# Wondering why I was put on short protocol, feel a bit cheated!!!!!



## Rosey78

Hello All,
Sadly just had our 1st unsuccessfully IVF Cycle  .  Also was our 1st and last NHS one.  All in all not really happy with the clinic we were at, as felt things weren't really explained that well.  Also a lot of the appointments were rushed, particularly on ET day as consultant was late and didn't even explain anything about the eggs, how things had gone, also why we wanted the 2 embies put back (he basically sat us down for all of a minute then wanted me behind the curtains quick sharp so he could get on with it, whilst saying he was late  ).  Nurses even mouthed quietly 'sorry' and apologised again as we left!

We have our follow up next week and I want to be armed with as many questions as possible, especially about the protocol we were put on.  My main wondering is about the treatment cycle and wondering if anyone out there has any advice re short/long protocols.  I think personally we were put on wrong protocol but you dont question things, especially when we know very little about IVF to start  

We paid for AMH which was 26.5 as consultant said it would help them decide which protocol to put me on.  FSH is 7.1 LH 7.5.  Anyways based on the AMH we were put on the short protocol 2 vials menopur to one water for about 9 days, with ceretide at end.  I had 7 follicles at start, on EC they got 6 eggs, 3 fertilized but buy time got to ET only had 2 little embies to put back, so none to freeze even.  Got BFN 2 weeks ago  

Since then have been doing reading etc and it seems most clinics put people on short protocol if they are older (I'm 31) and have low AMH, High FSH.  Which is a bit of a mystery to me as I'm the opposite to all of those things.  I now cant help but feel that we have been a a bit short changed and if I had of known more about short V long protocol and eggs,  or given a choice, I would have gone for longer protocol with an outcome that may have given us more eggs at least to do FET.  Im sure because of my bloods Id respond well to medication.    

I know that its too late now to do anyting, and if the outcome had of been BFP then I wouldn't even be thinking about this, but want to be as prepared as possible when we go next week.

Sorry for such a long waffly message, hope it makes sense!!


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## Rosey78

Hello All,
Sadly just had our 1st unsuccessfully IVF Cycle  .  Also was our 1st and last NHS one.  All in all not really happy with the clinic we were at, as felt things weren't really explained that well.  Also a lot of the appointments were rushed, particularly on ET day as consultant was late and didn't even explain anything about the eggs, how things had gone, also why we wanted the 2 embies put back (he basically sat us down for all of a minute then wanted me behind the curtains quick sharp so he could get on with it, whilst saying he was late  ).  Nurses even mouthed quietly 'sorry' and apologised again as we left!

We have our follow up next week and I want to be armed with as many questions as possible, especially about the protocol we were put on.  My main wondering is about the treatment cycle and wondering if anyone out there has any advice re short/long protocols.  I think personally we were put on wrong protocol but you dont question things, especially when we know very little about IVF to start  

We paid for AMH which was 26.5 as consultant said it would help them decide which protocol to put me on.  FSH is 7.1 LH 7.5.  Anyways based on the AMH we were put on the short protocol 2 vials menopur to one water for about 9 days, with ceretide at end.  I had 7 follicles at start, on EC they got 6 eggs, 3 fertilized but buy time got to ET only had 2 little embies to put back, so none to freeze even.  Got BFN 2 weeks ago  

Since then have been doing reading etc and it seems most clinics put people on short protocol if they are older (I'm 31) and have low AMH, High FSH.  Which is a bit of a mystery to me as I'm the opposite to all of those things.  I now cant help but feel that we have been a a bit short changed and if I had of known more about short V long protocol and eggs,  or given a choice, I would have gone for longer protocol with an outcome that may have given us more eggs at least to do FET.  Im sure because of my bloods Id respond well to medication.    

I know that its too late now to do anyting, and if the outcome had of been BFP then I wouldn't even be thinking about this, but want to be as prepared as possible when we go next week.

Sorry for such a long waffly message, hope it makes sense!!


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## LittleMissM

Hi,

Didn't want to read and run.
If I were you, I would note down all your concerns about the tx, about the way you were treated, including the late Dr, and take it with you to your appointment. That way you can refer to your notes so you don't forget anything.
Personally I have been on a LP on my 1st and this tx, so cannot help with diagnostics here, I think you ened to hear the reasons why from them.
If you are still not satisfied, then ask to put in a complaint there and then, and if you are lucky they may give you a second tx. I ahve heard of women being offered this on NHS after they complained.
I am sorry I cannot help more.

Sue


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## Jenny74

Hi Rosie78

I too was put on short protocol for my first tx and I only produced 2 eggs.  The reason I was put on short protocol was because I have PCOS and on a previous IUI cycle I had hyperstimulation so they aired on the side on caution.

However, people keep saying the first tx is like a practise to see how you respond to the drugs but I had had 4 attempts at IUI first so had practise runs and knew how I reacted to the drugs.  I felt my notes were not read thoroughly due to a few reasons and after I had my BFN I prepared for my review by listing exactly what had happened throughout the treatment and went through this at the review.
As a result of this we were offered a free cycle, the consultant went away and looked through my notes after hearing what we said and then wrote to us, asking we just buy the drugs.  He has also put me on the long protocol this time but warned me I have a high risk of hyperstimulation again and will need more scans.

I asked to see the boss for my review appointment so we weren't seeing the same doctor, this meant I had to wait a while longer but it was worth it as he is now over seeing my second treatment.

Stay calm when explaining what happened and have the details ready.

Good luck at your review 

Jen xx


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## agate

1) most people don't get spare embryos that are good enough to freeze - its a bonus if you do, but its much more common not to get any.
2) short protocol tends to give fewer eggs, but they may be better quality so it is sometimes used for patients who are at risk of over responding as well as for ladies who are expected to have poorer quality eggs.
3) your stimms dose was fairly low - so it suggests your clinic were trying to be cautious of OHSS - trying to reduce the risk of getting too many follicles - unfortunately, for NHS cycles there often isn't the budget to monitor you closely enough to risk a high dose on your first cycle, and many docs are not good at explaining or talking to patients. 

the good news is that you did respond pretty well on 150 u of FSH, so there is very chance you will be successful on a future private cycle, probably on a higher dose, whether it is SP or LP.

I would ask them what they would suggest doing differently, and get full details of the progession and quality of your embryos - so that you understand their quality - not just the numbers of them.

Before you do any private cycles, I would suggest getting a copy of you full file and seeing more than 1 clinic for an initial consult to decide who you want to cycle with - there is a big difference in protocols and procedures and customer care between different docs and different clinics. 

But, unfortunately, IVF is a bit hit and miss, especially if its a 'budget' cycle with limited monitoring and its your first go.

good luck


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## Bethany915

Hi Rosey - Just a very quick one to say that 26.5 is a pretty high AMH (I think an AMH of 30  suggests PCOS - you are not that high but still fairly high) - so I'm sure they went for the short protocol to avoid risk of over-stimulating, as the other ladies on this thread have mentioned.

Other than that, I've not an expert on either IVF or stims (being a natural cycle IUI-er myself), but I think as the other ladies have suggested, it's a good idea to write down all the points you are concerned about and refer to your list during the consultation.

Good luck with it!

B xx


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## almond

Hi Rosey, I'm so sorry about your BFN, it is a horrible thing to go through    I'm also sorry that you've had such a difficult experience with your clinic.

I'm a poor responder and on my first 2 cycles did a version of the short protocol for that reason - but I remember my consultant telling me that the classic short protocol which you were on is often used in high responders, to stop OHSS. I wonder if that is why they chose this protocol for you, given your amh result? But it would be nice to actually have things explained by your clinic, wouldn't it? Makes me cross   

I agree it's a good idea to be armed with lots of questions for your follow-up, and I hope it helps you move forward with whatever you want to do next   
Wishing you all the best
xxx


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## almond

Hi Rosey, you seem to have 2 threads as I think one was moved from elsewhere and I just replied on the other one - but pretty much said what the others have said
x


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## roxy1984

hi
i was on a short protocol for my icsi cycle, unsure of what dosages i was on, but i got 32 eggs and overstimulated abit, im only 25,they just said my bloods were fine and that short wud be best, im unsure of the amh level but think it may of been quite high because pcos was mentioned at my follow up,we did get 15 frozen embies as well, so im unsure on what the differance between long and short is,  but like you say you just go with what they tell you your going on, good luck for ya follow up and dont loose hope im pregnant now with twins so it can happen.xx


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## Bethany915

Hi again Rosey

To add to my earlier post - although I think there was a reasonable scientific argument to put you on a short protocol, there certainly was no justification to rush you through on the day of ET   - and you can say things like how you had heard good things about the clinic from other people and so you were really disappointed to be rushed through at such a critical time, with no opportunity to ask questions or be given all the information you were expecting.  

They may not be prepared to do you a free cycle (and I know you are planning to go elsewhere anyway) - but you could ask them at least to refund you the cost of the AMH test as a gesture of goodwill.  (You could even say something about knowing lots of other people who are considering fertility treatment and you would be much more likely to recommend the clinic if they take your concerns seriously and give you a gesture of goodwill.  Might just do the trick if they think it could affect their bottom line  )

Another question for you - is there a good reason why you have gone to IVF rather than trying IUI?  Or have you had IUI before and then moved on to IVF?  I don't think you have a detailed sig so I don't know your history.  Obviously, I know which clinic you are talking about - and I know they do tend to push people to IVF because their IVF stats are quite good whereas their IUI stats are poor (they would have pushed me towards IVF apart from I have an appallingly low AMH that there would have been no point - ha ha!).  Just a thought that if you are switching clinics you might want to consider IUI as a cheaper and less invasive option (unless you have significant male factor or blocked tubes or already tried it several times without success).

Good luck whatever you decide 

B xx


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## Rosey78

Hello all, Thank you ssssooooooooooooo much for all of the advice, it has helped a lot  

Bethany, im not sure about IUI as the only thing ever suggested to us was IVF.  Sorry I prob should do something a bit more detailed on my signature, just not very up on the PC.  Will try some point this week.

DH and I TTC for 3years,  6 yrs ago had lap which showed one blocked tube, adhesions and mild endo.  HOWEVER, repeat lap last year at UCL showed no blockage and they said I was told a false positive 6 years ago.  Some adhesion and scarring which they lasered and again mild endo.  Put in category of unexplained infertility.  As I said, all bloods have been normal.  DH swimmers are fine too.  This was our 1st experience of any fertility treatment, apart from the investigations last year.  Don't know much about IUI, will have a goggle and see what I find.  Does that info help at all

Thanks again everyone for your kindness


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## Rosey78

P.s Don't want people to think I'm moaning unnecessarily.  Just want some things clear in my mind before we have our follow up and all of your help has Been great. 

PPS 
Beth, it wasn't only ET day that was hectic and un-organised.  The day they started my meds and did 1st scan was a flipping nightmare too.  After ringing them in the morning to tell them Af had arrived and to say that I was planning on going to see my Mum for the wkend, they assured me it was fine and I could go in on Mon for 1st scan and to pick up meds, but they would ring me back.  I rang again in the afternoon just to check as they hadn't called me back and needed to get going to avoid traffic and again was told yes thats fine!!  Low and behold get to Oxford (had been stuck in traffic for 35mins on M40, else would have been in Cheltenham) to receive a call saying they needed me at the clinic by 4pm else we had missed this months cycle as I needed to do 1st jab on Sunday.  It was 1515  when they rang.  Was advised to get off at next junction and ring them to say how far away the sat nav was telling me I was, as the latest they could stay was 4pm!!!!  Got there at 1555, without hubby for support and a rather rushed clinic all in all.  Crumbs, now Iv had another rant........................ Sorry ladies!!!

 Does make me rather cross tho when I think of the treatment from start to finish!!!


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## Bethany915

Rosey - Oh dear, that sounds like another thing to mention to them at the follow up  .

Anyway, based on your history (i.e. good swimmers and tubes seem ok), I really suggest you look into IUI. You could do 3 cycles of IUI for about the same cost as one IVF - and there's no EC or ET to go through, just a basting (when they put the sperm into your uterus). There is an IUI Beginners Guide somewhere on here:

http://www.fertilityfriends.co.uk/forum/index.php?topic=16321.0

- and if you have questions after that, there are some lovely ladies on the IUI 215 board (we are all very excited as one of the ladies on the board got a BFP today  )

http://www.fertilityfriends.co.uk/forum/index.php?topic=246295.75

and we would all be happy to answer your questions  .

I know you mentioned switching to the UCL clinic (I always forget its name!) - and I know their IUI rates are good as I remember considering it myself.

B xx


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## Ceri.

almond said:


> Hi Rosey, you seem to have 2 threads as I think one was moved from elsewhere and I just replied on the other one - but pretty much said what the others have said
> x


Both threads have been merged together now


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## Daizymay

Hi Rosie,
I was told by clinic last week that due to my age (39) low AMH (3.5) I would be likley to be started on short protocol.
I think you're rants are perfectly justifiable. document EVERYTHING and write a complaint. Most hospitals have designated 'patient support services' a polite term for complaints team or advocates - who are there to help you voice your complaint in the best way - check your healthboards website for contact details. You may get a fob off reply (I did when I complained about waiting times for a laparoscopy), but as per the letter I re-wrote to say I wasn't happy with their response and within a week I got transferred to a private hospital for my treatment!
Re: IUI - i'm no expert but i think it would be an option - come and join us on IUI chatter 215: http://www.fertilityfriends.co.uk/forum/index.php?topic=246295.75
Hope that helps
daizymay


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## agate

a history of scarring, adhesion and endo MAY suggest tubal lining damage - even if tubes aren't blocked, if their lining is scarred they may not function well enough to waft the egg down to the uterus - this MAY reduce your chances with IUI and might be the reason you were sent straight to ivf.


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