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.

@thislittlebird I think the policies only specify if you're entitled to NHS treatments whilst using private treatments - so it won't be clomid specific. Your GP does sound awful - but after hearing so many bad things I'm not surprised! Lots of ladies on MN that seem to have super low progesterone yet still be told they're ovulating when they're probably not - plus lots of GPs just dismissing the effect of high TSH on fertility? Poor @paintfairy had to redo her blood tests a bajillion times cause the NHS kept accidentally doing the wrong tests - nevermind that you can only do them once a month each time!

@thislittlebird how old are you and how long have you been ttc? I'm 38 so not much time. But I did ask for the referral when I called in July. So the gp tests were only done for the referral, as they have to do that. What the tests said was irrelevant really as it was still to be passed to the hospital? So I can't understand why nothing was done for you. The hospital didn't advise wait time but they literally rang me less than 3 weeks after I knew the referral went in (I checked with gp) and my first appointment was only 2 weeks later.

@Juno231 ugh that sucks for @paintfairy, what tests did they keep doing? One doctor never offered me a day 3 test despite me saying one of my main concerns was early menopause. I spoke to another doctor about it Friday and she said day 21 FSH/lh won’t tell you a lot which I knew (on the plus side they’re within range for that time in the cycle and my private AMH and follicle count lined up). Progesterone is probably my issue anyway, and as you say, seems little understanding of it on the GP front.

I just read the ccg guidance and it doesn’t really say a lot beyond ivf and iui. On the fertility fairness site it looks like you have to have been trying 3 years to qualify for ivf in my area of London, so I probably won’t even get to use nhs ivf if I do get that far (that would be late 2022 and I won’t wait that long). We’d already been assuming we might need to pay for private anyway so maybe I won’t worry and just use both until it becomes an issue down the line.

I’m 37 now @paintfairy, 38 in May. Started in October 2019 and took a break when I was ill early 2020. I never asked for the referral in July because I was uninformed and naive at the time I guess. Assumed our “fine” results were actually fine. We needed two sets of tests to be referred or it would be rejected so it took us a couple more months from December to get those sorted once I had realised the tests weren’t really fine. My GP surgery sucks, that’s my best guess as to why nothing was done.

Good that your appointment was fast though!

@thislittlebird is that if it's unexplained though? I find for most places they make you wait 2 or 3 years if there's nothing wrong with you - but as soon as there's some kind of MFI or ovulation problems then that timeline is scrapped as there's no point leaving you to try naturally.

I'm in London too :) SW

@thislittlebird my gp surgery were useless. Managed to do 3 blood tests incorrectly! Wrong more than once. How hard can it be? But they were referring me it just took ages because they were useless.
Agree with above- if there's explained fertility issues there is no wait? Its only if they find no problem at all that the wait applies. With us- my DHs SA and my spotting both are a cause for concern. Even if only slightly.

Good point @Juno231 because they had to put me on the non-ovulation pathway or something but the website doesn’t specify anything about that in terms of wait time from what I can see?

Oh nice, I’m SE. It’s interesting how varied it is all over London when you look at the website, kinda crazy. I noticed Croydon offers no ivf at all anymore

It’s really infuriating @paintfairy. I was so annoyed when I got our result breakdown and they were not in fact “fine”. The GP still insisted dh’s SA was “normal” whereas the private fertility person said he needs to take supplements. It’s just so frustrating. Did you have progesterone issues with the spotting? I don’t have spotting despite my very low progesterone.

I guess my appointment might not be too long then if they know I’m likely not ovulating, which kinda makes the private involvement more confusing. I’ll have the call tomorrow and see what they say.

@thislittlebird all my blood tests were normal. But she said that doesn't necessarily mean it's OK. I suppose they'll see if any other tests show up a reason for spotting. If not they'll assume it's progesterone.

The progesterone stuff is very confusing @paintfairy. Will the next tests be following your upcoming appointment?

@thislittlebird I've got a scan on 1st. If that's OK then I've got to have a HSG/hycosy.

Oh that reminded me @Juno231 - that's the reason I'm having it later. If DHs SA is no good for IUI, we'd have to have IVF. So no need for a HSG in that case, as its irrelevant? But if all looks OK, they'll then check that is OK.

@paintfairy ah that makes sense! Not gonna lie I'm buzzing for the HSG. I feel like I haven't made any progress in finding out what's wrong since OH's SA in Oct so this feels like the first properly productive thing we've been able to do in like 5 months.

@Juno231 I'm excited to go too. 🤣 I don't fancy the HSG to be honest but I will try to push for it anyway.

Honestly I really wanted to avoid the hycosy/hsg altogether because the thought makes me very anxious, I need your level of chill about it lol. If we were going straight to ivf I think I’d skip it but it feels like I should do it if I’m likely to end up on clomid or similar.

Has your DH had any SA yet? @paintfairy

@thislittlebird I've had LEEP, a cystoscopy and about a million pap smears before so feel like my foof has been through the ringer already. I'm just hoping it won't be too bad!

@Juno231 I'll see how I feel when you report back. 🤣 But really I want to know my tubes are clear.
@thislittlebird he had one back in sept he requested from GP. He's got another this week.

Yeah my dh’s was August and another coming up soon (after he’s finished self-isolating). I’ve got him in new pants and on the supplements so hoping there’s a little improvement @paintfairy

@Juno231 that is a lot! I am a terrible patient and I’m a bit concerned I’ll react badly if there’s any pain. Wondering if I can take anything a bit stronger than paracetamol beforehand to stop myself freaking out.

@thislittlebird I'll be crapping myself if I have to go for one. Not going to lie.
DH was already on supplements before the last one. I keep telling him about his pants. 🙄

@paintfairy I get so anxious and stressed, if these people had seen me when I had to have one of those ibs tests they’d be keen to give me a sedative lmao. I might enquire about the cost of something to help me remain calm with the private clinic but I bet it will be pricey like everything else.

I just bought him pants in the end, he kept saying no and it was annoying because they’re just pants???? I got him some cotton boxers from Next and now he’s liking them more than he thought, he’s wearing them indoors and sleeping in them, better than nothing.

I forgot to say, was his SA result a bit off whilst on the supplements @paintfairy?

@thislittlebird he's got low motility.

@paintfairy mine too, just hoping the supplements will help.

Hi all :)
Been a bit absent recently and didn't realise there had been so many posts on here! No notifications! Whoops!

@paintfairy, your appointment sounded really promising! At least you haven't got long to wait for the next step which must be a relief for you! I'm really glad!

@Dancingfairydreams, sorry your appointment wasn't so positive for you. I never realised there would still be a risk of ectopic if you had IVF? What is the next step for you both? Are the hospital pushing for any other testing or is it a case of lowering your BMI for now?

@Juno231, a whopping 13min appointment! Either they're really busy or stretched with staff given Covid?! On the plus, at least you've had it and it was quit positive. Seems things are moving quickly for you! Just a shame you have had to do a lot of the leg work with the calls so far! Interesting about the early menopause though. It runs in my family too although the GP had carried out bloods previously and said I don't have any issues. I've always been worried about this factor to be honest with you! I'll keep my fingers crossed for you.

@dogmam, thank you for asking.

To be honest, not a lot has happened here. My initial telephone appointment is booked in next month. I had the confirmation letter through a few days ago. The appointment is with a nurse and will be a telephone consult only (no video call which I am thrilled about!). It states the appointment will be no longer than 15mins long and despite booking for a specific time, I could be called anywhere over a 5hour time frame.

There were 2 questionnaires in with the letter, one for each of us with pretty standard questions. Downside is, as it is only a telephone call, I don't know what to do with the paperwork as it doesn't say in the cover letter? I'd assume I have to send it to them but there is no mention of this and no contact email address. So bit clueless here.
Only other thing that has changed is I've started taking Pregnacare (I know, should stick to non commercial vitamins). It was on special offer and I thought it wont hurt. The only difference I noticed is that I have had a much lower pre-ovulation temperature than normal so can see a clearer rise in BBT. This month I got a high OPK (Clear Blue Advance) and my temp rose with it and after a couple of days I got my peak and my temp spiked, much higher than it does normally. Coincidence?
Either way, we only DTD for the 2 days before ovulation and a couple of days after (excluding other random days but they're not as important) so I feel like I've missed a chance.

@thislittlebird, Welcome! Sounds like your GP has been as useless as mine! She told me that my initial day 21 progesterone bloods were low (granted, they were), ordered a repeat test which was marked as fine. Was told it was fine by reception when I chased it, but when I asked for a copy of the results, I saw it clearly wasn't fine and was still low. Consequently, I've had to badger them for referral, which to be fair, they seemed glad to do.

@thislittlebird what is he taking?
@Flutterby8 mine was with a nurse but she was brilliant. So it might be ok?