Please help explain my fertility options through the docs

[Heyitshal]

Hi all, I've been trying for my first for around 2 years. I had a miscarriage last year July at 6 weeks. The week or two before I found out I was pregnant, I decided to ask the doctors for help and they did a blood test and all looked fine except raised progesterone - which was the pregnancy I wasn't aware of at the time.

Since the miscarriage I've not spoken to the doctors again as I decided that since I conceived naturally once I can do it again. That was almost a year ago now. I want to restart the process of getting support but I'm feeling lost as I don't know what this path could look like. I've seen a lot of things on MN that I don't understand, e.g. letrozole, IUIs, IVF (I know briefly what this is). But can you please help me understand what could be the next steps. My husband will be getting booked into get his sperm checked but other than that, I don't know what to expect.

I don't know anyone in my life who has had to go through this process, so would appreciate your support.

Thank you in advance, and I wish you all luck to those who are also trying for their baby.

Just for context I'm 27 years old, healthy weight, and don't have any conditions as far as I'm aware - PCOS, etc.

❤️❤️❤️

Hey - sorry to hear about your miscarriage and that TTC is taking a while.
Ive recently been through the gp investigations and referral process.

it does vary slightly between areas and GPs, but for me, GP ran hormone tests on day 3 and day 21, and would usually refer you for a transvaginal ultrasound but I’d had one privately. My husband had a semen analysis. As it was over the time criteria for our ICB, she then referred me to the fertility clinic, and there’s no further plan as such from the GP.
I know some GPs prescribe meds like clomid but I don’t think so much anymore?
and then I’ve got my first fertility appt which is 8 weeks since the referral was accepted.

My understanding (but haven’t got there yet ) is clinic will probably repeat tests, and then look at treatment options whether it’s medicated cycles, IUI or IVF.

I really recommend listening to the podcast Don’t Tell Me To Relax - it’s so informative and with regards to how to improve chances and what to investigate.
like I never knew most lubes harm sperm (so we’d been using lube that was probably killing them for ages!), and vaginal
microbiome can affect fertility and cause miscarriages so I did a home test with Daye and needed antibiotics.

also - if you don’t feel listened to then get a second opinion. First gp I saw was really unhelpful so I went back to see another who was amazing!

@Muddysocks1thank you! Ah okay so the GP will do a few tests and then the rest will be to a fertility clinic hopefully.
I'll have a listen of the podcast thank you! So hard to find information and social media becomes so overwhelming.

I appreciate your advice and hope things go amazing for you ❤️

This was our experience - others may have a slightly different one.

• made an appointment with GP who did some hormone blood tests and booked an ultrasound (we have a gynae clinic at our GP. Otherwise I think this is done by the hospital). Referred us to NHS fertility clinic
• first appointment at NHS fertility clinic took a very detailed reproductive / gynae history, repeat bloods, repeat ultrasound, DH told to arrange sperm analysis.
• also given forms to get further blood tests done at certain points of my cycle.
• second appointment was to discuss all results of the above. Another ultrasound for me. For DD1, all the results showed i had PCOS so we moved straight to letrozole. Letrozole is a drug that induces ovulation - so if you are not ovulating, it encourages your body to ovulate (its a newer version of clomid basically - fewer side effects and more effective). For DD2, at this point I was asked to have an HSG. This is a test where they inject dye through your cervix and check for any blockages that may be preventing pregnancy (if using an xray its called HSG, if using an ultrasound its called HyCoSy). Some hospitals will do this as part of the initial round of tests.
• agreed what the plan would be and then started treatment. For us, that was 3 cycles of letrozole to be taken on certain days, ultrasounds to check the eggs were developing and blood tests to check ovulation had occurred. If that was not successful then the plan was to move to IVF but it wasnt needed in our case.

Once you are in the process, my experience is that the doctors were very good at talking us through our options and the chances of success.

@CrispAppleStrudelsthank you! I really appreciate this. Glad to hear IVF wasn't needed for you ❤️❤️

I'd I was you at 27 I'd have all the basic fertility checks. My clinic did man and woman fertility mot for £500.

If nothing comes back from that I'd consider changing both of your diets, no drinking, no smoking, both take fertility supplements and maintain a healthy lifestyle for at least 3 months. No TTC In that period. You want good quality healthy sperm from your partner . After that I'd cycles supported by acupuncture.

I would do any fertility treatment until every other avenue is pursued.

I had 6 cycles of clomid and timed sex.

I then had 4 cycles of IUI. I took clomid, then had a trigger injection to trigger ovulation and the had sperm injected. The success rate is low but its less invasive than IVF.

After that I had 2 cycles of ICSI. That's where the stimulate the ovaries, monitor the follicles and uterine lining. Harvest the eggs. Inseminat the eggs directly with sperm. Then watch how they divide. After 5 days if the eggs divide properly you can have them implanted or frozen. Anyway, in my case it involved a lot of drugs, injections, pessary, invasive treatments. It's a lot physically and emotionally.

In the end I had 2 fresh cycles and 6 frozen cycles. My daughter was the last round. At that point I was suicidal. We decided to use the last embryo and then stop.

I want to urge you to move forward cautiously. It's not an easy road to take. If you have to take it then make sure you do fertility counselling. My clinic offered it free with every cycle. Honestly, I couldn't have managed without it.

Also, asda pharmacy do not make profit on fertility drugs. I would get a private prescription from the fertility clinic and fill it at asda. The only thing that was cheaper at the clinic was progesterone oil. Although, you'll have to price stuff up yourself.

I paid for all my treatment myself. It cost about 40k all told. The money is just money but the trauma was the real cost.

Anyway, I have 2 children. I was through ICSI. The other was a happy surprise. I also have 4 😇

https://share.google/1OmyHP6MBv7Kt7kzy

I went here. It was a long time ago but they were very good. I'm not sure where you are but thought I'd share.