NHS or private? 17 months and still no closer to being pregnant

[ShortyK]

Hello all,

I'm sorry in advance if I am posting in the wrong place, or if there are already similar threads but I would really value any advice people have to offer.

I'm 29 and my husband is 32 and we have been trying to get pregnant ever since we got married in December 2013. After 17 months we are still yet to be successful. I found out last November that I have pcos and my husband has also had 2 sperm analysis tests which both say he has low motility. I have only just received a letter for an nhs referral for a 'pre assessment' appointment at the 'nurse led fertility assessment clinic' at the local hospital in late August!

I feel as if I have been waiting so long and the thought of waiting another 4 months feels rather frustrating.

Are any of you in a similar position?

Although my doctors surgery has been very helpful, when I questioned whether or not to go private, they said I was the right age to qualify for nhs treatment and that it can all get very expensive very quickly when you are footing the bill.

Also, with my pcos and my husband's low motility will they prescribe a drug like clomid, or will they suggest going straight for an ivf-type procedure?

I don't know what the best decision is. A friend of mine has pcos, went private, got prescribed clomid and 4 weeks later was pregnant! I know I might not be that lucky but not sure I have the patience to wait 4 long months before even being seen by someone on the nhs. Or should I just sit tight, focus on healthy eating, exercise, etc.

Any thoughts, advice and suggestions would be most welcome.

Thanks,

Shorty K

[Vap0]

Hi shorty
I'm in a similar position. Next week will start month 20 ttc.
I went to the doctors after a year of trying and have been pretty much waiting since.
First they faffed about doing blood tests which was impossible to time (mad cycle ranging from 40 days to 15) and never had any reasonable results.
1st appointment in Jan they took some swabs.
Semen analysis came next.
Then I had a HyCoSy in March
Given the all clear and were sent away with an appointment booked for 3 months time I be prescribed clomid.
I haven't been ovulating.
Managed to get the appointment brought forward and is now on 11th May.
I'm wishing I'd gone private a year ago but annoyingly didn't.
I am really hoping clomid is the answer for me.
I don't really know the costs involved but compared to the emotional cost I would have been happy to pay.
Hopefully someone on here will be able to give you an idea of costs.
Have you had internal scans to find your pcos?
P.s. What's your bmi?
If you're over 30 or underweight you'll need to address that before the docs will do anything for you.
Are you ovulating?
Have you tried calling to see if the appointment can be brought forward?
After months of poas with opk's and having the news I had to wait for 3 + months to be prescribed clomid I had a good look online and decided to take soy which made me ovulate for the 1st time ever on 24th April. Woo Hoo! Annoyingly we missed dtd at the right time so holding out for next week...
I wish you loads of luck!

[belkins]

Hi Shorty,

I can only add from personal experience and hindsight...

I started my [in]fertility journey some 7yrs ago, fast forward to 2015 and I'm still trying, minus a DH (divorce, due to his infidelity - including fathering a child DURING my first IVF cycle) but with my new partner.

I waited well over 9mths for my first consultation and never actually even saw the consultant assigned to me, only his juniors. BUT I've had 5 rounds of chlomid, 3 iui's and 1 aborted ivf (due to exDH...) so can't fault them for the treatment I received. Sadly in hindsight I now believe it was somewhat pointless as what I really suffer from is recurrent miscarriage (I've had 7 v early mc's) which should have been their priority. I feel like I've wasted NHS money and that adds to the stress levels for me. The NHS follow a protocol tho, so they were treating the infertility (mild PCOS), rather than the recurrent miscarriage.

If I could do it again, I would have still gone with the NHS for the initial diagnosis and care plan, and then taken up family offers of loans to pay for private help. The NHS is BRILLIANT in most circumstances but I genuinely believe infertility comes way down on a list of priorities (rightly or wrongly) so you can get lost in the system if your issue is slightly 'off plan'.

In short, if you can spend the next 4months getting yourself fighting fit for the august appointment (health, mind, body) then do that, get any tests done on the NHS and see what they say BUT be prepared to switch to private if you're not happy with their plan. I used to hate it when people said it to me so apologies but.....you're young and august really isn't that far off and private care really does cost a lot (I'm just starting out with a private consultant and I've already spent £600 and not even started any treatment yet!).

Sorry to waffle, I'm not very good at being specific!

Best wishes with whatever you decide to do. If you can bear it (your peace of mind is an important factor to consider) waiting for the NHS really is a good option.

[ShortyK]

Hi Vap,

Thanks for your reply.

What is a HyCoSy? Sorry, I'm not quite sure of all the lingo yet!

I think I have ovulated a couple of times. at least I got a smiley face on the opks twice. Although not for a few months now and I have ended up giving up poas as my cycles can be all over the place (75 days once last year!). However, for the first time in a very long time I had a 28 day cycle last month. :)

When they told me I had pcos, I had an ultra sound an an internal scan and the consultant was very matter of fact and just said that's what I had. She wasn't the most friendly of poeple so I didn't feel I could ask her any questions (plus my mind went completely blank). I did have a blood test at the docs to see if I was ovulating but that seemed a bit pointless because I went in on day 21 and at that time my cycles were averaging 50 days. Needless to say the results said I hadn't ovulated.

I haven't had any of the fallopian tube drilling or dyes that I have been reading about on here. What are they for? All my friends kept saying relax and don't think about it so I have tried not to read too much but now I'm starting to panic a bit. I know I need to relax but it hasn't helped me this far!

My bmi is 31 so I know i need to lose a stone which makes me wonder whether I should focus on that while waiting for an appointment. I know you can't have ivf with a bmi above 30 but does this also apply to being prescribed clomid?

I will definitely call and see if they can bring the appointment forward. Are you still waiting for clomid too?

Congratulations on your ovulation! I'll keep my fingers crossed for you. :)

What is soy and where do I get it from?!

Thanks,

Shorty

[Tootsiepops]

I got pissed off with nhs hoop jumping and paid for private treatment after more than two years of trying. I'm now 11 weeks pregnant, but down the best part of £10k. Not that I'm in the slightest bit bothered about the money (although I may have been had the ivf not been successful!).

An option that's now opening up in some parts of the country is to have private treatment whilst carrying on with your nhs referral. My bmi was slightly too high for ivf on the NHS, but at 35, I didn't really feel I had another 6 months to waste trying to lose more weight. Especially as my AMH had dropped about 7 points in 10 months.

Anyway, I wrote to my local clinical commissioning group to enquire as to whether or not having treatment privately would rule me out of nhs treatment. They confirmed that it would not, so we picked a private clinic and off we went. If my first round hadn't worked, I'd still have had two attempts at ivf on the NHS.

The rules on this vary by area, so check first, and get your CCG to confirm in writing too.

It's a tough call. If you have time on your hands, I'd wait for the NHS. If you have money to spare and can fall back on the NHS if private treatment doesn't work, I'd go private.

[ShortyK]

Hi Belkins,

Thank you for sharing your experiences. I really hope you get a bfp soon and really happy you have a new partner to share your journey with. Sorry to hear you have had so many miscarriages but you mustn't think you have wasted nhs time/money. You are entitled to treatment just as much as the next person. I just hope they can figure out why.

I really value your advice and think I will wait for the appointment in August. I have heard amazing things about the NHS and completely understand that fertility may not be high up on their priority list so I'm trying to be understanding with the waiting times. I think I'll focus on weight loss, exercise, etc.

Did you get the 5 rounds of clomid and the iui treatment on the nhs?

I have recently gone through a close bereavement so my stress levels are quite high at the moment. I am going to see a therapist for some counselling but was also thinking about acupuncture as I have heard lots of good things about it. Hopefully come August my mind and body will be fit enough to get pregnant!

Thanks for your help and good luck!

Shorty

[ShortyK]

Thanks Tootsiepops. Congratulation on your bfp! That's great news. Did you fall pregnant on your first round of ivf?

That's definitely worth considering. The money is not a huge issue, though if we can get treatment on the nhs and save ourselves the money, it seems like a logical thing to do. I feel as though I can wait a bit longer but I'm worried I might then have to wait even longer for another appointment after the initial pre-assessment. I guess I just didn't think it would be this complicated and take so long to get pregnant and I'm still not even close!

Do you mind me asking how long you were waiting on the nhs before deciding to go private?

[Vap0]

Hi

The HyCoSy is an internal scan where they just check everything looks ok, they squirted dye through the tubes to check nothing was blocked. They told me this was the 1st step even though I told them I wasn't ovulating back in January and this scan does not help ovulation. I think it depends on where you live as some people go straight to clomid.

After my HyCoSy they said I needed to be 12st 4lbs. This takes me to about 29.5 bmi I think. I'm still a little way off that, I need to lose another 5.5lbs by 11th May! Mega diet and exercise drive until then but finding it difficult as I'm exhausted a lot of the time. I think my hormones are still all over the place hence the tiredness.
P.s. My ovulation problems are down to me being on depo for years.
Yes! Thanks! I was so excited when I finally saw my positive ovulation test! I must have gone thought about 200 before I had my positive
The soy was what helped me ovulate.
I don't want to suggest you take it as don't know your circumstances enough or problems however it works in the same way as clomid. If you are definitely waiting for clomid in your next appointment then it could help you...???
I bought mine on amazon, see link below,

www.amazon.co.uk/gp/aw/d/B000GY76L6?tag=mumsnet&ascsubtag=mnforum-21

How many lbs do you need to lose to be 29.9 bmi?
Have a think about how quick you could lose that and maybe take it from there.
I understand if you go privately for clomid they aren't as strict on weight however I believe the closer to an ideal bmi you are the more likely you will have success.

I'm on another thread on here where a very helpful person kitty has explained all about soy and how and when to take it. I'm quite new to all of this myself so would strongly recommend you do a lot of research before you decide if it is right for you. Thread link is below.

www.mumsnet.com/Talk/conception/2346914-soy-isoflavones-or-agnus-castnus

I look forward to hearing how you get on and what you decide.

[Tootsiepops]

Thanks :) Yes - we were lucky on our first go at ivf. Still can't believe it.

I was in and out of the NHS system for more than a year, but my treatment was rudely interrupted by an ectopic pregnancy.

I think generally, once you get to your first appointment and you meet the qualifying criteria, treatment can move quite quickly.

You might find this website useful if you're in England. You can look up your CCG and see which clinics you'd likely be referred to, and then you can cross reference the clinics with the hfea website to see roughly what the waiting lists are like.

www.fertilityfairness.co.uk/nhs-fertility-services/ivf-provision-in-england/

//www.hfea.gov.uk

That's assuming you get moved straight along to ivf. There's a chance they might ask your partner to make some lifestyle changes and do another sperm analysis in three months, then, if there's been an improvement, they might try you on clomid first.

[IfYouWereARiverIdLearnToFloat]

Hi Shorty, DH & I are similar ages to you & your DH. We got pregnant within 6 months initially after I came off the pill Jan '14 but I MC'd & it completely messed up my cycles. We spent next 12 months trying but ovulation was too late in my cycle to allow anything to happen and the length of my cycles was all over the place.

I felt the NHS route was moving too slowly for us but my GP was v blasé about it all. I decided at start of this year to go for acupuncture privately with someone who specialises in fertility. After 3 or 4 sessions my cycles became a regular 27 days & ovulation moved to mid cycle like it should have been.

If your on the fence about waiting til August or going private I'd recommend something like that? We're now 7 weeks pregnant & i'm so glad we did it this way.

Hope you get some answers soon. Have you phoned to say you'll take a cancellation if there is one?

[ShortyK]

VapO - Soy ordered! I'll let you know how I get on. Only on cd 10 now though so might have to wait a while before I try it (unless by some miracle I get a bfp). To get a bmi of 29.9 I need to lose 1st 2lbs but I think it's reasonable to think I can do that healthily in 3 months. Also, becuase of a recent bereavement I have been comfort eating so if I stop eating biscuits and cakes, it shouldn't be too hard to shift! I hope not anyway! I definitely have more of an incentive now I know I won't be entitled to anything whilst I'm carrying extra lbs.

Tootsiepops - Thanks for the link. I've just been looking into my ccg and now I have another dilemma! I recently moved but I haven't changed gps because it's convenient to get to from work and I've been there since I was a child. I have just read up on their assisted conception policy though and I would be entitled to 1 fresh cycle of ivf where as if I moved gps to where I live now I would be entitled to 2. The dilemma I have though is would I have to start all over again in terms of going to the new gp and getting referred? The treatment would still happen at the dame hospital as before. Or should I wait until I have the initial appointment and then tell them I have moved? So confusing.

IfYouWereARiverIdLearnToFloat - Sorry about your mc. It must be a good feeling to be pregnant again. Congratulations. Did you find acupuncture relaxing? I think I will def look into it.

[Vap0]

Good luck
I'd still call to try to bring your appointment forward. May save you a few weeks of waiting.

[ShortyK]

Thanks. I'll give them a ring tomorrow, though it might be closed on a bank holiday.

Good luck for the 11th. I'll be interested to know how you get on.

Think positive thoughts

Shorty

[IfYouWereARiverIdLearnToFloat]

It was fairly relaxing although an hours drive each way for a half hour appointment on a Friday night wasn't ideal.

It was the difference it made to my cycle that was great. I started to ovulate D12/13 instead of D20+ after about 3 sessions. And got down to a consistent 27 day cycle.

I'm 100% convinced it's made the difference between us getting pregnant & not. I know it's a bit airy fairy for some people but i wasn't keen to go down the medical route until I'd tried some alternatives.

[ShortyK]

I'm keen to give anything a try and have just booked my first session next Saturday :) I'm very excited. The lady sounded very nice and says she's treated lots of women with pcos so fingers crossed.

Also, tried to ring to see if I can change my appointment but gave up after half an hour of waiting. Must be the bank holiday.

[IfYouWereARiverIdLearnToFloat]

That's fab Shorty. I hope you really enjoy it & it makes a difference. Fingers crossed for some good news soon.

I felt like it was something proactive I could do to help & that gave me a bit more patience. Try the hospital again tomorrow - some people will get pregnant while on the waiting list (hopefully you!) so there should be a cancelation along soon

[ShortyK]

Yes, hopefully it will be me In the mean time I have acupuncture, soy and low gi to try so maybe, just maybe I'll see a positive line in the not too distant future. I'm certainly feeling proactive today!

[ShortyK]

Thanks so much for suggesting I ring and change the appointment - I now have one in three weeks! I'm so happy, can't believe I don't have to wait months .

[IfYouWereARiverIdLearnToFloat]

That is fab news ShortyK. I'm so happy for you. Three weeks is much better. Hope you get some answers soon. Good luck!

[belkins]

Brilliant news Shorty, well done on being proactive. Sometimes just plucking up the courage to make that call can be daunting enough, but look at the result! Three weeks will zoom by!

[Vap0]

Oh my gosh shorty that is amazing! I wished I had called early on to bring mine forward. I only learned that trick for this last appointment Never been as successful as you and had one in 3 weeks. Well done!
I will be pushing every time from now on.
Get dieting now so your bmi doesn't slow you down. Don't mean to be bossy. Good luck

[ShortyK]

Thanks! I guess I just called at the right time and there had been a cancellation or something. You're right Vap0. That's was the only downside for getting a new appointment so soon. I have been low giing it all day. I've ordered a recipe book to help too and keep googling everything before I eat it. I'm finding quite hard to work out which foods are have a low gi though and had no idea that carrots would change once cooked! Mind boggling stuff to me at the moment!

Failing that, maybe I'll just eat lettuce leaves for a few days before I go!

[belkins]

Have you tried the myfitnesspal app? It won't be much help for the GI side of things but I loved using it when I was watching my weight because you can scan your food in and someone else has already calculated the stats (calories etc) from it. It was just really handy to keep a close eye on how many calories I was eating.

[icy121]

Hi OP.

We went private after 9 months. It's bloody expensive. I've been diagnosed with pcos, so this is what we've (I've) done so far:

• initial consultation £250
  
• blood tests (glucose tolerance, androgen and one more o can't remember): £750
  
• follow up consultation £120
  
• clomid £25
  
• tracking scans with nurse £90 a pop (I've ha about 5)
  
• 3rd consultation after clomid hasn't worked £120. He did a scan £80. Use of the clinics scanner £90
  
• 21 day blood test £45
  

So far, so not pregnant.
OH semen analysis is next (he had 2 kids already) £145
Then consultant wants to drill my ovaries. Christ knows how much that will cost. Going to see if I can spin it so bupa pays, but doubt they will.

So yes, costs rack up very, very quickly. and still not fucking pregnant. Being barren is fucking awful,

[Naty1]

Also to consider is if you want a dc2 and if you went private whether you can afford more treatment for that.
As theyve identified a sperm issue it may be that they go straight to ivf, depending on how severe it is.
I did low gi but mainly switched to brown bread, rice, pasta. And for that sort of food had a side plate.

[ShortyK]

Thanks for all the info everyone.

Belkin - I will definitely check out that app. I need all the help I can get to lower my bmi in 3 weeks!

Icy - Thanks for your comprehensive list of what you've had so far. Really interesting to see. Can't believe that clomid is only actually £25(!) and all the money goes else where. It certainly does seem to get expensive quickly. I think I'll see what happens at the nhs appointment now it's much sooner and then decide. Sorry you're not pregnant. It can be so frustrating sometimes. My friends seem to have all fallen pregnant after a couple of weeks!

Naty -I used to think I'd want 3 children but right now I just want one! Certainly something to consider though. I hadn't really thought about future treatments.