Fertility problems?

[LibbyL92]

Hi!

I came off of the pill in October 2020.
I’ve been with my partner for 9 years. We have never used contraception since 2020.

Coming off of the pill wasn’t to conceive, more so for the side effects of the pill and being on it so long. But if it happened it, it happened.

I have not once fallen pregnant since coming off in 2020.. almost 4 years ago.

we’ve now been seriously talking about wanting children. But have realised there could be a problem due to the fact we’ve not been using contraception since 2020..

my OH went to the doctors on Friday for something unrelated but mentioned us wanting to conceive and explained the situation. He is being referred for bloods and tests.. his GP advised him for me to make contact with my doctor as well.

I’m going to contact my GO on Monday.

but what shall I expect? I’ll be complete honest I know nothing about cycles ect. I just know I’m regular also start my period around the 5th of each month. Normally lasts about 5 days.
with sex we just have it as and when. Could be once a week could be 2-3. Over the 4 there may of been weeks where it would have been less or more or not at all. But SURELY over the 4 years I would have fallen pregnant by now??

Is there anything I should be doing? What questions might be asked by GP? What should I expect out of this? Should I be asking for something in particular?

my age is 32 and my partner is 35. No children. We don’t smoke, drink occasionally and our BMIs are considered normal.

thank you in advance.

You may have just got unlucky with the timing. Given it's already been 4 years you could consider asking to be referred to a fertility specialist straight away because of waiting list times. Though hopefully you'll fall pregnant before an appontment comes round!

Firstly, track your cycle by using LH testing strips. LH is the hormone that triggers ovulation. Easy@home are among the cheapest and there is a free premom app which will record your levels and generate a graph when you scan them in. Make sure you have sex in the days leading up to, and throughout the surge.

More expensive but it can also be worth using clearblue advanced for a few cycles, as they also tell you when oestrogen is rising ahead of the LH surge, so you have more warning. This oestrogen rise is typically accompanied by several days of clear and slipperly fertile discharge. After ovulation it will be thicker and cloudier/ creamier again.

You could also look into tracking your temperature with a body basal thermometer each morning (cheap on amazon etc). After ovulation, the empty follicle that released the egg becomes the corpus luteum and starts to produce progesterone, which causes a slight rise in temperature. Using the same premom app (or another), you can enter your results each day and it will generate a second graph for you.

It's good that your husband is getting blood tests, and I assume also a semen analysis.

If your GP doesn't automatically offer them, ask for hormone blood tests to be done on day 3 of your cycle. They may also offer mid luteal progesterone tests to check ovulation status. Do any other blood tests on offer to get as full a picture as possible - prolactin, TSH, cholesterol etc.

There are further investigations possible (such as checking your fallopian tubes aren't blocked/ ultrasound of your endometrium and ovaries etc) but the above should start you on your way.

In the meantime take folic acid and maybe a prenatal vitamin if you're now actively trying.

Good luck!

Thank you for the detailed response.

would you suggest I do these things before I see a GP?

id like to have the blood tests for sure. And any other testing before possibly doing IVF.

I could have just been really unlucky, but 4 years really is such a long time?

with the blood tests would it be day 3 of my period and then day 21 (from day 1 of my period?)

Your GP should be able to do the first lot of tests - see what appointment waiting times are like when you call on Monday. A surgery phlebotomist or nurse can take the blood tests which may mean better availability.

If it's ages you could consider private tests. The results would probably be needed as part of your fertility referral, so pass them on to your GP afterwards.

Yes - around day 3 of your period for hormones. And then 7 days after ovulation for the progesterone/ the mid point between ovulation and your next period starting. You could try day 21 if you have a 28 day cycle.

If you do get referred to Fertility there will be several investigations before they move to IVF as a suggestion.

At 4 years you are well beyond the stage of using things like charts and LH testing strips so do not bother with either. At 4 years too of ttc without success there is a high chance that either one, or equally both of you, are subfertile.

You need a diagnosis first and foremost. IVF is a long way off yet and may actually not be needed.

Both of you should be tested in tandem. It is little point in solely testing you to begin with if they do not test your man at the same time. The GP should refer you asap to a subfertility unit.

Completely disagree that there's no point in understanding personal cycle for the first time in parallel to the testing. Will be able to time sex optimally while waiting for referral.

Have you been intentionally having sex around/during ovulation?

I haven’t tracked my periods.. but in the 4 years we would have definitely have had sex around ovulation which makes me wonder if there is an issue.

I'd recommend get cracking checking it out so you know where you are. Don't mean to be rude but time isn't on your side if you're going NHS route as it can take ages. And if it's still not happening when you know your cycle, TTC properly etc do consider going private if you can afford it.

Have you read 'Sperm Meets Egg Plan'? There should be a free download of it - just explains best times to do it etc.

You might have only done that, say, on 8 cycles. Or you might have done it on 30 cycles. That's why it's worth tracking!

You only get one egg a month so although it's tempting to just carry on and see what happens, it's worth prioritising knowing where you stand if you see what I mean. It's scary to be thrown into a world where 'infertility' is talked about so much but it doesn't mean 'you have a physical issue which makes it impossible to have kids', it's usually used to mean you've been actively TTC for a year and it's not happened.

Thank you. It has slightly knocked me.

I would just like to know where we stand. Not that I would want to fall pregnant instantly but to know if there is an issue how much time will we have ect?

are there better period trackers to have? I see there is one on iPhone under health. But I’d be happy to pay for an app.