where can you have a fertility MOT

[yentil]

I have a dear friend who hasn't had children and hasn't used contraception for two years yet hasn't got pregnant. She is worried about whether or not she is fertile or has some underlying issues and would like to have everything checked out.

has anyone had a so called fetility MOT / check up and if so where. her GP says she has to come in with her partner but her partner isn't keen on children (as he has some from a previous marriage)and this is a sore subject but she wants to know at least whats happening for her and the GP isn't being very supportive. Can she demand tests from her GP and if so which ones. otheriwse can anyone recommend a private clinic in London area where she can go - any idea of costs?
thanks

[SlightlyTubbyHali]

She can go to a private clinic and talk it over. A consultation with a consultant will be in the region of £180-ish, plus any tests. I went to the UCH ACU (a private clinic) for once-over, although I had more specific worries. It has since changed its name, but I can't remember what to. Most clinics do focus on people who definitely want IVF or IUI so she could alternatively contact the Zita West clinic as they do this sort of thing I believe (at vast expense - you'd see someone from the clinic and they'd refer her to the doctor).

I'm not surprised the GP does not want to do any tests without seeing her DP, as any issue may lie with him (regardless of whether he once was fertile) and issues with the man are far easier to spot than issues with the woman. A sperm count being less invasive than an HCG, for example.

One other thing springs to mind: her DP doesn't want any more children. Is your friend sure he hasn't had a vasectomy?

[Lychees]

Create Clinics do one for £200 or if you go to www.fertiltymot.com, I think this is the Portland, there is one for £825. I looked into both of these but then ended up getting some tests on the NHS and a private HSG.

[KnackeredCow]

The GP is the place to start. Perhaps she could see a different GP at the practice, initially? Her DH will need to be seen eventually, but most GP's are willing to get the ball rolling if the woman attends alone.

Eventually her DH would have to be seen to rule out male factor infertility, but as he has children already then that does seem somewhat unlikely.

These are the initial tests that my GP ran:

Rubella antibody test (to check I was immune before becoming pregnant)

TSH (thyroid stimulating hormone) to rule out hypo or hyper thyroidism that can be a cause of infertility and can be treated by a GP initially or a specialist endocrinologist

Fasting blood glucose (to rule out diabetes)

Bodymass index (being very under or overweight can affect fertility)

Follicle Stimulating hormone (FSH) and luteinising hormone (LH) levels - high FSH can be indicative of menopause or ovarian failure, high LH can be indicative of polycystic ovaries

GP should check her periods are regular (it's a good indicator of ovulation)

Day 21 progesterone (blood test done 7 days before your period is due to confirm that you are ovulatory

STI check - they are looking for chronic chlamydia infection that can be indicative of tubal damage

The GP will also advise her to take folic acid.

Following initial tests, which I am pretty sure she can demand from her GP, the next step would be a sperm test for her DH, and then a referral to the fertility clinic where they will arrange an HSG for her.

Where I live the fertility clinic absolutely insists on seeing the couple together at this stage as the medical history of both is important.

Hope that helps.

[KnackeredCow]

BTW completely agree with slightlytubbyhall re the possibility that her DH has had a vasectomy?

[yentil]

thanks most helpful. not sure about vasecetomy. i have enough faith in human beings to hope he would have been upfront by now [naive emotion]

[SlightlyTubbyHali]

BTW, as her DP has children already I am not sure of the extent to which the NHS will help. Certainly they won't give fertility teratment, so whether they would be willing to run extensive tests I do not know.

I was offered a laparoscopy on the NHS to check the plumbing when I already had a child, but I had had an ectopic pregnancy so there were other factors at play.

Other people might know more about this...

[KnackeredCow]

I believe you can have all the investigations done on the NHS, and some treatment to correct problems.

For example, presuming that all the bloods come back fine AND her DH has a normal sperm test, then she would have an HSG.

If an HSG showed tubal blockage, then she would be eligible to have a laparoscopy to attempt to correct the damage.

If that failed then the criteria for the funding of further fertility treatment such as drugs OR assisted conception is dependent on her PCT. My PCT will fund fertility treatment for a couple in which one partner has a child from a previous relationship as long as that child does not live with the couple.

If you follow this link it provides a map of the PCTs in England. If she clicks on her PCT it will detail the inclusion and exclusion criteria.