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.

Hey @Flutterby8, thanks for the welcome. Our GPs both sound equally as amazing as each other . What were your day 21 results like? You had a really similar scenario to me. Receptionist told me they were fine and only realised when I saw the results myself in writing months later. Will be speaking to the private consultant about my results tomorrow.

Private consultant suggested he try impryl @paintfairy. Men and women can take it so I was tempted to order some too.

@paintfairy I'm really not worried about the appointment being with a nurse at all. If anything, I find nurses generally seem to have more time for people and are a bit more approachable. I think its just typical apprehension!

@Flutterby8 gp told me I was fine early menopause wise based on my day 3 test but the doc has added amh to the test so that will be interesting to see. I'm surprised she did tbh as everything I've read seems to indicate the NHS doesn't take much stock in amh results. She seemed to think that if everything else is fine but amh is low she'd expedite my ivf path as time will be of the essence.

@thislittlebird do you have any friends with sedatives 😅. Quite a few of mine have xanax or valium at home I could have asked for if I needed it... I might just take some codeine on top of the paracetamol /ibuprofen I'll grab though.

@thislittlebird, my initial day 21 bloods were 16 something. These were taken on day 21 as I didn't realise any different. My cycles aren't 28 days long, so day 21 was pointless for me to be tested on, as I found out via this forum, not my GP.
When the GP asked me to have a retest the following month, I asked about going a bit later in my cycle as I typically have a 30/31 day cycle. I was told a straight no. Had to be day 21, even though I knew it wouldn't be accurate.
So I went on day 23 I think? Results were better, if I remember rightly, 24 something? I don't have them to hand.

It was this result that was marked as normal, which on paper and given the reference ranges is. But as lots of people pointed out on here, it should be over 30 to confirm ovulation.
When I asked the GP she wasn't sure but agreed to refer me anyway due to my age and how long I had been off contraception for without even a hint of a positive.
You'll have to keep updated with your conversation tomorrow.
I probably missed it somewhere above, what was the result of your day 21 bloods?

@Juno231, I was never asked to do a day 2/3 test? I assume that will be asked for at the referral maybe?

@Flutterby8 do we have the same GP? Lol. I was never asked to do a day 3 test either despite asking about it because of early menopause concerns. The first doctor I tried raising it with didn’t even pay attention to what I was trying to say about the wrong time of the month. I went for the private AMH test and follicle scan in the end and my AMH was 36 with 28 follicles. I’m not sure if it’s worth asking for the day 3 test now I’ve done those, I can’t change it, all I can do is carry on with the plan as it is for now.

The other GP I spoke to said it should be over 30 for progesterone. I’ve had results of 17.5 and now 10 (although I think if I had done it on day 21 it might have been a little higher this time, I tried to adjust it for my own cycle to day 23 and I’m not convinced that worked).

I’ll keep you posted on the call tomorrow. If it runs over 10 minutes I get charged £155 so I really need to plan my questions well around next steps/tests/clomid etc . The joy of private. It will be 11 minutes, I’m sure lol.

I’m not sure I do know of any @Juno231 but I do have one friend I could ask maybe, not a bad idea. I have some tramadol here from when I had a small op that I never used, maybe I’ll take one of those 😐.

@thislittlebird I'm just going to wait for my referral now rather than go back to the GP for day 3 bloods. Im sure I will get a better plan with the hospital than my GP will offer so Ill bide my time.
I will have to dig all the results out and look into them properly as i had other tests run at the same time. I didnt really pay that much attention to them as my progesterone was low. Thats a job for another day though!!
Sounds like your phone call will be like a quick fire round of questions!! Lets hope you can speak quick enough and get as many questions answered as possible!!

@Flutterby8 @thislittlebird I didn't think you were allowed to get a referral without a day 3 test? IMO it's just as important the day 21 one as it checks your thyroid functions, PCOS indicators, menopause indicators etc. Either way they'll make you "redo" them once you get to the fertility app but my god it's making me lose all faith in GPs!

@Juno231Ours just wanted two sets of day 21 (in which they do thyroid, lh, FSH too) and then off you go. I do think there’s a huge lack of consistency on this front across the system and it’s not reassuring.

Yeah I’m not looking forward to the quick fire question round @Flutterby8. I need to make sure I ask everything and worry less about the cost I suppose.

@thislittlebird yeah that sounds bonkers to me as the whole reason why those things are measured on Day 3 is that it has the least interference from your cycle - otherwise it can vary wildly across it. Doesn't matter though, the referral is most important as they seem to redo most of these tests anyway (which I'm now thinking might be because they know how random they can be depending on the referring GP!)

I had to have day 3 and 21 for the referral. It was the day 3 they couldn't get right and the referral bounced back because of it.
I'm not having to have them repeated though because they were recent.
@Juno231 has AF appeared?

@paintfairy ah yes I did read somewhere today that they only get repeated if it's been more than 3 months since they were last done. AF showed at 1pm! I'm so relieved for once.

Yeah I don’t get it @Juno231 but here we are.

I had my call with the private doctor (13 minutes 🙄) and they’re going to do a monitored cycle on me this month. I’m thoroughly confused by the range of reactions I get to this progesterone issue.

They think I do ovulate because someone who doesn’t ovulate would have a result of 3 or 4 so they think I’m ovulating and missing the peak. So I’m going for a follicle scan this week, a blood test when LH is detected, and then another scan later in the month.

I really hate all the waiting and lack of answers involved with all this, and the stress, obviously, and last but not least the cost of the private involvement. Hopefully by the time this monitored cycle is done I’ll have heard from the nhs re wait time.

@Juno231 wonder if they'll repeat later if treatment is ages? God i hope not......

@Juno231 oh and 🥳 for AF. Yes I know what you mean!

@paintfairy god I hope not. I'm ready to go for my day 3 on Thursday at least!

@thislittlebird oof that's frustrating. What I can't stand with private stuff is that you never shake the feeling of them trying to pump you for money? Much like mechanics and dentists you just have to trust they're honest and not taking you for a ride. I really hope they give you clarity on this progesterone malarkey though!

Yeah exactly this @Juno231. I want them to offer me more I guess, and it feels just as slow but in a different way and at a cost. I’ll do it, because I do want to know what’s happening with my progesterone etc but it’s going to be a hefty bill just to potentially get a similar result. And then what? It was unclear on the call because she seemed very unconcerned about my levels. I said to my husband it’s like they don’t think it’s as much of an issue as I perceive it to be. Frustrating.

I just wish I could speak to someone (and the nhs haven’t helped me much either) who would give me an honest and useful answer. What can I do? How do I fix this? People seem to be given clomid etc with much higher results so why isn’t it being discussed as an option for me? I don’t get it. Really hoping the nhs referral won’t be too long because a second opinion would be nice.

@thislittlebird yeah it's utterly frustrating how piecemeal, contradictory and at times arbitrary it all seems. FWIW I think you're doing the right thing to investigate it and once it come to the referral you'll be armed with more ammunition to advocate for the treatment you deserve.

@thislittlebird I personally would wait. The nhs are concerned about my spotting being progesterone related, even though my tests are fine. The GPs won't be that clued up, but you'll probably find the fertility referral changes that. And you'll have paid for nothing. Because the nhs will have done it for you.

My concern right now is time, I guess. I really just want to be put on something if my results are this low, and I don’t want to keep waiting for that when they may not even be able to see me for some time. @paintfairy

I’m wondering whether to tell my GP I want another blood test this month. Problem is I can’t just go on the day because of covid. This makes it all so much harder.

It’s so arbitrary, I don’t know what I’m doing anymore. But I see what you’re saying @Juno231, I just wonder if the nhs will accept the results?

Right now I am tempted to hold off. I’m so confused.

@thislittlebird have they actually put the referral through? My gp dragged it out by being useless and I was frustrated because I'm old. But once it went through, they seem to be on the ball. My referral was like 4th jan or something and by 1st March we will have had our first appointment (last week), I'll have had a scan, DH a SA (this week) and then a discussion on next steps. Which is not a bad time frame at all in my opinion.

It’s a good question, I might call tomorrow to ask if it’s gone through @paintfairy. My problem right now is two months feels two months too long when I may not be ovulating. I don’t know how to just sit here and wait for that, really. It feels like lost time, and the when I get the appointment they’re just going to run more tests on us I assume? I’m wondering if I can combine the systems to speed things up.

God now I'm worried about not having a day 3 test?
I'll be honest, I really dont want to go back to the GP and ask simply because they were clueless and I think I'd get more sense from someone a bit more in the know. I'm fully expecting to have everything retested now though.

I have been thinking about going private. Havent mentioned this to DH as I think he will think I'm jumping the gun somewhat. He will want to wait for the initial appointment and go from there I'm sure.
Should I assume that even going private they would carry out the majority of the basic tests again?

@thislittlebird i hope you werent charged for your additional 3 mins! In a way its good they're trying to monitor a cycle to figure things out, but its another monthbif not knowing.
Do you monitor your BBT or anything? Would that confirm ovulation at all?

@Flutterby8 no, not necessarily. My friend has gone private for ivf. Her DH already has a child from a past marriage, so they aren't entitled to ivf on the nhs. But they had all the initial investigations done on the nhs (because you are entitled to that) and she got copies of all tests. So when she went private- she didn't have to pay for all the tests, because they are ok to use what you've had (unless anything needs to be more recent or needs repeating).

Yeah like what paintfairy said, you can just provide your tests to the private clinic @Flutterby8. We uploaded ours to our client portal area ahead of our consultation and she talked to my husband about the SA he had on the nhs, and offered advice etc. Obviously if they need you to redo something or get another one they might suggest it. You can pick and choose what you get done really because of the fee factor, at this stage anyway.

And yes, I am sure I will be charged for the three minutes . They said anything over 10 will be charged so I do not think they’ll waive it. It’s frustrating but it is what it is. I’ve asked them for the costs of a monitored cycle and someone is going to call me tomorrow to discuss details and once I hear from her and get prices I’ll decide what to do.

I did monitor my bbt last month and I was chatting to @Juno231 about it at one time. I do think I ovulated but it looks kinda...weak???? I don’t know if that’s an official term. No big leap up and it dropped off really soon, was odd. I’m not going to temp this month, especially if I have my cycle monitored, it will just cause me more anxiety and less sleep I think.

Hello! Can I join? Apols for a long post in the middle of the conversation but looking for some women who are going through the same thing and have some wisdom.

I'm currently waiting for my first fertility appointment and I'm in a whole world of confusion. I have my referral which is good and I have an appointment in the middle of next month at a private clinic with NHS funding.

My GP doesn't seem to have been very thorough compared to some people's on here! A few months back I went to the doc because I was sure I had PCOS and I was right. Blood tests and an internal ultrasound confirmed that my suspicions were correct. I asked then if I could be referred to the fertility clinic but was told I would have to wait until we had been trying for 1 year. Fair enough. After the 13th cycle I went back and asked for a referral and I got one. Went online and booked in and I am now waiting. My DH rang the GP to see if he needed to do a SA but the GP said no point as they'd probably ask at the clinic. I haven't had any recent blood tests at the GP. I asked if I could have bloods to see if I am ovulating and the doc said no point as my cycle is between 26-35 days and too unpredictable.

I'm worried that the clinic are going to think we've gone mad turning up without any recent bloods or a SA.

But also, the referral was just for myself and doesn't say anything about my partner? Is this correct?

I have no idea what to expect during an initial consultation. Can anybody tell me what to expect? I feel nervous all the time about it which definitely isn't helping the situation.

I know I just need to ring to clinic and speak to a human there but I can't get through to anyone on their reception!