TTC with endo

[Daniela97]

Hi all, brand new here, but I've been lurking for months and am excited to finally join this board and chat with you ladies!
I'm going to be 35 in October, was diagnosed with endometriosis at 23 ( via a lap surgery) and now my hubby and I have been TTC for 4 months. I know it has not been that long, but I'm also concerned that my endo may play a part in my difficulty to conceive. I've visited my GP and I am not a big fan of her so I feel lost with advice as to what I should do. Knowing I have endo I feel I want to be proactive on this journey and just get minor tests done. I feel like all I see are tests through GP ( which I will prob have to wait another year for through NHS) or expensive fertility clinics that focus on IUI and IVF ( I'm nowhere near that stage yet).
I'm thinking I may need an HSG test to see if my tubes are clear, or maybe another Lap to clear out my endometriosis again? These are just my guesses. I just feel lost with this process and am not sure where to begin. I'm in the London area so if anyone has been in a similar situation and had a positive experience somewhere, please let me know!!

[SilverStars]

Hi if you are over 35 and have TTC for 6 months or more then you have the right to as a Gp ( any not just yours!) to do basic fertility tests. Usually they do blood tests, you will need a recent smear and then they send the male for a semen analysis. Usually. Often do more than one month of blood tests which is useful. Then usually they refer to an NHS hospital where you will see a dr and then they will arrange hospital tests. Need gp blood tests etc where I live before referral - my gp said need two months of what are known as Day 21 and Day 3 blood tests and a semen analysis done before get a referral to fertility unit here.

Unsure if it is different for diagnosed Endo patients but I would be asking for those bloods in 2 months times.

Many clinics do Fertity MOT's - with more advanced tests than often done by NHS hospitals.

[SilverStars]

In London the Zita West clinic for eg does Female fertility checks as stand alone packages, so am sure others do.

[Daniela97]

Thanks SilverStars for your input. I remember reading about being able to see a GP "after 35" but I thought that may have meant age 36? Lol. I'm from the United States and just moved here in May so some of this (NHS vs Private) is a learning curve for me. I will march into my GP once 35 though and asks for the blood work at least!! You boosted my confidence that I have a right to ask my GP for some of this. I also read some good things about Zita West so maybe I'll look into that clinic down the road if needed. Thanks again.

[AttilaTheMeerkat]

If your GP is unhelpful and you cannot communicate with this person then I would now consider changing GP practice or see another GP within that practice. Its no point anyway having a GP you feel at all uncomfortable with.

Have your periods become more painful over time?. As you've already had an endometriosis diagnosis a further lap op may be recommended to see how extensive this is now. You should be seeing someone like a consultant gynae anyway now given the previous endo diagnosis.

The general consensus seems to be that if you are 35 and have been ttc your first child for six months without success then you should be referred onto a subfertility unit. I would read up on the current NICE guidelines re referrals.

[Daniela97]

No, my periods are never painful, Endo just happened to be found when I needed to get a cyst removed. I read somewhere though that having no pain may mean that there is thick scarring, so much so, that it's beyond being even painful. Only a lap would be able to tell for sure. I told my GP about endo on my last visit and told her I was in the early stages of TTC but she seemed to think most women have endo, it was no big thing, and if I'm getting periods I'm ovulating. ( which I know isn't true!) my ovulating I don't think is an issue since I monitor my BBT, but still she seemed so dismissive of everything and just said " well some women can get pregnant and others just can't" .. I had no idea I could possibly get a referral to see a gynae due to my endo diagnosis.

[SilverStars]

If you used to US healthcare you may find the NHS is free but slow due to amount of people using it etc. Definitely worth going when 35 and after 6 months TTC ( so in 2 months say) to request the day 3 and day 21 blood tests. Tests to check your FSH, LH and progesterone levels. Note whilst it is commonly called day 21 it should be 7 days before period due. Also ask for: FBC, thyroid and prolactin!!

I really rate the consultant Dr Geprge Nduwke at ZW - after 7yrs of infertility have him to thank for my ds! Most of all, having seen a range of dh's he was a gentleman. He even came to us in scrubs just before he went into theatre to find out our HCG results ( was I pregnant he asked and congratulated us), he stayed late to fit us in a late apt when needed etc. We saw him when he used to be a medical director of a big fertility clinic.

When we were in NHS we did:
Gp blood tests x2 in 3 months
Gp ordered a semen analysis which took 4 weeks to wait for - so not long!
Gp referred us to NHS clinic - 4 month wait
Saw a registrar ( not a consultant), who ordered: more bloods, a second Semen analysis ( as low sperm count) - then we went back 4-6 months later
Then saw different registrar who ordered me a hSG.
After HsG saw a 3rd different dr, as each one we saw was doing their 6 month rotation in gynae! Then a 2 min chat with consultant. I did not need a lap due to no issues. Do you have private health care - may be able to use that for lap?

After 13 months we were classed as infertile and could have 1 free IVF cycle on NHS. After using up our one free cycle we went private. Self- referred to clinic and saw a consultant 3 weeks later. Then could cycle after next period if wanted to - but we chose to do more tests first, to see what went wrong first time.

I am a big fan of the NHS and know most people do not have to wait as long as I did. beware that they may say there is no cause of infertility and then before you can get free IVF they often say have to have TTC for 2 yrs - well that was the cae in my area a few years ago. Sadly we were both classed as infertile so got straight to ivf. Also if NHS says can have NHS ivf some areas have waiting lists. So worth starting tests straight away!

[SilverStars]

Oh yes you can ask for a gynae referral for endo - good idea. NHS waiting times means you should be seen by 18 weeks from date of referral.

[Daniela97]

Thanks for sharing your story. It seems like you went through a lot but it was worth the wait and all the work for your ds!!! you must have been thrilled to find out you were prego!!!
This info has really helped me. Being new to NHS I'm still not sure what I can ask for and what I can't, and I know it gets tricky especially with fertility. Who knew I'd be looking fwd to my 35th bday so much?! Lol. I think I'll start out with NHS with the fertility testing and see how it goes. If that starts to take too long I'll switch to private ( but at least I will hopefully have some tests already done which will make things cheaper). And I can also get a gynae referral. And who knows, maybe to my surprise, I will get pregnant sooner, but I feel so much better knowing this information and what my options are. Thanks again!

[SilverStars]

I hope you do conceive soon!

Do ask your gp receptionist for print out of all blood tests they do for you - you can then take them if switch to private and private clinics will accept any tests that are within 12 months of seeing them/having treatment.

[Clarabella84]

Hi, also new here. I was diagnosed with endo in 2012 and had a lap to confirm they removed some but not all and basically told us we had a 20% chance of conceiving naturally. Was put on a course of GNRH injections for 6months that stopped everything and was taken off those in October 2013 and told to get trying. A different consultant said there's no reason why I shouldn't conceive naturally so I do think each consultant thinks differently maybe. Anyway after 6 months my doctor referred us to the fertility clinic and we are now in the process of waiting for our first appointment. My gp said 6 months was the amount of time you needed to be trying with endo.

I would also say of you aren't happy with the doctor you are seeing ask for a different GP or change practices? You have to be insistent, it took me 2 years and multiple trips to my gp before I got my diagnosis
Hope this helps, good luck
X

[Daniela97]

Thanks Clarabella84 for the info. Yep, when they cleared out my endo I was put on injections as well which stopped everything. Did you have any endo symptoms before the diagnosis which were overlooked? I know someone who was ttc for over a year, finally was diagnosed with endo, had a lap, and was told she would need ivf in order to conceive. She took the summer "off" before pursuing ivf due to all the stress, and boom! She is now pregnant. There is always hope. Good luck to you too, Clarabella84!!