What sholud I expect of a first visit to gynae unit for infertility?

[nomoremagnolia]

Been referred by gp, DH sperm low on morphology (think thats right, the one where they are not formed properly) and my blood tests show I did not ov (but not sure if this is only a one-off as only one cycle tested)
Hospital cant give me an appointment now as they have none available in the next 4 weeks and cant book past that (Government targets!) so we are waiting for a cancellation which could be at any time and I want to be prepared!
Anyone know what I should expect? All advice welcome.
Thanks in advance x

Damn! Proofread message and not title! That should read 'should'

Bump, as I have just received my referral appointment, and I am wondering what to expect!

Both of you should go to the initial appointment if at all possible. It usually consists of the gynae and or nurse taking your medical histories and asking about your gynae history (i.e asking about irregular periods, any severe pain etc).

I would write down anything you want to ask of them no matter how trivial it may seem to be. Take notes. You do not want to leave there thinking, "oh I should have asked that".

Further investigative tests for both of you are usually arranged at this appointment. Both of your investigative tests should run in tandem to each other.

these are the questions i asked at my first meeting with the fertilty docs

? What tests will you be doing
? What kind of timescale are we looking at
? what the are the stats for the chances of a natural conception given my situation ?
? depending on that - what can they do to help you improve these stats and how soon can they start/I start.
? What care are they going to offer me given my medical history?
? and if they cant offer me the right care - who can?
? and again when?
? Have they identified the reasons for m/c and if not why not and
? when we conceive again what care will they offer me - weekly/daily scans?/bloodtests? so that they can identify any potential issues and sort asap.
? what they will do, what the alternatives are,
? types of medication?
? timescale for it all
? what sucess rate different procedures offered have
? what can be done about adhesions,
? what can be done about strep B in womb to maximise chances of IVF working
? If we go for a given option and it fails will that preclude other treatments being possible/offered

Thanks for the advice everyone, One more q...what can I expect from the first visit? And what happens next? Want to know as I feel GP fobbed me off and I don't want that again from the specialist.
TIA x

When I was reffered to gynacologist for fertillity probs he took a detailed history from both myself and DH, told us there were things that could be done to help us conceive before going down the IVF route (we were told by DHs GP that IVF was what we needed to have a second child)
He arranged for us both to have blood tests and generally got to know us both. It was nice and relaxed (not what I expected)
When we went for the second appointment he arranged for us to see the fertillity nurse who worked alongside him to start treatment with Clomid.

My first appointment was a full medical history including gynae history. I didn't go with dh (he couldn't get time off work) but consultant had his sperm test results from GP. They were ok, but on the lowish side, so she recommended he take Wellman tablets to help boost it, and asked that we bring another sperm sample back in three months to see if the Wellman helped. I also had a brief internal just to check everything was "in the right place", ie ovaries weren't enlarged and took a swap to check for any infections. We discussed what the causes of infertility were and which ones might affect me (bearing in mind previous med history and blood results from GP - ie there was nothing to indicate I wasn't ovulating or had hormonal inbalances) As I'd had a previous infection I was booked in for an HSG (x ray of fallopian tubes), they also went through the options if the HSG didn't work or they needed to make further investigations into the fallopian tubes. The consultant didn't go into much beyond that, she was really lovely and said there's no point in discussing IVF or other options if there wasn't anything wrong. She kept everything really positive, lots of reassurance. She made my next follow up appointment, which was for 7 months time (!) when I expressed surprise at the time wait, she said that cancellations came up quite often as many women get pregnant while waiting for their follow up appointment. I'm happy to say I was one of those... my appointment would have been this Wednesday, but I'm currently 28 weeks pregnant! Good luck, I hope it all goes well xx

Hi nomoremagnolia I just wanted to say your situation is very similar to mine. Dp has very low morphology (2%) and I'm not ovulating every cycle.

Pretty much what everyone has described was the same for our visit, but just something to bear in mind - dp also had his bits checked and his balls measured!! Just thought i'd pre warn you this could happen, as my dp was very shocked, and was rather quiet for a day or so afterwards!!!

Good luck

1wish - thanks for the warning! Think that might have caught him unawares!! DH's morphology is 3%, so we're v. similar. What did your specialist suggest doing next? Hope you don't mind me asking!

No thats fine nomoremagnolia
Unfortunatly their not doing much for us at all. I've been prescribed clomid (I got this on my 2nd appointment after my hsg)
and although the consultant said our chances were low, we should try with the clomid for a year.

There is little more they can do at present because apparently IUI has a low success rate with low morphology. And in my area all IVF has been suspended for the next 2 years so i can't have that either.

Must admitt i'm totally gutted, I knew i had a problem (always been irregular) but to hear dp has a problem and that his problem means we need IVF is gut renching.

Just gonna keep trying and hoping as dp actual sperm count was quite high, also feeding him loads of vitamins. But to be honest im terrified its not gonna happen.

Sorry for the long post, hopefully you'll recieve more diverse treatment and more quickly than we have. Good Luck x

Oh you poor thing(s) Can't believe IVF is suspended for you area, that's awful
My GP said she didn't know what the current criteria are for our PCT mind you, she didn't seem to know much actually... DH wil be registered in a diff PCT soon (long story, he's HM Forces) and they are less strict about IVF, so seeing as it's DH's 'problem' that might work in our favour. I think I ov late in my cycle rather than not ov, but GP says ov is always 14 days before cd1. Didn't argue as end result would have meant being referred anyway.

Hi Nomoremagnolia you know i think the same thing.

I've had 3 blood tests 1 said i definatly ov'd, 2nd one, consultant mumbled something (still don't know result) and on the 3rd one the consultant said it showed no ovulation, but seeing as it was a day21 blood test and that cycle was 42 days it would have missed it anyway.
But i was so desperate for my clomid i lied and said it was a30 day cycle, if that makes sense.

....Then another month I finally got a +++ on a clearblue digital opk (never had one before) on cd40, thought yeah this could be possible, some cycles i'm 50 days+, Bd like mad only to get af cd45, which is an icredibly short luetal phase and may explain my infertility.

Can i ask a personal question -Do you notice any fertile ovulation signs, such as ov pain or cm or anything, i don't seem to get anything, don't know if thats a problem too.

Sorry if this isn't making much sense, had a glass or two of wine

Hi 1wish
No I don't get any obvious ov signs, CM doesn't change much (that I've noticed) and don't get any pain. Am thinking of trying OPK but they seem very £££. Did chart for 2 months a while ago which showed temp rise at cd19/20 and a 10 day LP (29/30 day cycles) but since then cycles have shortened to 28 days so not sure when ov (think LP stays the same, so ov would have been cd18?) Am charting again this month too.

I'm thinking of charting too, (using opks at mo), but with charting do you have to take temp at exactly same time every day??

I tried it for a month but it seemed pointless as i get up at completly different times, do you think its worth doing?

Have you heard anything about your appointment yet? It's worth ringing up once a week to check for cancelations, because sometimes they forget about you and it jogs their memory!!

Just to let you know my first appointment was very different: I wasn't really anything other than getting me into the system. Took basic history, then I got booked in for HSG and scan and the usual day 1/21 blood tests. Then go back for this info in 4months.

I actually knew the gynae so don't suspect i was fobbed off with less than they usually give... so I guess what you get depends massively on the area.

1wish - you take temp as soon as you wake up, whenever that is. Once you're up and doing stuff your body is 'working' so temp could be affected by this.
Impatience - thanks for that, I think if that's all I get I would feel 'cheated' so thanks for the warning. My GP was quite 'disinterested' in the whole thing, just did blood tests and DH's test and then when giving results said "so what do you want to do now?" My reaction "get pg!" DH was cross with me for being rude I'm fed up of ttc, just want to make a positive move in the direction of being a mum rather than the failure I feel when AF arrives every month.

Impatience I know what you mean about it not being so indepth. I actually feel more qualified than my consultant, it's basically-

Do the sperm work?
Do you ovulate?
Are your tubes blocked?

Right lets send you on your way with a years worth of clomid then.

I wanted to know
Could i have hostile cm?
Do i need a d&C? (strange afs)
Have i got pcos or not? (never had a straight answer)
What can dp do about sperm count?

I've got a follow up appointment next month, gonna demand folical tracking or somet, cos i have no idea when (if at all) i'm going to ovulate, so taking the clomids pointless.

Sorry for the rant. Nomoremagnolia i'm sure your appointment will be much better, i just seem to live in a particularly shite area

A year's supply of clomid? Everything I've seen says you should only take it for 3 months before having a break.
And there was me thinking getting referred to a specialist was going to make things more straightforward. Know what you mean about feeling you know more than them too!

No consultant said as i was young (23) i can take it for a year, as my risk of cancer and that is alot less than someone older

To be honest don't know if i believe him, the more i read on here, the more i thnk he knows nothing. He said my cycles will come down and stablise at 28 days, but from what i've read on old threads it seems to make them longer if anything and definatly not 28 days.
I don't know what to think to be honest, just have to see how it goes