Hi ladies. I'm moving on to an IVF cycle after a few failed IUIs and unexplained infertility. My doctor explained "traditional IVF" to me as egg retrieval followed by a day-5 transfer of fresh embryos. My doctor suggested, however, an egg retrieval followed by a "mock cycle" a couple months later, followed by a frozen embryo transfer. The cost difference between the two procedures is pretty significant. Did anyone here have good experience with the "traditional IVF" with fresh embryo transfers? I'm struggling with trying to decide what to do.
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It seems to me that most bees have "traditional" IVF and start with fresh transfers, but I think @justdarling's RE only does frozen transfers. Did your doctor give you a reason why he thought frozen would work better for you?
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@ms.line: Thanks for your quick response. He did not specifically say that the frozen transfer would work best for ME as opposed to any other person. He said that a girl's body is possibly not the best environment to support implantation following egg retrieval. I was agreeing with all that until I later learned the price difference from someone else in the office.
I would love to hear that someone got pregnant following egg retrieval with a fresh transfer. I wish money wasn't an issue, but it sadly is.
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Totally understandable that you have to consider the financial implications - IVF is super $$$! I'm sure more bees will weigh in with personal experiences soon - good luck with your decision and your cycle!
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@ms.line: Thank you so much for your input and well wishes.
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Success story here! My diagnosis was PCOS. I had 1 failed TI cycle, three failed IUIs, and then got pregnant with my first fresh IVF cycle with 3-day embryo.
I totally support you making the decision based on all the factors, and money is definitely a huge one! Good luck! Let us know what you decide!
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My fresh cycle worked on the first try. However, my sister did a fresh cycle that had to be canceled before her retrieval because of her estrogen levels. She had the same issue during her second fresh cycle, but was able to retrieve and freeze everything. She got pregnant twice from frozen transfers (although her first transfer resulted in a miscarriage). So for her frozen worked out very well because it gave her body a break. She has a very hard time with stims (they give her terrible migraines) whereas I react well to stims, so my fresh cycle went as well as it could have.
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@ineebee: Thank you so much for your response! Its great to hear your fresh cycle worked after the retrieval.
@twodoghouse: Thank you so much for your response as well. I'm so glad to hear your fresh cycle also worked. I'm glad your sister ended up having success as well. I suppose I could plan to do a fresh transfer, i.e., "traditional IVF" and if my doctor thought my estrogen levels were too high, then well, I guess I'd just by default be moving on to the expensive mock cycle and FET. Thank so much for your input.
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My RE's plan for me was to go right to the frozen embryo transfer, so I skipped the fresh transfer. They wanted my body to recover from the stims and they felt frozen embryos are a bit hardier (sp?) because they go through the freezing and thawing process. They said this is recent research within the past year that supports this. I'm pregnant now from that transfer so it worked for me.
I do know plenty of IVFers who did fresh transfers and had success, so I think fresh cycles can still work.
Oh, not sure how you feel about your RE, but I switched from my first clinic because I wasn't really happy with their IUI protocol (reduced monitoring) and staff issues. The new clinic was known to create an individualized protocol and had a better success rate from people who tried other clinics and failed. Their SART data didn't show it though, so when I switched, it was all up to chance. Anyway, my first clinic gave me an unknown diagnosis but my second clinic finally got me diagnosed (PCOS and DOR) and put me on meds. Oh, I switched clinics after 3 failed IUIs. My new clinic diagnosed me and felt I could be successful with IUIs so I did another 3 IUIs. They didn't work so we moved to IVF.
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There is a member here that also has a website about IVF. It's in my reader, so I've followed her journey. I think her first child was a fresh transfer. Her website is Breath Gently .com. - you should check it out.
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My wife and I (we are a same sex couple) had success with our first fresh IVF cycle as well. We had 7 previous failed IUI's with no known fertility issues (other than lack of sperm ha) We transferred two day three embryos which resulted in our 8 month old son. It was definitely a crazy time in our lives and we are so lucky it worked on the first attempt. Good luck in your decision
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Fleshed worked and two fets (not using vitrification) did not. I believe I have an underlying immune issue that was lowered when I was stimmed.
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@bluestriped bee: Your RE's plan sounds like my RE's plan. I'm so glad it worked for you. My RE didn't spend a whole lot of time - maybe a few minutes - talking about fresh transfers. That's interesting about how you switched clinics. I feel fairly comfortable with my RE and generally really like him. I did briefly think about getting second opinions but that's maybe just for cost reasons and I'm not sure its worth my effort. But do you know how its possible that your first clinic skipped the PCOS and DOR diagnosis? Did you have PCOS symptoms? And isn't DOR found via a blood test? That does make me so nervous to think my "unexplained IF" may really be easily explained. I'm so glad you got your IF finally sorted out and are are now pregnant.
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@TemperanceBrennan: Thank you for the website recommendation. I will look it it up this weekend.
@muffinsmuffins: you are funny.
I'm so glad to hear the fresh transfer worked for you. I'm really leaning towards taking that route. THank you for your input and congrats to you and your wife on your little boy. @brownie: Thank you for your input. I'm so glad to hear the fresh transfer worked for you. I'm so sorry the two FETs did not. Do you have more embryo's stored for future FETs?
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@agold: nope we went done another path and are done
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@brownie: So the fresh transfer worked, right? And the FET trying for a sibling did not work?
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@agold: I had no signs of PCOS. My RE took blood and noticed that I had subtle signs of high/low (can't remember which) insulin levels. Not enough that I would be called diabetic. Also, I think there were other factors, too. Oh, I've had kinda long cycles at 33-34 days and they think that was also a sign of PCOS.
Oh, my first clinic didn't really take my blood regularly... once every 6 months and they certainly didn't look into my insulin.
As for DOR, I did have a history of low AMH. I think there were other factors that I can't remember.
I was very hesitant in switching clinics and getting a second opinon. I really wanted to start the IVF process. You know how with IF, time is always an issue... why can't I be pregnant yesterday. Well, I was getting more and more annoyed with the nurse that had at the first clinic so I took it as a sign to look around. Also, I asked my first clinic if I could be seen by another RE in their office and was annoyed that they told me I would be treated like a new patient if I switched RE's within their office. (Would have to do everything all over again.) Plus, that RE was busy and it would have been a full month before I could see them. I called around to other clinics and the clinic I ended up with could fit me in 2 weeks.
Oh, cost was an issue. I have no IF coverage for IUIs and IVF. I had some diagnostic and blood work coverage. As you can tell, my first clinic had a lot of red flags when I ended up leaving. So at that point, I just want to say goodbye.
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@agold: correct. One live birth (son) two fails for siblings.
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Fresh cycle with donor eggs worked for us (we're really early though, only 10dpt.
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I've done both now. My daughter was conceived after several rounds (and was a fresh transfer, 5 days after egg retrieval.)
Since then for #2, I've done frozens and had no fresh cycles - hormonal issues have led to all embryos being frozen, and then we've had to transfer several cycles later.
So far, I've had two pregnancies off frozen cycles, but they haven't worked out -- the fresh cycle with my daughter has been the only full term baby. That said, it's due to the embryos, not the frozen transfers.
I know LOTS of women who have good luck with frozens! But my gut always prefers fresh.
That's my website - it's in my profile - thanks for the link @TemperanceBrennan x
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I've had pregnancies after both 1 fresh and 1 frozen cycle. The fresh didn't turn out-- a "blighted ovum." I'm currently 35weeks pregnant with the frostie.
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My 10 week old was a fresh IVF transfer baby. Our issue was male factor so we did ICSI and conceived in the first cycle. I was really lucky and we have 4 more frozen embryos. Its the freezing that is the expensive part, as we have to pay yearly for storage.
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@agold: My 12 week old DD is the result of our first fresh cycle and an eSET. I know that some clinics see better results with frozen protocols but a fresh cycle still generally has good success rates
ETA: I understand the $ issue. Our cycle was 100% OOP and was almost $18,000 by the time we were all in -
My doctor only does FETs. He will do the egg retrieval one cycle, wait a cycle, and then do the transfer the next. He wants to give the woman a month to come down from the stims and provide and ideal environment for the transfer. The success rates really good - and it worked for me on the first try with a single embryo transfer. For us, this procedure wasn't any more expensive than other clinics who did it the traditional way, so that wasn't a concern for us. We are actually starting to prep for our second FET so that our LO will have a sibling.
Is there a possibility of deciding to either do a fresh or a FET once you know how many embryos you get?
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My twins are the result of a 3 day fresh transfer. I was unexplained...it's definitely a tough decision...good luck!
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@bluestriped bee: "why can't I be pregnant yesterday.." I totally understand this! It sounds like you had good reason to consider leaving your first clinic. If they didn't take blood tests regularly, I can see how some issues could easily be missed. Low AMH isn't great either. As I'm thinking back, my doctor didn't say anything too positive or negative about my AMH. I would have preferred a definitive response like "you are great" or "this is bad". What was the timeframe like from when you first started IVF to when you got pregnant?
@brownie: Congratulations on your son. And I'm so sorry about the two failed sibiling attempts.
@winter_wonder: You are very newly pregnant?!? Congratulations! Can I ask a couple questions: After your egg retrieval, how were you feeling before the fresh transfer a few days later? Did you experience any amount of OHSS? I'm really wanting to do a fresh transfer so I hope it will work out for me!
@jaguar: Thank you for your input. Congratulations on your daughter and best of luck as you try for a sibling for her. I'm feeling very encouraged to hear that the fresh transfer right after the egg retrieval was successful for so many here. My RE more or less said that within the last year, it makes so much more sense to skip the fresh transfer. Which I suppose could be true, but its just so much money to skip a potentially good viable option. I'm going to check out your blog soon. Thank you for sharing it.
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@agold: thank you! The first time I did ivf, I just felt sore after the transfer. I spent the weekend in bed with a heating pad and drinking Gatorade. But I didn't have any OHSS symptoms. I remember feeling perfectly fine after about 3 days or so.
With our last round of ivf we used donor eggs so I didn't go through the egg retrieval or the recovery process. Let me know if you have other questions!
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@FliegepilzHut: I'm so glad that one of those worked out for you. Did you do a "mock cycle" before you did the FET? And do you know if you are having a boy or a girl? (I can't help but ask about the baby.
)@macintosh: Congratulations on your new baby! I'm so happy to hear the fresh transfer after egg retrieval worked for you. Its so true that each and every additional step taken in this IVF process costs so much. I'm hoping so hard that I get some embryos to freeze. I think freezing them costs $850 and storing them costs $900 for three years, with that amount being prorated if we take them from storage early. That's a lot, but its maybe the only costs I don't feel entirely sick looking at because it seems like such a bonus to get extra embryos. I will be doing ICSI also.
@mrswin: Congratulations on your new baby! I just had to look up what "eSet" is. Did that specific option cause you any additional costs? My RE's office didn't even address it but its something I might be interested it. I will be paying 100% OOP as well. With your costs being up where you said they were, was that just IVF egg retrieval and a fresh transfer? Or did you have additional things? $18,000 is a tad less than what my RE's office quoted for IVF w/ICSI (skip fresh transfer), mock cycle, and FET. I started seeing stars when that number was put in front of me! I was thinking it would only cost around $13,000 which is still overwhelming, but its just what I thought it would cost.
@justdarling: Your doctor sounds almost like how my RE sounded. When I was meeting with him, he totally brushed over the fresh transfer following egg retrieval for all the reasons you stated. It makes sense to me, but I also didn't fully like the idea of waiting those extra months for embryo transfer, even though I fully understand the reasons for it. I totally like your idea of making this a game time decision. If I only get two good embryos, maybe it will sway my decision one way or another. But also, like the girl posted above about her sister, maybe the decision will be made for me if my body is just in no shape for a fresh transer. Thank you so much for giving me another option to consider and ask the RE office about. And best of luck with your upcoming FET.
@Caly: Congraultions on your twins! I can't tell from your little profile picture - are they boy and girl? What was a tough decision for you? Were you trying to decide between fresh transfer and holding off for a controlled FET? Did you transfer two embryos? Thank you for your input.
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@winter_wonder: Oh gosh, using donor eggs and having a fresh transfer that way is really almost an ideal situation since you get the fresh eggs and your body isn't going through the retrival process. (And I know its a bummer in a way to use donor eggs, so I'm not ignorate of that fact, just looking at the silver lining.) I was actually an egg donor for my sister about four or so years ago. My sister has specific fertility issues. But I don't appear to have any identifiable issues so I am actually really bummed to have to be going through IVF myself. I'm going to my sister's same RE and they are treating me really nicely because of this. I'll totally accept sympathy in this situation.
I honestly thought the egg donation process was physically the worst thing I have even been through, even though I was happy to be doing it. And I just didn't really pay any attention to what I was doing, or what my sister was doing when it was all going down because I was stupidly confident that I would never have to do that again. So now I'm here dealing with my own IVF and I feel like a clueless dummy. 
I've been talking to my sister about it, but she just deals with different issues than me. Also, fresh transfers were all that were really encouraged when she was doing it so I really am happy to be hearing about all of your experiences and getting your advice. I'm so happy you are pregnant and I wish you all the best. Thank you for sharing your information.
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@agold: Similar to @justdarling: I had my retrieval in end October and had my FET at the end of January. I did have holiday travel that might have delayed my transfer date.
Oh, I transferred two and currently pregnant with b/g twins.
As for cost, I only saw the cost of one complete cycle with FET or their guaranteed plans. For me, since I was under 31, it was $17k (with ICSI but no PGD) plus the cost of meds which was about $4k. If you are paying out of pocket for meds, I would call WinFertility. They had had the best prices. A lot of the other fertility pharmacies were quoting me at $5-6k for my meds. Oh, their guaranteed plans were $28k plus meds. We struggled with the decision on what to do. We decided that take the gamble and just do the one complete cycle plan.
Lastly, I, too, looked into egg donation a few years ago but my AMH was lower than what they wanted. (They said my AMH shouldn't affect me when I TTC... Little did they know.) My sister went through the process last year and successfully donated.
Sorry to hear that both you and your sister has had trouble TTC.
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@bluestriped bee: Thanks for all your info. How sweet! Boy and girl twins. IVF/MOCK/FET was quoted at approximately $15,000. Meds are estimated at $4K, but my RE's office lady said she put me on a 1/2 list. She also suggested I apply directly to the med makers (follistim and gonal f) to see if I can get an even bigger discount. I will check out what you suggested also. Just doing egg retrival and fresh transfer would be about $10,000 plus the same amount of meds. This all includes ICSI. Not pre-genetic testing - that is $4,750! I'm leaning towards doing the fresh transfer at $10,000 and holding my breath and crossing my fingers that it works. Then if I need to do a FET, then I need to do a FET. But why would I voluntarily skip a fresh transfer? Obviously I know the RE (mine and yours at least) say skipping a few cycles after retrieval is best, but is there any reason to skip the fresh cycle? I'm leaning towards no. I so appreciate all of this info I'm getting here from everyone.
As for being an egg donor, that wasn't really anything I had ever thought I would do and it wasn't an easy decision. But I love my sister so I wanted to help. Sucks I'm here though. The RE insists that my previous egg donation has nothing to do with my current unexplained IF. So I try to just trust that.
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@agold: So interesting to read your question and responses as we are at a similar crossroad in our IVF/ICSI-decision making. I am going to soon post another question on HB about IVF packages (what? huh?! how to even process that..?!!), but I wanted to just pipe in to say that my RE said she will aim to do a fresh cycle instead of FET only, even though that's what seems to trending with REs lately. When I asked her about this ("I've heard recently that some clinics are only doing FET..."), she said that she agrees with that technique but not for me. It may be that time is of the essence with me (I'm 39) and she doesn't want to lose time. I'm fine with that. Just another perspective, if that helps you.
As for cost, we've been quoted one fresh IVF w/ICSI (no PGD) at about $14K, which includes all monitoring, SSG/trial transfer and anesthesia. FET is about $3500. Meds are quoted per cycle at $2-5K. All is OOP for us, too.
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@agold: An eSET doesn't cost any extra but is encouraged at my clinic unless there is a good reason to put more than one back. Just an FYI I live in Canada and I used a clinic affiliated with a major hospital so our IVF cycle was a little lower cost than at some other clinics. Also here there is no separate charge for anesthetic.
The $18k included IVF with ICSI, all the monitoring, about $4k in meds and the cost to freeze our extra embryos. If for some reason we couldn't do a fresh transfer we would have received a small refund.
Is there any chance you can get a second opinion. It seems like the RE may be trying to "sell" the most expensive option. Are you DH's numbers normal? What testing have you had done at this point? Was your sister successful with your eggs? All these factors would influence my thoughts on what to do -
@agold: Wow, I had no idea you were an egg donor. I have such admiration for donors
But, I'm sorry you have to go through it all. I can imagine you never thought you would be having this experience. Good luck with everything!
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@agold: ah, yeah, if I was given that $10,000 fresh cycle option, I could see why you would consider it. We were lucky and was able to retrieve 12 eggs, 10 were mature, 8 were fertilized and 7 were successfully frozen. We transferred 2 and have 5 left in the freezer. So we could have done a fresh transfer and still be able to do FET.
I don't know what I would do, but money wise I could see myself leaning towards the fresh transfer.
Anyway, good luck in your decision and journey. IF is so hard emotionally and it sucks that we have to make decisions based on our wallet. -
@Amorini: I'm so glad you are finding my question in any way helpful. I didn't want to have to post this question, but I didn't quite find what I was looking for on this blog, or any where else, otherwise. I didn't even quite think to ask about prices of packages on here, but its soooo helpful to be able to compare to what every one else is paying. I'm generally a huge bargain shopping so its been hard to just accept this price. I'll keep an eye out for your question and be sure to answer it if I can. And thank you for telling me your RE encourages a fresh cycle. And for what its worth, your quoted prices are around the same as my quoted prices, I think. The FET was a little more than $1,000 more, but it included a mock cycle.
@mrswin: thank you so much for your response. I'm so worried about my RE trying to sell me the highest priced option. I really hated to be thinking that though because I want to fully trust my doctor. But he did sort of brush over the fresh embryo transfer option and I didn't think twice about it when talking with him, but was just blown away when it came to the point an hour or so later when I was talking to the financing lady. So I'm thinking I want to call the nurse assigned to me and ask her about my RE's thoughts on doing fresh embryo transfer (since I didn't ask any questions about that when I was meeting with the RE). If I get the feeling like he isn't into it, then I suppose I would consider a second opinion. I already know who I would go to for that. But I'm really worried about the time and effort involved with the second opinion, and with going to a new doctor's office. I don't have the energy to do that so I would really have to extremely doubt my doctor's honest or whatever before doing that. I actually like my RE so I feel badly even thinking anything like that about him. But thank you so much for your honest opinion.
@winter_wonder: thank you for your kind words. it was certainly not an easy thing to do but its been all i hoped it would be. I'm so happy for girls to be able to get pregnant any way that they can.
@bluestriped bee: Thank you so much for your opinion. I appreciate you saying you would consider the fresh transfer. So that's pretty much what I'm going to do as long as I think my RE is cool with it. Because in general, yes, its just so expensive. I wish I had that kind of money lying around but I just don't. Its going to be tough to pay for and we've been saving since we knew we were headed in this direction. I've been putting off this IVF consult for about four months after my last IUI. I'm just generally not excited to start this. But I want a baby and I'm really not getting any younger. My husband want's to wait until our next tax return and I nearly felt sick to my stomach. That's the first time I've ever felt like I didn't want to put this off any longer.
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I did not read all the responses but wanted to weigh in. I got pregnant with a fresh cycle (day 3 transfer). I have had two subsequent frozen transfers and neither has worked. Therefore I prefer fresh. However, my dr says that frozen technically have a better success rate (I think something to do with them being strong enough to develop to day 5 and survive the thaw process).
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@bloved: that sure would be a lot to read at this point! Thank you for your response. I'm so happy to hear your fresh transfer was a success for you. Sorry about your two FETs. I can't recall if my RE said that FETs now have a better, or just the same, success rate as fresh transfers. He said that there is now a new freezing process that is better on the frozen embryos and he also said its a way to control the womb or whatever "environment" to make the best situation for implantation. All makes sense but I still like the sound of fresh embryos and want to do that if I can. Everyone's responses have been so helpful.
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@mrswin: Sorry but I forgot to respond to your other questions. My husband's SA is normal. I've had all sorts of testing done, but mostly like lots of blood work and an HSG and some ultrasounds. I did two months of clomid and two IUIs with injected medicines and gave up. All my tests are normal. My sister did get pregnant with the first round of fresh embryos but the subsequent FETs were not successful for her.
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@agold: What an interesting thread! I'm expecting a wiggly little boy!
We did a "mock transfer" (they want to make sure to place the embryos quickly and in the best possible position) before both of our transfers. I felt really good by the time of my 5-day fresh transfer (no OHSS)! And the FET meds were really easy...except of course seemingly endless series of progesterone injections! 
I think waiting for a FET is only a great option if you have lots of high quality embryos. We started off with solid retrieval and fertilization numbers, but ultimately only had five Day 5/6 embryos to transfer/freeze (and transferred 2 each time). If you don't mind me asking, how old are you?
I would love to hear that someone got pregnant following egg retrieval with a fresh transfer. I wish money wasn't an issue, but it sadly is.
I'm so glad to hear the fresh transfer worked for you. I'm really leaning towards taking that route. THank you for your input and congrats to you and your wife on your little boy. 
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I've been talking to my sister about it, but she just deals with different issues than me. Also, fresh transfers were all that were really encouraged when she was doing it so I really am happy to be hearing about all of your experiences and getting your advice. I'm so happy you are pregnant and I wish you all the best. Thank you for sharing your information.
I think waiting for a FET is only a great option if you have lots of high quality embryos. We started off with solid retrieval and fertilization numbers, but ultimately only had five Day 5/6 embryos to transfer/freeze (and transferred 2 each time). If you don't mind me asking, how old are you?
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