TTC - GP Won't Refer Before 12 Months, Need Advice!

[Zenii]

Hi everyone,

DH and I have been TTC for 10 months now (had my contraceptive implant removed early November last year). Unfortunately, we've had no luck so far. I've recently been diagnosed with mild PCOS after a scan, haven't had AF in over two months, and my OPKs haven't shown any LH surge. Blood tests also showed slightly elevated testosterone levels.

Our GP (NHS) isn't keen on referring us to a fertility specialist before the 12-month mark, saying we'd likely get turned down anyway because we're not officially classed as infertile until we've been trying for a year.

Just wondering if anyone has been in a similar situation and could help answer a few questions?

Is it true that we'd be rejected for a referral before 12 months, even with my PCOS and other symptoms suggesting infertility? Should I push my GP to refer us anyway?

Once we're referred, how long does it usually take to get an appointment and go through the initial tests?

Is it worth considering going private at this stage?

Thanks so much for any advice or experiences you can share!

Your gp is correct in what they are saying about it being 12 months, 10 months although it feels like it isn't a long time to be trying. I would definitely wait till after the year mark like advised, for me the appointments took forever to come but we were just coming out of lock down so not sure if that's why. I found the appointments useless and took forever, trying for 9 years it has eventually happened naturally for us. Best of luck .

The 12 months is strict, and also resets if you get pregnant and then have a miscarriage (my experience). I would say 10 months isn't that long, especially if you account for the time it can take for your body to adjust after stopping hormonal contraceptives, which can be months itself. Are you making all lifestyle improvements you can (both of you)?

Agree with pp, 10 months isn't that long op, although I understand it feels long.

We TTC for 13 months with dc2...I was convinced something was awfully wrong, then it just happened whilst we were awaiting a GP appointment.

Dc3 was then conceived when using a condom at a totally 'wrong' time of month...we're still not quite sure how the hell it was possible. There's often no rhyme or reason to it and I think having a 12 month time limit is necessary due to that.

As far as I know, the 12 months is a national standard across the UK.
Probably because anything up to 12 months is still classed as normal, even though it may seem like a long time when TTC

Would they refer you (or can you self refer) for some bloods? I had my 3 and 21 day bloods at 11 months, referral for the specialist went in at 12 months, appointment booked around 19 months. Not sure it did anything getting the bloods sooner other than making me feel like I was doing something proactive.

We had to wait three years to be referred for any sort of help. Twelve months is the average time most couples conceive.

NICE say earlier if any conditions known to cause subjectivity, I refer at 6m if anovulatory pcos.

Thank you so much to everyone who offered advice on my post, it's been very helpful to read about your experience.

I haven't had a period for about 2 and a half months, but this does not seem to convince my GP that I have anovulation.

Had a blood test, but as my periods are so irregular (sometimes go months without AF), it was hard to know which phase I was in at the time.

Thanks! Yes, lifestyle changes were the first thing we did. I prioritise exercising every day (when I can), only eating slow-burning carbs, loads of veg, fibre, and vitamins. Sadly, no change with AF, though I do feel much better overall!

10 months is only really "10 goes". Yes they are strict about the 12 months. Just keep at it.

If you only have a period every 10 weeks, and your progesterone test showed no ovulation, they should refer now. Go back and show them the NICE guidance

https://cks.nice.org.uk/topics/infertility/management/management/#when-to-refer

Not for those with a reason to be subfertile, see above - should be sooner.

Thanks for the link it is very helpful! I'll go back to the GP to discuss the referral again.

The 12 months is strict so although it feels like it 10 months really isn’t too long.

It depends on your area but waiting lists for fertility treatment can be up to 3 years, so depending on your age and finances it may be worth looking privately.

Good luck x

Speak to your GP, or go private if possible and get your prolactin level checked. I spent years trying, had ovarian drilling, clomid and a year on the NHS IVF waiting list only to find I had raised a prolactin level and that's what was causing me to only have 2 periods a year, and not my PCOS. Three months on medication for that and DS1 was on the way and DS2 took 8 weeks on the same medication. If I'd had a more switched on GP that spent more time doing his job and less time shagging the practice nurse behind his wife's back it would have saved a hell of a lot of heartache and also the money
I spent on things like supplements, reflexology and acupuncture that never were going to work!

Thanks for sharing your experience! I'm glad it worked out for you in the end, it must have been a very frustrating experience.
My prolactin level was also a bit high on my blood test. Have you been referred to an endocrinologist? Do you think it might be worth asking for that?

I had a confirmed PCOS diagnosis from several years before TTC and I did not need to wait 12months to be referred. I went through my endocrinologist rather than the GP but I don't think that should make a difference? In the end, due to covid, it was 12months before we actually had our first appointment, but it wouldn't have been had the first lockdown not happened. Like a pp, initally i was referred to endocrinology as my prolactin was raised. They formally determined it was PCOS, put me on metformin, then referred me onto fertility when i mentioned TTC at one of my regular appointments. I did letrozole rather than clomid for DD1, then DD2 was a natural conception after i lost over 2 stone. Are you taking inositol? It works the same as metformin and is good for many PCOS sufferers.

Thank you, and no, because I'm 52 now and annoyingly still regular as clockwork 😂 the boys are now 14 and 16 but I want to stop other people going through what I did!

So sorry, my phone died! - in your case however, I would ask outright if your prolactin has ever been checked and if not just ask the GP to do it. I was under an endocrinologist for years but he was utterly hopeless too and it wasn't until I was having the blood work done to start IVF that this came to light. I tried to make a complaint about medical negligence but the attitude was very much 'well, you're pregnant now so what's the issue?'

Good luck with it and keep us informed!