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 My first result on day 21 was 16. The GP called me about this and asked me to have another test done the next month.
As I don't have 28 day cycles, I asked if I could have it on day 23/24 and was told no.
So I had it done 7 DPO (which was CD23), even though the GP didn't agree but figured it wouldn't be accurate in day 21.
My result was 24.
I had to chase the GP for this as nobody contacted me.
When they emailed the results (after being told its all fine), I realised it was low.
From speaking to the GP she really wasn't bothered/worried but is referring us anyway.
What we're your results like?
I assume 24 is too low? Despite actually being classed as normal in the ranges given.

Hi @dogmam we crossed paths on one of the other threads. I’m glad to hear that investigations are progressing for you. I’m interested to hear how things continue for you.

I’ve been pushing things through privately (applied for a new credit card...) and also chose a female specialist. DP SA was normal, although morphology right on the bottom end of normal. He’s taking a supplement now.

I’ve had the day 21 test (normal) and the delightful “wand” scan, which showed things were mostly normal but picked up a polyp and that my lining is a bit thin (she said that might be due to interference from the polyp). Interestingly I have felt almost from the start that it was implantation that was the issue for us. Of course that is yet to be fully proven but it is the only abnormality picked up so far.

She referred me for a hycosy earlier this month. Tubes clear but confirmed the polyp right in the best location for an embryo to implant. Typical. Interestingly following other comments in this thread, the doctor who did the hycosy specifically said that I did not need to abstain afterwards and we could continue to ttc as normal. Perhaps it depends on the fluid they use. Mine was just saline. I was worried after reading lots of bad experiences but for me it was fine. A little bit uncomfortable but that’s all. I didn’t even have bleeding afterwards.

Now I am trying to get a hysteroscopy to remove the polyp and have an initial consultation next week. Unfortunately that one is with a male doctor, which will make it harder for me, although I know some people don’t mind. But he comes highly recommended so that is something.

@Flutterby8 I think generally they look for it to be over 30, so 24 sounds borderline. I initially had mine on the wrong day and it came back as 9! It sounds like a lot of GPs don’t have a good understanding of fertility tests. And I might be wrong but I think the ranges they give are mostly just averages, not what’s optimal for fertility.

@juno231 if your family history is early menopause that must be a worry! I can totally understand not wanting to leave things without getting a clinic involved, I'd think they would be keen on getting tests and things done quickly for you.

@kitekat81 hopefully your appointment on Thursday goes ahead, or at the very least it will still be a telephone one. I don't understand why some appointments are cancelled all together when they could still do them over the phone, maybe ring them before hand to check?

@flutterby8 hi! I bet your pleased you've been referred but I get why you're feeling nervous. I was exactly the same and still am about the whole thing really.
How annoying that you had to point that out to your GP! Our GP also told us my partners SA were normal and it was by chance we requested a copy to be emailed and looked for ourselves and saw they were low!
As you say, fingers crossed it happens for us all naturally, before treatment.

@dinosaurus86 oh hi! Ah I'm pleased you've managed to get some tests done! Good news that theres nothing major come back. My partners morphology was 3% and the clinic didn't seem to concerned when we spoke the other day, think she was more bothered about the low motility we have. Hopefully the supplements improve things for both of us.
Yeah, I think a female doctor is always the preference, maybe you could ask to change if you feel top uncomfortable? Is your partner allowed in with you?
So as you are getting all tests done privately, if treatment is recomended will you stick with thek or go through the nhs?

Hope everyone's ok!

@Flutterby8 silly of the gp not to let you move the test to a more appropriate day! Mine was on CD26 to accommodate for an ovulation that wasnt on CD14 - which most aren't! Mine was 62 at that point though. 24 isn't within the normal range I was given I don't think - I was told it had to be over 30 so definitely push for further investigations as you might need clomid potentially?

@Juno231 I honestly don't think the GP really understood. As it was a 21 day progesterone, she insisted on 21 days. I see where she is coming from but its not useful if your cycles are longer than 28 days!
Even going later than day 21 I still had a low result which I am frustrated about.
On the report though it says that for mid luteal timing the range is 12-49mmol/l.
So in theory, I am bang in the middle. But not high enough to suggest ovulation definitely happened.
If I had the bloods 8 days before my period is due (I misjudged by 1 day), would it still be lower than normal even if I ovulated?
I don't know how quick progesterone rises and when it falls back.

@Flutterby8 I've attached the NICE guidelines you can use if anyone pushes back on your concerns. 6 DPO won't have changed much I don't think, although perhaps you would have been just over the 30 threshold. It's good to have it looked at now anyway in case 30 is high enough to indicate ovulation but too low to sustain a pregnancy? From memory a day 21 test should be fine as long as it's taken between 6-9dpo. Mine wasn't bang on 7dpo either as that fell on a Sunday unfortunately.

@Flutterby8 Your GP sounds like an idiot. Mine told me it needed doing 7 days before I thought my period was due. My cycles are slightly short so it meant mine was before day 21. But at least she knew that! 🙄 My result was 40 something on my first one. No idea on the next as I lost interest after the nurses needed to do 100 of the bloody things.

@Kitekat81 I'm not 39 yet (only just 38 this month) but I will be if they drag their feet and make me wait a year. IYSWIM. We've been trying just over a year.

@Juno231 thank you for the ranges, they confirm what I thought they should be from extensive google searches!

If my progesterone levels are too low, is there anyyhing I can do before the referral to help this at all?
I'm taking Folic Acid, but just a cheap supermarket own brand as I heard some brands can really mess with your cycles?
Any honest reviews on supplements that have helped and not expended your cycles?

Is anyone else here taking their BBT daily or using OPK's?
Do you think it is still worth doing or does it just add additional stress?
I'm currently doing both. I do find it helpful but I dont want to become that person who becomes obsessed with it all!

@Flutterby8 I think I read a study that showed high doses of vitamin c throughout the cycle helped with progesterone. But it may be that you would be helped to get a stronger ovulation by something like clomid.

Thanks @dogmam - for now I’m staying private. The dr said I should be eligible to have the polyp removed on the NHS because of the small cancer risk and because I have family history on the maternal line. However she also said that pretty much nothing is happening on the NHS at the moment, so it would likely be a long wait. So I’m just paying for the hysteroscopy. If it comes to IVF I’ll probably try to get on the NHS list, but again it depends on the wait. I’m just not willing to wait that long if it can be avoided.

@Flutterby8 I've just checked my results. It was 47. And the ranges noted as being needed on it, are the same as what @Juno231 posted above. So no idea what you GP is on about.
I don't bother with opks or temping any more. The temping particularly stresses me. But my cycle is pretty regular. So it depends whether it stresses you or not? If it doesn't then I think it's fine to do.

@Flutterby8 tbh I'm not sure how to increase progesterone with supplements. Might be worth reading it starts with the egg? I do both opks and bbt and don't find it stressful at all. In fact I think not tracking would stress me out more as I'd always be wondering if I'd ovulated and second guessing myself. Tbf that's because OH would never be able to DTD 3-4 times a week so I rely on my tracking to make sure we hit the right days 😅.

Thanks for your reply @paintfairy and confirming the result ranges are the same as @Juno231 mentioned.

I've been temping for a while now and while I know it isn't 100% accurate as I am a shift worker so it isn't taken the same time every day, it does give me an outline of what's happening. I started using the Clear Blue Advance OPK's 2 months ago and I think they really helped me know when the right time to DTD is. As you mentioned @Juno231, trying to get DH to DTD every 2-3 days throughout the month would be near impossible so this does help.
But they do stress me to some extent as I've had high readings which then return to low and then back to high before a peak. It isn't as straight forward as I hoped it would be!
If people don't mind me asking, how long have you been TTC for and how old are you?
I'm 36, off contraception for almlst 3 years now, not actively trying all that time but not taking precautions. Been trying properly for a while but not a sign of a positive so far.

@Flutterby8 I'm 38 this month. Been actively ttc for just over a year now. If contraception since June 2018. This would be our first.

@Flutterby8 I'm 39 ttc#1, think I might be the oldest in this chat? I've been off the pill since September 2019 but properly trying since April 2020 so only 9 months properly trying, although it feels like forever! I've still a few months to go until we hit the 1 year mark so still really hoping I can conceive naturally 🤞🤞🤞 but each month that passes it feels less and less likely. It's hard as I know that because of my age it should take me longer to conceive naturally, but also each month that passes my chances of conceiving with intervention also get lower 😢 so getting the right balance between allowing enough time to conceive naturally and not putting off intervention for too long is going to be tricky. Really hoping that my fertility appointment will help with that decision, I think like everyone else I'm hoping for the magic solution but it's probably not going to be like that!

I do take my bbt and use OPK's, I also think I would find it more stressful not to do it, and I'm going to be thinking about ttc pretty much all the time anyway, so might as well do it with all the information! I know a lot of people use Clearblue opk's, I haven't tried them so can't comment, but I get on just fine with the Easy@home OPK's. They are really cheap so you can use them 2,3,4 times a day to find your peak, and you can see the lines yourself rather than having a machine read them, I'm not sure whether that would be more or less stressful though! 😄

@Flutterby8 I think I'm on the younger end at 32. Am on cycle 13 but have been off the pill since Sep 2019. Mum and great grandmother both had early menopause at 30/31 so that was a concern for me which led me to get the ball rolling on tests in July 2020.

Hi ladies

Just catching up! I'm 30, ttc our first for 15 month.. never had a positive test before :(

Got my letter following the clinic appointment, it was just reiterating our conversation and that appointment letters will follow for ongoing tests so just awaiting those.

In other news, AF due in the nexr few days. Don't feel any different to usual so not getting my hopes up although we did try SMEP this month so you never know!

Also, I only use opks, just the one step ones from Amazon and they work great for me, I have positive tests on CD 16 more or less every month so confident using those, although I was thinking of trying a different cheapy brand as my last batch were really light, even the control line. I have considered starting with BBT but not sure if I want to go down that road, I'd be mortified though if it showed I wasn't ovulating around CD16 after all!

@dogmam Hm if you have regular cycles and get a peak around the same time each cycle then it sounds like you could give BBT a miss! Mine varies from CD11 to CD17 and OH is not very BD happy so I sort of need the BBT/OPK combo to make sure I don't make him touch me unnecessarily lol!

The one thing I would say is that BBT has made me realise that I usually ovulate same day as the peak so I need to make sure I BD in advance of the peak! I imagine others perhaps only BD on their peak day and forget that ovulation can be a few days later...

Its so nice to hear that all of us seem to be in very similar situations and all similar ages too. Its a lonely place when you dont know anyone else physically going through the same issues.

@Kitekat81 I felt the same as you, conscious about my age but didnt know when to ask for help. Because Id had bloods and scans (hormone bloods and pelvic scans but not for fertility) a couple of years ago I figured I was fine so booked DH a phone consult as I was convinced it was him 🤦🏼‍♀️ Turns out my progesterone is low and I felt a right wally! Luckily they have made the referral with very little effort from us so hopefully the appointment will come round quickly.

@Juno231 My mother had an early menopause too so I have been subconsciously worried about that for a while. Ive had bloods for hormone levels several times before and always been told theyre fine so have fingers crossed. Ive never had any symptoms of early menopause though which is a bonus! It is terrifying though!

@dogmam sounds like your cycles are quite regular so BBT prob wont confirm anything more for you.
I only do it because my cycle varies from month to month. Also it helps me know when AF is about to make an appearance as my temp always drops dramtically!
Ive just had my peak OPK for 48hours (clear blue digital) and still no temp spike. Seriously my cycles are a mess.

@juno231 haha don't make him touch you unnecessarily. What about trying SMEP would that work for him?
Yeah think I'll give the bbt a miss then and just continue with opks. Don't think I could go cold turkey and ditch everything haha

@flutterby8 yeah I know what you mean, it's nice that everyone's in the same position and having similar thoughts. Have you told anyone in real life? We haven't but now that treatment couldn't be a likely potential for us I feel like maybe we should, or do people even go through ivf and not tell anyone? Can't imagine having successful ivf and then not actually telling people that the pregnancy was a result of it, but then again I can imagine the pressure of people knowing you're going through ivf and the constant updates you'd have to give, would be tough.

...aaaand just like that CD1 has rolled back around!!

@dogmam sorry to hear about CD1! Always a bore :( Quite a few of my friends know I'm over a year into TTC so they'd know all about my IVF as well. I just haven't told family as I'd find that super awkward. I think FIL and his wife suspect not all is right in our baby making dept though.

SMEP would kill OH! He's a BD once every 10 days kind of guy, but puts up with it during FW for the sake of baby making. E.g. I'm 10DPO now and haven't DTD since I was 1DPO lol - and I reckon he'll wait until the night before AF before remembering about his husbandly duties!

@juno231 yeah I mean it would deffo be awkward telling family that essentially we are having unprotected sex and can't get pregnant! But then again I feel like I'm going through something that is such a big deal and would quite like a little bit of sympathy haha
Ahh maybe no to SMEP then! Do you get stressed about having to tell your other half you're in your fertile week? Fingers crossed AF stays away this week for you!

@kitekat81 did you have your appointment today?!

@dogmam actually for me it's more that my parents would have zero understanding of it. I'd get a lot of stupid comments like "just relax" and weird old wives tales from Eastern Europe from my mum. So I know I'd have very little patience for it. I can also see my dad making insensitive jokes about it and then when I don't react well to it it would be my fault for having no sense of humour. Lol my family are a mess though so there's no comparing if you have a lovely normal family!

And yes as my ovulation does vary month on month (CD11-17) it means I'm always stressing about starting our every other day BD too early and running the risk of OH running out of steam, or starting too late and only getting one round in before a sudden ovulation. Annoyingly I then often ovulate same day as my LH peak so I've had a few cycles where OH just refuses to BD on ovulation day as he's too tired. Feels like a constant balancing act!

How have you been today considering the witch arrived? Will you have some wine tonight perhaps?

@dogmam sorry CD1 has turned up. It always feels like a disappointment. Have a glass of wine or 2 and think it's an new month which will hopefully be a lucky one!

I haven't told any of my family about what is occurring. I honestly have no idea how I would tell my mum to be honest! We're close but I don't feel I could talk about this and I don't know why.
DH's parents don't live near us and aren't really involved except the odd phone call. Theyre not aware either.

My boss is aware that we have been trying and that things haven't been going to plan. She knows we've had initial tests but that's it. I need someone in my workplace to be aware because I work in the medical sector and a large proportion of what I do can be risky so it's better to be safe than sorry.
I don't think I'd want to tell people if we have to go down the IVF route. I don't think I could deal with the questions. A friend went through IVF and she always wished she never told anyone as she just felt so incredibly under pressure. Alot of the time she just felt like a failure and people asking about it just upset her. She has 3 beautiful children now and doesn't regret anything except not keeping it private.

I'm 1 maybe 2 DPO today. Waiting for fertility friend to give me the crosshairs to confirm ovulation. Wanted to try the SMEP this month.
Absolutely no chance DH could do that. I just have to leave my OPK in the bathroom as a subtle hint at the moment to make him aware 😂

@juno231 oh god the just relax comments are enough of a reason to not tell anyone! Oo I'd be interested in the eastern European old wives tales haha
That must be super frustrating if your other half refuses on your ovulation day and also really tricky to time when to start if you have such a varying fertile window. It's hard though as if that's the way he feels and all the more reason for a BFP to appear so no more pressure on any of you.
When is AF due for you? Do you tend to test early?

@flutterby8 yeah it's a conversation you don't really expect to have to have with your mam!! It's such a massive thing to share and once it's out you can't take it back. How has your boss been? Have they been supportive with appointments etc?
My fertility clinic is an hour away from me so although I'm working from home, I certainly couldn't just nip out for a quick appointment so going to have to tell my manager at my next one to one.
It's so interesting to hear about your friends thoughts on regretting telling people about her ivf.

Yeah the subtle OPKs being left out is a good reminder haha. Actually SMEP was good I found, although we started from CD10 rather than 8, and didn't do the '1 for good luck' at the end as find it's pointless as I likley already ovulated 3 days earlier.
I deffinetly felt like we had the best possible chance this month after doing that as I always feel like maybe we could of done more/different timing etc other months.. so yes when AF arrived it was extra shit as really had my hopes up!! Saved the gin for tonight so gonna have something nice for tea and a couple of drinks!