How long should I wait before seeking help?

[Nappyhead]

Hi all - I'm ttc no.2. It took 18 months ttc before no.1 (we were in the process of tests when I fell pg) and it's been 7 months so far this time.

I'm 34 1/2 and I just wondered what your thoughts are on whether I should talk to my GP or whether he will just send me away to keep trying!

Also - I had an emergency c/s with DS and am a bit worried that it has affected my fertility.

Or should I just expect it to take as long as the first time as maybe me and DH are just not super-fertile?

xx

Hi Nappy, most GPs will only test after one year of trying if you are under 35. I think your GP will say you need to try for another 6 months and see what happens.
I have fallen very easily with my first 3 pregnancies (one being a miscarriage) and my first was an emergency c-section. I am over 35 and so GP did tests when we had been trying for about 8 months. It was a long process, long waiting lists, etc. We managed to conceive natually after nearly 2 years of trying and whilst waiting for the last test. It was hard and I'm sure the worrying didn't help us. I tried accupuncture in the end to try and make me relax and get my body in tip top condition, fell after about 5 months of this. Anything that can help you relax, eg accupuncture or reflexology, may be worth considering.
Good luck.

Hi nappy. I've been just about 1 year ttc number 2. I also had an emergency c-section with ds. I've been seeing a consultant for 2 months now and the first thing he wanted me to do was have my tubes checked as I'd had a c-section. I've finally agreed to having it done to put my mind at rest. He told me that after any pelvic surgery adhesions can occur and that also with age signs of endometriosis can also be problematic.
I actually started seeing my consultant for a short luteal phase - after 3 months charting I realised my LP was too short and went to GP. I quickly got referred to see nhs gyn and have since gone privately. I did tell them that 'd been trying a few months longer than I had actually been!

I have been through this and it is agonising.

If I were you I would go to the dr and lie and say you have been trying for just over a year.

If not they probably wont take you seriously.

I don't think the c-section will affect your fertility. It didn't affect mine.

I had a similar experience to you - got pregnant whist undergoing tests. Second time around I got pregnant straight away though.

Thank you for all your advice - I think I will go to my GP.

Buttercup babe - I'm really interested in what you said about short luteal phase. I think I might have this too, but I don't know enough about it. I ovulate on average on day 19 of a 30 day cycle. Does that sound short to you?

Also - were your tubes ok when you had them checked?

Hi, nappy. I'm having my tubes looked at a week tues - only because insurance company is willing to pay for it.
The luteal phase business is a tricky one. I was ovulating day 18/19 of a 26/27 day cycle. I have been treated with hcg injections which lengthened it to 13 days. My consultant said mine was too short and wanted it to be at least 12 days long. He also said that quite a few gynae's don't believe in short luteal phase which is ridiculous. A friend of mine had this too and is now pg with dc2 (both conceived with hcg to lengthen luteal phase). I am going to continue with hcg after my lap and dye (as long as all goes well). My consultant thought seeing as the insurance will pay to check my tubes, we may as well do this so that I can continue with hcg treatment knowing everything else is ok.
Anything else you need to mknow about short lp ask away....

Thanks so much buttercupbabe. So I should probably go to my GP and ask about the short lp then? I reckon at best, mine is about 11 days - and sometimes it's shorter than that. I had a cycle a couple of months ago where it was 7 - I obviously convinced myself it must be implantation bleeding until AF arrived in full force and proved me wrong?

What's the score with the hcg injections? How often do you have them? Does your GP do them?

I've got health insurance so do you think I should push for a lap and dye as well? Is that a day case under local anaesthetic? Sorry for all the questions...

xx

Hi Nappyhead,

The general consensus seems to be that if you're over 35 and hae been trying for six months without success then advice should be sought.

Seeing as you're nearly 35 now and it took 18 months to conceive your first child I think a visit to the GP is in order. I would ask for a referral to a gynae.

First and foremost you need a diagnosis of the problem.

Don't think about HCG and the like just yet, just focus on the visit to the GP to get that referral. Both of you should be tested at the same time; it is little point testing you solely only to discover later on that its your man who has the fertility problem.

In answer to your questions anyway the HCG injections are usually done under supervision of a gynae at a subfertility unit.

The existance of luteal phase defect is controversial; some think it exists whilst others do not.

The laparoscopy is done under general anaesthetic (this is keyhole surgery) as a day case although some patients can stay in overnight. You do not want to have this surgery if you do not need it. It is often used to diagnose endometriosis (as it is not detected on ultrasound scans and blood tests).

Hi nappyhead. I agree with attila - don't start worrying about hcg etc just yet. Go and get a referral first; once that happens the consultant will check you out and advise you on tests and treatment(if any is needed). Since I sought help from my gp 6 months ago I have managed to convince myself that I had an under active thyroid, I was starting the menopause, that I wasn't ovulating...the list goes on and none of the above were true! With the luteal phase, everything I have read has said 10 days and more is sufficient for implantation.
Who are you insured with? We we're with axa until a month ago and we were having to self-fund as they paid nothing for fertility investigations. My husband's company then changed to Bupa who are paying for investigations into secondary infertilty up to diagnosis. It's worth phoning and checking out what they cover but make sure you phrase it as 'investigations into infertility'.
I know it's a horrible thing to go though but try not to jump 2 steps ahead all the time thinking you need to have this and that done - I've done that myself and I think it's just added to the stress. The consultant's have lots of experience and will know what to do to help you.

Hi nappyhead. I agree with attila - don't start worrying about hcg etc just yet. Go and get a referral first; once that happens the consultant will check you out and advise you on tests and treatment(if any is needed). Since I sought help from my gp 6 months ago I have managed to convince myself that I had an under active thyroid, I was starting the menopause, that I wasn't ovulating...the list goes on and none of the above were true! With the luteal phase, everything I have read has said 10 days and more is sufficient for implantation.
Who are you insured with? We we're with axa until a month ago and we were having to self-fund as they paid nothing for fertility investigations. My husband's company then changed to Bupa who are paying for investigations into secondary infertilty up to diagnosis. It's worth phoning and checking out what they cover but make sure you phrase it as 'investigations into infertility'.
I know it's a horrible thing to go though but try not to jump 2 steps ahead all the time thinking you need to have this and that done - I've done that myself and I think it's just added to the stress. The consultant's have lots of experience and will know what to do to help you.

Hi again - well I have now been to see my GP and am none the wiser. She said I shouldn't worry, me and DH clearly don't have any fertility issues as we have a child already (even though I said it took 18 months to conceive him and I'm now nearly 35!)

She said if I really really want to be tested, she would suggest I'm tested for polycystic ovaries. (?) I told her I'm pretty sure I ovulate - I have regular cycles and have been using ovulation kits.

She also said that the emergency c-section would make no difference whatsover and ended the whole consultation with "I suggest you just go on a holiday..."

What do you think? Am I worrying unnecessarily or should I see someone else?

xx

I would go and see someone else tbh. Someone a bit more understanding. PArticulary given your age (sorry!) when I was first ttc I went to see gp after about a year, and then it took 3 years of tests, treatment etc to concieve ds. I asked at the time what would happen if I didn't concieve no. 2 straight away and they said to try for 6 months and then go back to gps. I'm 33 and am ttc, and I WILL go back if nothing happens soon!

Also it's wrong of the gp to say you clearly don't have any fertility problems - because you might!

Is there another GP you can see about having hormone levels checked and maybe a referral. A friend conceived her DC1 naturally, and with no apparent problems but discovered after trying for many months that her DH had problems and the only way they could have dc2 was with IVF, (they think he had had mumps in between). So it might be an idea to get your DP checked out too.

Definitely get DH checked out too. Men's fertility can be more volatile than female and is very affected by stress, diet, drinking, smoking etc. Are any of these things a factor for DH?

PCOS is always a possibility - I have PCOS and refused to take GP's word for it after basic tests when had been trying for a year that I didn't have PCOS or any fertility problems. Went privately to gynae as GP could not refer due to PCT guidelines and guess what - I was right. Gynae advised lose weight (which I did, 1.5 stone) and after 3 months on Metformin, and husband taking wellman, conceived DS who is now 8.5 months old. Do not think we would ever have conceived if had not insisted on private referral and got that diagnosis.

At 6 week check GP advised me that when we want another baby he will be happy to prescribe Metformin after 6 months of TTC, so even he accepts that he was wrong.

Good luck.