Got fobbed off by GP, going again, what should I be asking for?

[ntt]

Hi, I'm new to this board. We've been ttc our 2nd child for 7 or 8 months now. I'm 36, I've been using the ovulation predictor sticks, bding before anticipated ovulation and when the ov sticks are +ve. I went to the doctor last month as I understood from another gp at that practice that if you've been trying for 6 months once you're 36, they would give you fertility treatment. Anyway, this doctor said, "you will conceive, just do it every 2 days around ovulation" and sent me on my way.

I will see a different doc when i go back, but I have no idea what I can reasonably expect or ask for. I certainly don't want to be fobbed off again. Dp is will be away from August until mid December, so we really want to do all we can to become pg before then, otherwise it's another year. And ideally, we want 4 before I'm 42!!

In the meantime do you have any tips that might help us? ie assistive lube, and I heard something about taking aspirin??

Thanks so much, we're beginning to feel quite depressed every month

x

bah - stupid doctor! i think it's positive that you're seeing a different gp. some are more sympathetic than others. i think good gps take ttc for the over 35s seriously and don't make them wait the year that used to be recommended.

the best thing to do is try to bd every 2-3 days through your cycle (after ovulation as well) or at least for the two weeks that straddle your ovulation if the thought of all that bding is too exhausting! you could also try to chill out a bit, as I am convinced stress is a big factor in not conceiving BUT i know that is nigh-on impossible when you're ttc and each month is a real let-down.

When you go to see this gp ask if you can have the intial tests to see if you're ovulating (even if you think you are already) and dh's sperm is ok and take it from there. good luck x

by the way, they won't start 'fertility treatment' for you - what they will do is set off a series of test (like the ones I wrote below). as each stage takes a few months to wait for appts and results, many couples actually conceive during this time. at 35+ 18 months to conceive is really not that unusual, unfortunately, but most people get there in the end.

my gp was the same only he said to me if it dont happen at your age give up am 40, so i waited until there was a locun on and went then, been trying 4 16 months now, they have just done a few tests, and gave me clomid

Thanks Moomin - blimey 2 weeks Dp will be pleased! We'll give it a go though.

trace - how insensitive! Good luck with the clomid

ntt

Would certainly ask to see a different doctor next time of visiting. This one was not helpful in the slightest. To say to you, "just do it every two days around ovulation" is at best misleading, at worst plain wrong.

At the very least you should have a blood test done to see what your hormone levels are like. Bearing in mind how useless this GP seems to be I would ask to have all tests done at hospital.

If your periods have become more irregular and or painful over time stress this to them also.

OPK usage can be misleading too. These can show a false positive result if used. A rise in LH is not immediately followed by ovulation and women can have more than one rise in LH every month. If you are one of many women who are producing higher than average LH levels then the kit will read this.

Would say make love when you both feel like it, ask that you are referred to a gynae and stop using the opk's forthwith.

Aspirin should only be taken under proper medical supervision.

Most couples will conceive within 12-18 months; after this length of time there is likely to be a problem with either one or both parties if conception has not happened.

Definitely get the tests done to save you needless time and stress. Particularly, the blood tests to check you are ovulating (although I guess you are since this would be your second child). I used the predictor sticks, noted the rise in LH, tried to conceive on the days they recommended and ended up getting very depressed. When I had tests done, it turned out I didn't ovulate (no external signs of this) so although predictor sticks showed rise in LH on certain days, nothing followed this rise so no wonder we weren't conceiving! I ended up using clomid which was great.

NB for clomid, we were told to make love every two days from day 10 to day 20 (and if you haven't made love a few days before that, it takes 3 days for sperm to get up to scratch or something (can't remember reason. Anyway, to be on the safe side we tried on day 7, day 10 and then every 2 days until day 22. Pretty unromantic to say the least but it worked both times :).

good luck.

hank you for the advice - I didn't realise that it took most people 12-18 months, it's longer than I thought. My periods are usually normal and regular and only very rarely really painful. Dp had his sperm tested a couple of years ago and he was told that it was on the low side and quite slow moving due to his fondness for a drink(!) Anyway, he's agreed to cut it down from a bottle or two of wine a night to about half a bottle, so I'll keep my fingers crossed.

I'll see if he'll get it checked again and ask the gp about getting my hormone levels checked.

I'm really feeling the pressure now with the old body clock ticking away. Aargh. Isn't it awful.

Sorry ntt, but I would say that your dh really needs to cut down the alcohol more than that. Half a bottle a night is still quite a lot. He should also be taking zinc (and omega 3, 6 and 9 I think - can anyone else confirm this?).

It took us 2.5 years to conceive because of dh's low sperm count (not caused by alcohol). In the end, he gave up alcohol and caffeine completely for 6 months just to give us the best chance possible.

I wish he would, but I don't know what I can do to get him to stop. He is so touchy about it. I'm sure he will take any recommended supplements and give up caffeine though.

Did you get your baby Littlefish?

Yes, we got our baby!!! She is 18 months old and completely and utterly, astonishingly wonderful.

We were told we would not be able to conceive naturally and were due to start IVF. The month before we started, I found out I was pregnant.

There's a great book called "Natural Solutions to Infertility" by Dr Marilyn Glenville which we followed. It's hard work, because it suggests you spend at least 3 months (both of you) preparing yourselves. This means giving up caffiene, alcohol, red meat, cow dairy, switching to organic food if possible and taking lots of supplements.

It was all worth it in the end though!

Would say that alcohol is a huge factor though, and if you have male factor then you're going to have to tackle this at some point. When I had my last IVF cycle we were sharing a room with a couple on their second treatment. The first had been at the time of the last World Cup and his sperm count was only a third of what it had been prviosuly tested to be, just because he had spent the month watching footie in the pub. Bascialy they had to go on to ICSI at the last minute, and the cycle failed. They were very much relieved when 3 months later it was back to normal levels, and they didn't need ICSI.

Could you at least ask your GP for a sperm test, esp as you've had one before?

Brilliant Littlefish, well done! thanks for the book tip, I would follow it to the letter, but dp, well, that's another story.

It's the alcohol that's the problem, I guess I know it is. He's not an alcoholic, but, being from Irish stock, it's always been a part of his life and it's become psychologically linked to winding down at the end of the day; he likes a drink if he's had a difficult day, or to celebrate a good day, or to highlight a dull day. He'll have a drink because it's the weekend, or because it's midweek, in our local lovely beergarden when the sun's out, or when we're cuddled up watching a film if the weather's bad. And now, of course because of the footiel! He knows he should stop, at least until we get pg, and he has cut down lately. But everytime I mention that he should cut down more, he feels so guilty that it causes an argument.

I will ask him to have another sperm count, (though I'm not looking forward to it) I will also try to ask the doctor in private if he can explain to dp how he can increase his count if he stops drinking for a few months, I think this might give him a real goal to work towards - something positive rather than negative.

I'll look up ICSI, all these terms are totally new to me

Hi ntt - I completely sympathise about the dh/alcohol thing. It took my dh 2 years to cut it out completely. He started off just cutting down, but would still drink every weekend, and have a huge blow-out with his mates every so often. I think he finally realised (having read the book) that it really did take both of us to be serious about it. I had already given up alcohol 2 years earlier. I seem to remember that the book said that it takes 3 months to produce healthy sperm from start to finish, and even one night of heavy drinking will interrupt the process. I can't remember exactly what it said, but it was something like that.

By the way, his friends were amazing about it when he told them why he wasn't drinking (just said we were going to have IVF) - they supported him completely and never, ever, ever teased him about it. I thanked them all once I was pregnant, because it had meant so much to us both that they had been supportive.

ICSI is a sort of IVF. Basically in IVF they mix the eggs and the sperm in a test tube and wait to see how many eggs fertilise. With ICSI, it is used when there is a very low sperm count. Individual sperm are injected into individual eggs to force fertilisation. Unforuntatly, there is also a higher chance of non viable eggs/sperm being used, because natural selection is being bypassed. ICSI is only about 8 - 10 years old I think, so there are fewer statistics about it.

We were going to have ICSI before it all happened naturally for us, so there must have been one little swimmer, however slow, who knew which way to go!

Oh, just remembered. When we spoke to our GP, he said that there was nothing you could do to improve sperm quality, so don't expect to get the right sort of info from your GP - particularly the one who fobbed you off!

GPs are not experts in fertility. They are all-rounders, but you need to speak to someone who knows properly about fertility. Are you in London? Zita West runs a clinic and uses lots of natural methods to improve fertility. Do a search on her name in Google.

Hi ntt - just seen this thread.

Not going to give useful advice I'm afraid - just solidarity.

My DH doesn't produce sperm naturally at all. He's been having various hormone injections for a year and a half and now has a reasonable sperm cont - but it's still on the low side.

The big struggle was getting him to give up cannabis - which makes the sperm stoned (honestly - they swim in random directions).

Then he drank more to make up for it - nightmare.

We've finally got there. He still drinks - but really very little. Men seem to need to take it one step at a time. It's great that he's cut down, but really he needs to allow himself more like 8 units a week. That needs to be spread over the week not in one binge, and he needs about 3 days where he doesn't drink at all.

Good luck. Sounds like he loves you and he'll get there in the end.

Well, after posting yesterday I realised how angry and depressed I was about his drinking and blurted out how I desperately wanted him to stop and how I haven't felt able to tell him precisely what's on my mind. I even ended up in tears (most unlike me). Anyway he's promised that he'll stop drinking completely until we're pg, and threw away what we had in the house! Hurrah! We even got some zinc tablets and I've ordered some Preseed (lovely name!)

Littlefish, I hope his friends can be as supportive as yours were. It's the ones he works with that will be the problem I think, but from what he said yesterday, I think he might be strong enough. We're near London, so I'll have a look at the clinic you suggested. Thanks.

Hopecat - Wow hormone injections for men! Great - there's definitely a lot of help out there from the sounds of it. I'm glad you finally got there - it must have been a struggle for both of you. Lol at the stoned sperm! Our Gp a couple of years ago described dp's sperm as being drunk! I think giving up drinking completely is going to be easier for him, 8 units a week will just be too much of a tease.

Thanks ladies, wish us luck x

Oh ntt - well done! I know how painful it must have been to talk to your dh about the alcohol, but it sounds like a really positive outcome. He deserves a huge kiss for throwing out all the alcohol.

I agree with you about cutting out alcohol completely, rather than just limiting it. I think I would find that easier too. (The same way that I don't have chocolate in the house because it's easier to have none and at all!!)

Sending you very best wishes and loads of luck!

xxx