Fertility testing

[MrsKFR]

Hello

Am going to talk to my doctor about getting fertility testing and was wondering if anyone had any advice on what to say or ask. We never get to see the same doctor at my practice so I don't know any of the doctors well and don't feel I have any sort of relationship with any of them.
Thanks

How long have you been trying and how old are you? Do you have other children and, if so, how long did it take to conceive them? Were you previously on hormonal contraceptives and, if so, when did you stop taking them? Depending on the answers to those questions will depend on whether your Dr will agree to do some fertility testing or send you away to try a bit longer.

Explain to them how long you’ve been trying and that you would like them to run some baseline bloods for you and a semen analysis for DH/P

Thanks- I meant what should I ask or make sure they test for. I don't want to criticise them but I don't want to be fobbed off either- if like to know what the best practise would be.

Just be clear that you’ve been trying for a while. I had to go back twice and be a bit persistent. It depends on your age as well.

Have you been through all of the temping/charting/opk rigmarole? Be sure to tell them that you’ve tried everything.

So I have been doing ovulation tests and also got a positive pregnancy result in Feb but then had bleeding a few days later so basically a chemical pregnancy. I'm 37 and we have now been trying for 6 months. I know they might save keep trying for a bit longer but then I will just go and get it done privately as I don't see the point in waiting to find out if we have any issues or problems as I'm 38 next month.

It will probably take 6 months to a year for all the possible tests you need prior to IVF to be completed so they probably will ‘refer’ you ‘straight away’ but your first proper IVF appointment might take a while. No point doing these tests privately unless you go directly for a private cycle and get them done at the clinic you intend to use - they are expensive and many ivf clinics won’t accept the results unless they come from themselves or within a specific timeframe and / or from your ‘usual’ GP.

I wasn't thinking of trying ivf just yet! From reading online there can be lots of little things that are out of balance or getting in the way- surely there are things you can do before going for ivf. It seems there are lots of things you can check for- even if it's just to make sure there are no obvious things stopping you.

Sure there are lots of things you could try before IVF but at your age It’s not recommended. IVF becomes less effective as you get older. Your success rate at 38 is already far lower than it would have been if you were 35; so the question really is if you have the time.

I was referred at 35 after ttc for 2 years. Took another year to get in front of a ivf consultant. Then between 36-38 I had 2 egg collections and 3 transfers and a lot more testing (I forced clinic to consider Leve 1-2 testing before the usual point of 3 failed cycles; they found lots of issues and it took 6 months of treatment before they were willing to do a FET). I got my BFP eventually but it did take ages.

What is Leve 1-2 testing?

Sorry Level 1-2 testing. It’s a package of different tests - usually offered to older women / those who are being suspected of having repeated miscarriages. Tests a lot of conditions that may cause implantation failure. Level 1 testing can be done with the GP if they are willing to do it. Level 2 testing (this is antibody testing) tends to be done via the fertility clinic.

The initial tests you need are day 2/3 and day 21 bloods (although they call them day 21 bloods they should be done 7 days before suspected AF so, if your usual cycle length is 35 days, you’ll need the bloods doin on day 28) He will need semen analysis.

It may be possible to get an AMH level done but, depending on your area CCG, these can sometimes only be requested by a fertility consultant and, if you have them done by a GP surgery you will be charged for them (this is what we found but our surgery received a request from hospital to do the bloods as the phlebotomy service at the hospital were struggling with capacity at the time - and we were still nearly charged for it!!)

Thanks for the info. To be honest if we have to do IVF the only option will be private as no one seems to be funding it these days especially if you're older. May I ask if you had success at ivf or naturally once you had had your treatment?

I got my BFP the first transfer after my Level 1/2 testing. That’s why I keep hammering on about them. Every test done as part of the package found something wrong with me! If you go private demand those tests before you even do any cycles / take any meds - will save you time and money as while they are expensive (2k for me but I didn’t do karyotyping) but still only a fraction of the cost of a failed cycle.

Hi, we had all our tests in my early 40’s and got the results shortly after my 43rd birthday (after many cancelled and rebooked appointments) by which time it was too late for any NHS funded treatment. DH and I agonised over things for a while and, eventually, decided to give private IVF a try.

We looked into the cost of treatment with donor eggs here in the UK and also abroad and found a few clinics with good statistics for women over 40. We saved and funded a cycle in late 2017 which was, sadly, unsuccessful; then we’re going to go for a second cycle about 6 months later in the spring of last year however family things got inthe way including a bereavement and having to move out of our home and sell it. We finally went for our second cycle in January this year (a few weeks after my 47th birthday) and I am currently. 22+4 with twins and expecting to have them in early September.

We booked a double appointment with the GP and I told the receptionist what it was for. The GP booked me in for cd1-5 and cd21 blood tests, triple swabs (chlamydia etc), ultrasound scan and I had to get my smear up to date (but was due the following month). Dh was booked in for a sperm analysis. These were standard tests and the GP couldn't refer until they were all back.

Once they were all back we got referred to the fertility clinic. Waited about 4 months from referral to first appointment. Now been booked for hsg, scan and hysteroscopy with follow up in 4 months.

Everything does take time so if you've been trying a year or more go now. We won't even be thinking about starting treatment until we've been ttc nearly 2 years (18 months in now)

Good luck 🤞

I’m just coming to the end of the journey now. Had all the tests in about four months- lots of bloods (my consultant liked to do 2/3 day and 21 day every month). I’m now on the first month of Clomid to help encourage ovulation.

Good luck with it all!

Good luck everyone and thanks for the info. After sitting here for over an hour the doctor hasn't even rung for the scheduled phone appointment. This is why I feel like just booking tests at a private clinic for reassurance and know if we have any easily identifiable issues that can be sorted quickly.