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.

@dogmam ha well my Polish granny wears and amber necklace to help with her heart problems so that should tell you something about the type of things they believe in! I also had a Russian friend tell me to eat lots of ginger to get pregnant but eating lots of ginger is supposed to increase miscarriage risks lol! I'm due Sunday but tested with a cheapie this morning. Stark white as per usual so I'm waiting for cycle 14 to commence.

Hi ladies, sorry for my late update after my appointment yesterday. To be honest it was a bit of a sobering experience, lots of information to take in, and I've been feeling a bit emotional about it since. Doesn't help that af arrived today (fully expected as my bbt dropped, but always an emotional time).

So here's how it went. First of all a nurse took blood pressure, height and weight for me and my oh. Then we went through to see the doctor. She opened with "so I see you're 39..." . Can't remember her exact words, but my age was the main theme of the whole appointment. She wasn't unkind, just fairly blunt about it. She took us both through a checklist of questions (do I have regular cycles, cycle length, how long do I bleed, taking folic acid, smoking, drinking, drugs, STDs, medical conditions and medication, any operations, how often do we have sex, any problems with erections/ejaculation, how long have we been together etc). She went through my blood test results - my progesterone was good (57) so that's a good clear ovulation. FSH not great though - 10.7, when ideally should be below 10. It goes up as you approach menopause, and nothing can reverse it. She said it might have been lower if I'd had it a few days earlier (had mine on day 5). The nurse took another blood sample to measure TSH and check my thyroid, I'll get those results next Tuesday. There's another blood test you can get for AMH (to check ovarian reserve) but not available on NHS so would need to go private. Then I had a vaginal ultrasound scan (wasn't expecting it on the same day!) She said I had a good thick lining (11mm), but my follicle counts weren't great. 5 on one side, 1 on the other, so 6 in total. You need between 5 and 15, and it's not great to be at the lower end of that - my age again.

Then she said the only thing left to do is an HSG, and it's a 4 month waiting list for that. If the HSG identifies that both my tubes are blocked (would need to be both) then that would be an infertility diagnosis, and we would go on the waiting list for IVF - the waiting list is 10 months. If no blockages, it would be "unexplained infertility" and we would need to have tried for 2 years before we go on the waiting list. So if there is no diagnosis, 2 years trying plus 10 months waiting list would take us to January 2023 - when I will be 41.

The conversation was useful in some respects in that it's pretty clear now that going NHS is not an option for us. She was pretty open in saying that if we have the means, she would recommend we look into private ivf options, and really as soon as possible. I said should we at least try until April as that will be 1 year trying, she agreed but even seemed reluctant to recommend waiting that long. We suggested that we could start by trying to get the HSG done privately, and she thought that was a good idea. There is some evidence of women getting pregnant after an HSG because it flushes debris out of your tubes, so if that's the case for me I'd rather do it sooner than later. Even if it's not, it at least moves us forward on our journey a bit sooner than waiting 4 months to do it on the NHS.

So that's our next step. There have been quite a lot of tears today, not helped by af's arrival, plus one of my younger colleague's was showing me her new baby bump on our video call today; then my oh suggested we watch Friends to cheer me up, and of course it had to be the one where Rachel is about to have her baby and is freaking out as she doesn't know how to change a nappy (I would love to have that problem!) Am feeling very old, and less hopeful than I was two days ago that this is going to work out for us.

Sorry this is rather a depressing post, I really don't want to bring anyone else down with me! I think I just have cd1 blues, hopefully will be feeling more optimistic in a few days!

@dogmam my boss has been very suppprtive. She too had difficulties conceiving and was referred for her fertility worries. She was also the same age as me so I guess she can really relate. She had twins after Clomid. So far the apppointments ive been for have all luckily fallen when Ive had days off from work following our rota so no issues. I also have a very supportive managing director who will happily authorise time off if needed (not aware of our problems but would understand).

@Kitekat81 so glad you have had your appointment but sorry to hear its been a bit emotional. I guess AF hasnt helped that either.
It sounds like a really thorough consult though and I guess in a way, although they seemed to pin point your age, they did give some pointers of the next steps.
At least they were honest about the wait times with the NHS. 4 months doesnt sound like a long time to wait, but in the grand scheme of things, when youve been trying for a long time it really is.
Although a HSG doesnt promise it will work for everyone, its always good to have it done, and if you are able to go down the provate route then do it.
I can understand though how deflating it can be, especially if they just seemed to pick out your age as a disadvantage.
Lots of women now have children later in life, its not a shock anymore. Lots of women in their late 30's and early 40's go on to have happy and healthy children. Appreciated risks are higher, but there are risks with every pregnancy and people shouldnt be treated any differently in these situations.
I hope youre feeling a bit more positive today 😊

@Flutterby8 thank you 😊 Yes I am feeling a bit better about things today. I've been reading about low ovarian reserve and it doesn't necessarily reduce the chances of natural conception, as long as one egg is popping out every cycle then it's the egg quality rather than quantity that matters, and there are things I can do to help with egg quality. Bearing in mind that all our tests so far have come back ok-ish, and assuming the blood test they did on Thursday also comes back ok, the only thing left which might be preventing natural conception would be if my tubes were blocked, so that's why I'm keen to get the HSG/HyCoSy done asap to see where I stand there. I know 4 months isn't too long to wait, but as the doctor seemed to think that time is running out for us I'd rather pay to get that done sooner rather than later, it's £500 so not too bad. If they are completely blocked I know that we need to move to ivf asap. If they aren't, we'll keep trying naturally until the year mark in April but then start looking at ivf I think. I'm also looking into acupuncture and whether that might do anything to help me. Really wanting to throw everything at it over the next few months in a last ditch attempt to get pregnant naturally if we possibly can!

@Kitekat81 glad you're looking at things in a positive light today. Its so hard to feel beaten up by all of this.
Hopefully your bloods will come back normal your tubes will be OK when you get them checked. Although if they are blocked it gives a quick answer and a quick fix as well which will be a win win for you! I'll keep fingers crossed.

After my repeat 21 day bloods and chat with the gp she said about referral.
I received a letter 3 days later asking me to book an appointment at one of two hospitals. Neither of which I thought did any kind of fertility work? I'll have to look that up as they're literally my local 2 hospitals. I'm confused.
Either way, I haven't completed the paperwork yet. It made me feel really nervous to be honest. I've read alot about people being turned away from fertility clinics if their BMI is too high etc. I know mine is high. I'm not obese. I need to lose weight but a previous injury makes it hard to exercise. I'm making a conscious effort to eat better but I think I'm now worried we will be told I'm too fat to be eligible.
I know I need to just get over it and make the call to book but I guess its just real.

@Flutterby8 the paperwork they gave me at the hospital said that BMI should be between 18.5 and 30. Do you think you'll be in that range?x

@Kitekat81 yes I am in that range. The higher end but yes, within it.

Just popping on to say that you don't need to abstain for a whole cycle when you have the HyCoSy (I had one in early November).

It needs to be done after you've finished bleeding, and you can't have sex from the start of your period until you have the procedure done. However, if you book it for the week or so between the end of your period and when you're due to ovulate (assuming your cycles are reasonably regular), then there's no reason why you can't TTC once you've had the procedure.

@Flutterby8 that sounds like you should be ok then? Don't worry too much, just wait and see what they say at your appointment. And it might take a while until you get your appointment, so you have a bit of time to see if you can bring your BMI down a bit before then 😊

@itssquidstella thanks for popping in and that's good news about not needing to abstain for the HyCoSy. The first clinic I've got a quote from said I would need to abstain for a month before the test, but that seems excessive. Everywhere else I've read says just abstain from the start of the cycle.

@kitekat81 hi! Just read your post about your appointment. How are you feeling? Have you had a chance to think about things now it's not so fresh? It must be really tough but it sounds like you've had a such a thorough consultation and although difficult, lots of information about where you're at with everything. It also sounds like you have made some decisions about the HSG/HyCoSy so that's good, at least you have a bit of a plan. Sorry AF arrived, I'm in the exact same boat but here's to another month!
Also, how was the scan? I'm nervous for that part..

@flutterby8 did you manage to look into your referral and where you have been referred? My GP done an e-referral and there were 5 hospitals to choose from, I rang a couple up and asked about waiting times etc but it was a hard decision to choose who to go with. With your BMI, if it's in the range then I wouldn't worry too much in terms of what the clinic will say, obviously it's great if you can get it down but as long as it's within the range the clinic state, then it's not like they can turn you away.

@itssquidstella thank you! Did it bring you any success after you had it done?

I got my letters through from the clinic with my appointments for bloods, scan and other halfs second analysis, it's in March and our follow up consultation to discuss results is April. It's gonna be a long wait! But I know some people have had much longer waits so can't complain.

@dogmam I'm 5w3d pregnant today, second cycle after the procedure. I'm not sure the two are related, as my tubes were clear so don't know if there was anything to 'flush out', but it's a happy coincidence (although still v early days so am being quite circumspect given previous losses)!

@dogmam thank you, I'm feeling ok. You're right that the appointment was really good in that I came away with a lot of information, and a clear plan. I've booked a private HyCoSy for next month, and I decided to book an AMH blood test for the same day as that's the last test I haven't had. Am worried about that one as it gives an indication of how good a candidate I would be for IVF, and my borderline FSH and low follicle count doesn't bode well for that. But I'll try not to worry too much in advance, just have to wait and see. That's great you've got your appointment letters! The scan was absolutely fine, it's an unusual sensation but not uncomfortable at all, less uncomfortable than a smear test.

@itssquidstella that's wonderful, cautious congratulations to you! How long have you been trying? Will this be your first baby?

@dogmam i have had a look at the referral paperwork and its quite underwhelming! I was expecting a referral to a fertility clinic as such. But after a google search about the hospitals they are gynae clinics only? Maybe Ive missed something, please tell me if I am going mad?
One does offer the basic fertility investigations as in TV scans for lining thickness, Hycosy and bloods and semen analysis. All of the above we have had done minus the Hycosy.
But I think thats all that they offer?

I need to phone to book anyway so I will call and discuss with them. Its been so hard to get time to call. Work has been super busy, ive not finished on time for the last week and when I get round to calling the reception is closed.
DH has said wait til the end of this cycle and then book if no joy. The end of my cycle isnt far off to be fair so Im happy to do that. Think he wants to see if anything happens this month. I think we timed it better, poss not perfect but what is perfect 🤷‍♀️
Currently 6DPO and honestly feeling out of sorts.

@Kitekat81 jeepers I can see why that appointment would have been emotional but in a way I'm glad they didn't mess you about and instead put you on a clear path of what needs doing.

I gotta ask as well - did they weigh you in front of OH?? That's my big fear about this appointment (I know lol, please don't laugh) as I'm a lot heavier than I'd like to be and my OH is blissfully unaware of how much I actually weigh 🙊

Two weeks left until my appointment, I promise to keep you all updated.

Thanks @Kitekat81 ☺️ I'm a nervous wreck, to be honest. First baby and we've been trying just over a year but have had two MCs in that time.

@Juno231 lol yes they did sorry! I went first, but the result didn't mean anything to me as they did it kg and I only know stones. Then my OH, to be honest he didn't seem remotely interested in my weight, he was only interested in his own! 😄 Maybe your OH will be the same? Or you could ask him to respectfully cover his ears at that moment 🙉 🤣

@itssquidstella it sounds like you have had a rough journey so far 😢 I have everything crossed for you that this one will be your happy ending, you deserve it! ❤

Thanks @Kitekat81 ☺️ good luck to you too!

@Kitekat81 haha all the more reason for me to hope it's a phone appointment then 🤣

Ladies I've got my appointment in 2 weeks but am sort of thinking I could get the chlamydia test out of the way before then - reckon that's a good shout or that they'll make me redo it for the hycosy anyway?

@Juno231 I can't advise on this unfortunately, as I had to confirm I'd done an std test before I got my referral to the fertility clinic, and I actually did mine nearly a year ago! I was having some irregular bleeding at the time so had an std test as part of looking into that, they haven't asked me to do another one since then x

@Kitekat81 I'm sorry to hear your appointment wasn't that positive. Yes we are old. We know. But we still want help? I do hope you manage to get sorted.

I've actually got my appointment date through now. 9th Feb. It'll be by phone. I've had to complete a load of forms and send them back. It is a lady dr though. I know my tsh is OK. My progesterone is OK also. I've seen those. I've not seen the day 2 results though - I was just told they were normal. I also had a generic blood test in 2019 for my spotting so I'm not expecting that to show much if I need one again, and I had a pelvic scan then also (2 actually). SA showed slight motility issues but it wasn't dire. So I'm not really expecting them to find anything thrilling this time. We shall see i guess? But I'm 38. So.......

@Flutterby8 the way it works here is you are referred to the hospital (only 1 that is logical, so no choice). They start the investigations. But on reading, they don't do ivf there. They refer you to a clinic (think you get a choice) if it gets to that point. So it could be similar where you are? The hospital just does all the investigation work.

@paintfairy thanks for the info about the referral. I dont know why I was shocked that it was a local hospital to be honest. In my mind because we have had bloods, semen tests and ultrasound scans I figured we would be referred somewhere different! Its such a learning curve but Im glad youve pointed that out to me! I feel better about it now and a bit silly for thinking it would be to a specific fertility clinic!

@Dogmam if you get IVF you'll be on similar dates to us, I think. We just got referred to ICSI after two years of trying.

We both have problems. I have polyps which are coming out next month and dp has bad normal motility, as in they're swimming the wrong way.

We're starting in September all being well.

@kitkat what a horrible experience. I'm sorry.

I had my Hycosy done privately bas knee something was wrong and referral has just come through for Laparascopy (needed.)

We're thirty six this year, and the Gynaecologist seemed genuinely unconcerned about our age and actually said he'd be worried if we were forty three.

Where in the UK are you? Do you have good private options? Our only private option would have been in neighbouring city.

@Flutterby8 I did assume it would all be done at the clinic also. Seems silly not really, because surely they are paying either way? So they could? Areas maybe differ though too? But that's how ours works. I'm just hoping they aren't useless!

@theotherfossilsister I'm in Scotland and no there aren't a lot of private options! Our local NHS fertility clinic usually does 'self-funded' so that would have been ideal, but they've stopped offering self-funded treatments due to Covid 😣 so I think the only private option is a bit over an hour away, which is manageable. That's where we're going for the private HyCoSy and AMH test, so it will be a good opportunity to see if we like them as a clinic in case we decide to go down the ivf route. I really hope they will say something a little optimistic about our chances, and that they don't also write me off as old with probably only rubbish eggs left! I don't blame the NHS fertility doctor we saw at all, I know it's their job to be realistic with us. I was just a bit in shock as although of course I knew there would be more likely to be difficulties at our age, I've seen loads of 39 year olds and women in their 40s both irl and on here who manage to get pregnant just fine, so I didn't think I was completely over the hill just yet 😔