First visit to fertility centre - what can I expect & should my partner be there too?

[lozster]

I've just got an appointment for early Sept to attend a fertility clinic. I know that I am not ovulating from tests that my GP did (hence the referral) and my partner has already done a semen test (result to GP in next couple of days) pending the appointment.

Will the clinic be expecting me to arrive with my partner? I kind of assumed that they would however now I'm wondering if they will expect to see just me. He is planning to come along but the hospital is miles away and it will involve both of us taking most of the day off work. I'm thinking that if I'm in for a long haul here of multiple appointments should I 'save' his time for when I might need him more? The GP seemed to think that I could just be prescribed clomid and was going to do it himself until he found that the rules for my practice had recently changed and I would need a referral. Has anyone had a similar experience and know if the fertility clinic are likely to just prescribe Clomid straight off (assuming semen sample ok) or whether they are likely to do further tests, where I might need someone with me, to find out exactly why I'm not ovulating. There is no obvious reason why I'm not - no health issues, normal periods etc.

Thanks for any answers!

You should both attend the initial appointment if at all possible as such appts can lead to considerable nerves. Apart from providing each other with moral support he can ask questions too of the staff as well.

Would suggest you write down any questions you want to ask well ahead of time - no question is daft. They will ask you both questions about your lifestyle, medical histories and general health and your menstrual history.

Semen analysis is a test that often requires repetition; they should test you both further to find out exactly where the fertility problem lies.

They should arrange further tests for you in terms of blood tests and internal ultrasound scans to assess the state of your uterine cavity and ovaries.

You need a diagnosis first and foremost.
With regards to clomid you should be monitored whilst on it as it is actually quite powerful stuff. No monitoring is a no-no as you would not know whether its doing its job or not otherwise.

Do not leave there thinking, "oh I should have asked xyz". It is vital too that the three of you can work as a team. Also ensure that you are both fully conversant with both how and why they are going to do subsequent tests.

Good luck, you will need to be persistant in order to get answers.

Our clinic asked to see both of us a the initial appointment. Before they prescribed me clomid they did (another) ultrasound, rubella and chlamidia screening and semen analysis on my partner. They would have checked my hormone levels but already had the results of these from my GP. I was initially prescribed 3 months and if we are unsuccessful I have to go back to have my tubes checked. Atilla is right, you should be monitored with ultrasounds and blood tests whilst on clomid. I haven't taken my partner along to these checks as I had to go back 3 weeks running but I believe tube checks can be a bit nasty so you might want someone with you if you need that done. Hope this helps and good luck.

I would take him. I went alone to my first appointment as the letter was addressed only to me and it wasnt until it was too late for DH to get the time off that I realised it probably would have been a good idea for him to be with me. When I got there the registrar said it wasn't a problem he wasnt but that 'of course partners are always welcome' I could answer most of his medical questions myself but in hind sight it would have been nice if he had been there just for moral support and to ask questions on his own behalf (on the other hand it was kind of easier talking about our sex life without him there ) Also if your FC clinic is in a hospital then its likely the waiting room will be in the Mat ward which means you will be surrounded by pregnant people, which can be a little disconcerting under the circumstances, I would have been better off with someone to distract/support me.

As someone said to me when I asked this question on another thread 'you are both trying to make this baby so it makes sense for you both to be involved' As already mentioned there will be later appointments he wont be needed for.

sorry forgot to say good luck! We have our 2nd appointment early sept too, which DH is definitely coming too :D

thanks so much for the responses. I will definitely take him along.

saladbomb thanks for the warning on the mat. ward location. As it happens my partner had to take his sample there (in under one hour when we live over a half hour away) so that was weird for him (!) but at least it pre-warned me! It does seem a little insensitive doesn't it?

Atilla that's a great rundown. It seems logical what you say about needing a diagnosis - it was the GP who was suggesting just starting on Clomid straight away - I wonder if he wasn't fully informed or maybe it was because of my age (38 - no children) - he seemed concerned and referred very quickly.

Thanks for the advice - it's really appreciated

Hi,
like others have said it is important for you both to go to the first appointment, as they:

• ask detailed questions you both need to answer
• may order tests there and then which may involve him.

If possible it would be good to ask your Gp to get your bloods tested more than once - as the hospital will insist on this - and also make sure your smear is up to date and ask the practise nurse to give you a chlymdia test. Treatment will not be given before these basic tests are done. When I had my first appointment the doctor ordered:

• 2nd semen analysis
• more blood tests for me
• chlymdia test
• Full blood count tests
• Transvaginal scan - to check health of uterus/cervix, check for fibroids and cysts

The 2nd time I went he ordered more bloods, a 3rd semen analysis (as dh's not good results) and a HSG for me.

Hi hope you don't mind me butting in on this thread.

I have first appointment on Wed so am interested to hear all your experiences.

How long have you had to wait between appointments?

I am so desperate to get cracking!

Hi,
I had my first appointment last month. The appointment letter said my husband had to attend as well, and he was asked questions about his medical history during the appointment. I was prescribed Clomid straight off at the appointment without any further tests being done. From reading other people's experiences I am wondering if that was the best thing though as other people seem to have had more investigations both before and during Clomid.
I had had blood tests done by GP but not on the right day (couldn't be done on day 21 as I hadn't had a period in months), so I have to have those repeated but not before starting the drugs. My husband had booked a semen test but the appointment wasn't until after the clinic appointment and that was ok. He also referred me for something he called a dye test but I don't know what its proper name is, but I've not had a letter to tell me when that is yet. I've never had an ultrasound scan and only have to have 3 blood tests (one for FSH and LH, one for rubella and one for day 21 progesterone) before the next appointment at the end of October.
Hope everything goes ok for you at your appointment and you get some answers.

Hi there ladies,

Hope you don't mind me butting in as well (am sensing that referral to FC is looming).

Hi Keziah - did your GP arrange all the tests you have listed? Quite a contrast to the bloods I had taken. We are going to get the results from DH's SA this week so I might mention that it would be good to get some of the tests you mention done, esp. if there is a long wait for the appointment at the FC.

Good luck to all you ladies for your variuos appointments.

Hi ladies, would you mind me asking how long it took before your GP referred you? Thanks!

stegasaurus I'm no expert but the 'dye test' could well be HSG, this is where they fill your womb with 'dye' and take an x-ray, its actually just saline solution and is clear (which i find slightly disappointing ) They may have put you straight on clomid to get you ovulating if you haven't had a period for ages. I would ask at your next appointment if you are worried.

Boba82 think they aim for 8 weeks between first and 2nd, thats when I've got mine, might be slightly different between FC's tho?

Wanting i think it depends on circumstances. How old you are, how long you have been trying and if you already have kids. I am 38 and been trying for 3 years and never been pregnant so got referral straight away although it did take a while for an appointment to come thru.

I know 30+ you need to have been trying for a year and 35+ for 6 months, no idea if -30 tho.

Thanks ladies

Saladbomb I'm 28 and my GP referred me straight away as I'm not ovulating every month. We have been TTC for over a year now. GP did initial blood tests, smear and chlamydia test on me & 2 SA on DH. Letter came through approx 2 weeks after referral and approx 12 week wait for appointment at clinic.

Starlet - my Gp ordered the tests, and they can do so easily. However, I didn't have the HIV and Hep blood tests till we knew we needed IVF as no need for them till get to that stage:

• rubella antibody test
• HIV, Hep(all of them), FBC, Thyroid check, Prolactin blood test (prolactin if high may be reason not ovulating so better to test that
• Smear test and chlymdia test - can be done at same time
• LH and FSH tests - on day 3 of cycle and 7 days post ovulation (known as 21 day test assuming a 28 day cycle!!)

Then the dr at fertility clinic ordered me the Trans Vaginal scan the first time I went, a 2nd set of bloods for me as my progesterone low and a 2nd SA for dh.

On 2nd visit to fertility clinic they ordered 3rd SA as dh's results not good (poor morphology) and hormone profile for him and a 3rd set of bllods for me.

We have been told due to dH's results we will need IVF or similar, so clomid is out of the question as first line treatment.

Wanting - I am 34, been ttc for at least 2yrs and Gp referred me after initial tests and because of the length of time ttc. Took 12wks to see dr at clinic and then 3mths between first and 2nd visit adn 8weeks between 2nd and 3rd visit. Go on Thursday and hope to find out out treatment options then and queue for those. Need certain time between apt's as some tests depend on cycle length etc.

If any abnormalities in dh's SA we learnt that a man renews his sperm every 3mths throughtout his life, so testing 3mths after first test may provide better/worse results (worst for us.)

Sorry, I have waffled.

Thanks for the information, Keziah. How are things? X

I'm so glad I found this thread. We've just been referred so we're waiting for our first appointment and stupidly I didn't think to ask the Doc what would happen and now I'm fretting!

Doc has said we should hear within four weeks so I'm hoping that the appointment isn't too long a wait. She also said that they weren't able to prescribe Clomid at the Docs any more so I have to wait for that. Bit of a shame really as I wanted to get started to feel as if something was happening.

I've had blood tests (5 I think it was) and a smear and all ok. MrC has had his sperm results and all ok as well although one part of the test was slightly low. Again I wish I'd asked more questions!

So now it's just a question of waiting!

Starlet - would definitely get your FSH and LH repeated while you wait and get a 2nd SA for your dH, plus an up to date smear and chlymdia done at the same time - and any other tests you can get your gp to do! Starlet, we go tomorrow for our 3rd apt with NHS fertility dr's. Seen different dr each time, but under one consultant who I have seen once. Hopefully tomorrow they decide on what treatment we need, as long as my HSG and scan results were ok.

Boba - our wait was about the same time as yours. Hope it has gone well, your apt. Wonder if you come out with more tests - that is what happened to me the first time.

MsChutney - yes according to NICE gp's not meant to give out clomid as it is meant to be monitored at a hospital and also if there other problems not found out it is not going to work. Might be worth asking gp to order a 2nd SA for dh, as hospital will ask for that when you go and it will save time when you go. I have learnt this the hard way!!

Had good apptmt today. Had internal check and bloods done. Have booked me for HSG and ultrasound and they will monitor my hormones over 10 weeks via urine samples. THe usual gap between now and next apptmt would be 4 months but due to our holiday in 8 weeks ours will be 5 months which is xmas time so I go back 7th Jan.

Feels like an age away but this is mostly due to this urine malarky with me. HSG waitlist is currently 12 weeks at Edinburgh Royal Infirmary.

DH given all clear due to new research on SA, he is 'normal' afterall.

Hope this is of some use to anyone waiting.

wanting I was referred immediately after basic blood tests showed no ovulation had occurred. I think not having any children and my age may have driven this decision. The referral was a computer code to self book so I logged on everyday for 4 weeks and I think I only saw available appointments 3 times - once was too soon before partner's semen test, next was when I'm on holiday then finally one appointment came up for the start of Sept.

I'm concerned that my Gp didn't do all the tests mentioned here eg. chylmidia and that I'll be sent back again. I'm also a bit worried about the gap between your appointments boba - that seems like a long time + HSG 12 weeks too.... I'm 38 and concerned that time isn't on my side - the second GP I saw said as much Heck - I was digging in for a long haul but I'm now fretting.

Hi - lozster you should not be sent away for not having all the tests, but why don't you go to your health centre and ask the receptionist for a nurse appointment for a smear and chlymdia test - you should easily get that done in August and don't need a gp to refer you - you just make an appointment I would think, or you could see your gp first if you wish.

Boba 12 weeks is a longish time, but it doesn't matter as long as it is done before you go back in January - and although a long wait, I didn't get HSG test ordered till my 2nd appointment and it seems like you have all tests, plus urine, that I have had over 8 months! I felt when having tests that at least there was a reason for delay and things were happening at last. But then it has been 6yrs of ttc~1 and 2yrs waiting for treatment!!! Feels like it might actually happen sometime soon.

ok - returning here for an update. Good job I took advice here and took partner as he was definitely needed! Very relaxed at clinic - histories taken from both of us taking half an hour plus. Confirmation that we would both be suitable for IVF which was a bit startling as it seems so early in terms of me seeking help but perhaps not in terms of my age.

Course of action is to to have some further blood tests (chlamydia, rubella, HBs Ag)and the dye test (hysterosalpingogram). If the dye test is ok I've been given a prescription 50mg chlomid for 5 cycles that I can get immediately. I have an appointment for March in case the chlomid doesn't work. The registrar said that if it doesn't we should try IVF not more chlomid but let's see. There will be no monitoring of ovulation whilst taking chlomid which I am a tad suprised/worried about .... but I'll start another thread about that one....

thanks all and hope this helps anyone else who is either waiting or thinking about asking for a referral.

Glad it went OK lozster I am surprised at the lack of monitoring during clomid as I was under the impression (from the NHS guidebook) that this is required. I think you should query that to be honest.

Do they know why you aren't ovulating? And have you considered acupuncture? Its might be possible to get you ovulating again if it a hormonal imbalance that is stopping it and might also help if you have any side effects from the Clomid.

Loads of luck with it, keep us posted. I have 2nd appointment next week and will be SO much more prepared thanks mostly to MNers.

And do you mind me asking how old you are? I am 38 so a bit worried I am beyond eligible (or will be soon)

I'm 38 too Saladbomb hence I think, the fairly speedy route I've had from GP to clinic to Clomid to (it would seem) and IVF cycle if the Clomid doesn't work. I think the 'strategy' is to only do exploratory work to determine if treatment will work or not rather than do exploratory work to determine the actual cause of the problem. The clinic I went to publishes criteria for IVF treatment as well as success rate (70% which I was surprised by - it seems very high) I think health factors such as BMI are used to determine suitability (eligibility?) for IVF and the cut off age (I may have this wrong) was 43. There's obviously other stuff about your partner's sperm sample too. Essentially we were told that we meet the criteria if the Clomid doesn't work.

Yes the moniotring of the Chlomid is preying on my mind - I started another thread!

Hope the second appointment goes ok - it's odd the different routes that are recommended isn't it?

Yes, it seems to vary a lot but then if you think about it everyones situation is individual and there are so many different factors. Plus it depends on how far down the road your GP has taken you with tests etc. We were referred straight away due to my age but In a way my first appointment was a bit of a waste of time as we hadn't had my DHs SA results back yet (actually the GP had but they hadnt sent them through to the FC clinic, great!) and also our consultant was not available so we saw the registrar instead. No disrespect to him but the nurse seems more switched on than he did! So I also think individual service providers handle things differently. I hope we see the actual consultant this time!

Plus, our problems seem to be with DHs slightly low count rather than me as we know I am ovulating, therefore I think we would be offered IUI in between clomid and IVF. Was that not mentioned as an option for you? Will check out your other thread, there is also a Clomid support thread out there which might be good for you to have a gander at (might see you there shortly!)

I've been reading this thread with interest.
DH & I were referred to a fertility specialist in Feb after 3 years TTC
I actually got PG in the same month but lost it at 6.5 week.
The specialist had arranged for me to have chlamydia test & rubella blood test (had already had 21 day bloods and DH had a semen test).
Because of the pg & MC everything was put on hold, but after 6 further months TTC I have arranged an appt on Thursday to see the specialist again.

Unless he fobs us off (we were told to go back next March originally if no joy) I'm guessing that the tests will be back on the cards.
What really makes me angry, and the more I think about the angrier I get is that I had a smear a couple of weeks ago and I aked when I booked it if I could have the chlamydia test at the same time in preparation for Thursday. When I turned up, the nurse who I seen wouldnt do it twittering on about if I had chlamidia I would know about it by now, but in the same breath went on about how it was a silent condition

Is the chlamydia test compulsary?
Was I right to ask the nurse to do it at the same time as the smear, and was she stupidly wrong for refusing???