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  1. #1
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    Red face A few IVF questions from a newbie

    Today I spoke to a fertility specialist about IVF and we talked about what would be the best case for me..but not in great detail because I don't want him as my fertility specialist for IVF.

    His opinion is that I should just keep trying naturally as I get pregnant very very easily.. but my problem is that due to my messed up chromosomes I have a high chance of miscarriage and I am now dealing with a potential second trimester loss as a result of it.

    I would do IVF only to rule out genetic issues with the embryo.

    He has suggested to me a medicated cycle because he thinks I'll have a higher chance of getting a few embryos that are suitable and survive as opposed to just testing a single embryo.

    My concern is that medicated IVF will mess with what I already have...regular ovulation, good fertility, really good lining etc.

    But my concerns with natural are:

    1) If my one single embie is affected by my condition and not balanced therefore it can't be transferred, will they still charge me for a full cycle? If not, will I still pay a large % of the cycle cost?

    2) What if they damage my embie during testing.. will I still have to pay full cycle cost ?

    3) How cheaper is a natural cycle compared to a medicated one generally?

    4) How much roughly would 1 natural and one medicated cycle cost me (I don't even know if this can be answered)

    Final question... is there something in between.. something where say they do a very mild stim cycle so instead of 1 egg, you produce 3-4 eggs. If this exists, is there a point doing something like this?

    I am thinking..... depending on cost... I try natural IVF cycle TWICE and if I fail both, I try a medicated cycle. I just feel like its better trying natural first and then medicated then the other way around.

  2. #2
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    Hey I can't answer all your

  3. #3
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    Default A few IVF questions from a newbie

    Hi @Simil. To answer your questions:

    1) Yes. You have to pay for your cycle as soon as it starts. There is no refund if you don't get any eggs or if they have to cancel the cycle for whatever reason. Once they've collected the eggs, fertilise them and get them to day 5, if they are suitable for testing, you pay upfront the costs for testing. Unfortunately, there's no guarantee and if they are abnormal, you don't get any money back.

    2) my understanding is that there is a very low chance your embie will be damaged during testing, but if it is, you'll have to speak to speak to the company who's testing the embies to see what your recourse will be. You might also want to read the terms and conditions of the document you sign to have them tested.

    3) Yes, but not by a lot. It's usually about $1,000 cheaper. It also depends on where you go. Some places are cheaper and some are quite expensive. You're looking at (out of pocket) between $1500-$5,000.

    4. The first cycle will usually result in a higher out of pocket cost, but subsequent cycles get cheaper. Again, you're looking at (out of pocket) between $1,500-$5,000 for first cycle and between $600-$4,500 for subsequent cycles. Shave off about $1000 for a non-medicated cycle. You might want to google a couple of places and check their fees page. They advertise their fees and OOP costs.

    There are FS' who administer very low dose stims to get very few eggs. A natural non-medicated cycle will fetch you 1 egg and a medicated cycle will get you anywhere between 1-20+ eggs depending on your age and egg reserves.

    Usually, low dose stimms get you about half of your AMH number. High dose stims net you more, but they say low dose preserves quality whereas high dose tends to compromise quality.

    I agree with your approach. If you have karotyping issues, do a natural cycle so you get the benefit of having the embryo genetically tested. If after two cycles you get abnormal embryos, then a medicated cycle would be the way to go.

    Good luck and I'm so sorry you're having to deal with a potential loss.

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    Simil  (20-05-2017)

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    So sorry to hear about what you are going through. Have been reading along. In regards to ivf, i would do a medicated cycle. Mostly as you will (hopefully) get quite a few eggs. Not all fertilise. The more embies you have to test the better. Ones that pass can always be frozen. Transfers are much easier than having to go thru another cycle all over again...and cheaper. Ivf can become quite emotionally draining so this approach may be the most efficient. Just my opinion though. I wish you all the best.

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    Hi Simil, I too have been following your journey. I would definitely do a medicated cycle. You need lots of embies to play with as you lose plenty at every step. Only about 60% of eggs fertilise in the first place. Of those many do not develop. Then you may have some not chromosomally normal. Then if some need to be frozen , quite a few don't survive the thaw. I suggest trying to budget for a 3 cycle go at this. Things don't always go to plan. The first cycle or two can be a trial and error.
    If you only get 1 egg collected, there's a good chance it won't fertilise or won't be normal etc then you have paid for a full cycle and have nothing xx

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    Thanks everyone!!

    I just had a quick look and it would cost me around 4k for a natural cycle with monash ivf... but everything would rely on that one egg.

    A medicated cycle would not only cost me 1k more but id have to spend around $800 for each embryo to be tested.. so that could end up being an extra 4k.

    Hmmmm i am leaning towards trying a natural cycle first.. at least once but still deciding.

    Out of the 3 times i tried , two miscarried and one worked sort of in a sense that via ivf it would be picked up as normal (despite the freak rare genetic duplication, which is most likely de novo and not genetically passed).

    So i could try 2 natural cycles for 8k give or take..

    Or i could try 1 medicated and lets assume 5 are suitable to be tested, it would cost me approx 8k.

    Or i could go
    1 natural - 4k
    One or two non ivf attempts
    1 medicated 8k

    And see what happens. I feel like i want to leave the medicated cycle as a last resort because of how many stories ive read of it back firing and messing up natural fertility.

  9. #7
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    I agree with @bel2466 - much more efficient and less for you to go through overall if you go straight to a medicated cycle. FETs don't need generally need much in the way of drugs (or you can do natural cycles) and you can do them back to back, but most clinics like you to take a break after cycles where you have eggs collected so you could end up pushing your journey out quite some time.

    We've done IVF because of male factor infertility. I ovulate fine on my own, have no lining issues, etc. I've had between 8-12 eggs collected on fresh cycles, and only between 1-3 embryos from those batches have survived to transfer or freeze - that's with well above average fertilization rates.

    Currently pregnant with my second IVF bub, but after DD1 was born my cycle return 5 months later and it was like clockwork again from that time onwards.

    For all the stories you might read of IVF messing with things, I'm sure there would be many more like mine that have come out the other side of it with no problems, so please don't let that fear get in your way.

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  11. #8
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    Hi there, I've been following your story and I'm sorry you're having to make these sorts of decisions. You are an amazing woman.
    Having been through IVF I would recommend a medicated cycle first up.
    As pp's have mentioned the chances of a single embryo making it through the process are slim.
    We got 8 eggs, 7 fertilised and 4 made it to freezing. I'm told this is a very good result as usually less than 50% of embryos make it to day 5. You then have to go through the process of genetic testing, where probably more of the embryos will be discovered to be unsuitable.
    If you're going to go through the egg pickup process anyway why not try for 5-10 eggs and minimise the amount of procedures you have to do.
    The process for a frozen embryo cycle is a lot easier and less invasive, also more flexible. You could be looking at 1 full stim cycle then multiple FETs from that cycle = cheaper and less invasive. My 2 children are from a single stim cycle.
    Only you can decide what's best in your situation and I wish you the very best of luck.

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  13. #9
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    I think that given @Simil has been able to fall pregnant, it's likely a non-medicated cycle will produce a good egg which will result in a good embryo. I think she just wants some assurance that that embryo is genetically normal so she doesn't have to go through another potential loss. I, personally, don't think she'd have a problem doing a natural IVF cycle. If in three cycles the embryos are all genetically abnormal, then I, personally, would want to increase my egg count so more than 1 embryo can be tested.

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    Something else to think about is that, as i understand it, some clinics do genetic testing differently too - ie they charge per 'batch' rather than per embryo, so it might be that you find somewhere that does this where you would save money by testing quite a few at the same time.

    I've been reading along with your diary too, and given the chromosome issue that's come up unexpectedly for you, you might need a specific PGD test developed for you too, not just an 'off the shelf' one, if you know what i mean, so those costs you've seen on websites might not be accurate for you. I think an individual appointment with a clinic or clinics is going to be th he only way to get an accurate picture of potential costs.

    Ps I've never read much abour IVF messing up natural fertility. But would you even be looking to go back to this anyway?

    I agree with what lots of PPs have said - medicated cycle is probably the way to go.

    A natural cycle is far too much money riding on one egg that might not even fertilise. In your costings, have you also factored in the private hospital fees, anesthetist, cost of time off work etc for multiple egg collections when you might only need the one medicated cycle to get lots of eggs for testing?

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