tests prior to my EPU.

    I haven't had any bleeding but have had severe pain and some bloating but I've been I contact with my dr on their emergency mobile number over the weekend about this (EPU was on Friday). Did they give you a contact number? I would try to call them and ask some questions if they did. Did they give you any paperwork with info to take home about side effects or when to seek medical assistance? I would think there is some minimum standards for duty of care with these procedures.

    Hope you get some answers and feel better soon.

  4. #4
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    Hi StrayCat and Emily3011.
    Thanks so much for your advice. Really helpful and now i don't feel so much like I am over reacting.

    Today is a little better. Still a bit of pain but no more spotting so that's a relief. I guess everyone has different responses.
    I didn't receive any paperwork with info - only a discharge form advising Post Operative Care is 'as per the clinic instructions' but no instructions were given. I did also find a prescription attached for panadeine forte so fortunately I figured it out.
    I think the nurse who spoke to me afterwards to advise the eggs were not suitable to progress, was a little out of her depth. Not sure why as I am sure they deliver this type of news fairly often.
    She did call and leave a voicemail for me today asking if I wanted to schedule another appointment with my FS or if I didn't want to proceed any further, then not to worry about it. I am not sure how to take that?
    I've heard this clinic likes to move the more difficult cases on as we tend to ruin their stats. I think I was being given a hint but can't be sure.

    The clinic is actually one of Canberra's premier IVF clinics. So I am paying top money (almost $10,000) for what I am beginning to think is very low grade service.
    I've had numerous problems with them up to this point like losing test results and having to repeat, constantly having to chase them for test results which take a week for them to provide, them forgetting to provide me with forms, info packs and even required tests to take and then being spoken to like I am an idiot because I should have known. I am an organised person so I've found it a little frustrating.

    I think my stim drugs were pretty average - 200 puregon and orgalutran with ovidrel trigger. I am 36 and fully expected my eggs are ageing but it was a bit of a shock that none of the 5 were any good. Apparently 2 were 'empty'? I don't even know what that means? One was immature and 2 were abnormal.

    I spoke to their account person today and was advised I will receive approx $500 refund for the ICSI and ET. After the medicare claim we will still be out of pocket approx $3,800. The way I figure it, Medicare paid for the drugs, my private health paid for the EPU and we were told immediately after surgery that we weren't going any further. So I think that's pretty expensive for one blood test and one ultrasound and one in office consult with the nurse when we started? I had not seen the FS at all since we started until the day of EPU when she asked me to sign the consent form without actually going through it with me and the nurse called me 4 times only. It doesn't add up for me but I don't think there is anything I can do. I am going to try have a reasonable conversation with them anyway.

    Anyway, enough griping from me. I have already booked a consult with the other clinic here who I have heard are quite good. So no time to waste and fingers crossed!

    Emily3011 - how are your embies going so far? I hope it's good news.
    StrayCat - are you planning on going again soon?

  5. #5
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    I'm in cbr and I'm pretty sure I know who you're with and i had a similar disappointing experience including no feedback on an ultrasound that ultimately led to a missed m'c over 5wks later when all the signs of m'c were there once i looked back. Ended up hospitalised and they still couldn't get hold of the FS so my gp had to step in. A similar non responsive, maybe book back in to see your specialist if you can even get in in the next 2mts, type response after my m'c. Needless to say i changed clinics, had an FS i could phone and would call back within an hour, answer questions and change my dose if needed daily. Nurses were all wonderful and personable and would really take their time with bad news and just let me sob on the phone if needed. Totally different experience. PM me if you want more details.

    I'm so sorry you've had to deal with such bad treatment given its already such an emotional and expensive roller coaster as it is.

  6. #6
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    Hi canberrahopeful. I'm sorry to hear about your crapy experience. I've had 10 cycles in two different clinics here in Perth which finally resulted in a gorgeous baby girl 3 months ago.

    First cycles are always a bit of a test in terms of dosage etc. your results could just be bad luck. Your fs might decide to push you a bit more next time (I was on 450 puregon my last cycle) to get more eggs and hopefully a couple of good ones there. Do you knew what your amh is? You said you did ICSI, did you go the ivf route for male factor infertility only? Anything we know about you?

    I would see that same FS one more time to hear what they would do, what they'd change for next time. Changing clinics could take a while, for me it was about 3 months before we could see the new FS, then he ran some tests and got me to see an haemathologist, this took an other three months... So id advise you not to give upon the first clinic just yet. If you can afford to overlap them a bit, you might decide to try a second cycle with the first clinic.

    As per the way you were treated... How many days did you stim for? Maybe after your first scan the follicles were already big and needed to be picked up, next time they might scan you before?

    As per discharge, I've found a few of the nurses at the day surgery to be quite ... Inefficient. It might not reflect on the actual fertility clinic but more on the day surgery unit. Either way, have a chat to someone about your experience, and definitely ask about the money, but next time you might see different nurses etc.

    Having to go through ivf really sucks, and I am sorry you had to have such a crappy first go. All the best for the future.

  7. #7
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    Sounds like a really bad experience. Are you with Genea? I would have thought it unheard of to go to EPU with one scan and one blood test?? How would they even know how your follicles are growing? Did they give you any indication prior to epu about egg quality?

  8. #8
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    Wow, thank you all. Good to know i am not going mad.
    @HeyMissA - Congrats on your impending addition! I will PM but I haven't figured out how to yet. And to think I work in IT!
    @lilla - sounds like you have had quite a process to get where you are. I can't imagine doing 10 cycles. Particularly after the drugs for EPU. They nearly drove me crazy. But it's pleasing to hear you finally got there.
    The nurse was actually the fertility clinic nurse. The day clinic ones were even worse, if that's possible.
    We were referred straight to IVF/ ICSI for DH low sperm morphology. I'm 36 and DH is 31. Everything with myself apparently looked ok. But is there some way they can get an idea of egg quality prior to EPU? Maybe something was missed. Being very new at this I am relying on my FS to guide us but I am not confident she has done the best for us.
    My scan on day 13 showed 8 follies - two very large follies over 22 x ?, two around 18 x ? and then smaller ones under 10. They asked me to keep going with puregon up to day 15 and they did the EPU on day 17. Is this longer than normal?
    We are scheduled for our first consult with another FS in early December. I am not keen to start the next cycle until well after the New Year anyway. Just some time to relax over the Christmas break.
    But maybe you are right - go back and see what they say. I'd like to know if they actually do think I have poor egg quality (so I can bash myself up for that) or if it was the drugs. At moment I am just so cranky I am afraid I will say something rude. Might wait until the hormones settle a bit.
    @clementimeGrace - No, not with Genea but it's who we are going to see to possibly change to. I am with the other competitor who used to be with Genea when they were SIVF and then she went out on her own.
    Perhaps this is the way this clinic does it with everyone? I feel like they run with one size fits all and if it doesn't work, move them on...

  9. #9
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    It sounds like some of the eggs could have been over cooked, crazy that they did one scan. I know quite a few people who have ended up at Genea after bad experiences with the other clinics.

    Tween Low is fab is you can get into see her.

  10. #10
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    @CanberraHopeful I think it is a little strange they did the scan on day 13, I get scans day 8, 10 and only if I need one more on day 12 ish. As mentioned each clinic does things differently but seeing you are paying for a premium service all scans and tests should be included including extra unexpected scans, I pay about the same for my treatment and I have had lots of extra tests done during the cycle, I often get tested too much and feel it is excessive. Your cycle protocol sounds pretty standard besides the one and only scan and BT plus zero communication. Day 15-17 still on stims is ok, I know women who stim til day 21 and are now pregnant. The reason why you probably only had 1 scan as your follicle sizes were ready to go. My clinic aims for 3 follicles over 17mm to go to EPU which you had.

    When you say the nurse told you what happened to your eggs I now understand what she means and sadly it was just bad luck for this cycle. Empty means you had follicles but there was no egg in there, immature means they were not ready and would never fertilise. The 2 that were abnormal means the chromosomal count or something else was off and they would not develop into healthy embryos and therefore not viable for transfer or freezing. See what your fertility specialist says but it seems like it was a 'normal' cycle with unfortunate results. As they 'cancelled' it, it does not affect their stats as it was not a full cycle. I am sorry this happened to you - something similar happened to me and I was devastated. It does not mean your eggs are crap or you can not have kids it just means there weren't enough of them and unfortunately no viable embryos this round but that does not mean ever. This is why clinics aim to get as many eggs as possible as there will always be non viable eggs etc. Moving forward I think your drug dosage will be upped and look into a new clinic, no need to go back. Very similar happened to me and I didn't even see my FS again and have to have a miserable talk only just to move clinics plus pay for her time, everything the next clinic needs to know is in your medical records and they will put you on a new protocol.

    Did you and your partner get tested for genetic abnormalities?

    Once again it was just an unfortunate cycle, I think the clinic did the best they could but due to only 2 eggs fertilising and not being viable they had to cancel it. If it makes you feel any better my subsequent cycle I had a normal excellent quality embryo, sadly they did not implant but am happy to know we can make healthy good embryos. You will be able to too.


 

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