First fertility appointment advice

[Hopefulhedgehog]

DH and I had first GP appointment in September and day 21 bloods. Bloods appeared to confirm ovulation and I have v regular cycles with no issues. TSH was on the higher side - 3.9 but no concern from GP. Next step is referral to fertility clinic and we have virtual appointment in December.

Does anyone have any words of wisdom for me about what is likely to be involved in this first appointment or any tips or questions we should ask etc? I want to make the most of the appointment.

Thanks!

Our first appt was in person and she scanned me (observed low level of eggs and Antral follicles)
She asked a few questions then made some recommendations for more investigations, I chose the laparoscopy. We also had an AmH blood test done which also indicated low ovarian reserve.

Has your husband already had his SA? If not they will probably want that before they do anything else

Thanks @ellesbellesxxx no my DH hasn't had SA yet - the GP didn't mention it

I had my 1st appointment last week at the nhs fertility clinic.
DH already had 2 semen samples analysed and he has low sperm count.
They took our fertility history then said that I need a pelvic scan and a hsg scan to check my tubes aren't blocked.
They took vaginal swabs to check for infection as these are mandatory prior to the hsg.
The junior doctor had a chat with the consultant and he came in and said we need ivf so if my scans are fine they will refer us to the clinic for ivf. We can't afford ivf and I don't think I want it so he said after the scans I will be discharged. We don't qualify for nhs ivf.
The hsg scan should be this month between af and ovulation. The pelvic scan should be around 2 months.

Thanks so much for responding @fairgame84. I hope your investigations bring you some answers. I'm trying to feel positive about getting the ball rolling with tests etc but it is a bit daunting

At our first appointment they simply said 'unexplained infertility'. They gave two options, ivf or clomid with iui. It was all a massive shock but we pulled ourself together quick and got the ball rolling on ivf. Luckily this was all NHS.

Initial health questions, smoking, alcohol etc.
How long we had been trying.
Advised which tests to have, so I had;
The 21 day test again
Internal scan to check ovaries, any cysts.
Hsg.
DP done a sample test.

Once all these tests were done we went back in and told unexplained and asked if we wanted to go down the IVF route.
We agreed and thankfully we have our LO.

This was all pre Covid so I assume they book you in for scans etc once you've first meeting.

What I will say is, go in with an open mind. Nothing can prepare you for what's ahead.
I was very excited our first round but sadly ended in MMC, I found the next two cycles very hard mentally!

Hope all goes well.

Thanks @Franca123 had you already had scans etc via the GP? All I've had so far is day 21 bloods and DH hasn't had anything

Thanks @Moonshine11 how long did you have to wait for scans etc? I'm worried with all the covid delays the investigations could take forever although I'm pleased we got the process started

We got onto them straight away so within the month after our first app.

I'm not sure how things are at the moment but from what I've heard the delays aren't as big as last year.

Can I ask how long you all waited for initial assessment? Im in glasgow and only recently been referred

It took 2 months from referral to our appointment.

@TheDaydreamBelievers I had first GP appointment mid-September - bloods 2 weeks later. GP did referral on 12 October and we've got first fertility appointment mid December. I didn't think that was too bad all things considering

Hi there. I'm going through all this at the moment so might be able to help. It's been quite a long journey for us as we had our first appointment at the fertility clinic in March and are now just in the midst of our first round of IVF, so it was 8 months to treatment for us.

At the first appointment with the fertility clinic they will likely do general health/ lifestyle questionairres, ask you how long you've been trying, any other fertility issues in the family etc.

They will definitely ask your partner to do a semen analysis - honestly I would get him to go down to the sexual health clinic and have it before your appointment. You have a month still, and that way you will have a little information about him as well.

They'll refer you for an ultrasound scan to look at your ovaries and uterus, and more bloods (I have had so many blood tests!)

They will probably also talk a bit about IVF but are unlikely to recommend it there and then if your partner hasn't had a semen analysis. I think that is the most important thing to get done if you can.

They may also recommend you take various vitamins/ supplements if they are are thinking of sending you for IVF.

I'm sorry you're going through this, it's not an easy thing. Good luck.

One thing that may be worth finding out is if you're eligible for NHS funded treatment, and how many rounds. It's a real postcode lottery at the moment and every NHS Trust seems to have different criteria for this.

Thanks @want2bemum and best of luck for your treatment - it's a tough road. I am in the north east so I think we are quite lucky here in that the funding is for 3 rounds. I'm trying not to think that far ahead and just keep TTC while we get through the tests etc but it's hard not to start thinking that way.

Are you going to Centre for life?
That's where I went!
They are amazing 🤍

Yes @Moonshine11 that's great to hear!

I haven't had day 3 bloods just day 21. What is it they look for in the day 3 ones? I'm guessing I may have to have these now.

My progesterone was 47 on my day 21 bloods which I think is fine as I understand it should be over 30 to confirm ovulation

Hey just going through all this myself we first went to the gp who did 3 sperm tests on my DH first couple came back bad morphology but 3rd one seemed to improve from changes such as cutting back coffee quitting alcohol completely and changing out diets and more exercise I also had day 1 and 21 bloods was all normal they then refered us to a nhs fertility which we had a phone call appointment and just asked basic questions and told me which I already knew that we couldn’t get ivf on the nhs and they sent me through for a pelvic scan but I had one done private at the fertility clinic where I will now be having my ivf done but just waiting for my amh results so come back it’s worth trying get the tests done on the nhs if thinking going private if can’t get it on the nhs x

Hi OP - make sure you discuss your TSH level in the appointment as it’s recommended it should be below 2.5 when you’re trying to conceive. They may well recommend you start a low dose of levothyroxine to bring the level down. Good luck with the appointment and your TTC journey.

I had no scans. Thr feeling was, anything untoward would be picked up during the ivf process anyway. And ivf was the solution to most issues anyway. I know some doctors don't agree with thar approach. But ultimately, we had a baby relatively quickly via ivf so we were happy.

Thanks @YessicaHaircut I was a bit concerned about TSH and previously unaware if any thyroid issue. I didn't have a follow up with GP he just referred me straight after bloods so have never discussed the results.

Wow @Franca123 that seems an unusual approach but I guess a good one if IVF was going to be the outcome anyway

Thanks @hopefulmumma90 and good luck with your treatment. We would qualify as far as I know so sticking with the nhs for the time being