Unexplained Infertility & Fertility Apt Upset Advice Please

[Minniemad0110]

Hi all,
sorry if this becomes more of a rant but I am finding things a little challenging right now.

summary:
aged 32
dh and I ttc for 2 and a half years
may 8 yo I had a perforated appendix with sepsis
i had a MC Nov 24 which ended at 5 weeks 5 days (I am still blaming myself for this)

so my dh and I had our first nhs fertility apt yesterday after 1 year of waiting!
prior to the apt my dh had his sperm anaylsis that came back all fine and I had my 21 days bloods all came back ok.

we both really wanted some answers at this appointment.

we go to the appointment and then Dr is very lovely. However she says because we have been ttc for 2 years and had a pregnancy there’s nothing they can do. Both our tests results are okay so she can’t do anything about that.
I kept asking why we were having this problem and she kept saying ‘what problem, you got pregnant in 2 years that’s normal’ which I admit really infuriated me. I asked about my tubes and things wrong and she said ‘because you had a pregnancy everything is working fine’.
she also told me to stop BBT and instead do the deed 2-3 times per week! Oh and the usual of ‘stop stressing’

now I feel so lost and don’t know what to do.

does anyone have any advice? I feel so lost and fed up right now.

A lot of NHS doctors will reset the clock if you have a positive pregnancy test - so if the wait time in your area is you have to try for 2 years before referral for fertility treatment then the clock will reset from your miscarriage in November

Sorry, yes it usually does reset if you’ve had a pregnancy even if it’s a miscarriage. In your position I would go private for a initial fertility check to see if anything is flagged up.

I mean this kindly- but what did you want from this appointment ? Fertility treatments ( IVF etc) help people become pregnant- you did become pregnant and although you had a miscarriage the chances are you will again.

She is right optimising both of your health is the best thing you can do right now.

Out of interest why do you blame yourself for the miscarriage ?

i think i was expecting more. A lot of people I know have been to appointments and been given a prescription for chlomid and other medication to try. I think that’s what I was wanting. I really was wanting an answer.

im very anxious by nature and a big worrier. When I got pregnant I was so anxious something would go wrong. Now I blame myself that the stress and worry caused the misscarriage.

in all honesty I feel broken. I wanted answers as to why I’m broken

A lot of people I know have been to appointments and been given a prescription for chlomid and other medication to try. I think that’s what I was wanting. I really was wanting an answer

But they wouldn’t have been pregnant. That’s why they were being treated. You became pregnant and now it’s two months on from that point. I take it you haven’t experienced several recurrent miscarriages? If so, then it would be a different stream but that doesn’t seem appropriate from what you have said.

Stress and worry had nothing to do with your miscarriage, however you would be well placed to have assistance to keep health anxiety in check before a future pregnancy.

She’s right. You’re not struggling to conceive, it’s just that when you did you unfortunately suffered a miscarriage, something which happens to one in four pregnancies.

Personally I think that BBT charts and ovulation sticks are a marketing scam and if I ruled the world they would be banned. Couples have been having babies for centuries without needing to obsess over when they ovulate and making sure they have sex at the exact optimum time, and ironically fertility is dropping now.

Nobody is denying that there are people who suffer with infertility, but the truth is that having a baby is such a primal urge that when it doesn’t happen as soon as we want we automatically assume that there must be something wrong.

I’m sorry you’re struggling, been there, but tbh I would follow her advice, bin the ovulation sticks and have sex, and have it often. Make sure you’re both as healthy as you can be, and given you’ve already shown you’re able to conceive, you’re likely to do so again.

Stress can actually affect ovulation, so when people say you just need to relax they’re not wrong, even if it’s not what you want to hear.

Chlomid would only help if you're not ovulating on your own - do you have any reason to believe this is the case? Are your periods regular, do you have any symptoms of PCOS?

The GP hasn't done nothing — you've both had tests which have come back normal.

I'm sorry to hear you're struggling after your MC - it's really miserable. I went to the GP after two MC in a row and was told that wasn't so unusual, and they'd only consider it "recurrent" after 3 in a row. At the time I thought that was entirely heartless and unreasonable, but I did then go on to have 3 full term pregnancies in row with no further MC. Unfortunately MC really is common, and isn't necessarily a sign that you have fertility problems.

I am so sorry you are going through this. It’s not normal to only get pregnant once in 2.5 years. If I were you I would:

• book in for some fertility tests at a private clinic to rule out a few things or hopefully find an answer.
• read ‘it starts with the egg’ this book will give you both lots of tips to optimise your egg and sperm health.
• make sure your partner is doing his bit too ie not smoking, limited drinking and no hot baths.

please don’t have your hopes set on the nhs finding any kind of problem. They will do the basic of tests eventually and then they refer you for ivf. By the time you get to ivf, they still don’t know what’s wrong so you waste any free rounds you have available while they experiment.

I have experienced this during covid. My nhs fertility testing was cancelled during covid so had to go private for tests. It’s best to pay privately for fertility tests so that if you do get to ivf you go in with more information than normal.

also get the data for your partners nhs sperm results. My husbands came back from the nhs to say ‘normal’ but it’s nonsense as they class normal as anything above 10% ie if 100 men were in a line from best to worst sperm, men numbered 1-9 would have an issue and 10-100 would be normal. The same sperm test privately showed that my husband would be highly unlikely to conceive even with ivf as they look in more detail at the sperm.

So sorry to hear you’re going through this, I can’t imagine how emotionally exhausting it all is. If you can afford to, I’d highly recommend that you and your DH seek out a functional medicine practitioner. They can look into aspects of fertility that won’t be checked on the NHS. Best of luck xx

Kindly OP you did conceive so you are unlikely to be given a clomid prescription. Your friends who were given it would have not been able to conceive. It’s frustrating when ttc takes a long time and you have a miscarriage but currently you won’t be flagged as having issues conceiving as you’ve recently managed it.

Hey, I agree with the answers above but just wanted to add. I've had 7 losses ranging from chemicals to 2nd trimester.

I'd ask to have gen bloods to check your healthy (thyroid function etc also if you are ovulating) as the docs may be able to offer that now and not in another 2 years etc.

If you have the money I would 100% recommend private fertility tests and scans. I complained for Years about long periods, strong cramps (but genuinely believed I was just a wimp) turned out I have endometriosis and had lumps crushing my ovaries/tubes. The specialist said this could have been effecting the quality of my eggs when falling pregnant (and hindering ovulation as only one ovary was able to actually release an egg). In short I was scanned by the NHS twice and had various blood tests which found nothing, 6 weeks after my last NHS scan the private clinic had found the cause and referred me for surgery which I had within weeks.

It seemed a lot to pay £500 for the private bloods/scan however it gave me an instant answer and plan to fix it.

I do think it's a great sign you got pregnant as rubbish as the outcome was and hopefully it happens again for you quick! I've had 7 losses in the past 4 years so I know how draining this process is. Take care of yourself. Xx

Please don't blame yourself for the miscarriage, its not your fault.
Infertility is really emotionally and mentally draining.
Unfortunately I think your expectations of the NHS service in this area were too high. Exact answers don't always exist.
They've done tests on you and they haven't flagged any issues. There's a positive in there, even though it doesn't feel like it.
As others had said, there's different 'types' of infertility, as you've been able to get pregnant, you don't fit into the type of being unable to conceive and the next referral, for being unable to remain pregnant, doesn't happen until you've had 3 recurrent MC sadly.
If its causing you a lot of stress, it might be worth having a private consultation.

That sounds incredibly difficult. So sorry you've had such a rough time. I'm obviously not a doctor but 2 years to get pregnant does really seem the far end of normal so I'm not surprised you're feeling frustrated. I think I'd feel exactly the same in that situation. I think if you possibly can, some private fertility tests could give you some reassurance and next steps. I know it's so hard to "relax" on command but maybe it could help to have a more casual month where you just have regular sex - might just give you a bit of a mental break. I really hope you find yourself pregnant again soon. Also, your mc was absolutely not your fault at all - it won't have been anything to do with stress but just one of those absolutely shitty things that happens to 1 in 4. Give yourself some grace.xxx

Hi OP, I'm so sorry the doctor was so dismissive of your struggle, and callous. 2 years is a long time to have only one pregnancy anyway, at the point you'd qualify for IVF according to NICE guidance so being told it's 'normal' is bollocks. Unfortunately the NHS is a bureaucracy, so you won't get any answers from them now they've ticked the boxes on basic tests to offer you - instead of consulting with you for a diagnosis. You're much better off going private at this point if you can afford it, or even going abroad where it could be cheaper.

Have you had an ultrasound done? My friend with a similar struggle managed to get pregnant after 2 years only to lose it early on, and an ultrasound showed many fibroids which made it difficult for an embryo to implant and grow. A burst appendix and infection can also cause scarring and blockages to the fallopian tube - you might have gotten pregnant as a one-off but have damage that could make it much harder. https://www.fieldfisher.com/en/injury-claims/case-studies/90-000-for-appendicitis-diagnosis-delay-that-caused-infertility

You could get a private ultrasound scan and HyCosy to check for fibroids, polyps, fallopian tube damage as a first step.

As for the patronising advice to 'not stress' - it's ridiculous when doctors proffer it because most women in the developing world live under great stress, and these nations have some of the highest fertility rates. While taking the time to enjoy life, have spontaneous, unscheduled sex more regularly, and taking a break for some time is always a good thing - you'd expect more scientific, medical advice from a doctor. It's just a way of them saying they have no idea what's wrong with you.

The MC was definitely not your fault! I hope you get more answers privately and have positive news soon.