36+ 6months ttc what to expect from gp

[fairgame84]

As title.
This will be our 6th month ttc number my 2nd, DHs 1st.
I'm 36 so advice is to see the gp after 6 months rather than 12.
No even a whiff of a bfp so far, positive opks every month. We don't smoke or drink, generally fit and healthy, not under or over weight. We have sex 3-5 times per week.
I probably have slightly too much caffeine but I work nights and long days and struggle with tiredness.
What will the gp do?
I'm expecting not a lot because I already have a dc.

Hopeful bump .....

Hello 👋 I'm 37 trying for my 1st and called GP after 6 months of 'properly ' trying. First thing they do is order blood tests which you have done on day 3 and 21 of cycle- the day of the second one varies depending on length of cycle. The idea is that measuring certain hormones on those days indicates whether you are ovulating or not. My GP also referred me to fertility clinic straightaway, but I think their willingness to do this does depend on area you are in and sometimes whether you already have children or not.

Thankyou.
I don't expect they will refer me to the clinic but hopefully I will still be able to access blood tests. Maybe they'll go as far as doing scans etc

I called just before I turned 36 after 9 months of trying for DC2. It only took 1 month to conceive DC1 (but I was 29)! The doctor arranged a sperm test for DH and left some forms in reception for me to pick up to book blood tests at a certain point in my cycle. This was last Summer and not delayed by covid at all. DH had his test (normal) but I got pregnant on the 10th cycle before I had my blood test.

I think you should definitely get the bloods. I actually had the same test done a few years ago before I was ttc as I was concerned about a change in my cycle. I would also expect them to do investigations like scans, hycosy etc, but it does seem from posts I've seen on here that people's experiences really do vary depending on the NHS trust. I've also recently heard of occasions where someone has been told by their GP they can't have any investigations because of trust policies re women who already have children, only to find out on further enquiries that they are entitled to it- so don't let them fob you off! Hopefully you won't have any issues anyway and will get your BFP soon! Good luck!

They will possibly order some bloods.

Do he aware though that some trusts don't cover secondary infertility, even if it's with a new partner.

If it's DH's first and your CCG doesn't cover tests for secondary infertility I would strongly recommend you get an SA done privately. They cost around £150 but at least then you can eliminate DH as the problem.

Thankyou all very much. I'm going to find the policy for our ccg before I approach the gp so I can make sure I don't get fobbed off.

DH has decided he doesn't want me to go to the doctors as he doesn't think there is an issue. He wants to leave it to nature and God's will. He's religious, me not so much.
I'm worried because of my age, he thinks I'm worrying too much.

@fairgame84 there may well not be an issue- they say it often takes couples with no issues a year or more to conceive. I think the advice about approaching doctor after 6 months if over 35 was put in place in case you do end up going down the ivf route as that involves long waiting lists and has better rates of success the younger you are.
On the other hand, the blood tests can provide a bit of reassurance, or sometimes pick up in an issue which may have a relatively easy fix, I think.
How do you feel about the idea of not seeking medical advice at this stage?

I get where he is coming from. I think I just wanted the reassurance. There's lots of reasons why we haven't conceived such as my age, my shift pattern, stress.
There's not much point in me going to tests if he doesn't.
I'm happy to leave it another 6 months as we wouldn't be able to have ivf on the nhs and we can't afford it privately.
I think one of the main issues is that in the time we've been ttc, 3 colleagues have announced their pregnancies and I've really taken it to heart. Its made me feel like their is something wrong when the chances are we just need more time.

@fairgame84 Pregnancy news can be so difficult when you're ttc. And often it seems to come completely out of the blue because most people don't talk about the struggles of trying and only tell the world when they're past the 12 week scan.
There is a really nice thread on here for ladies ttc at 35+ which I've found really helpful TTC 35+ thread 11 www.mumsnet.com/Talk/conception/4256930-TTC-35-thread-11

hi @katree and all just wondering how everyone has got on here ? I'm in a similar position. Been ttc #1 for about 6 months no luck. I'm 36. Went too the GP she sent me for some bloodtests but I realise they were just general looking at vitamin and iron levels. When asked she said LH and FSH were also tested and 'normal' but she didn't specify to take on a particular CD so I think she was fobbing me off. She said she would test for PG or do day 3 or 21 tests because I have regular cycles. Basically told me to come back after been trying for over a year cos I wouldn't get referral till then! Getting slightly worried and anxious about it all now...Thanks
x

Hi @Chamomile85 - definitely push for the day 3 and 21 bloods. You should be able to get these on the NHS - I had them done twice before I was even ttc just for reassurance. Is there any way you could see a different doctor or go private for investigations? You shouldn't have to of course, but if it's causing you stress and worry, sometimes it really helps to get some answers
Although my go was great and referred me to NHS fertility clinic right away, it was really difficult for me to contact that clinic to arrange the further investigations they'd written to me saying I needed. Every time I called the phone number a got a message saying 'we can't take your call and you can't leave a message'. So I ended up having a scan, HyCoSy and AMH test done privately for about £600. Those investigations revealed one of my tubes is blocked and also my ovarian reserve is relatively low. Because of this the consultant advised me to try IVF as soon as possible and I've just started my first cycle (first injection yesterday). We are really lucky to be in a position where we can fund it ourselves.
A few weeks ago the NHS clinic emailed me to say they were going to refer me back to the GP as I hadn't been in touch with them. I responded saying I had tried to get in touch months previously and sent them results from private tests. I have a consultation with one of their doctors scheduled later this month and hope we can get advice on whether any other treatments might help and possibly an ivf cycle if this one doesn't work out (my Ccg will fund one if you've had fewer than three done privately, I think)
I'm really glad we got the tests done privately, rather than waiting, as it gave us a picture of what was going on and feeling like we were taking action helped with the stress.
Sorry for the essay! I think what I'm trying to say is if I were you, knowing what I know now I would push for the GP to take action and look at private options if you get no joy.
I'd also say that sometimes conception does just take time and hopefully you don't have any issues and it will happen soon for you anyway, but it's good to be aware if there are issues so you can plan your next steps.
Sending strength and good luck- I hope you have positive news soon x

Hi @KatRee Thanks so much for the advice. Yes it's very frustrating that my GP hasn't been willing to do more soon. Her answer was for why she wasn't doing day 21 was that I must be ovulating because my periods are regular! And I have no idea why she thought my LH/FSh were normal if she didn't know what CD I had bloods. I assume there are long waiting lists where I am which is why she doesn't want to refer yet. I was considering private tests but it is hard to know what clinic to approach. Then If they identify and issue proceeding with treatment is obvs going to be much more expensive than tests so kind of need to have all the money at the outset. Trying to keep as calm as possible but also being realistic about time. It's good to hear that you are making progress and that you have persisted getting answers for yourself. were there any reason for your tube to be blocked? Really wishing you good luck and calm vibes with the first cycle. All my fingers crossed for you. Keep us updated!
x

@Chamomile85 Really sorry she won't refer you as I know it can be stressful waiting and not knowing. I don't understand her reasoning either - Surely if it was as simple as regular periods= ovulating the blood tests wouldn't exist? The first time I had them done which was about 3 years ago before ttc, it was because my periods had got lighter, but they were still regular then and still regular the last time I had them done on NHS too. Any chance you can see another doctor? I've seen quite a few stories on here where people have got a completely different response from a different doctor in the same practice.
Strangely I went for the private tests without even considering they might say do ivf now and we'd have to pay for it. It was such a shock- I was hoping they might shift a movable blockage with the HyCoSy and say I still had lots of eggs left and plenty of time! Maybe you would get good news, or they could identify an issue with a more straightforward fix. I just went to my nearest clinic so I didn't have to think too hard to begin with
The private consultant who found the blockage said it was most likely the result of an infection I didn't know i'd had. But I wonder if it might be endo- I was offered a laparoscopy on the NHS a couple of years ago to see if I had it, because I had some symptoms ( including the light periods- apparently light periods, not just heavy ones can be a sign), but I didn't go for it and now regret it as I wonder if I do have it, is it impacting my chances. I was so uninformed back then
Thanks for the calm vibes- I've needed them today! I'm kind of in the dark about how it's going until I have next scan on Wednesday and the not knowing is causing my imagination to run away with me!

Most GPs will have less knowledge on this than you. They are generalists, so the detail on fertility is not always there - except the basics. Having said that I did go to a fertility specialist who scanned me and said I hadn’t ovulated, my progesterone came back 13 on day 21 . I had been doing bbt ( she had no idea what this was) and knew I had ovulated. I ended up pregnant that cycle.
So you need to go to a good clinic and get assessed properly for these tests. If you ovulate early or late - doing cd21 tests are meaningless because they assume everyone ovulated cd14/15.

@KatRee Thanks for sharing your experience and wise words. I guess even though they found a blockage it was good to know and have some explanations? Interesting u thought it could be endo, never realised light periods were a sign I thought it was mainly extreme pain? How did the scan go ? it was this Weds right? You are definitely moving in thr right direction!

@littlemissnc it is concerning that GPs seem to know less than most of us plus Dr google. I am pretty sure I ovulate late (day 21) on basis of opks and temps so would hope a pg test confirms that. Great u got your bfp! what cycle ?

I think they are supposed to do the 'day 21' tests 7 days before after us due. Because I had regular periods my gp was able to advise the correct day to get it done, which was something like day 28. But you are right, @Littlemissnc, it seems from hearing stories on here some gps don't really check that they are getting the right date and specialists should be able to provide much better help
Thanks for asking @Chamomile85, I actually had another scan this morning too. Things seem to be progressing ok- the nurse counted 12 decent-sized follicles, which shows I'm at least responding to the stims and I thinks it's an ok number with my AMH. Hopefully they'll be able to get a few good quality eggs from them next week 🤞🤞🤞