IVF how to start the process

[EttasEden]

Hello, my DH and I have been ttc for a year now. He has moderate oligozoospermia/oligospermia producing 9mill sperm. Everything my end seems to be fine (regular periods every 28days, private hormonal blood test came back normal and I'm ovulating day 14) we are early 30's, don't drink or smoke, healthy and not overweight. My GP is pretty unhelpful, I haven't seen him for a few months now. How do I get the ball rolling for IVF. GP referred DH to a urologist but that's on hold due to Coronavirus. I've been reading and we have a 6% of becoming pregnant each month naturally (which GP failed to mention) I have been off the pill 2 years in Aug but officially trying since last June. Any advice on how to get on the IVF waiting list would be much appreciated. Thanks

Hi. For us a bit different. This was 10+ years ago. My GP referred me to hospital as thought I had polyps. I happened to mention it to the gynaecologist that we were trying and had been for a few months. He said to come back in 6 months for the normal checkup for the polyps. At that point he asked how things were going at trying to conceive. He then put us into the system for tests. All came back fine. He said that he would send an appointment if still no luck after a year (I think) as we hadn’t been trying long enough for us to have IVF on the NHS. After that we decided to go private (to start with for the initial appointment to see where we were) and just phoned up for an appointment with the IVF clinic. The private doctor was like yep let’s get cracking now so in the end we had the whole IVF privately. We were fortunate we could afford it and was successful with twins the first round.

Thank you. We really can't afford private, so it isn't an option for us until we run out of NHS funded IVF. I am so happy you had twins first time! So lovely :) me and DH have been together for 8years and I put off ttc for 2years until last year and now I wish we had just been trying all that time. I think NHS is 2 year ttc waiting list but this last year feels like forever. Plus a baby takes nearly a year to grow and that's just if we were successful 1st time round, it will be at least 2 and a half years from now 😢

How old are you op, do you smoke, what is your bmi and do you have kids already?

Sorry just realised you answered those! See your GP and ask for a referral. Check your ccg fertility policy online,. Most offer one cycle, some offer none at all, a few offer 3.

Expect to wait 3 to 4 months for the first appt then the same again at least to start a cycle. And start saving. One cycle only rarely produces a baby, sadly.

Hi I understand re going private. If we hadn’t we would have just had to wait for the 2 years to be up and then gone to the doctors.

If your doctor isn’t very helpful is there another doctor at the practice you can see?

Because you are under 35 you may need to wait a year of ttc before getting a referral to IVF, but that’s only next month.

I’d make an appointment with your GP and be firm and say you’ve been trying for a year now and you would like a referral. If they decline I would speak to another GP if possible.

I’m in Scotland so our rules might be different but it’s 12 months ttc under 35 and 6 months ttc if over 35. I was referred and now on waiting list which took about 3-4 months

Why straight to ivf? I would say IUI should be done prior to the highly invasive ivf. Have you had your tubes checked? After a year of trying my gp was happy to refer is to fertility clinic in local hospital. We were trying for 3rd. You can probably ask for referral just having a phone consultation with gp. After referral things moved very quickly for us. Clinic sent us online questionnaire then a pack of forms for tests: sperm, my bloods on cd5, hycosy (tubes and womb check). They wanted us to have it all done over a month, otherwise they’d send us back to gp. Once done a consultant told us our diagnosis and next steps in our case a laparoscopy which was successful and resulted in bfp 3 months after operation.

I too am a bit confused as why you think IVF is the 1st option? Sounds move like you need a referral to an infertility clinic initially. It doesn't sound like you have even had a full infertility workup as yet. Have you actually been checked for your hormones including testosterone levels, thyroid, deficiencies and both been fully checked for STI's? Have you had an HSG or Hycosy to check uterine and tube shape and patency? Amh for egg reserve? etc etc?

I'd see a different GP at your surgery and explain the situation and lack of referral or further tests?

IUI is very low chance wise of getting BFP due to DH sperm. Will push GP, we have 3 tries at our current CCG.

@elouera I've had all hormonal bloods taken privately and due a scan, I had a scan about 2 years ago (unrelated) and everything looked fine, but you never know.

I have no DC's, 2 years in Aug on no contraception and 1 year in June ttc actively monitoring etc.

For oligospermia IVF is recommended from researching, ICSI is also mentioned.

You need to push for a referral from your GP it can then take a year to get started (especially with the recent covid situation) so sooner the better.

You'll have to have more tests done - uterus scans, HSG etc, letter confirming your funding has been approved, then a group presentation and then you can start - being NHS of it falls
Over Xmas time then you get bumped into the new year and some are even stricter about what day of the week your period starts as they don't work 24/7 364 days like private clinics do

You only mentioned about you not having DC. If your husband has any children you won't be eligible for IVF on the NHS

Don't bother with IUI - you have to factor in at least 10 rounds to have the same success rate as one cycle of IVF

IUI is for cases where sperm is an issue I thought. From google:

During the IUI process, the highest quality sperm is selected and injected into the uterus where they are left to fertilise the eggs naturally. IVF in comparison removes the eggs from the body and has them fertilised in a lab. This means that IUI is a less invasive procedure, also involving fewer drugs than IVF.

But I’m not a doctor.

With 6% chance a month statistics would expect you to be nearly pregnant by now 1.06^12 is nearly 80%, therefore there might be something else (maybe not and you‘ve just been unlucky so far).

@Worriedmum97

IVF with ICSI is for male factor/sperm issues

IUI tends to be done more for same sex couples using donor sperm

Sorry for not being clear, we both have no DC. Never been pregnant, but I've always been religious with my pill etc.

@ivfgottostaypositive thank you, really helpful. I'm going to get on to my GP next month, as it will have been a year then.