Dr has moved the goal posts for help from one year to two - advice needed (and did you go private?)

[onedaybaby]

Hi,

Long story short, but we have been trying for almost a year and a half. I ovulate late and dh has a low sperm count. He had his tests after a year. When getting the results, we have now been told that we can not be referred until 2 years of trying by a new dr. We thought we were in the process of starting the ball rolling to get referred as we were doing all the initial tests but unfortunately our old dr has now left.

I was just wondering what time scales you had been given before you can seek furher help, and whether or not you went private? It would be interesting to know what costs are involved.

Thanks :-)

most gp's refer start the ball rolling with tests after a year (or after 6 months if you are 35+). If you have had the tests, I would be pushing for some treatment, especially for a low sperm count as I believe there are quite a few things you can dietary wise to help that improve. Do you ov late and have an ok luteal phase or a short luteal phase?

If I were you I'd be insisting on something happening as you usually have to go on a waiting list anyway. Whereabouts in the country are you?

forgot to ask, have you had your day 3 and day 21 bloods done?

I think there is a lot of flexibility in this, and I'd consider seeing a different GP at the practise if you can?

Thanks for the quick replies. Yes I have had those two blood tests (several times) and I have a short LP. My old dr was sympathetic about LP while the others don't seem to be.

I'm worried that the practice states 2 years rather than just the dr. I'm interested to know if there are some goverment guidelines I could look at.

NICE guidelines state:
"People who have not conceived after 1 year of regular unprotected sexual intercourse should be offered further clinical investigation including semen analysis and/or assessment of ovulation"

www.nice.org.uk/nicemedia/pdf/CG011niceguideline.pdf

Hth x

Oh, and this one caught my eye too (from the same document):
" People who experience fertility problems should be treated by a specialist team because this is likely to improve the effectiveness and efficiency of treatment and is known to improve patient satisfaction"

one I would insist on a referral to a gynae.
It sounds like you have had the initial tests which have highlighted a problem so I have no idea why they are stalling.
A short luteal phase can indicate other problems (PCOS, thyroid problems) especially if you have spotting before AF for exanple and this should be investigated regardless of whether you are TTC or not.
Not trying to worry you but I would be very assertive about this if I were you.

It is possible that your PCT has changed the goalposts so there may be little the doctor can do. However, seeing as they have already diagnosed the problem in your case, it seems pointless to make you wait and see for longer.

oneday - i got all the tests done through my GP and all came back normal and was told to go away and try for another 6 months which I did. Around 15 months in, I went to see my GP again about my shortish LP and was told to go away again. She bascially told me to put it to the back of my mind, i.e. relax and it would happen. I enquired about doing IUI but was told no. To be fair she was very nice but it was very frustrating - she was telling me basically to go away and try for 2years. i'm 32.
So I bit the bullet and went private and have been going private for about 6 months now. My private gynae told me my LP is too short (10/11days) and my progesterone levels should be above 40 (they were 30). Ok I'm still not pregnant, I have bills that are burning my pockets but I have been moved through clomid, I'm on extra progesterone every month and now on to IUI so i feel like something is being done although at times I hate being messed around with as actually my shortish LP only seems to the problem. I do wonder whether something might have happened if I had have just sat back and 'relaxed' but I think it depends on character actually. I'm a worrier and I feel i need to be doing something and how long do you wait to see if something might just happen.
Anyway, The cost of going private is the biggest problem. I'm in London, it's not cheap and it's not easy for us to fund but desperation has set in!

sorry i meant to say and didn't mean to be me me me but i would try and push for a referral if i was you. i'm not assertive so couldn't do it! They really should be moving you through the next stages now, don't let them fob you off.

Do you have private health insurance?

they will cover a couple of gynae appointments, tests and scans for 'irregular mentruation'
Do not mention you are TTC!

Thanks everyone. That's a really helpful link PopcornMouse. After reading it, I'm wondering if we should push for help on the low sperm issue rather than the short luteal phase.

I've had the following tests: Thyroid, Day 21, Day 3, Ultrasound and chat with a gynaecologist.

My LP is averaging at 7 days, with a cycle of 31 days. Bleed is averaging at 11 days, but I had acupuncture for a couple of months, and recent months have seen that to be about 8/9 so I have high hopes that that figure will be a lot less in the future!

Hi again Joycep!

one an LP of 7 days and an 11 day period does sound abnormal to me. I would push to see a gynae to have that investigated, regardless of the TTC issue.

oneday I think you should push on the low sperm issue too. Our Dr was willing to do our tests after seven months of ttc - though that was due to DH's medical history giving grounds to suspect a low count. We're both 33.

The tests confirmed DH's count was very low so we were referred straight away to an ACU and after further tests it was just 11 months after starting ttc that we were told we should start IVF/ICSI. We also got our NHS-funding agreed at this stage too. The cycle took place about 13 months after we started ttc.

Aside from the fact the cycle was unsuccessful (and the liklihood of us ever conceiving is low as it turns out I'm a bit broken too ) we have been very lucky at how quickly things have moved. Once we were at Guys ACU I remember us saying "Obviously we won't be able to get our NHS funding until we've been trying at least a year" but we were told this wasn't a problem - we had clear 'male factor' problems and the PCT agreed to pay up without any trouble.

If you don't mind me asking how low is your DH's count? Also worth checking out what you might get funding-wise from the NHS as this varies from area to area and whilst three cycles of IVF is probably worth waiting for you may feel that one cycle of NHS treatment isn't. Also worth investigating whether you'll still get your NHS funding if you've have private treatment - i.e. can you have a private 'go' at something whilst your waiting for NHS treatment.

Sorry - just realised that my post 'assumes' you need treatment. It wasn't meant to make you feel that you'll definitely need help to conceive and hope it doesn't offend.

Just wanted to share how things had happened for us and that in some ways, especially having read the experiences of others on various MN threads, I think that having a 'male factor' diagnosis can mean that navigating the whole tests, referrals etc. process is little simpler.

I think you should push to have all 3 issues (sperm count, short Lp and abnormally long periods) looked at in all honesty. If your GP is not being helpful, maybe see if one of the docs at the practice specialises in fertility issues. Regardless of ttc, you need to get your cycle looked at. What were your FSh and LH results? Were they similar? Did your progesterone come in at a level to indicate ovulation?