TTC experts whats our next step?(7 Posts)
TTC for 18 months, DH has a normal sperm count but a very low number of ones that can actually do the job. Have seen a urologist who said anatomy is all normal and just keep trying. I have had an ectopic pregnancy and one tube removed but blood tests and temp charting show i ovulate almost dead on day 14 (though not sure how having one tube affects this- do they just float off into the body??)
So saw GP after 9 months of trying, changed lifestyle to increase chances as advised and now thinking of next steps. GP usually does what is asked but not anymore if that makes sense? When we went last time she just asked what action we would like to take and i asked for sperm/ blood tests and to see a specialist. So would like to go in armed and ready with a plan!
So my questions based on your collective wisdom are:
-Would clomid be useful in this situation?
- are there any drugs that boost sperm quality
- if we do need to look at more treatment is it worth going straight in for IVF or working our way up? We are self funding if that makes any difference to available options
Thanks and sorry post is so long!
How old are you? Not that it makes a massive amount of difference, but the option of wait and see what happens is a lot less attractive in your late 30s than in your 20s.
Have you actually seen a fertility specialist at all? My doctors used to do basic blood and sperm tests then send you off to the local fertility centre to see a consultant. These are the people with the knowledge and the power to actually help you, discuss the options, and give you the information you need.
IMO, clomid won't help as it seems like you are ovulating OK with decent egg quality anyway. I haven't got knowledge of what might help you, but there might be steps between waiting and IVF/ICSI for you both.
It depends what your local NHS is like for being proactive, but in your circumstances it might be worth going privately for a bit. We self referred to a local fertility clinic (where we saw the same NHS consultant anyway!) where the consultant sat down with our results, gave me a scan, talked through the options and gave us lots of information pertinent to us. The cost of this consultation was about £700 as I had a scan, but we left there feeling listened to and empowered for the first time in years. The NHS wasn't bad where we were, we just had to wait months for an appointment each time, and going private cut this out completely.
That is really useful information thank you
I agree that the appetite for waiting and seeing would depend on your age. Do you have any idea why your previous pregnancy was ectopic? I only ask because if your remaining tube is also likely to be affected, then I would want to think about moving straight on to ivf, to take the tubal factor right out of the equation. If you do do ivf, there is a version called ICSI, which might make sense for you, where they select a good sperm, and inject it directly into the egg.
I would ask your GP how she now rates your chances of conceiving naturally, bearing in mind previous tubal failure and sperm issues. I would also ask whether, bearing in mind you are self-finding, in an ideal world she would see you move straight to ivf or try naturally for longer.
Most gps have limited knowledge so ask for a referral. Even if you would self fund ivf you can get a consultation and pre-lim screens paid for that would leave you with spare cash for the actual ivf.
Hi, if you are seeking NHS treatment the next step is to be referred to your nearest NHS fertility unit, where you will usually:
- have an initial consultation, they may repeat SA and bloods. Then perhaps send you for a HSG to check your other tube is open and all is ok
- then another consultation to discuss reasons for not conceiving and a treatment plan. IUI is an option before IVF both NHS and privately. If a medical reason is found then you can have whatever treatment your PCT funds as long as you meet the criteria (no children, in weight and age bands etc, and not a smoker.)
If going private it will take less time, more will be done straight away and perhaps more tests or checks and then a treatment plan.
I doubt clomid would be offered unless there is a medical reason that is identified that it would treat.
Sadly it can, for some reason, take time to conceive naturally and I think if you have lost one tube then that reduces natural chances (I am happy to stand corrected) by half, i.e. you need an egg released now the side you have a tube, so it may be that it is just taking longer to conceive due to that reason alone. Or there may be a reason why that happened.
I guess your dh is taking men's fertility supplements to help improve his sperm, which can take 3months to make a difference. So having another SA 3 months after starting them can show if that makes a difference.
Thanks everyone, seems like back to the GP for advice is the best bet then
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