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.

Hi All, i wonder if you can help. The dr has suggested 300 units of gandotrophin and a long down regulation. What does that mean in English lol. Is that long protocol then?

@PurpleUnicorn01 yes that would be long protocol - basically means you'll start your injections in the cycle before IVF to down regulate your hormones (induce artificial menopause really). I presume you mean gonadotropin - (so Gonal F perhaps) to stimulate the production of follicles. I would assume that would be once your IVF cycle starts down, after the down regs?

@juno231 thank you. Ah man i was hoping for short protocol as i hate injections. But it is what it is.

What was your AFC and AMH @PurpleUnicorn01, out of curiosity? Since they've gone with LP...

I am making my list for tomorrow, it is substantial but I know I won't need to read it all out lol.

Sorry what's AFC? AMH was 6.1 which nhs class as low but elsewhere they say its normal. @thislittlebird. I had a follicles count as part of my pelvic scan. I think i had 10 which is normal on any given cycle without medication.

I was actually shocked they said its classed it as low when 2 other Drs said its normal. Who knows lol

@PurpleUnicorn01 ah ok, that explains the long protocol. Sorry I should have typed it fully, AFC is antral follicle count. It probably is normal but just the lower end of normal maybe? I think the nhs cut off for AMH is 5.4 so maybe that’s why they consider it more low than a clinic without that cut off.

@thislittlebird AFC was 10 which again is normal. Thank you that made me feel better.

Hi Ladies, I just finished my first fertility appointment with Exeter Ferility Clinic.

It was arranged via video link between Consultant Iryna Roshko (and a nurse who was watching in) and my partner and I. The appointment lasted about half an hour.

She started by asking us both a few questions about our life styles (ages, whether we smoke, how much we drink etc) and then she asked me some more in depth questions about my cycles. She was interested in my cycles being irregular lengths (shortest 32 days, longest 47 days) and that my periods are long and painful. She was concerned that I could have a) PCOS (although previous tests results render this unlikely) b) low ovarian reserve c) Endometriosis

She wants my OH to have an SA
For me she wants:

• Prolactin blood test (any time in cycle) - GP to organise
• Clamidia blood test (any time in cycle) - GP to organise (results will take 4 weeks+)
• Blood test for ovarian reserve (any time in cycle) - at local hospital
• We have booked a HyCoSy (tubal test + Ultrasound) for in about 3 months time (needs to be in 1st 10 days after period starts)
• I have to ask GP to confirm I had both MMR vaccines as a child.

Our follow up appointment has been left open pending above.

She said there were some pills she could give me to stimulate ovulation but she would only prescribe them to me if OH's SA comes back OK.

If everything above comes back OK and I am still getting long painful periods then she will want to book in surgery to look for Endo.

And that's it. Its now on me to book the tests with my GP and to get the ovarian reserve test done at the hospital.

Feels like progress!

Hello ladies,

We had our first fertility appointment yesterday so as this thread helped me while I was waiting, thought I’d share my experience to hopefully do the same for anyone else who is worried.

We were offered a same day cancellation so not much time to prepare. First, both our medical histories were taken. Then moved on to the tests we had already had done by the GP. DP was told his SA results were very good and that the rest of the appt would focus on me. My blood results were all fine, smear fine, they would have wanted to do an ultrasound there and then but luckily it had already been done and again my results were normal.

So the next steps were to have an AMH blood test. Then I had two options, either a laparoscopy and dye procedure which the gynae said he was offering to me based on my severe period pain. Or checking my tubes with X-ray. There was a lot of talk of endometriosis and how if he found some during the lap, if it was a small amount, he could deal with it there and then. He also said if I was under GA he could flush my tubes properly, as if it is done while awake it’s painful.

He said the pain I have during my period is too much and he wants to know why. He was perplexed that I hadn’t been investigated before. Not for lack of trying!

If all is found to be ok after the lap then onto 6-9 months of clomid. If tubes found to be blocked, straight to IVF. Not too sure about the clomid idea, I do ovulate every month and don’t want unnecessary medication. But will need to wait and see what the lap findings are first anyway. He couldn’t give me any idea of the waiting list times for the procedure but my consent forms were done there and then, so will just have to see when I’m called up now.

Felt very scary and sad to be hearing IVF being put into our plan. Yesterday evening I felt like calling it all off and just being happy with our little family of two (+ the pets). Going to take some time to let it all sink in and not make any rash decisions.

Thanks again for this thread which gave me some idea what to expect.

@kay00, that is definitely progress and its great they are checking everything for you.

@CausingChaos2 welcome! You are amongst friends here. We all understand what you are going through. I haven't had some of those tests but im sure some of the other ladies have.

Thank you Purple that’s really kind

I haven’t got any friends who have gone through this so it’s good to have people to chat with who understand. I hope everything is going to plan with your treatment too.

@CausingChaos2 yes just waiting for funding approval confirmation, then hopefully get a treatment start date.

Yes it is difficult when you feel alone. There's only so much i can talk to OH lol

How are you feeling about starting treatment Purple I imagine it’s mixed emotions?

Oh yes definitely! I think half the time the men don’t understand the anguish we go through.

@PurpleUnicorn01 thanks xx It really is great having these threads to discuss whats going on, I feel like it is all getting very technical now and my OH has no idea (he looked like he was going to fall asleep in the fertility appointment lol!)

@CausingChaos2 Interesting that they are looking to get you a LAP and HyCoSy so soon - good if they feel Endo might be causing your pain. I was asked about the level of pain I experience, I really feel like that's difficult to define! Its painful, but paracetamol helps.

@CausingChaos2 yes definitely mixed but mostly anxious. My AMH is 6.1 so worried about how many eggs il produce.

@kay00 yes mine has an annoyingly positive attitude lol. The 'don't worry, it will be fine' im thinking i can't not worry lol

Hi Kay00 yes you’re right it’s hard to measure. The consultant did say that if the pain was manageable with things like ibuprofen or paracetamol he wouldn’t be offering the lap yet.

At the moment, I have to take codeine, mefenamic acid and paracetamol. Even then it’s totally debilitating and the first 1-2 days of my period are spent in bed unable to do anything. Strangely by day 3 I don’t need any painkillers. I’d really rather not have surgery but at the same time it probably does need investigating.

Oh I bet Purple and it must be even harder when you’re waiting for a date so in limbo land. Will be keeping my fingers crossed that you hear something soon and it all goes to plan.

I had an awful experience, I’m in bits. I’m sorry I’ve not read above yet, have been crying since the appointment.

No one wants to help us, they don’t want to know. Told us we don’t meet the criteria despite my very low progesterone and husband’s motility. Go away and take impryl (he’s already on it) and get some day 3 tests for me. I can join a “long waiting list” for a lap if I want.

I broke down in the doctor’s office, she was horrible. It broke me, I was so optimistic I was finally getting help but no, just more useless people and being told I don’t matter. I’m exhausted and can’t stop crying.

@thislittlebird. Im so sorry to hear that. My friend had the same issue. She just reapplied in a different borough. Maybe that could be an option. There's lots of people who can still help you. You just got a horrid Dr, theres many who can help you. Im sure of it x

Littlebird That sounds awful, I’m so sorry. Can you ask for a second opinion from a different doctor? What did they say you didn’t meet the criteria for?

@thislittlebird i'm so sorry to hear that! That's utterly rubbish. Is it possible to approach a different fertility clinic? or even ask your GP is the will prescribe the progesterone for you to use in your LP?

For your OH you could try self referral to a Urologist... they are meant to be much better then the standard fertility clinics for male fertility: www.privatehealth.co.uk/doctors-and-health-professionals/urologist/

@thislittlebird I'm so sorry they were rubbish! how on earth do you not qualify - isn't your age alone a qualifier?! I know it's tough, tiring and not how it should be - but please don't give up and push back as soon as you pick yourself up.

@Kay00 I'm really pleased for you that you got the ball rolling

@CausingChaos2 a lap sounds like it would definitely be a good idea!

@PurpleUnicorn01 AMH is related to age as well so 6.1 could be good for one age and bad for another, which the nhs doesn't seem to take into account?

I’m so confused right now @Juno231. It was such a horrible experience and I keep sobbing. She didn’t ask us anything, no medical history etc. She clearly knew we’d complained to PALS and kept saying it wasn’t her fault, and how she didn’t want to hear about our GP. Didn’t even mention my low progesterone, and said his results didn’t count as “explained”. Well what does count as explained if a progesterone level of 10 and 9% motility doesn’t? I’m so upset.

I feel like we’ve got such a short straw at every stage through this process and I can’t see any positive outcome for us. It feels like everything is stacked against us.

I want to scream at them “why us???” Why do we have to be treated this way and others do not?

@PurpleUnicorn01 how did she go through a different borough?

@Kay00 we can go private but I really thought the nhs would class us as explained since we have low results. I don’t understand how that’s unexplained. The joke is my GP referred me to get help because she wasn’t sure I was ovulating and this asshole has just sent us back to the GP. Why did I waste months and months waiting for this pointless referral?

We contacted a private urologist last week but his secretary just stopped replying after the first email. I feel so lost right now.

@CausingChaos2 they just said we were unexplained so need to try for three years. I really don’t see how we are.

@thislittlebird she registered at another surgery by her parents address which is in a different city. Then had her notes transferred over.

@thislittlebird this doesn't make sense though. You've been trying for how long now? and are what age? those factors alone should qualify you for assisted conception. Or is she saying you're falling into the unexplained category and will therefore have to wait 2 years? Cause I'm pretty sure that's not the case if you're over a certain age. I would complain again and this time about this doctor's manners as that is a huge part of their training and she's clearly failed catastrophically in being caring and empathetic.