What next...?

[Nixz]

Hi, have been on MN for ages but never really posted on TTC threads...until now

When i was 17 i was admitted to hospital with severe abdominal pains, after many years of tests etc I was diagnosed with Endometriosis, poly cystic ovaries and i also have a blocked fallopian tube. When i was 22, dp and i had our last consultation with the hospital and the consultant advised us to go away and think about fertility very seriously and decide when we want to go ahead with teatment.

We went on holiday and 3 weeks later i discovered i was pregnant!!!! The drs were amazed, we were overjoyed etc and everything went fine.
However, we havent been able to conceive since and on my last visit to the dr, i mentioned this to her and she advised us to begin thinking about fertility treatment again. This was in June and i have now come to the conclusion that we DO need some help but i'd like to know what the procedures are, for example:
Will i have to have all the tests/ops again?
I know i ovulate as i have been testing, will i still need to have day 21 test for ovulation?
How does fertility treatment start?
Would be v greatfulk for your advice!

sorry, also wanted to know - what options are available and how long does it take to actually begin the treatment!

does anybody have any experience of treatment that they can share with me!!??
I have absolutely no idea what to expect

You will need to be retested again most likely blood tests and ultrasounds initially. These though will not determine if the endometriosis has come back - that can only be determined through laparoscopic (keyhole) surgery.

Your partner should also be tested at the same time you are undergoing tests to ensure there are no male factor problems present.

If you have been self testing (e.g with temp charts or opks, particularly opk's) I would not rely on these to give you a fully accurate result. With polycystic ovaries usage of opk's is not adviseable anyway as these can give false readings (the kit measures the excess level of LH in the bloodstream and thus gives a false positive result).

Only blood tests can give a fully accurate picture of whether you are ovulating or otherwise.

I would discuss the initial steps re referral to a gynae (you need one of these) with your GP. The GP will give you the criteria for treatment in your area. If you have a child already the criteria may well be different.

You can wait several months to get the initial appointment; it does depend very much on the waiting list.

Thanks Atila - didnt know about the false positive for the OPK!
It looks like i have a few years of testing and waiting ahead of me then
I was really hoping i didnt have to hav the tests again, mostly the one which found i had a blocked FT, that was v painful.
How might the criteria be different if i already have a child?

I also should have mentioned that i am almost 30 now and ttc for a few years.

.

Oooppss!
Not many replies! Perhaps if im more specific in my questions.....
Ive heard people on here talk about clomid, i know its a fertility drug and i think i know how it works but here is my question. Is this the first step in fertility treatment? How long does it take to get to this stage? What are the chances of it working?
I realise i have a long way to go as ive only taken the first step and made an appt with my gp, however i really dont know what to expect.
Thanks

I have only just started TTC baby#1 so I have no idea about treatments and tests etc so can't offer any suggestions, but I just wanted to wish you all the best!! And bump your thread up to the top so some other MNers can see it and offer you lots of useful advice. MN is fab for that!! Everyone is so lovely and helpful!!

Babydust And Crossed Fingers xx

Thanks very much - and good luck to you also xx
I have just been to the Drs and i am off to Liverpool womens as soon as my referral appt comes. I have to have my progesterone test and dp has to be tested prior to this, she did say though that i may not have to have all the tests again.
One thing that she did tell me that i wasnt aware of was that the test needs to be done round about 7 days before AF as this is when ovulation occurs - i always believed it was 14 days before AF.
The ovulation predictor kits said i was ovulating 14 days before, however the GP said they were not reliable at all.

Hi Nixz

Ovulation does not always occur on the 14th day!!. Ovulation can occur earlier, later or not at all in any given cycle. It is therefore possible to have periods without ovulating.

With PCO (I see you were diagnosed with that also amongst other problems) you are less likely to be ovulating regularly if at all. If your periods are very irregular you may be able to have the blood tests done according to calendar days i.e the 3rd, 10th and 21st of each month (the hospital should advise you on this). This will give them an idea of what your hormone levels are currently like.

Clomid is often given to women where ovulatory problems are present. In your case they may well decide on a surgical route earlier than later due to both the previously found endo and the blocked fallopian tube. They may well do laparoscopic (keyhole) surgery to see the state of your organs now.

I wish you well

Nixz,
The progesterone test needs to be done 7 days before AF because that is when it will be at its peak, but ovulation occurs at 3-8ish days before that if everything is alright. There must have been a misunderstanding with the doctor.

god its so confusing.
if i have a 36 day cycle, when am i at my most fertile?
I usually get some small twinges in my tummy and i can tell by my cervical mucus etc and that is about now!
If i went from the doc then, i would be at my most ferile on 31st oct (af 5/6th Nov)
Even so, we have been seriously trying for 18months now so i suppose we have had sex at the right time a few times!

I would say that in a 36 day cycle you are at your most fertile somewhere between days 19 to 26 (ish), but if you watch symptoms like your cm then that is a much better guide than looking at the calendar. Having said that, though, i don't know how polycystic ovaries affect CM..