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.

@Juno231 i share your anxiety, im not far behind you. I got my AMH test via superdrug online, its really simple, the hospital accepted the results too, its not too expensive either just to put your mind at rest u could get that done. I think they will recommended ivf or icsi i think as the last SA showed a low overall count. But let's see. It's unfair they make u wait the 2 year mark. Will they apply for your funding etc now so you're actually ready to start in July?

@juno231 I wouldn't have thought they'll fob you off on Thursday, don't think they would waste an appointment slot on not giving you some sort of plan. Hopefully that's the case anyway.

@purpleunicorn01 any luck chasing your appointments up?

@kay00 welcome! Yeah think it's different everywhere, you could maybe even ring the fertility clinic and ask the question as they probably get asked all the time.

I am really not coping with having to wait until the 20th April for our follow up appointment! I understand there's waiting lists etc to start treatment but feel like nearly 2 month is a lot to wait for SA and ultrasound results. I am so tempted to ring and ask for them and just say I need a copy as I'm getting tests in the meantime done privately (I'm not).
The other thing I'm stressing about is not having a HSG done, it seems odd to me that I will potentially be put forward for IVF after only a SA and ultrasound, never knowing if I actually have blocked tubes. Same with the day 3 bloods, my GP before I was referred only done day 21 bloods and when I asked at the clinic when I was getting my ultrasound, they said they don't need to do them. It just feels like lots of investigations are being skipped and instead going straight for IVF.

@dogmam that would stress me out as well, especially if it's something that could be sorted without IVF. Did they not even do any day 3 tests this time around? Sounds odd as that's where they'd spot PCOS/thyroid concerns etc. Any chance you can email the consultant via their secretary and say you haven't had an HSG or day 3 bloods booked and express your concerns? Perhaps they could set something up for you without having to wait another month to see them first.

@PurpleUnicorn01 I've had my AMH done twice online before but the numbers did fluctuate a fair bit so I don't trust the accuracy of it tbh. The thought of sending a blood sample via post and expecting accurate results don't add up to me in hindsight. From what I gather I'd have to wait until the 2 year mark and then apply for funding and THEN go on an IVF waiting list. So could potentially be a year away still if I wait for the NHS.

@dogmam with mine, they only do HSG if the internal scan (and SA) is OK. They don't need to do a HSG if you are going straight to IVF. I've got that next, because our other stuff is fine. But had it not been, they wouldn't have bothered. Its annoying you have to wait for results though- they just told me on the day of my scan (I had an appointment straight after to speak about it). I've found the nhs OK so far with no delays. So we'll see how it continues. I honestly expected them to be useless but I cannot fault anything so far......

@dogmam how are you?

Yes apparently there's an 8-12 week wait on the scans and SA so I've booked them privately to avoid any lengthy delays it was much less stressful, maybe that might be an idea? My second appointment is also end of April so can't afford to miss that due to the delay. Also call your drs secretary weekly and try getting cancellation slots.

@juno231 oh gosh that is really disappointing, i hope your next appointment goes well.

Also @dogmam don't worry i haven't had a HSG either just the same tests as you.

Yeah fair point @dogmam - I sort of assumed everything else had come out fine for you but if there's MFI or similar then they'd skip HSG as there's little point.

It's a bit flawed though cause if you have blockages I'm pretty the embryo can get stuck in the wrong place even with IVF - but I suppose the risk is much smaller then.

My understanding is they don’t worry about checking tubes with hycosy or hsg if you’re having IVF. I guess it must work without it, not heard of it being an issue anyway.

My appointment still feels so long away, it’s getting me down. I can’t try this month, next month I’m not sure yet, and then it’s still ages until mid May. I guess I’ll call them with the request to put documents and scans on file.

@thislittlebird everything seems far away when you go through this process. We understand. Yes get them to put them on for you. . Ive tried to plan little things in between to look forward to, or else it drags

Yeah that makes sense @paintfairy only getting the HSG if the first tests are fine, which our SA is not so that explains it. Think I would still feel better having it though just for peace of mind, it feels like a big thing still not to know if there's a problem with tubes even if IVF was to work.
My scan results were pretty much given to me whilst I was getting it done, that's where she mentioned the number of follicles and lining was as it should be etc, but it was just chat as she was scanning rather than a proper conversation about it.
@juno231 the clinic did take bloods at my last appointment but it wasn't day 3 bloods, she said it was to check thyroid etc, I did mention that the GP didn't do them so do I need them and she said no as the bloods they were taking now would give them everything they need to know and overrules the day 3 bloods anyway(?!) Something along those lines.

Also.. I have rang the clinic this morning to ask what the IVF wait time is.. it's currently 5 month from the date of follow up appointment after initial investigations to starting ivf. Then in between the two is implications counselling sessions and consent forms.

So potentially if on my follow up appointment in April I get the go ahead for ivf, we would be starting in September.

I think 5 month is reasonable and gives time to get your head around stuff and prepare/get a little holiday in!

I think that’s why I’m going to get a hycosy done anyway. Because it will put my mind at ease I’m functioning properly I suppose, or should be able to, even if they don’t think I need one when I get there.

@PurpleUnicorn01 yeah, the time passes so slowly, it’s frustrating. And my 38th birthday will be right after the appointment, it’s stressing me out a bit.

I started taking an anti-anxiety medication today that the dermatologist gave to me. My ovulation looks like it’s going back to being late again after a month off from acupuncture and it made me very anxious this morning when I realised. Hoping the drug will help me be less stressed about it all after a couple of weeks.

Yes that sounds stressful. I know a lot of people find counselling useful through this anxious time.

Yeah I think I’m saving any possible counselling for further into all this @PurpleUnicorn01. I have general anxiety and it’s just cranked right up by all of this, my body is not playing ball!

So I had my results follow up appointment with the doc this morning (she was half an hour late lol). All test results are fine (AMH of 21.3 so I'm relieved) and OH's SA showed 84m/ml, 7% morphology and 72% motility so that's really good too. So basically she said I am officially diagnosed as having unexplained infertility. Next steps is waiting until the two year mark to apply for IVF.

I asked her whether we'd be good candidates for IUI (privately) and she said no there's no point as I ovulate well and there's no MFI so there's no added benefit to it compared to just good old regular BD.

She did offer to refer me for a laparoscopy so that's what I'll be waiting for next.

@juno231

That's a relief at least that everything is okay with both of you. Did she book you in for the 2 year mark then?

Hi @juno231 how are you feeling? Pleased to see everything has come back ok! But can also understand if you're a bit deflated at now having to wait until the end of the year. What's your thoughts? It seems unfair that if say the SA were poor, you could be on the way to IVF a little earlier. On the other hand, as much as I hate the saying, it is very likley to 'happen when it happens' now that you know there's nothing wrong.

Did you ask what the wait time was for ivf?

@PurpleUnicorn01 @dogmam well remember this just means there's nothing wrong with the tests they've done - but there's lots they can't test for or won't test for on the NHS. So it's frustrating more than anything. I'm glad I can get a laparoscopy done whilst I wait though - it feels productive still.

She had no idea what the wait times were but I might email her secretary to see if there's anything they can tell me. I came off the pill in Sep 2019 but their paperwork says July is my 2 year mark so I'm not going to correct them on that...

@Juno231 yes I see what you mean and you're right at least you can get that test done. And it's great that have it down as July so it's no as far as the end of the year.

Appointment went well today. I asked all I need to. We are entitled to 3 rounds of medicated iui and if for some reason it goes wrong (over stimulated or you get covid etc) it doesn't count. You get 3 actual tries. Hopefully these will be back to back but it hinges on if you want to, and how many others need it that month. They prioritise the people who didn't have it the previous month. If it doesn't work we can have 1 round of ivf and the wait time is about 3 months atm. So not bad at all?
They sent us for bloods (I'm to email next week and see if results back) and DH had to fill in a consent form. HSG wasn't too bad at all. I was bricking it but I didn't find it awful. Slight cramps (I took ibuprofen before) but not as bad as period pain or anything and over pretty quick. No weird foof cleaning like@Juno231had 🤣 and they were women. So far I've found everything really good and positive and them supportive. I feel like I've had a day out! Strange going anywhere. Theoretically we can start IUI next cycle. All my tests have come back OK - no why we can't conceive I've no bloody idea. DHs last SA was normal. So whether it's the progesterone I've no idea?

Definitely don't correct them on the 2 year mark @juno231 but it's strange your investigations haven't really shown much different to mine, yet they are trying IUI with me? Maybe it's the spotting that's swinging it? So you have to wait until July before you can even apply? Or is it they are letting you apply in July ready for September (and so in fact know that's the correct month)?

@paintfairy

That's exciting! How are u feeling about it? When's your actual start date?

@PurpleUnicorn01 just so relieved the hsg is over to be honest! But yeah, good i think? If blood tests are back and everything OK then we can start next cycle. Which is just over 2 weeks away! Seems a bit soon!

Arghhhh!!! So excited for you. That 2 weeks will fly!

@PurpleUnicorn01 i know it will! The only thing that might slow it is if I have to have an extra blood test. DH had one for something specific in his family. If it comes back he's a carrier then I'll have to have a test. I'm then not sure what that even means in terms of carrying on, if both were positive (although it's unlikely for me). But my test might not be back in time, if I have to have it. I've got to email midweek next week to see if his results are back. We shall see.....

Hopefully all goes well for you