Go appointment for secondary infertility what should I be askinc

[Prayingforamiracle2]

Hello,

we’ve been trying for baby number 2 for over 4 years now. I got referred to gynocology 3 years ago for a tugging pain I get behind my C-section scar and going for a laparoscopy in April to investigate this. When I mentioned to gynocologist about struggling to conceive she shut me down and said I needed to loose weight and my bodies done it before so it can do it again.

we went for private fertility testing everything come back normal and all he advised me to do was loose some weight or try IVF. I have lost 6 stone since then and still have not conceived.

I am at my wits end now and it’s really getting me down so I have booked at Gp appointment to discuss and see if there’s anything else that can be done.

does anyone have any idea of what I should be asking for or what to say to Gp just so I’m not missing anything as I find it really emotional to talk about and worried il come out and of forgotten to ask certain things.

thank you

You won't be entitled to fertility treatment with the NHS as you already have a child. Your private fertility testing gave you the results of normal. Did you test your partner? Get a sperm test and if that's normal too - or even if it's not - private IVF is probably your best bet.

(done all of the above myself)

Yeah this sorry OP, as you already have a child you aren’t entitled to IVF on the NHS

I am well aware I am not entitled to IVF on the nhs and at no point did I say I expected to be. But surely there’s bloods to check hormone levels etc that can be done to check in ovulating etc so wanted to know if people knew what tests I should ask for.

I would look into seeing a fertility mentor.
One who looks at helping you get pregnant naturally.
Mine is extremely knowledgeable. I've having my vaginal micro biome tested which can apparently often be the cause of secondary infertility.

Sorry I thought you said you’d already had those tests done privately and nothing was found to be an issue?

I had a scan and Amh level tested but that’s is all. My understanding is that amh is only useful in going ahead with ivf the fertility consultant advised us to go away and try. Naturally as all our results were completely normal including my partners

Oh and you can ask for bloods at the gp they can only say no, mine just did what I asked for. I have progesterone, full hormone panel, ferritin , prolactin, LH/FSH, oestridiol, renal profile, the only thing they wouldn't test is thyroid.

The GP is not going to give you any more extensive testing than a private fertility test... Some things on fertility are just unexplainable op and the only route is to explore IVF. An Ivf clinic will look at your tests results you already have and advise. They can also probably run more tests. Testosterone and so on.

But really a lot of it is down to luck but of course you can try all sorts of weird and wonderful and of course expensive add on treatments as part of it.

And realistically, if the GP ran an 'ovulation test' - whatever the result of it is, your options are to either continue trying naturally or do IVF. same as they are now.

Good luck and let us know what they say. Maybe they'll be uncharacteristically helpful!

As I said previously I had one blood test for AMH and a scan done privately that is all. There are a number of tests that can be done through a gp such as progesterone thyroid etc all of which can affect fertility. Just because I have a child doesn’t mean I am not entitled to answers. But thanks for your opinion.

My GP did bloods and a vaginal swab

They also tested DH's sperm.

All normal.

I then went private for a Hycosy and the private fertility doctor also prescribed clomid. Thankfully this worked and we got DD2.

Hey, it is so hard isn't it dealing with secondary infertility. You mention a c section, I was just wondering if you have ever had a pelvic scan to check the c section scar? The only reason I mention it is because I had a private scan done last October which showed a c section defect (also known as an isthmocele) and my myometrium had started to thin out and the scar has a pouch collecting blood. A defect occurs in about 60% of women who have a c section and a small percentage of those women then have difficulties in conceiving.
I actually conceived ok last February but had to have a TFMR and after that was getting spotting in between my period which led to me having the scan. I was also struggling to conceive after the loss. I have just had surgery to remove my old scar from my uterus and resewn up. Hoping it was the cause of my secondary infertility. Also had stage 4 endometriosis which I hadn't known about removed at the same time. Certainly an avenue to explore x

Hey! Definitely is hard. Yeah I get a lot of pain on one side of the C-section scar like a pulling tugging type pain which is what I’m going for laparoscopy for so thinking might be the issue so we shall see what happens

@Prayingforamiracle2 hopefully that's is the cause and they will be able to do something about it. I ended up going private for the surgery as it is a postcode lottery with whether NHS will do the surgery to fix a isthmocele which is shocking really.
Have you had your AMH levels checked at all? NHS won't check AMH levels so it will be something you would need to look at privately. I had mine checked through Hertility

Yes had it done through private fertility clinic all was normal

@Prayingforamiracle2 im in the same position as you and currently in contact with a clinic arranging to have private fertility tests done!
it’s not true that the NHS can’t do more, if your not ovulating they should be able to provide ovulation medication if that’s the case? Would be worth you checking if that’s an issue?
I’ve been using a vaginal temp tracker and now I’m not ovulating so currently looking into medication for ovulation induction, though nhs wait list for a scan is currently 12-18 months for me, so think I may end up going privately, but we’ll see how the tests go first!

Thank you! Nice to know that we won’t be completely fobbed off. I understand we are not entitled to ivf on nhs and we are prepared to pay however if I can save myself 10s of thousands of pounds obviously I’d much rather do that 😂😂😂

@Prayingforamiracle2 absolutely! I’d also much rather have ovulation induction medication if this would work for me rather than IVF! Good luck hope you get some answers! The wait time is just frustrating! I had a letter back in October to say they acknowledged my referral and I’d hear in 12-18 months! I really don’t want to wait that long to then potentially need IvF anyways, so we’ve decided to start investigating further!

@Mummysparrow this is interesting! I had a c-section with my first! Hoping this is what was needed for you! Good luck!

@Prayingforamiracle2 Do you have irregular cycles?
I've just been referred, even though I already have one child and had a mmc in September.
What helped me get referred was tracking everything, I got a femometer ring, and use opks etc, the GP did cd 21 test and the results showed I'm not ovulating
Did you struggle first time?

Nope regular cycles. Positive opks on day 13 and bleeding 14 days later on the dot. No struggles first time me and my now husband had only just got together and happened straight away! All so confusing how can fall so easily first time and struggle so much for the second

If you’re thinking of the IVF route, I would make an appointment now and they will tell you all the tests they would require. You can book through them, or book your own (Randox health are very reasonable for tests). It’s much quicker than waiting around for the NHS and they probably won’t give you all of them so I’d just get them all out the way.

The most likely explanation is egg quality. If your scan was fine and other bloods, and the fact you’ve already had a baby, it’s most likely quality. This is what we have been told by both NHS and private doctors. You can try and improve through diet and lifestyle changes. The book ‘it starts with the egg’ has some useful information.

If you are having a laparoscopy anyway I would ask if they can do a dye test at the same time to check whether the tubes are patent. Please use barrier contraception for the next month as they will not even consider it if you are possibly pregnant.