It's all too much

[Elbadram]

All I want is a baby, it's not supposed to be this bloody hard!!
Me and hubby have been trying for 18 months now without a sniff of a BFP. I have had endo since I was a teen and had 6 ops. It seemed to be dormant and when I came off the pill 18 months ago I had 6 months of light regular periods. Then they just stopped, no warning, Aunt Bloody Flow had decided she didn't want to visit.

I put on weight rapidly after coming off the pill and after 5 months with no AF had a scan and was diagnosed with PCOS. GPs don't seem very knowledgable and said my hormone levels were borderline but they'd say PCOS because of the cysts and no periods. Eventually given Metformin and basically been told to go away twice. Im currently 2 stone overweight and am trying really hard to get it down with running and healthy eating. Been told they won't refer me to a specialist despite having 2 gynae conditions because we haven't been trying for 2 years and I'm overweight. I think the weight is a symptom of the PCOS as only happened once I came off the pill and the metformin doesn't seem to be doing anything.

Since November my cycles have started to come down from 120 days + to 80/60/55 and then last month I had a 4 day bleed on D52 that was very light but as it went on for 4 days I thought it was a new cycle. Been using OPKs since the bleed stopped and 12 days later I got a very definite positive on ICs and CB. 13 days after that and I started the hideous heavy and painful AF I'm currently having.

I'm so confused, I don't know if I've now just had a really short cycle (25 days) or whether the bleeding at D52 was just breakthrough and I'm actually at the end of a really long cycle again. The longer I'm off the pill the more chance I have of my endo flaring up again as well, so worried about that making things even worse.

I've tried temping but my cycles were so long it just looked like a mountain range. I am just so fed up and frustrated by not know what's going on. I know OPKs aren't often accurate with PCOS so I don't even know if I'm ovulating at all and the GP has said they can't do D5/21 tests until I've got some sort of a regular cycle.
I'm sorry for such a long post, I feel like my body is failing me and the doctors don't want to help me. Me and hubby want a baby so much and try not to get too hung up on it all but it's so hard.

Any wise words appreciated, thanks so much for reading.

[birchygoo]

Hi that all seems very unfair - can you change your GP?

I have had a quick look at NICE guidelines.

pathways.nice.org.uk/pathways/fertility#content=view-node%3Anodes-defining-infertility-and-criteria-for-assessment-and-referral

A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner. Offer an earlier referral for specialist consultation to discuss the options for attempting conception, further assessment and appropriate treatment where:
the woman is 36 years or over there is a known clinical cause of infertility or a history of predisposing factors for infertility.

Women aged 36 years or over and people with a known clinical cause or history of predisposing infertility factors should be offered an earlier referral (before 1 year) because of the impact of these factors on fertility. Delays in referral to specialist services can have a negative impact on patient care and treatment outcomes.

For my area it is 1 year if under 35 and 6 months if over 35 or have had a history of chlamydia. However on reading further i think this might mean 1 year of seeing subfertility clinic as well for their investigations before IVF.

I have taken this information from the NICE guidelines as well though

1.3.4.5 Women with irregular menstrual cycles should be offered a blood test to measure serum gonadotrophins (follicle-stimulating hormone and luteinising hormone). [2004]

1.8.1.3 Advise women with unexplained infertility who are having regular unprotected sexual intercourse to try to conceive for a total of 2 years (this can include up to 1 year before their fertility investigations) before IVF will be considered. [new 2013]

1.8.1.4 Offer IVF treatment (see recommendations 1.11.1.3–4) to women with unexplained infertility who have not conceived after 2 years (this can include up to 1 year before their fertility investigations) of regular unprotected sexual intercourse. [new 2013]


www.nice.org.uk/guidance/cg156/chapter/recommendations#investigation-of-fertility-problems-and-management-strategies


Regardless of all this you can ask for a referral to obs and gyn to discuss your PCOS and a dietitian to discuss diet plans if you feel you should be losing weight but are not!

[Elbadram]

Thank you so much Birchygoo. Do you think I should go back again and ask for a referral? I have specifically asked and stated that surely with my 2 diagnosed conditions I should be referred back over and she said 'they won't see you until you've been trying for 2 years, and your BMI is too high. Then she has just prescribed Metformin for 3 month stints . She is supposed to be the "family planning" expert in the practice.
I had seen one of the other doctors before who sent me for my scan and then a different one when I originally started on the metformin and he didn't know what he was doing. I wasted 3 months on a 500mg dose that I've since been told was completely pointless at such a low dose.

Maybe me and hubby should go together and demand a referral. I feel they're putting me at much greater risk of more severe problems with my endo if this isn't investigated.

Just so frustrating!

Thanks again for the NICE guidelines

[birchygoo]

Yes I think you should go back. Even change surgeries if you have to. Gp should at least do some investigations themselves, blood tests for you and sperm analysis for dh.

If you need IVF treatment your BMI has to be under 30 but in my area you can get a referral to fertility clinic to assess if you need IVF or if other treatment would be needed first. I think its worth another visit armed with NICE guidelines and at least then can then explain why they are not referring you.