It's not happening for us - what next?

[Emarosa]

My husband and I have been trying for a baby since September 2020, and very actively since August 2021 (we got married in July).

We are trying not to worry too much, but for the last three cycles my period has been very late - I still have not had my period this cycle and I'm on day 42, before that I had 39 and 37 days. I'm usually around 32-34.

I came off the contraceptive pill in September 20, having taken it since my teenage years - so I don't really know much about my 'natural' cycle. I'm 30 and my husband is 40.

We're at the point now where we are looking at our options - and are considering going to a private fertility clinic for tests. Does anyone have any experience of this? Does it sound too soon? Any recommendations for what to look out for when choosing a clinic?

We're hoping everything is fine, but if there are any problems we'd rather know now...

Are you in the UK? If so your first call should be to your GP, if neither of you have children already you’re likely to be eligible for treatment on the NHS, no need to go private initially.

We were given Clomid first, then two rounds of IVF, all on the NHS.

@LawnFever

Are you in the UK? If so your first call should be to your GP, if neither of you have children already you’re likely to be eligible for treatment on the NHS, no need to go private initially.

We were given Clomid first, then two rounds of IVF, all on the NHS.

Thanks LawnFever, that's good to know. I heard that the NHS won't consider tests until you've been trying for over 2 years... the thought of waiting until September was putting us off. I'll give the GP a call though, that's a good idea.

It depends whereabouts you are, different authorities have different rules, I think we’d been trying for a year when we first got tests then Clomid.

How old are you?

It’s a year here- I’d definitely talk to your GP first.

@Emarosa the vast majority of places it's 1 year for investigations - the 2 year mark is usually for IVF if you have unexplained infertility.

With your long/irregular cycles are you confident that you're ovulating? And that you have timed BD in line with your late ovulations? Other than getting the ball rolling with the GP asap I'd recommend you start tracking BBT so you get a better idea of what's happening.

The initial tests your GP should offer is for you to do a day 2 blood test and a day 21 progesterone test (although with your longer cycles it will be a bit of a pointless test if they insist on it being on day 21). Your OH should be doing a semen analysis alongside all this. Some places might insist you have an ultrasound as well before they refer you to the local fertility clinic.

Ask questions, read up on these tests as GPs are notorious for getting them wrong - I have seen countless of women here being made to do the tests at the complete wrong time in their cycle or being told everything is fine when the results really, really aren't. So always ask for the actual results and not just their conclusion of them.

[quote Juno231]@Emarosa the vast majority of places it's 1 year for investigations - the 2 year mark is usually for IVF if you have unexplained infertility.

With your long/irregular cycles are you confident that you're ovulating? And that you have timed BD in line with your late ovulations? Other than getting the ball rolling with the GP asap I'd recommend you start tracking BBT so you get a better idea of what's happening.

The initial tests your GP should offer is for you to do a day 2 blood test and a day 21 progesterone test (although with your longer cycles it will be a bit of a pointless test if they insist on it being on day 21). Your OH should be doing a semen analysis alongside all this. Some places might insist you have an ultrasound as well before they refer you to the local fertility clinic.

Ask questions, read up on these tests as GPs are notorious for getting them wrong - I have seen countless of women here being made to do the tests at the complete wrong time in their cycle or being told everything is fine when the results really, really aren't. So always ask for the actual results and not just their conclusion of them.[/quote]
Thanks @Juno231, that's all invaluable advice... Particularly your last paragraph.

I have tried ovulation tests, but not for a few months - we found the "timetable" aspect of them a bit emotional and challenging, but this was before the three late periods - so I'll try them again in the next cycle to try and work out what's going on. I'm pretty sure I have been ovulating in previous months, though I am worried about this cycle. We have timed BD since August, generally through a calendar in an app (I don't think very accurately) and then also with the tests. Last month we didn't time it, but just followed the NHS advice of every 2 days.

This cycle has been a bit stressful (we're moving house and have busy jobs) and I also had Covid over Christmas....

However, I'm only 30, and I don't think I fall into any of the categories for late periods on the NHS website.... So I'm a bit concerned.

I would suggest you start charting your basal temperature, you'll need a basal thermometer and you need to do it at pretty much the same time every morning before you move when you wake up. Start the first day of a new cycle and go right through until your period, every month and your temperature will tell you if you are ovulating at all and when you ovulated.

Pre ovulation your temperature will be below 36.4 and post ovulation over 36.4 but it will be a significant jump up from your pre-ovulation temperature. Mine the day after ovulation jumps to 36.4, the day after 36.8 and once you have seen three days of high temperatures you know you have ovulated. Your temperature should then stay above 36.4 until the day or maybe two days before your period starts when it will drop down. If it drops quite quickly after three days and you have a progesterone problem as progesterone production is what pushes your temperature up.

You should after a few cycles notice a pattern, for example the week before I ovulate my temperature is around 36.24 ish, on the day before I ovulate it drops pretty much always 36.18. Not everyone gets a pre-ovulation dip but it's super handy if you do.

Taking your temperature is also useful for looking for implantation, some people get a temperature dip at implantation but not everyone. I don't.

The free app Fertility Friend is handy for recording your temperature and it will interpret your temperature for you and tell you when you ovulated. If you use OPKs and chart ewcm too you should see them matching up with your temperature results.

Should say too if you are seeing a flat-ish temperature line then you didn't ovulate that month but don't panic initially because no-,one ovulates every month.

The book Taking Control of Your Fertility is really helpful too.

Your DH definitely needs a sperm test too, don't assume it's your problem. X

On the 21 day blood test, it must be 7 days after you ovulate which might not be day 21 for you. If your day 21 blood test is taken on the wrong day it's a total waste of time as your progesterone peaks 7 days after ovulation and if your test misses that peak then it will show you are not ovulating when in fact you could be.

The NHS considers a result over 20 to be fine, all the private consultants I've ever spoken to say they want to see a result of at least 30 and really closer to 40.

First of all go to your GP, they can run a test to check you're ovulating. They'll definitely do that now as it's almost 18 months.
Secondly google sperm meets egg plan and use it in conjunction with OPKs.
And if you can afford it, you might as well get there fertility checks done privately now as the earlier you do ivf (if required) the higher the chances of success

You need to go to the GP about your cycle anyway, there should be more of a pattern now you've been off contraception so long. They will definitely be able to run tests etc for that, just not start you down the fertility help route. It's clearly a factor, so a good first step.