Help-Doctorsays2yearwait

[30andready]

I am feeling very very upset after my doctors appointment yesterday. I have been trying for nearly a year and have quite irregular cycles with delayed ovulation and short luteal phase. I have had some initial blood tests done which were normal. She told me in no uncertain terms that NOTHING can be done for another year (ie two years of trying). She says that she has referred so many women after one year of trying who then get their appointments and get pregnant. So she has changed her tune now and says that NHS guidelines reccomend two years before anything. She was determined on this point. Is there anything I can do? I feel totally devastated at the thought of waiting for another whole year when there could be one simple thing wrong which could be fixed.

It took me just over a year to get pregnant- both healthy, mid-twenties, non-smoking and non-drinking. I also had a miscarriage. My doctor who is a Kiwi said that this 'one year' thing we have become obsessed with in this country is putting women under too much pressure. In all his training and work in other countries he says it's entirely normal for a healthy fully fertile couple to wait two years to conceive. I do know this doesn't help you at all when you're convinced there must be something wrong. I do sympathise too, it's so frustrating and agonising. It's hard not to expect it to happen straight away but chances of conceiving if you have sex at exactly the right time are only 30%.

All that said I assume you are charting? How long is your luteal phase? If your luteal phase really is short or you have other concerns about your cycle I would not hesitate to see a different GP. Even though I think the NHS 2yr guidelines are right for a healthy couple with no fertility issues, you know your body best and if you feel something is not quite right then I think you are absolutely correct to pursue it.

I do wish you luck. I have been there.

Thank you for replying. My cycles are between 30-36 days and on two occasions I have ovulated on day 28 with only a 7/8 day luteal phase. I realise this could be due to coming off the pill but obviously when you know for sure that something is not right you want to get it checked out. If I had a perfect 28 day cycle believe me I wouldn't have been at the doctors surgery yesterday!

There are people that have perfect 28 cycles?!?!? I thought that was a complete myth anyway! I know coming off the pill can have an effect on your cycle but if it still isn't calming down or regular by now then I would start wondering why. And yes, as you quite clearly know, you cannot get pg with a 7/8 day luteal phase. There are MNers on here who have had luteal phase problems, if you keep bumping they'll see this for sure.

Is there another GP you can see? If you've been recording your cycle and it's so up and down then they must take you seriously.

Hi there.
I think your options are either to wait OR to change GP and/or to seek alternative help.
I'd encourage you to consider acupuncture - try to find one who is a gyneacology specialist rather than generalist (I have seen three and only just understood acupuncturist can and do specialise - maybe I'm dense!.

I have been ttc for 3 yrs - initially my doc wouldn't refer me but a colleague in the same practise said she's happy to refer over 35s after 6 months ttc. Given your name I guess you are younger - did you have both a day2/3 blood test and a day 21 - you need both to be sure you hormones are in balance and are ovulating, and I assume your dp also has been tested?

Hi 30andready,

Irregular cycles are often caused by hormonal imbalances and in this regard a condition called polycystic ovaries is a common culprit.

There is no evidence to suggest that the pill is responsible for failure to ovulate. The pill also leaves your system very quickly after a person stops taking it. What the pill can do though is mask symptoms of any underlying hormonal problem.

I would lay off charting and such like; it is little point in doing such a thing if menstrual cycles are irregular.

Do you have the results of the initial blood tests and were these explained to you properly?. I ask about blood tests as hormone levels can appear within "normal ranges" if looked at separately - but not if the levels are compared. Were your LH and FSH levels measured?. An imbalance of LH to FSH would strongly indicate polycystic ovaries. If the hormone levels were not compared against one another the test result is meaningless.

Many gynaes like to see women after a year of ttc without luck so cannot quite understand where your GP is coming from.

I would look into being a patient at another GP practice as this one is just completely unhelpful. Your other option is to ask this GP for a referral to a gynae as a private patient and from there pay to have the initial tests done. Your man should also be tested at the same time your tests are carried out to ensure that there are no male factor problems.

HTH, do not be fobbed off!!!

Thank you so much for all your responses. Yes, I have had day 3 LH and FSH tests done and they were very similar.(FSH 6.3, LH 6.4). I also have been having acupuncture with a wonderful lady who has been helping me. My GP is making this decision about me based on "all the other women she has referred in the past after one year who then go on to get pregnant when they get their appointments". She dismissed luteal phase problems entirely. Is it relatively easy to change GP practices? Or is it possible to see another GP in the same practice? I guess they would stick to their colleague's reccomendations though. I do have a gynae I have seen in the past I could see privately but obviously was trying to avoid that expense. My man has not been tested. When would that normally happen? Thaaaaaaaaaaaank you so much. I feel so alone!!

Hi

high-dosage B6 (100 to 200mg) supposed to help short luteal-phase

although takes up to 6 months

worth trying whilst you battle with your GP

30and ready
Glad you have had day 3 bloods - it is a start however your GP can easily send you for two further important tests useful before the hosp referal:

• have you had a day21 blood test (this will check you are ovulating being seeing if you have enough progesterone in the latter part of your cycle)

-has your partner had his swimmers checked

Oh and did they test for day 3 oestrodiol too?

Ooops sorry just re-read to see you bloke has not been tested. The GP can organise this too - suggest this should be done pretty soon - there is no point you having lots of tests and treatments if he also needs some treatment (diet, acupuncture, supplements ect can all help swimmers)

Hi 30

As the otehrs have said I would say your GP is being particulalry unhelpful and would recommend you seek a 2nd opinion.

What does it matter if all her previous referrals ahev ended in the person getting pregnant?

All that means is that she wasted her time in dictating one letter which would have taken her approx 2 minutes.

Since there may be a waiting list, any sensible Dr would surely refer first, appointments can always be cancelled.

I would firstly consult anotehr GP in the same practice (no, they don;t have to agree on treatment, just because they are partners in the same practice), and if that fails, change surgery if possible.

I would also recommend having your thyroid levels checked.

Acupuncture really sorted out my cycles, btw, so definitely keep going with that!

HTH

Hi 30andready,

I noted this:-
"FSH 6.3, LH 6.4"

There's your underlying cause. It doesn't have to be much out and if another day 3 was done it would probably show a bigger gap. The blood test results were not properly interpreted to my mind. They are within "normal ranges" yes but it is only when compared that an imbalance is seen. GP never did this did she, not surprised really as many of them seem ignorant when it comes to PCO/PCOS.

I would see another GP in the same practice or if that does not work, consider seeing the gynae you previously saw. Both of you should have tests done now as a matter of priority at a subfertility unit (don't let the GP mess with you anymore).

They probably would have tested your man upon referral, not all GPs do semen analysis prior to being referred to the subfertility unit.

Thank you ladies. You are very helpful. She said: no to progestorone test, no to swimmers test, no to oestrodial and no to any referal or any other action for another year. I will seek second opinon in that practise first as it is very close to where I live and has in the past been good. Its just stressful isn't getting into these battles ALONG WITH EVERYTHING ELSE!!!!!! I will definitely continue with the acu and start the B6.

You def need to change GP!