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.

Hahaha @paintfairy, that would be a different level of service lmao

@thislittlebird @paintfairy that's how I read it too lmao!! Thought you took it well considering how inappropriate it was!

@PurpleUnicorn01 I think the NHS app depends on your GP surgery? I had it at my old one before I moved in Oct but the new surgery uses patient access and none of my new tests have ended up on there.

@thislittlebird @Juno231 glad it wasn't just me! I'm still sat laughing to myself! 🤣

@Juno231 what a shambles about your appointment date! Thank goodness you questioned it otherwise you would have a ridiculously long wait! Have you had your AMH tested yet? I got my results back this week - mine was 2.2

Lol @thislittlebird I chuckled at the receptionist "helping" your hubby with his SA 🤣🤣🤣

@Kitekat81 they haven't mentioned testing my amh but part of me doesn't want to know!
2.2? That's not ideal is it? What does that mean for you?

It certainly would have been more of a shock than the offer of a phone call! Lol

AMH seems such a big range, I’m not sure what it tells beyond the egg levels roughly

@paintfairy no it's not ideal. It ties in with my low follicle count (6/7) and means I have reduced ovarian reserve. It doesn't necessarily mean I can't get pregnant naturally, as long as I'm popping out one egg a month then technically I can get pregnant, but as I don't have as many left it means the eggs I have left are likely to be lower quality. The main thing it indicates is that I wouldn't be a great candidate for ivf. Ivf is all about the numbers, they want to get the most eggs out of you because the drop off rate from retrieval to fertilisation to having embryos suitable for transfer is big. Starting an ivf cycle with only 6ish follicles wouldn't be great, I'd be lucky to end up with even one embryo. I'm going to try and find out a bit more about natural ivf which is supposed to be good for people with low AMH. They focus on just getting one good egg out of you, so you don't have as many stimulation drugs and the cost per cycle is lower. The success rate isn't great, but apparently it's similar to the success rate of normal ivf for someone with low AMH. So I guess if I'm going to do something with a low chance of success, I might as well do the cheaper one with less drugs involved? I need to do a lot more research about it. There's also nowhere near me that does it so it would require a lot more travel costs if we went down that road.

@Kitekat81 I don't know where you're based but create fertility are meant to be the best as natural ivf and they don't even have a minimum amh requirement the way most other ivf clinics do from what I gather. All you need is 1-2 good embryos after all!

BTW low amh doesn't mean low quality eggs either - but if you're worried I'd def start with the ubiquinol if you aren't on it already.

Thanks @Juno231 yeh I was looking at Create and have signed up to one of their webinars. They don't have any clinics near me (I'm in Scotland) but I still don't want to rule anything out. Yep I've been taking 200mg of ubiquinol since about July last year, and upped it to 400mg when I turned 39 in November.

@Kitekat81 interesting. Yes that makes sense though and seems like a good option. I honestly never realised until the last few days (never really looked!) how much they mess with you for ivf. I honestly assumed they just drugged you to support the stage of your cycle. Not shut the whole thing down and did their own thing. Which seems strange to me, but what do I know! 😏 Its not something that sits that comfortably with me if I'm honest. But I'll cross that bridge when we get to it.

@paintfairy yeh ivf is so invasive. I never realised about the whole 'artificial menopause' thing until recently, I was like what?! What if it doesn't come back?! And injecting myself everyday, would need to be so strong to do that (I don't think I could do it, I'd have to get my partner to do it). But it does work for a lot of people, and I'm sure when they have their baby in their arms they forget about all of that!

Apparently if you have low AMH they have to push your ovaries/follicles a lot harder to try and produce as many eggs as possible, so they put you on a "long protocol" i.e. more intense stimulation drugs over a longer period, which makes it even less appealing vs. natural ivf.

Yeah I really am not keen on the whole ivf everything (doctor told me I would need short protocol) but I don’t know what else to do if we can’t get pregnant through other means, it’s horrible. My friend’s friend had to have it and she definitely thinks it was worth it to get her two children but the prospect is so daunting.

I think my partner would have to inject me too if we got to that.

@Kitekat81 I think that's how I was! Kind of threw me. I just assumed they worked with your body. 🤣 Clearly not!
@thislittlebird I suppose after the event it'll seem worth it, if it works for you. But if you have to do it several times it'll be difficult. Easier to be a man!

I think I'm gonna have to against the grain here and say the mechanics of IVF really don't phase me (it's so cool what they can do! Assisted hatching in particular boggles my mind) and I don't mind self injections. It's just stuff we have to do right? No point thinking about it too much, we just have to get on with it - one day at a time :)

@paintfairy soooo much easier to be a man. OH keeps moaning about his SA last week and every time he mentions it I remind him he didn't have a small man wiping his nether regions with his face right up to it like I did.

I’m no good at self anything really lol, the chance of me successfully doing an injection worries me. I’m a wuss. The other concern is I have a fair amount of follicles so I’d be at risk of OHSS, but at least I know that now.

Men really do have it so much easier.

@thislittlebird ah yes that explains why they already know they'd go short protocol on you!

Yeah @Juno231, I had 28 they could see. Not PCOS levels but still enough for a bit of a risk.

Morning All,

How are you? @thislittlebird @Juno231 @paintfairy @Kitekat81

Finally have my first appointment with gynaecology tmrw. Woohoo. Finally get to know what happens next and most importantly the timescales.

@thislittlebird that's reassuring though as your high follicle numbers should make you a good candidate for ivf, and your chances of success are higher I think? Also, you probably have more time on your side as you don't need to worry so much about diminishing ovarian reserve?

Good luck tomorrow @PurpleUnicorn01! Let us know how you get on!

@PurpleUnicorn01 good luck tomorrow!

I'm counting down until AF comes so I can call to book the HSG. Yay. And eagerly awaiting to see if I spot this week on the progesterone.
@Juno231 yeah mine moaned a few times and I did the same thing! If only it were that easy for us!

Hi ladies, just catching up!

@juno231 great news about brining your follow up appointment forward, totally worth getting on the phone to them to say the June date was ridiculous. Do you know what the plan will be going forward depending on the results?

@purpleunicorn01 good luck for tomorrow, just remember to finish the call with a clear plan at the end of it and write stuff down, there's that many abbreviations I found scribbling stuff down as they spoke really helped me to remember what was discussed.

@paintfairy it'll be interesting to see how you get on with the progesterone.

@kitekat81 hopefully the webinar will be helpful and help you decide if maybe natural ivf is the best option for you.

@thislittlebird where are you at with everything now? Just waiting on SA?

I've been thinking, I'm no expert on ivf etc but I'm being told by the clinic that if our SA results haven't improved then we would be eligible for IVF.. But isn't ICSI a better option if there's an issue with motility?

How's everyone coping month to month? Now that you are having investigations etc are you focused on starting treatment or still feeling it might happen naturally? Obviously we all would prefer naturally I assume but I persinally kind of wish we could just get on with ivf now.

@dogmam, im well thank you. How about yourself?

Yes that's great advice. Will be sure to keep you all updated

@dogmam icsi is part of ivf though! I think it's pretty pricey though so wouldn't be surprised if the NHS doesn't offer it? As for our next steps - nothing has been mentioned at all which has had me extra cheesed off at the thought of not knowing until July had I not pushed for something earlier.

I've also been getting grumpy today thinking about how OHs first SA said he had an abnormally high white cell count (from memory the report used the words very high and exclamation marks) and how no one has mentioned it since (although the doc had none of our results..) even though reading about it leads to damaged sperm and infertility? I'll be intrigued to see what his repeat SA shows!

Overall I can't decide how I'm doing tbh! In general I'm better because the ball is rolling finally but with the HSG I think it's also raised my hopes and I think the next few AFs will be extra devastating as that hope fades.

@dogmam yeah agree. It's expensive and only used if absolutely necessary. The sperm have to be pretty dire to use that. Normal ivf don't forget is much easier than the sperm having to work hard to do it naturally. They wouldn't do ivf if they thought there was no chance of fertilisation.
@Juno231 I honestly don't even know if the white count was tested on ours? Is that usual?

@paintfairy no idea, we got a big page of lots of different things being checked 🤷‍♀️ I'll try and get the doc off of OH to report back