# Newbie to Fertility Friends - any advice on whether I should change clinics?



## applesandpears (Apr 2, 2009)

Just wondering if anyone has any ideas as to whether it's a good idea to change clinics after a couple of cycles? After a naturally conceived miscarriage in December 05 I've had 2 cycles at the ACU at Chelsea and Westminster. Had dd from first cycle, 2nd cycle failed but was able to freeze some eggs and became pregnant from that cycle but miscarried 3 weeks ago at 9 weeks. I'm 42 in July so realise that age is obviously affecting the quality of my eggs. In a way the clinics are not really doing that much with IVF. Once the correct drug dosage is achieved and providing they can take out and return the eggs okay there's not much more involved. On the failed cycle had a different doctor put them back - don't know if that made a difference. The Lister obviously has a good reputation, deals with many more women and has a better success rate for my age group - 23% compared to 16% for Chelsea and Westminster. The Lister see many more women -476 compared to 48 at Chelsea. Then of course there's ARGC which seems to achieve better results by monitoring women more closely. 

Have an appointment booked at the Lister for end April and waiting to hear back from ARGC just to hear what they say - but of course they will want to sell their clinics. Anyone have any advice? Thanks in advance.


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## applesandpears (Apr 2, 2009)

Any advice anyone please?


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## Han72 (Feb 15, 2007)

Hi applesandpears  and welcome to FF!

So sorry to hear about your recent miscarriage lovey . The decision to change clinics is such a personal one it's difficult to advise really. It doesn't sound as though your first clinic has done much wrong, but if you really don't feel comfortable there then yes, a change might be useful for you.

Did you have any frosties left or would you be looking for another fresh go? Are you a normal or a poor responder? These are all questions that need to be taken into account when looking for a new clinic.

The Lister has a good reputation among poor responders and you've clearly done your homework with regard to their results. The ARGC also has excellent results and each cycle with them is different as they monitor you daily and change your meds accordingly, but they are rather more choosy about the patients they will treat. For example, if your FSH is high (over 11-ish) they will monitor it for a few months but will only treat you once it comes down to closer to the 10 mark or below. If it won't come down, I believe they won't treat you (don't quote me on that, perhaps they will make an exception depending on circumstances, but that's the situation as I understand it). Tx with the ARGC can be stressful (and expensive) due to the daily monitoring but the results speak for themselves.

I think the best thing is to do as you are doing, go to see each of them and then make your decision based on the merits of each. But I think you've made a good start in picking the best 2 clinics in the country. There is also the option of tx abroad, I've heard great things about the Jinemed in Turkey for example...

If you hang on a bit one of the lovely mods will be along to give you all the links you need to the various parts of the site which are likely to interest you. There's a particularly helpful link to a list of questions to ask during your first appointment (which typically I can't find now  ). Obviously you're not a newbie to IVF as such so some of it you might not need, but it's still helpful as a reference and might eve flag up things that you hadn't thought to enquire about before

In the meantime, have a look here for stuff every FF newbie needs to know!

http://www.fertilityfriends.co.uk/forum/index.php?topic=101841.0

Wishing you all the best of luck!

xxx


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## applesandpears (Apr 2, 2009)

Hi Nix

Thanks so much for taking the time to write such a detailed reply. 

I haven't got any frosties left unfortunately. I think I'm a mixed responder. On my first cycle I was on 225 iu Menopur, produced 4 eggs, 1 fertilised - grade 2 - and dd was born. On my next cycle 2 years later I was on 300 iu of Gonal F as I was a bit older, produced 14 eggs, 7 fertilised, 3 grade 1s, 2 grade 2s, 2 grade 3s. 2 were put back and cycle failed, 2 survived the thaw and I got pregnant from that cycle but miscarried. I can't remember what my FSH was exactly - think it was about 8. 

As you say, I don't think the clinic has done that much wrong but they are a bit disorganised - we have to try and keep one step ahead of them - and the Lister does have better stats. However, if it's my eggs not being as sprightly as they were even the Lister won't be able to get around that one. 

Thanks for the advice on where to look on the site - still trying to navigate my way around. 

All the best.


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## Han72 (Feb 15, 2007)

Hi again

sounds like you're a normal responder to me lovey! Obviously the dosage on the first cycle was far too low, hence the low number of follies but you still got preg (congrats on DD by the way!) and it looks like they got the dosage spot on the next time around, even if it was a BFN.
Was it a very long time ago?  It is true that age can be a factor but it is very encouraging that on your last fresh attempt you had embryos good enough to freeze and you got pregnant from those frosties, even if it did unfortunately end in miscarriage.  

I have to say if you're looking for a clinic with good organisation, don't go to the ARGC!  They can be a nightmare as far as that is concerned as it gets so busy and they keep everyone's records on paper rather than on computer...  They are faultless when it comes to the medical care but the admin can be a bit hit and miss.  I go there anyway cos I know they're the ones most likely to get me pregnant but I do take into account the fact that they're horrendously busy and c0ck-ups sometimes happen.  

I can't really speak for the Lister as I went there once but only had a few preliminary appointments before I moved to France (long story) but I think all the big clinics are victims of their own success to a greater or lesser extent and the admin sometimes suffers as a result.

I should point out here that these are my personal opinions and not those of Fertility Friends!  And I don't want to put you off the ARGC as I think they're fab but you need to go into it with your eyes wide open...

All the best honey

xxx


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## Bambam (Feb 14, 2008)

Hello applesandpears and welcome to Fertility Friends 

It's so hard weighing up the pros and cons of the different clinics available to us  I know the clinics in my area have open days / evenings so perhaps see if the ones you mention have any coming up you could go to.

We also have *location boards * on here. These are especially useful to find people who may be using the same clinic and or in the same PCT area. For the *London Clinics ~ *CLICK HERE

We also have a board for the *ARGC ~ * CLICK HERE

Here are some links you might find helpful at the moment. Please do have a look around and explore and start posting around the boards and making friends. FF is a wonderfully supportive community and you can only get the best out of it if you start posting and joining in so, please do so.

*What Every New Member Needs To Know (includes a list of common abbreviations) ~ *   CLICK HERE

*What can improve egg quality and quantity ~ * CLICK HERE

*TTC over 40 ~ *CLICK HERE

You can have a bit of fun or just gossip while you are on FF too so check out the general chit chat / jokes / hobbies area:

*Girl & Boy talk - Community & Fun Board ~ *CLICK HERE

You can also chat live in our excellent chat room. We have 4 newbie chat sessions in the chat room every week on (*Wednesday*), where you can meet other new members and get technical support with navigating the site and using all the functions available here.  CLICK HERE FOR INFO ON NEWBIE CHAT 

Wishing you lots of    and 

Amanda xx


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## Caz (Jul 21, 2002)

Hi applesandpears, welcome to FF. 

I am sorry to read of your recent m/c 

I am answering this as an ex-Lister patient (Nix was at the ARGC so you'll get both points of view on those clinics you mentioned). I think the decision to change clinic is quite a difficult and personal one. Normally I would say avoid if you can because your current clinic "know" you and how you cycle and will be better placed to get the right treatment protocol for you but... if you are not happy with aspects of the treatment or with the treatment protocol they offer and they don't seem able to offer you anything else/new then it is a consideration.
You mention you are a mixed responder. To me, with a good FSH and the results you have it seems that one particular drug is better at getting results than another for you. That's surprisingly common actually! As you have seen though, sometimes quallity over quantity is better. The Lister are particularly good at dealing with older ladies/poor responders and quite flexible in their clinic protocols. The ARGC are excellent, buyt very intense treatment wise (and it does translate into costs, I'm afraid although the Lister are also on the more expensive end tx wise). 
There is a Lister girls thread here: http://www.fertilityfriends.co.uk/forum/index.php?topic=181930.405 which you can seek other opinions about and you can also look in the clinic reviews board for what patients have said about the clinics.
My own opinion would be that you ought to book a consultation at both clinics and see what they say. you can then either change (if you like one better than another) or, at the least, you know you have looked and the worst you have done is lost the cost of a couple of consultations!

Do shout if you want any more info about the clinics. We'll try and help.

Loads of luck.

C~x


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## applesandpears (Apr 2, 2009)

Hi Caz

I had dd in August 07 and the failed fresh cycle was in September 08. The frozen cycle which resulted in the m/c was in January of this year. Thanks for your opinions on ARGC and the Lister. There seem to be some doctors at other clinics who think that the daily scanning at ARGC is unnecessary. It's so hard to know, isn't it? Surely if it were necessary other clinics would be doing it as well?

Best of luck with your treatment and thanks once again for your replies. 

Hi Amanda

Thanks very much for the welcome and all the info. This seems like a great site. 

Hi Caz

Thanks so much for your response. Congratulations on Benjamin - only 6 months older than my dd. Strange to think they'll be in the same school year - there seems to be such a difference between toddlers of that age now. I do think that a long, difficult route to having a baby makes you appreciate the little things even more. 


It is interesting how one drug - and a higher dose - can have such an improved response over the other. With the first cycle we were paying for the cycle but were told that we could ask our GP if it would be possible to get the drugs on the NHS. To our great surprise she said yes - saving us about £800 - but it meant having Menopur instead of Gonal F which the clinic said would be fine. For our second cycle as we were paying anyway we went for Gonal F as originally prescribed. The doctor and nurses were cockahoop with the response but even then I thought that, sod's law being what it is, the cycle might come to nothing - and of course that is what happened. We then expected nothing at all to come of the frozen cycle as the chances are less so were fairly stunned to get a BFP. It's all such a roller coaster ride, isn't it?

All the best and thanks once again for taking the time to respond.


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## clucky (Nov 5, 2008)

Hi Applesandpears 

So sorry to hear about your recent MC.   

I thought I would reply to you as I have had treatment at both the Lister and ARGC! 

I first attended the Lister when I was 42. That was my first IVF treatment so I didn't really know what to expect. My hormone levels (FSH, LH, E2) were all ok and my AMH was on the low side but pretty good for my age. They put me on a standard long protocol and after a slow start they increased the medication and I eventually got 7 eggs. We should have had ICSI, but we didn't even know it was an option, so only got one top grade embie from 5 mature eggs which was disappointing. At our follow up they said that apart from doing ICSI next time they wouldn't alter anything and it was all down to egg quality and my age. I believe they do immune testing and some of their patients take DHEA to improve egg quality with their knowledge but none of this was mentioned to us. Post ET there was no involvement from them at all.

For our next cycle we went to ARGC. As Nix says, they focus a lot on FSH, but don't do the AMH testing. They decided I should do a short protocol and we got 6 eggs, and 3 very good embies  using ICSI. Our next cycle at ARGC resulted in 8 eggs, 5 embies and one frostie. At our 2nd cycle they focused more on implantation issues and I did immune testing and took some medication related to that. We are now on our third cycle at ARGC and have greater focus on lining/implantation related issues. 

I do think each clinic takes a while to get to know you and for a first cycle at a new clinic they will probably do their standard thing (taking your history into account) and see how that goes.

ARGC and the Lister are very different clinics - 

The Lister is more 'hospital like'. I'm not sure it really better organised - we had a couple of admin slip-ups there too, but it does feel more institutional and organised! The Lister treatment protocol is much less demanding on you time and energy - very few blood tests and fewer scans. At the Lister we did not see any doctors during stimming, only for the consultation and EC/ET. We were assigned a regular person to do the scans, which was nice, with pre-arranged appointment times. The nurses give the med instructions, presumably following consultation with one of the doctors. 

At ARGC, doctors do the scanning, but there is no real appointment system so you can wait around sometimes. Once you start stimming you need to attend for daily blood tests, scans every other day and in the 2nd week of stimming you may need 2 lots of blood tests in the same day. Based on the blood test results your daily meds are decided and phoned through to you. There seems to be more focus post ET and I believe there is follow-up monitoring/testing for ladies who get a BFP!

They are both busy clinics - the Lister is the largest in the UK so you can feel like you are just a statistic, and ARGC is always v busy and can feel chaotic. I would say with both of them you need to be vigilant and pro-active about your own treatment. The costs for the basic treatment are very similar but ARGC will work out more expensive due to the daily blood tests. As Caz and Nix suggest, I think it is a good idea to attend both and decide from there.

Wishing you the best of luck with your next cycle

clucky xxx


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## applesandpears (Apr 2, 2009)

Hi Clucky

Thanks very much for taking the time to write such a detailed reply. Really sorry to hear that things haven't worked for you so far and to hear that the Lister didn't live up to your expectations. I think you're right that the first cycle is an opportunity for the clinic to work out what level of drugs you need and is really partly guesswork on their side. 

The Lister seems to have a very similar procedure to C+W so we are wondering if Lister would confer much of an advantage. 

Thanks once againfor your response and the best of luck with your treatment.


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## Han72 (Feb 15, 2007)

Wow Clucky, that's a great summary of tx at the ARGC! And yes you are correct re the monitoring post BFP. They monitor your HCG every 48 hours to ensure it is doubling correctly and will take the appropriate action if it isn't (progesterone/IVIG/etc as appropriate) They also scan you at 6 weeks if I'm not mistaken...


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## Caz (Jul 21, 2002)

Thank you from me also Clucky, I think that's a fair summary of treatment at The Lister too and it's good to see the comparison as people often ask and I can only ever give them what I know about the Lister and what I've heard of the ARGC. 

I have to say I didn't find the Lister particularly institutional - hospital like, yes, but then it is in a hospital so rather unavoidable! They don't have you in a hospital gown and theatre environment for ET though (I recall that being a rather relaxed affair with the radio going, having a natter about holidays abroad and my skirt hitched up...  ) I know some clinics do go the full on scrubs and masks affair for ET and I know some hospitals have nurses do ET rather than consultants so... maybe more hospital like compared to the ARGC (not sure what the ARGC do) but certainly very unhospital like compared to what  had been expecting after watching some IVF programmes. I guess whether that's a good thing or not depends on the individual as I am sure some people would be reassured by the more sterile theatre feeling and others would get more stressed out by it - personally, I get palpitations just driving past a flipping hospital so anything to make me feel more at ease is good for me! The only real complaint I ever had about the organisational side was that for ET you always waited at least an hour longer than they said. Rather frustrating but then, that's the danger of giving appointment times for something so unpredictable. For all the other appointments I had there I never waited longer than about 20 minutes. Considering how busy they can be, I was impressed.  
I would also say that they can and do have a flexible approach to treatment proctocols. I know a lot of the ladies on the Lister threads would suggest things to their consultant and often that would be taken on board and incorporated into the tretament protocol. I did 6 cycles with the Lister (including 2 FET). My first go was a BFN and it was chalked up to bad luck and same again next time but after that we did look at a lot of different things we could do or tweak for next time including immune issues. At one point I was considering changing clinics and if they had not been able to offer me anything different I probably would have but I always came away from the follow ups thinking they were as frustrated by my lack of success as I was and there was going to be something a little different we could try next time. I was never unhappy with the treatment protocols, after all, just the end result! 

Nix, yes I believe the ARGC post BFP support is second to none. Between that and their very intensive monitoring, and the fact they really so operate 365 days a year to the convenience of when it's right for you to have your EC/ET etc. I do think that goes a long way to contributing to their fantastic results. I know one FFer who had her baseline scan on Christmas day because that's when she needed it! 

I will say one word of warning about the ARGC (and ARGCers can feel free to correct me if I am wrong). From all that I have seen and heard on FF of the ARGC from patients who have been there, do not judge them completely on the first consultation. I have often seen people say they have come away from that first visit feeling very negative because the place feels disorganised, that they don't care, that it takes them ages to repsond to calls etc... By all accounts that is a trend that DOES NOT continue when you start your actual treatment and you will find nobody to rival them in the care aand attention they pay to your treatment. It's worth remembering that when you make your decision as you may be tempted to write them off on the basis of this and you would not be doing them justice.


Hope that helps.

C~x


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## Han72 (Feb 15, 2007)

Caz said:


> Nix, yes I believe the ARGC post BFP support is second to none. Between that and their very intensive monitoring, and the fact they really so operate 365 days a year to the convenience of when it's right for you to have your EC/ET etc. I do think that goes a long way to contributing to their fantastic results. I know one FFer who had her baseline scan on Christmas day because that's when she needed it!
> 
> I will say one word of warning about the ARGC (and ARGCers can feel free to correct me if I am wrong). From all that I have seen and heard on FF of the ARGC from patients who have been there, do not judge them completely on the first consultation. I have often seen people say they have come away from that first visit feeling very negative because the place feels disorganised, that they don't care, that it takes them ages to repsond to calls etc... By all accounts that is a trend that DOES NOT continue when you start your actual treatment and you will find nobody to rival them in the care aand attention they pay to your treatment. It's worth remembering that when you make your decision as you may be tempted to write them off on the basis of this and you would not be doing them justice.


Caz man, you're showing me up, as a current patient I should have written that! 

xxx


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## applesandpears (Apr 2, 2009)

You ladies are amazing. Thanks Caz for such  detailed information. C+W is the same as the Lister with not much contact after a BFP. However, we were told that if a miscarriage is going to happen then there's nothing you can do to stop it. I was taking Progesterone but once I stopped that I started to bleed 2 days later. 

Have just been filling in the form for ARGC but from looking at the ARGC thread it seems as though we won't be able to get an appointment for at least a couple of months although people on the thread were saying that cancellations do come up. 

Thanks once again all for taking the time to post.


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## Lilly W (Apr 6, 2009)

I'm also new to the site.  Just a quick note to say how helpful this thread has been.  I have had 6 attempts at Nuffield Woking who have been great but they don't seem to be able to offer me any differences to my treatment.  I have always had good quality embryos but they haven't implanted and there have been little suggestion as to why.  I am hoping that when I change clinics they will be able to carry out more tests - the immune thing could be relevant?  I too still can't decide between the Lister or AGRC.  I have an initial consultation this week at the ARGC and hope to make one with the Lister following reading this.  Any advice on implantation issues and where will be best.  My only concern is I live in Fareham and travelling to London every day may not be great for the ARGC - any idea how long that goes on for?  Also my last FSH was 12 so they may not treat me anyway....... 
Grateful for any ideas......


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## ajhunt (Apr 7, 2009)

Hi there

Its always tempting to change. I stuck with The Bridge Centre for two IVF cycles and two donor egg cycles in Kiev and have just started with ARGC. I am also 42 so may have to stick with donor eggs. Its a personal decision, I know lots of people who chopped and changed and were still not successful but I would advocate a more personal approachthat the ARGC and offering. Everyone woman is different. So far I am waiting for the results of Humira treatment before I start again so have everything crossed.


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## applesandpears (Apr 2, 2009)

Hi ajhunt

Thanks very much for your response. Best of luck with your treatment.


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