Switch from ARGC to Lon Fert Centre, or another?

[Lucy P]

Hi, I'd be glad of some opinions. I'm in my mid-40s, and have been at ARGC trying with my own eggs for the past year. We waited 6 mths for the first appointment, but were glad to be taken on (though our chances were said to be less than 1%), as several other clinics had refused us. I've had IUI on several occasions (both stimmed and non-stimmed cycles), but haven't been offered IVF due to too few follicles (max 5). I know ARGC has wonderful success rates with women younger than me, and the 2 main doctors are kind, talented and dedicated. Most clients seem to be very happy there. But I am thinking of switching to the London Fertililty Centre, or possibly somewhere else.

Almost certainly because of my age, I feel that ARGC isn't very proactive in my case. For BTs and scans - needed even on a natural cycle just to maximise my slight chances - I really have to push. Even when on stims I find I am sometimes almost begging for these tests - though others are being monitored very carefully indeed. I understand why less effort is put into me - since I produce a max. of 5 follicles, and those have low probablity of containing good eggs - but its still important to me!!

There's very little opportunity for discussion, and even when asking direct questions (e.g. about follicle numbers and sizes), I find it hard to get clear answers, or explanations. For instance, when I had very high E2 at the beginning of the month, I had to work out for myself that it might be due to left-over follicles; I've also had to work out that my LH surges sometimes might be too weak for definite ovulation, and at other times might come too early for eggs to be mature.

I know that some of these things can sometimes be helped with meds, but monitoring is important to see if and when they should be given, and I at least need to know what's going on, psychologically; and to be reassured that anything that can be done, is being done.

Also, a few times I've wondered if I've fallen into a communication / information gap. When I am being monitored, I find that one doctor might be doing the scans or making the decisions one day, and another the next (or even later the same day). On the other hand, there are just 2 doctors to deal with, and they do the scans and look at the results themselves - so other clinics might be worse in this regard.

To be fair, when I push (or rather beg) I do find ARGC will help, and (at my pleading) have twice let me stim on cycles when my FSH has been well beyond their usual cut-off point. Sometimes they are amenable to suggestions - like taking a suppressant / antagonist to keep the LH down, or a trigger if it seems doubtful - but it is me who is often asking about these things - and I don't think I should have to. But again, another clinic might be worse.

I think that (humanely) the doctors are waiting for me to come to terms with the idea of using donor eggs. But unless I feel we've thrown a bit more at this, I'm not ready to do that. For instance, I would like to try IVF with AH/ICSI, just in case it would work even with a few follicles, but also to see if the egg casings are too thick to make even IUI worth pursuing. Recently ARGC indicated (again at my pleading) that they might try this, as long as I was realistic about my chances.

Is there anyone with experience of either or both clinics, or any other that might be helpful to an older woman not quite ready to turn to d.e. yet? We've attended an LFC Open Evening, and were quite impressed by the clinic's deputy director who seemed easy to talk to (tho' like ARGC he did say my chances were virtually zero), and also the speed with which we could get initial consults with both him and Prof Craft.

To sum up I'm looking for close monitoring, good communication with the doctors, continuity of care and proactive input even when the odds are low.

Thank you for any thoughts or help

Lucy P

[caz1]

Hi Lucy
I had first ICSI (unsuccesful at LFC) - under Kelada and Craft. Both were great. Altho I have to say all the negatives you listed applied to us too - we saw different doctors almost everytime we went (in fairness Kelada was ill at the time and he promises he'll be around more next time!). We also were v disappointed when we had to choose a donor back up a few days before ICSI (for DH sperm - hes got v few) - they really had NO good choices - and we felt that was poorly handled.
Overall tho - everyone was v nice and technically I had the feeling they were excellent - its the embryologists who - I think - are the key people- and I think the LFCs one are good. Nurses lovely too and someone always available to help

We looked into teh Bridge centre for a 2nd opinion as to why our ICSI didnt work - which is less swankey but still good . THe big guys there (grudzinskas) there actually said to us that he would have done EXACTLY what the LFC did and that he recommended we stay there.

One of his reasons for him saying dont change is that the LFC had all my details and knew how I reacted to drugs etc and that gave them an advantage over a totally new place for next time. this may apply to you at ARGC?

LFC is good - not perfect and a bit disorganised. I do know that they seem VERY keen on slightly older patients. But to be honest I am sure its not materially better than the ARGC, but I dont think you'd be wasting your time going there especially if you dont feel 100% with were you are.

Not that helpful i guess- good luck anyway!!

Take care

Cazx

[caz1]

also Lucy - if you are trying to get your head around the donor thing - JOIN the club - we have tiny tiny chance of iCI working and then we'll have to use donor sperm - but cant yet get my head fully around the concept.
I know is slightly different situation for you - but similar in many ways.
VERY glad to swap thoughts on this anytime!

Cazxx