First Fertility Clinic Appointment Tomorrow

[dogmam]

Me and my partner have our first appointment with our fertility clinic tomorrow!

We went to the GP after a year of TTC and after 21 day bloods and partners SA, we were referred straight away to the fertility clinic. GP tests were in October/November so it's moved along quite quickly so far.

Feeling slightly nervous but also excited to hopefully get some help! My partners SA showed low motility and morphology so I assume that will be discussed..
What else should i expect from this first appointment? Is there anything I should be asking?

Thanks in advance! I'll update this after the appointment tomorrow as I know there are a few others on here who are in a similar position and might find it useful.

Ok, i've had my appointment. Here's the update!

I started spotting today. This tells me (so I assumed) I've ovulated and I would put it at yesterday. So it was interesting to go today. Scan lady was nice. She said everything looked OK and she could tell I had ovulated from my right ovary (today is CD13) and she asked if my cycle was regular and where I was at. She wrote the report there and then. I had to just go back in the waiting room. Then I was called in to see the fertility nurse. She checked my height and weight and my bmi is OK at 26.9. She confirmed my scan was OK and everything looks fine in that respect. There was fluid but that's consist with ovulation apparently? I told her I'd started spotting today. She's actually given me some progesterone pessaries to try for the rest of this month (good scan timing)! To see how I respond to them, as it'll be a good trial. She said you can get them on prescription but as they are expensive they don't like them being given out. I didn't have to pay today. And if she's right I might even end up pregnant this month. They might delay my period though but I'm to do a test in 2 weeks, because if I am pregnant she wouldn't want me to stop them, I'd need to carry on. If I'm not then I can stop them and wait for AF. When AF comes I'm to call up and book in for a HSG and not have unprotected sex. On that day DH would have to come with me and they'll go through all the consent forms (need ID) and get all the paperwork done at the same time. And we could actually start the IUI next cycle (assuming tubes ok).That seems fast and very scary!
DH is like- do we not want to try ourselves and see if the tube check just works? And I'm tempted to ask them that. If we can use the progesterone (even if it means paying) and try for a month or 2 on our own first, following HSG. Because in theory there's no reason we shouldn't be managing this for ourselves.
His test wash for SA was fine. They need 5 million but really they like to have 8 million in case. He's got 15 million. I asked about the other issues and actually everything was normal on this one! His motility was 35% (25% last time). She asked was it cold last time but they did take an hour to do it and I think it was less this time. So that's good news. Maybe a one off (who knows) but its not so dire its a problem, clearly.
So yeah, still moving forwards.

I think the time scale is all pretty fast considering. I don't really think they could have gone much faster, for those worrying about it?

Hi ladies, exciting for some of us that are progressing with investigations and moving forward!

@juno231 I was laughing at how you described your HSG experience! Pleased it wasn't too uncomfortable and also good news that the SA is booked for this week, hopefully you don't have to wait too long for the results of everything.

@paintfairy aw your appointment yesterday sounds like it was really productive, your clinic sounds fab! You can't ask for more than that in terms of timescales can you! Good news that the SA has improved, I can see why you might want to wait a while and try naturally for a couple of months.. hmm something you are gonna have to have a good think about. All very positive for you though, exciting!

So my appointment yesterday.. (I'll give lots of detail incase it helps anyone else to know what to expect when getting an internal scan). Me and my other half were called in for the appointment, he was took to the 'production room' to do his SA and that was it for him. I was shown to a small room by a health care assistant and told to undress from the waist down and the doctor would be in shortly.. I was dreading the awkwardness of should i lie down, sit down, stand up etc!! But the doctor when she came in was so so nice and made me feel comfortable. The scan itself was a good 15 minutes, and she spoke to me throughout the whole thing to tell me what she could see, she turned the screen round too so I could watch (not that I knew what I was looking at!). Anyway.. she said everything looks good and 'ready to receive pregnancy' although she counted my follicles and I had 20(!) on the left side and 12 on the right, she confirmed my cycle length and said something along the lines of, because my cycles are normal and that I don't have symptoms of excess body hair, not overweight etc that I don't have PCOS however the high number of follicles could be an indicator of it, but without any of the other symptoms I don't have it. If IVF goes ahead however, I would have to be closely monitored due to the high number of follicles and I would be prone to overstimulate, which results in usually a cancelled cycle (all of this was new to me, I have had to do a major Google to find out what all of these terms/words mean!). No polyps or cysts so all in all she was pleased. Confirmed IVF would go ahead if SA hasn't improved, if it has improved, IVF would be in October when it will be 2 years ttc. After the scan I got my bloods done and my BMI, then whilst I was getting ready to leave the bloods room the doctor who done my scan come back in the room and asked me if I would do another scan on a different machine.. So I had to do the awkwardness all again, but it was because the second machine was more advance and she noticed something on the first scan that she wanted to check out in more detail.. something to do with the cavity (?) and if it's over 1cm then it can mean you are prone to misscarige and mine looked big, but it was 0.87cm so she was fine with that. I asked about a HSG and she said there's no need at the moment as if SA doesn't improve we will get IVF regardless of HSG.
I felt very very looked after, I was worrying for nothing and look forward to the follow up in April!

Also in addition to that huge long post!... I was day 20 of my cycle yesterday (28 days cycles usually for me), I still haven't had a peak OPK this month (usually get peak day 16), but she confirmed I had ovulated and said OPKs are not always accurate! So just a reminder to not get obsessive with OPKs!

@dogmam sounds productive! No, that's why they didn't do my HSG straight away. But because SA was ok and scan ok, we move to that next. Fingers crossed your SA has improved!

Good to hear you guys are doing well.

Excited for you all! @dogmam i love yiur accounts they are fab. @paintfairy how are you feeling? @juno231 how are you getting on now?

@dogmam sounds like a brilliant day progress wise! Sounds like you could have PCO without the S then? No idea if that affects TTC at all other than the overstimulation you mentioned. On the bright side, sounds like that would mean lots of eggs to harvest if it came to IVF?

@PurpleUnicorn01 I got a peak LH test on Sunday so was super lucky with the timing of my HSG in the end. DTD Sat/Sun/Mon so should be covered and it means OH can have his SA on Friday now no problem.

Am dying to find out the results of the scan and blood test though! Considering how little time I got last time with the doc, I think she'll be rather annoyed when I'll ask her to tell me all of my results line by line lol. I just don't want to end up with them saying everything is fine only to find out later down the line that my TSH has gone up further or something.

If at the next appointment they fob me off and tell me I just have to wait until the 2 year mark I have already decided that I will ask for her professional opinion on if there's any point in us doing IUI privately in the meantime. I'd also want to know if she knows what the IVF waiting times are roughly and to confirm how many rounds of private IVF we'd be allowed before forfeiting the NHS one. I don't particularly want to end up at the 2 year mark only to be told it'll take another year before it's my turn to have IVF so I'm planning for backup options!

@PurpleUnicorn01 how are you? where are you at in your cycle now? when is your appointment again?

@Juno231 that sounds like an anxious wait. It seems silly though they are making you wait. I have my first appointment with gynecology on Tuesday, fingers crossed. Its on the phone. I will ask them what the waiting times are and will post on here if it helps. Also if you have it privately they won't actually know anyway. just saying. I was going to go to Turkey and have it as its cheaper than here but that just depends on the waiting times here. Will let tou know when I find out more info.

Hi ladies, this thread has been really helpful so thank you for starting it and adding your experiences.

I haven’t been referred yet. GP has done bloods, swabs & smear for me. OH has had semen analysis. GP has now referred me for an ultrasound which I’m hoping doesn’t need to be timed at a certain point in my cycle as I’ve been given an appt to attend rather than me arranging it for a certain date.

Juno your experience with the HSG sounds awful although I’m glad they were kind.

@paintfairy good news, and really nice that she gave you the progesterone to try. How long has the process been to this point for you?

Also good news on his SA, had he done anything in particular to get the better outcome? My husband went on the hottest day of the year last year and I’m sure that didn’t help his results.

@dogmam I had a similar number of follicles, can I ask your age and was this NHS? I’m 37 and had 17 and 11 and the doc was thoroughly unbothered about the number of them when I asked her about PCOS. She said you could be borderline but wouldn’t worry, I prefer the answer you got. I don’t have any of the other symptoms either. I knew I’d be at risk of OHSS so am going to make sure that if I get out on clomid or something that I’m monitored. Like @Juno231 said, I’ve wondered if it could be PCO no S.

My DH is going for his next SA soon, maybe next week, really hoping it’s better.

@thislittlebird I have just seen your earlier post about your referral letter finally coming through for a May appointment, I hope it goes quick for you, I had a similar wait but have seen lots of people on here who have had a 6 month+ wait so I don't think think it too bad, totally get though that you're frustrated with the cockup they made, could you ring and ask for cancellations? Also re private tests, I think it will be fine as long as there's not a huge gap in between other wise the nhs might want to repeat them. Does your clinic take private patients, maybe you could stick with them?
I'm 30, so not sure if that makes a difference to follicle numbers?? As @juno231 mentioned, I've never heard of PCO without the S?? I'll have to give it a Google. I usually skip any PCOS threads as didn't think it applied to me with having zero symptoms. Something to think about I guess!

@purpleunicorn01 ah I'm glad you have found it helpful! How are you feeling about your appointment next week? Hopefully you are armed with lots of info to go with and know what questions to ask. Keep us updated!

@causingchaos2 pleased you have found it helpful! The ultrasound can be at any time of your cycle, that's what my appointment was yesterday, they are just checking for any cysts, polyps etc. That's good that your GP is sending you for lots of tests, sounds like you'll have a head start if you get referred to a fertility clinic.

@juno231 oo your opk peak timing was perfect, that was lucky! Especially with the timing of the SA. Hope it's a lucky month for you!! Apparently the HSG gives you increased changes for the 3 month following it.

@paintfairy obviously ideally the SA has improved and we concieve naturally but on the other hand I feel like if it hasn't improved then I'm closer to IVF so it's a funny one.. not sure how I want the results to come back as.

@dogmam Great, thank you, I’m glad it doesn’t need to be timed. I hope the sonographer talks me through what they can see too. It’s good that you got the results there and then instead of an anxious wait for a report to be written up.

@dogmam, im nervous and excited all in one go! That's a great point about questions. Any suggestions? My only question at the moment is when can we start lol thank you.

@PurpleUnicorn01 yeah I feel optimistic. I think!
@Juno231 the waiting for results is the hardest bit I think!
@thislittlebird the referral process? The GP did it early Jan. The GP part took longer than the rest of it so far, because they were useless! Literally did nothing to change the SA. He was on the same supplements etc. But it was done sooner, so whether that made a difference? The first time it was an hour old.
@dogmam no, I know what you mean! It's all so complicated.

Hello everyone. This has been such an interesting and reassuring thread to read. I had a phone consultation with a GP yesterday after two 21 day blood tests showed my progesterone levels at 9.3 and 7.2. So shockingly low. In all likelyhood not ovulating regularly. GP has referred us for further fertility investigation and honestly I have been a mess of emotions since yesterday. Had to leave my work early and took the day off today to regroup.
I have had a pregnancy last year which ended in a surgically managed Ectopic and I lost my right tube. So I must ovulate sometimes but it all feels very hopeless. Been trying since June 2019.
Your knowledge has helped me understand what to expect going forward and I can be asking for too, so thank you.

@paintfairy that’s good on the SA front, hoping my DH will improve too 😬

Referral process yeah, it’s frustrating how slow mine is but yours sounds ok after the slow GP bit.

@Positivity2019 hello, so sorry to hear about your ectopic, that sounds awful. Feel free to join me in the low progesterone club . Mine was 10 last month, but I’ve read some threads since where people have got pregnant despite low results so maybe there’s hope for us yet.

@thislittlebird it’s quite a shock getting such low results isn’t it. That is quite reassuring though that people are still successful despite low levels.
I have been researching vitamins and supplements that might help but it’s so overwhelming. I was taking Vitamin B6 through last year. I tried wheatgrass supplements because I heard that might help. I dabbled in Coq10 although not for very long. I stopped it all last Autumn because I was just feeling overwhelmed by it all.

Yeah it’s a lot because you suddenly don’t really know if you’re ovulating or not @Positivity2019. I suspect I am but whether it’s every month or not is hard to say. One doctor said to me that it would be 4 or under if there was no ovulation, no idea how accurate that is.

I’ve started taking b6 after ovulation this month exactly for this reason, and I also read that vitamin c is good for progesterone from what I recall, so I added that to my collection. There’s a fair bit of useful info online if you fancy going down the low progesterone rabbit hole when you’re feeling up to it. I did read some positive threads on the topic though and I found them quite calming.

I think stress can interfere with it too when we produce too much cortisol so I do wonder if that’s much of the issue for a lot of us.

Hi there, I’m 34 and have been offered IVF via the NHS after 2.1/2 years of unsuccessful attempts of conceiving. I really don’t know which clinic to choose. Has anyone any experience of the HEFA website? Or does anyone have any recommendations? I only know of the ARGC clinic but that’s a private clinic and it’s one of the best in the world. Any recommendations for NHS funded clinics? Thank you in advance smile

@ThashG that will be really specific to your trust I think? That is, if I look at my local ccg policy it lists which clinics I can choose from, so it's not just random ones where I can pick whatever I want. So check that first, then check their stats against your Age/AMH or whatever and def check for user reviews! E.g. one of my options is St Helier but if I check mumsnet for it the feedback is godawful and I'd avoid it like the plague if I could.

@xpeach123 do check this thread if you're wondering about your first fertility appointment! (creepy lurker here, soz!)

So ladies - OH had his SA this morning and I emailed the doctor's secretary to let her know the last test has been done and can I please arrange a follow up. She emailed me with a number to call to set this up (no offence but how does it work to have a secretary that doesn't set up appointments?). It was the wrong number but the person gave me the right one to call - which in turn took 15 min of being on hold to get through... only to be told my 8th of July appointment is the follow up! I told them surely it's unreasonable to have to wait 6 months between appointments just to hear what my results are? So the central booking guy agreed and said he'd try and move it forward for me, and booked it in for the 25th of March - PHEW!

Now I'm panicking that the SA results might not be done by then? But surely they should be! @paintfairy your OH's didn't take long did they?

On the one hand I'm anxious because I've clearly altered the timeline the doctor had set up but on the other hand I'm fuming. The results could show something is wrong and they would wait another 4 months to even start to address it? Plus it ignores the part where I could take the results and just go private to sort it AND it ignores that the doctor was concerned that my AMH might be low and said if it was, we'd get started on assisted conception straight away.

Oh that’s interesting @Juno231. Glad they moved it forward, six months for results is stupid.

My husband has to ring and book his own SA too and then the second time the receptionist actually offered to do it for him which was a shock. He still did it himself in the end.

I’m sure my husband’s results took a couple of weeks at absolute most.

Have you got your AMH results now? I don’t understand why the nhs work like this tbh, it’s really odd and makes no sense. Why not book results appointments straight after or get the GP to tell you? It’s strange.

@Juno231 my husbands results came within 10 days. Also download the nhs app for you both. I think you can link it to your drs surgery results to show on there. I know you can book your appointments through it.

@Juno231 OMG. What on earth? A secretary that isn't a secretary? 🤣 July is ludicrous. As you say- for a proper follow up maybe but not for your results! You need to know if anything is bloody wrong. And ok you asked and they have moved it, but why were they being idiotic in the first place? I bet most people just accept it. My appointment was a week and a half after DHs SA and the results were back. So you should be ok?

I'm not even sure if they are testing my AMH to be honest. That's another question to add to my list! I'll email next week. I'm a bit confused. As I'm to sign paperwork for funding etc at the same time as my HSG but I'm sure she mentioned blood tests. So what if they come back with something? Whatever they are even for! 🤣

@thislittlebird omg. I misinterpreted that. The receptionist offered to do it for him. 🤣 I was thinking- that's a bit involved?! 😱