GP referred fertility tests vs private fertility tests?

[whomoon]

I am 35, TTC #1 and just gone past the 15 month mark. I’ve had initial investigations at the GP with blood tests done, all within normal range. I’ve also had ultrasound scans for spotting before my period and there were no issues, evidence of endo, PCOS etc. My periods are regular and as far as I know I ovulate mid-cycle, based on OPKS.

I’ve been relatively relaxed up to this point, ‘what will be will be’ and all that, but starting to think we need to start proper investigations.

But I don’t know whether to get the ball rolling with the GP, and risk being on long waiting lists, not getting proper information to my questions/worries etc, or just cut right to it and go privately.

It would be great to get advice as to which route to take?

Is it one or the other do you think? How long do assessments take? I wouldn’t want to waste time through the NHS, but also concerned going private could be a money pit if things take longer than we’d hope.

I’m very new to this, so any insight would be greatly appreciated xx

We were told the NHS will not provide funding for fertility treatments until you've been TTC for at least 2 years, so if that's something you were ever likely to consider rather than just continuing to try naturally, it's worth getting the ball rolling with the GP.

Also because some areas specify that you need to have been referred by the time you reach a certain age. For example ours states you need to have been referred for fertility treatment no later than 6 months before your 35th birthday I believe, so again, it's worth getting the ball rolling with a GP, just in case. Some areas are quicker than others.

We first went to the GP September 2020 and are currently in the two week wait following our first, and only, NHS funded round of IVF. So it's been about 18 months all in all.

If you can afford to go private for initial tests though, honestly, I would. At least then you've got an idea what you're working with. Then if for whatever reason you do find that fertility treatments are the next step, you should theoretically be able to be referred right away for NHS funding (assuming it's available in your area)

@Barryigdig
Thank you so much for your response and advice.
That’s a really good insight to know how long the GP may take.

I had wondered whether going private for the tests, and taking these to the GP to have the NHS funded treatment is possible.

I am very lucky that my dad just gifted me some money from the sale of his house, so we’re in a position to go private, at least for the initial tests. And having researched opinions quite a lot, going private seems to always be the recommended route if it’s affordable.

I really wish you all the best in your TWW xx

If you can afford go down private route, it’ll be quicker then if they find something you can always see if NHS will help you. I had my basic tests (checking levels on x days of cycle) and I got my husband to have a sperm test on NHS then my private consultant used those to analyse so I didn’t have to pay them to do them

@Gamechanger2019

If you can afford go down private route, it’ll be quicker then if they find something you can always see if NHS will help you. I had my basic tests (checking levels on x days of cycle) and I got my husband to have a sperm test on NHS then my private consultant used those to analyse so I didn’t have to pay them to do them

Thanks for your response @Gamechanger2019I can afford the initial assessments but won’t be able to afford the full treatment, if it ends up going down that route. Perhaps I can go back to NHS for funded IVF if we need it?

I had my bloods done with the GP last March (all normal), but I think that’s too long ago and may need to be done again?
DP isn’t registered with the docs and will need to do that and then book in for an SA.
I’m thinking it’s worth paying the money just get both of us moving along quicker then the NHS will be, and have someone who can guide us/answer questions. GP seems clueless, and I know I will be in limbo waiting for referrals, whereas I could just call the private clinic and have more control as to what happens.

Perhaps that’s the bottom line, I can’t control TTC, but i can have some control going private with investigations/treatment.

That’s what I thought too, I wanted to know answers and didn’t want to wait for NHS. Are you using clear blue ovulation sticks? I found those really helpful too

You need to be aware that NHS have strict criteria, and having more or probably repeated tests in private sector won't get you any further in queue for NHS funding.
I am sure you are not looking to queue jump but I would not like you to have hopes dashed.
First thing your dp needs a sperm test and that can be done quickly and for free on NHS.
Most private clinics will ask you to have all tests you have had done on NHS, repeated.. Its called "making money"
Posters whose private clinics used NHS tests results are lucky and it is certainly not the norm.
If you cannot afford the whole private treatment I'd suggest you get dp registered and a, sperm test done ASAP.
Your gp cannot refer you without this.
Then ask gp to refer you for ngs treatment now.
Save your money and start adding to it in case you need private treatment rather than paying for tests you've already had done.

I had fertility tests in 2019 privately and from booking to the appointment it was two weeks.

@whomoon some of the previous advice is probably incorrect, depending on your location. Usually for over 35 you can be referred after TTC for only 6 months. You can check your CCG policy by googling it (hospital name CCG fertility policy)

One route doesn’t preclude the other. If you need IVF unless you have lots of ££££ spare best to be in the nhs system, see your Gp for a referral and start a private work up at the same time if you wish

@Theredjellybean

You need to be aware that NHS have strict criteria, and having more or probably repeated tests in private sector won't get you any further in queue for NHS funding. I am sure you are not looking to queue jump but I would not like you to have hopes dashed. First thing your dp needs a sperm test and that can be done quickly and for free on NHS. Most private clinics will ask you to have all tests you have had done on NHS, repeated.. Its called "making money" Posters whose private clinics used NHS tests results are lucky and it is certainly not the norm. If you cannot afford the whole private treatment I'd suggest you get dp registered and a, sperm test done ASAP. Your gp cannot refer you without this. Then ask gp to refer you for ngs treatment now. Save your money and start adding to it in case you need private treatment rather than paying for tests you've already had done.

Thank you so much for your advice @Theredjellybean Definitely not looking to queue jump in the NHS, but just wanted a clearer, better managed route to proper investigations/treatment, which I’ve read NHS are slower or more difficult to get clear answers on. But I appreciate your advice on repeating tests being a money maker. Will my year old blood tests be valid do you know? I have enquired with my go practice to get my partner registered so we can get a SA booked in. Perhaps I’m trying to get from 0-100mph without properly thinking of the (free) routes available to me. It’s probably our own fault waiting 15 months to get to this point, and should’ve carried on with tests I had in March 2021. I guess I just didn’t want to accept it wasn’t going to happen naturally for us and kept ‘seeing what will happen’

@Gamechanger2019

That’s what I thought too, I wanted to know answers and didn’t want to wait for NHS. Are you using clear blue ovulation sticks? I found those really helpful too

Yes I’ve used OPKs for a good few months, but stopped the beginning of this year when I wanted to take a break from it for a bit. It was reassuring as every month indicated I was ovulating, and I started to learn what other ovulation signs were, so I use those now instead of stressing about using OPKs.

@Chanel05

I had fertility tests in 2019 privately and from booking to the appointment it was two weeks.

Thanks for your reply @Chanel05 Can I ask, was the first appointment simply a consultation with you and your partner? How long were the appointments for blood tests, scans, results review after that? An insight into what happens and the timeline would be really appreciated! X

[quote Cinnabomb]@whomoon some of the previous advice is probably incorrect, depending on your location. Usually for over 35 you can be referred after TTC for only 6 months. You can check your CCG policy by googling it (hospital name CCG fertility policy)

One route doesn’t preclude the other. If you need IVF unless you have lots of ££££ spare best to be in the nhs system, see your Gp for a referral and start a private work up at the same time if you wish[/quote]
@Cinnabomb thank you for your advice.

Can you explain what you mean by CCG policy? Do I have to select the hospital I believe I’d be referred to, or simply the area I live? Sorry I’m not clued up on what to do, or read into.

I definitely don’t have spare cash, but have the money to do assessments and perhaps one round of treatment.

But based on previous advice, getting into the NHS system and getting myself/us referred definitely seems like the right route to start off with. Then at least I’ll be preparing myself/getting my head into the likelihood of needing treatment and go down the private route if we need to.

This is a very specific point but NHS blood tests in my experience are not as extensive as private ones. They don't test for prolactin, for example; apparently they used to years ago but don't now. It was by going private i found out my prolactin was too high, caused by a benign tumour ,within 3 weeks of going onto the medication, I was pregnant.

@Bosabosa

This is a very specific point but NHS blood tests in my experience are not as extensive as private ones. They don't test for prolactin, for example; apparently they used to years ago but don't now. It was by going private i found out my prolactin was too high, caused by a benign tumour ,within 3 weeks of going onto the medication, I was pregnant.

Gosh, that’s incredible! @Bosabosa So without that one test, there was no other way it would’ve been discovered and treated? What a brilliant success story

@whomoon unfortunately different areas have different policy for fertility treatments. Do you know what CCG your local area is in? You can just Google it and then Google what their policy is, how long you have to try for beforehand etc. normally it’s 6 months if over 35.

Writing as I sit cuddling my 7 week old! We went private last jan/Feb for tests, mainly as I thought the nhs had enough on its plate with covid and also because we could better book appointments around work. It turned out we were “fine” despite years of ttc and so the consultant prescribed basically a hormone boost for me for 3 months whilst writing a letter to my doctor so we could bypass tests and go straight to ivf for unexplained fertility (basically our only fertility option). Turns out the boost did the job though so the letter wasn’t needed. I don’t see it as trying to queue jump, more so trying to save nhs resources.

@whomoon indeed!
I would not have known to ask for that test so do check whether you have had your prolactin and micro prolactin levels checked

@Bosabosa
NICE no longer allow prolactin tests unless you are anovolatory or have an ovukatory disorder.
For the OP.. Have you looked at NICE, they show what NHS expects as routine tests and sperm analysis is number one.
Before you spend money, your dp needs to get tested. It is the one basic simple explanation for you not conceiving that so far has not been explored.
It is pretty simple to organise and may give you the answer and moving forward with fertility treatment due low or no sperm is considerably cheaper (ICSI aside) than full ivf.
Emotionally definitely as hard but ££££ cheaper if all you need is donor sperm

@Jonesy88

Writing as I sit cuddling my 7 week old! We went private last jan/Feb for tests, mainly as I thought the nhs had enough on its plate with covid and also because we could better book appointments around work. It turned out we were “fine” despite years of ttc and so the consultant prescribed basically a hormone boost for me for 3 months whilst writing a letter to my doctor so we could bypass tests and go straight to ivf for unexplained fertility (basically our only fertility option). Turns out the boost did the job though so the letter wasn’t needed. I don’t see it as trying to queue jump, more so trying to save nhs resources.

What a great success story! What was the hormone boost you were given if you don’t mind me asking?

[quote Theredjellybean]@Bosabosa
NICE no longer allow prolactin tests unless you are anovolatory or have an ovukatory disorder.
For the OP.. Have you looked at NICE, they show what NHS expects as routine tests and sperm analysis is number one.
Before you spend money, your dp needs to get tested. It is the one basic simple explanation for you not conceiving that so far has not been explored.
It is pretty simple to organise and may give you the answer and moving forward with fertility treatment due low or no sperm is considerably cheaper (ICSI aside) than full ivf.
Emotionally definitely as hard but ££££ cheaper if all you need is donor sperm[/quote]
Thank you for all your advice.
I am definitely signing DP up for the SA. The delay in doing one has completely been due to not wanting to accept there might be problems, and seeing what happens, rather than any reluctance on DPs part (not that you’re saying that of course). He’s absolutely on board with being 50/50 in investigations, not leaving it up to me etc.

Hopefully with this information, and my blood tests, we can move forward on the right route.

@Bosabosa again this is CCG dependent - I was tested for prolactin and so was my friend.

@whomoon I suspect your tests from a year ago will need to be re-run but just get the ball started asap. Even if you do initial tests privately it's crap like waiting for the fertility clinic referral that will take time on the NHS. I'd do the private stuff wisely with guidance from your fertility consultant tbh. Eg you'll most likely have to do a hycosy but if the NHS waiting period is 3+ months you could ask if you could just do it quickly privately etc.

[quote Juno231]**@Bosabosa again this is CCG dependent - I was tested for prolactin and so was my friend.

@whomoon I suspect your tests from a year ago will need to be re-run but just get the ball started asap. Even if you do initial tests privately it's crap like waiting for the fertility clinic referral that will take time on the NHS. I'd do the private stuff wisely with guidance from your fertility consultant tbh. Eg you'll most likely have to do a hycosy but if the NHS waiting period is 3+ months you could ask if you could just do it quickly privately etc.[/quote]
@Juno231 @Bosabosa I have looked at my test results from March 2021 and they do include serum prolactin. It came back at 276 so within normal range.

I’m completely going back and forth with what to do. Having been through scans via GP before for spotting before my period, it was all arranged fairly quickly, so I’m wondering if I should do my tests again, then get the GP to refer me to a fertility clinic, and see how long the wait list is then? If it’s too long, can I take my results and the SA to a private fertility centre locally to me?

@whomoon we have been TTC 16 months now and I'm 36. I rang up GP in July last year to get all the bloods done and DH's SA done. Was fairly quick to get the tests and results. At that point, GP referred me to the fertility clinic (mid Aug) and said the wait on the NHS is about one year in my area and we are still waiting to hear back from the clinic for an initial appointment, it's been over 7 months! GP also arranged ultrasound to rule out PCOS, which took about 3 months, although she was completely clueless about interpreting the results. So last month we decided to go private. Within 4 weeks I have had two consultations, AMH blood test and HSG. She has now referred me to IVF on the NHS and said the wait was about 3 months. So currently waiting for a letter for an IVF initial appointment. The private clinic accepts NHS results and are able to refer patients to the NHS for treatment. So something to keep in mind when you choose a private clinic. I think my advice would be if you have the funds, to get an HSG/Hycosy and AMH tests done privately which will speed up the process for you. SA should be fairly easy to get done through GP. My HSG results showed I had a blocked tube which I wouldn't have known otherwise.
Good luck with your tests and journey xx

@whomoon the first appointment was bloods that I had done to check TSH, vitamin D and AMH, which was 5 minutes in and out. Then I came back a few days later and had a scan as well as DH having a SA (which he really didn't want to do) and then 20 minutes later, sat down with the consultant to talk about SA results and my scan.

I think the first thing you should do is find out what CCG (Clinical Commisioning Group - I think) area you are in, and then look up their policy on NHS fertility treatment. This will give you an idea whether you are under any time pressure to fit in NHS treatment.