Fertility problems - what happens next?

[Alibobster]

Hi I would be really grateful for some advice please. Have a ds age 3 1/2 and been ttc again for 2 1/2 years. In that time have had two mc. I was referred for blood tests (testing for clotting, genetic abnormalities etc) and they have all come back clear. I have an appointment to see consultant tomorrow and I just wondered what the next step would be. I last saw him in November to get blood test results and all he did was tell me results were clear and told me to come back in four months. I wish I had insisted back then that something was done and I just hope I'm not fobbed off tomorrow.

Anyone?

Hi, I am waiting to see consultant for first time in April, but in my 20min appointment I aim to get a plan of action, whatever that may be. Sorry can't share anything more helpful as ttc#1 for 18months.

Have you had day 2 and 21 blood tests? And internal tests and husband semen analysis? My gp done that, as more basic.

Hope it goes well for you

Hi Ladies.
Been ttc for almost 2 1/2 years and have had 2 missed miscarriages in that time (both times I discovered at 9 weeks that the baby had stopped growing at 6). We already have a ds who's nearly 5 and I got pregnant within the first couple of months of trying for him.
Had my first appointment with the gyne today and was really disappointed since it was more of a chat than anything else. My doctor has already told me he suspects I have PCOS (a scan after my mmc indicated it too) and took bloods from me a few weeks ago to try and speed up the testing process. I suppose I thought that today would just be a formality and I would be put on Metformin to help regulate my periods then the problem would be solved! The gyne today said that my bloods had come back fine but he wants to take another 4 samples at different points in my cycle over the next 2 months, he also wants me to have another scan, my Dh needs to have a sperm test and then we have to go back to see him in 4 months. I'm totally gutted as it feels as though I'm no further on and now have to go through investigations I've already had. Gyne said he's not sure it is PCOS after all and that he thinks I may not be ovulating (? I'm still having periods, infact they are abnormally heavy!). He also said that your eggs rapidly decline after the age of 35 (I'm 33) but since I started my periods very young (9) my ovulatiory age is about 37 - marvelous, kick me in the teeth why don't you! Aaaaagggghhhh! Really feel like crying, especially as yesterday would have been my due date from my second mc.

Hi chubbymummy - sounds like they doing lots of tests, even if it is frustrating. I have my first hospital appointment in 8 weeks, secretary told me it was a 20min slot, so am not expecting much from it.

My Gp referred my dh for a sperm test (SA) already at the fertility clinic, I had general bloods and one 21 day blood test - so I guess your tests ordered are what I will have. The blood tests hopefully will help them correctly diagnose you. I also don't think I am ovulating this month, despite usual periods - as I am using a CBFM and for first time in 6mths it hasn't had a peak day! This links in with my high prolactin level from general bloods and even higher (843) with day 21 test. Do you know what your progesterone level was on 21 day test? (or rather 7 days before period starts)? If not PCOS but due to ovulating they may give you different treatment - which might work quickly, rather than metformin.

I am 34.5 - am in the same boat (but this would bein my first)agewise. Not surprised you feel like crying with that anniversary.

What can you do to help you conceive and cope with the 4 month wait? I say this because I know my BMI a bit too high and I am not fit etc, so I have resolved to try and improve my physical state whilst I wait for my 1st appointment etc. For me, I need to feel am doing something to help (oh and Idon't drink enough fluids etc!). Guess other people not the same, just thought I would share in case it helped.

Thanks for your comments Keziah. It sounds like we both have the same plan of action! I've gone back to weight watchers and I'm determined to shed some weight by the time my next appointment arrives. I know that if I'm not ovulating and need Clomid I won't be offered it unless I'm in a healthy BMI so there's lots of work to be done!!! On the plus side my scan appointment arrived this morning and it's for next Saturday (so I don't even need to beg for time off work). I've also spent a fortune topping up my supplies of ovulation sticks, pregnancy tests and sperm friendly lubricants.
My last lot of bloods was normal but I'm going for tests on both day 21 and day 28 this month and next month. Struggle to get bloods from 7 days before my period is due as my cycle lengths can be anywhere between about 28-43 days!
Alibobster how did you get on at your appointment?

Chubbymummy - great that you got such a quick scan appointment, and a sat, wow! I too spend a fortune on sticks,preseed etc. Sounds good idea to test at different points in the cycle. Do you have any other tests to be done, or dh's SA?

I have in the past 6months when monitoring my cycle (first yr I didn't) ovulated day 15-6, but this cycle I have had 11 high days and no peak on my monitor ... so haven't a clue. Roll on mid April for my appointment!

Alibobster - did you get more tests ordered, with a come back in x amounts of months also?

Other than the scan and the bloods we've only got DH's sperm test to get done (he was thrilled about that I can tell you lol). He's doing that at the end of the month as I don't want it to interfere with my fertile time. He has to abstain from doing anything for a couple of days before hand- which is not productive when ttc!
We've just been out for a long walk in the countryside to try and burn off some calories. I'm shattered and dh has flaked out on the couch but ds is still full of beans!

Chubbymummy - I agree, we had to time dh's SA at the right time! Amazingly my dh didn't comment on it at all, I think compared to what I made him read about smear tests etc and other things I may have to go through in testing he realised he was having it easy!

Well less than 2 months now till we have our 1st appointment at fertility unit.I am taking photocopies of all the tests the gp has carried out, so hopefully we can miss out most of the tests you had to have done - had all except a scan.

I too am trying to move my BMI down to something more respectable... I have read different things about what level the NHS will give you treatment for - my Gp said 30 (which I can just scrape) but someone else said her cousin (in same city as my hospital) was told she had to be 26, but gave her IVF (and a child!) at 27. Yes, I have no idea where toddlers get all that enery from!! We did a long walk Sat.

It's good to be able to talk to somebody who knows what I'm going through. All my friends in real life have 2 or 3 children and seem to fall pregnant at the drop of a hat. It's frustrating when they complain about being pregnant or having 2 children close together when I'm struggling to get pregnant (or stay pregnant when it happens). My ds is desperate for a brother or sister and has started to get upset when he finds out that any of his friends Mum's are pregnant. He doesn't understand why we can't just pop to Tesco and buy a packet of seeds then one can grow in my tummy (if only it was that simple . He seems to be the only one out of all is friends who's an only child and although I try to arrange lots of playdates for him it isn't the same. I'm very aware that the age gap between him and any future children (fingers crossed) is growing ever wider.

I had already been dignosed with PCOS but had day 2 and day 21 blood tests, I think one is for progesterone and one for FSH.

I had a HCG (I think that's the right term!) where they x-ray your fallopian tubes to check they are clear.

I also had an internal ultrasound to have a look at my ovaries again.

OH had two semen analysis checks, I think at a month apart.

I am overweight too and was told the treatment for me would be Clomid firstly but I had to get my BMI below 30 to have that.

Good luck with everything!

Hi

after a VERY frustrating few weeks with my gp, who refused me a separeate referral to endocrinology (he said the local hospital have a monthly joint apt with endo/gynae) I now have no referral for anything. I had a fertility referral at the 2nd nearest hospital on 19th April, but they don't do joint endo/gynae so to get on the other list I had to lose that appointment only to find out that the other hospital Ineed to go to has not released any dates for appointments, so can't have one. Waiting 2 weeks for hospital to write to me, if they say still no dates released have to go back to gp to chase up. Uh, how does that help? I asked to be put on joint, once a month day - choose and book knew nothing about it.

So - contacted a different gp at dr's today, told her 3mth saga, what appointments I had and she said I should have already had from my gp a 2 day and 21 day blood test done, and a chlamydia sweep. Why can't all gp's know the same thing. She also gave me a referral letter for this joint clinic so can book it, on choose and book system - get home to find that they also have no released dates. So - can't see anyone and I have known for a month I cann't conceive due to my prolactin level being too high. I had to tell my gp all about prolactin level as he didn't know much about it and ask for endo referral and a day 2 test - all of which he refused.

But I am still nowhere - 18mths down the line, no appointments and no treatment. Therefore no chance of a baby.

redandyellow... have you had the results back from all of your tests? How long have you been ttc and do you have any children already?

Keziah that doesn't sound good at all! Keep on at them and don't give in. Could you afford to go private or is that not an option? I don't know how much something like that would cost but it may be worth looking into.

It's taken me so long to get referred for treatment because the first doctor I saw at our surgery was very dismissive of me. He told me that I could obviously get pregnant because I have a ds and have had 2 miscarriages. I was told that lots of women have PCOS (this was after I'd had a scan following 2nd miscarriage and was told PCOS was likely) and it has no bearing on fertility and doesn't cause miscarriages. I didn't feel as though I could go back to him after that and thought I'd be met with the same attitude if I went to a different doctor. After a particually bad period where I was physically sick and fainted from the pain (a problem that has developed since the surgery following the first miscarriage) I plucked up the courage to go back. I saw a different doc and his attitude couldn't have been more different. He asked loads of questions and referred me to the gyne there and then.
I don't hold out much hope of a pregnancy this month as ds has been really ill for a couple of days and sleeping in our bedroom. He timed it perfectly to coincide with my (supposed) fertile time and although we've managed to sneak downstairs for a quicky when he's been sleeping it's a far cry from my usual routeen of bum on cushion for an hour after the event (very romantic isn't it )

I haven't been offered a day 2 blood test just days 21 and 28, that probably means that when I have my next appointment in 4 months they'll say "oh, you need to go for a day 2 blood test" then ask to see me another 4 months later!

Yeah, my FSH was slightly high, I think about 10 so higher than it should be at my age (I'm 33). Showed no sign of ovulation happening and showed PCOS (which I knew I had). Tubes all clear and DH's swimmers excellent. Weirdly I had pretty regular cycles. I don't have children.

So I carried on as normal thinking there was no way I could conceive for about a year and a half and not really trying, just trying to lose weight so I could go back to the Consultant. Then we made the effort to BD every other day from about day 10 of my cycle to day 20. I fell pregnant last month but it ended very quickly and then I am now pregnant again this month and keeping everything very tightly crossed and hoping this one wants to stick around!

Congratulations redandyellow, that's fantastic news! Hope everything goes well with your pregnancy and you are soon holding your own little bundle of joy.

Congrats redandyellow - and really encouraging to hear too.

chubbymummy - this other gp was really hepful, rang the clinic herself today and also got told no dates released. So she ripped up choose and book referral and wrote an old fashioned referral (didn't know they could, or what difference it does) and is waiting for a consultant to read it and hopefully give me an appointment. Am so tempted to go privately, but don't actually know who to - as need an endo and a gynae in same appointment apparently!! And need to save money in case need fertility treatments, as cannot go privately for everything - difficult decision when to use up one resouce.

I will do the day 2 and 7dpo/day 21 test this cycle and book that chlyamidia test as the Gp said then that we have done everything so they shouldn't waste time on any basic tests. Am beginning to think I have PCOS,so encouraged to read about pg redandyellow.

Glad the GP was helpful today Keziah, it makes all the difference who you see unfortunately. I know what you mean about the cost of private treatment, I haven't actually researched it but with my bank account being severely overdrawn I know it's not an option!

Well I had my scan yesterday. The radiographer was reluctant to share the results with me but I put her on the spot a bit. She said that I haven't got PCOS! I asked if I was ovulating and she was very cagy about it but eventually said that I've ovulated this month from my right ovary (sort of got the impression that my left ovary isn't up to much) but she wouldn't tell me anything else. Got bloods tomorrow and next Monday then 2 lots next month. My next appointment to see the gyne came through yesterday too, it's not until 13th July so I'll have to wait until then to find out the scan result in full.

Great news that you have no PCOS chubbymummy!

After my great hassles in changing hospitals etc, I managed to get a date for May6th with a fertility dr that also deals with endocrinology issues in pregnancy (am so hoping this dr can prescribe me medicaiton I know exists to reduce my prolactin level) and then today I got a phonecall asking if I wanted a cancellation apt this Thu - "yes please" was my reply

I know it is just the first appointment, but hopefully they will give me tests like you had chubbymummy, so we can see what is going on with me!

So - why not tell the receptionist you happy to take any cancelled apt's? worth an ask.

That's fantastic Keziah! Fingers crossed that you get what you need. Let me know how you get on. x

Thanks Chubbymummy

Saw a nice SHO, asked lots of questions, looked at the day 2/3 and day 21 blood test results, SA, general bloods and filled in a form. He showed good respect, then went and spoke to the consultant I am under, who actually popped in for few minutes. He has ordered another cycle of bloods, another SA and a scan for me. Go back 3 months after results from those, no date yet. My scan is not the one with the dye, but a more basic one - hopefully in next 2 weeks they should post a date to me, if not I know how to chase up now

Consultant wouldn't give me anything to reduce prolactin level, even though it is too high to conceive according to NHS it is not high enough to treat!! - needs to be 1000 and it has gone from 673 to 843, so am going to ask my gp for a blood test once a month to get evidence to see if it is still high and I am still not pregnant. However, the consultant did understand my immune problem and asked the SHO to research that (although I told him my immunologist said it would not be an issue), so hope they find something out.

After this scan, go back and guess get the scan with dye etc - is that what scan you had cm?

At least feel more motivated to ttc again

Thanks for support.

How are things going for everyone?
My next appointment with the gyne isn't until July so nothing until then for me.
Keziah, the scan I had was just an internal one, no dye involved.

Hi -chubbymummy, I have seen the junior dr now, done all form filling, met consultant briefly - had another SA for DH ordered, more bloods for me done and the transvaginal scan done - which provisionally the lady said was ok.

So for me, wait till end of June to see dr again. I guess then they will give me the HSG test (dye test) and go back 3 months later. Am keen to find out if progesterone level risen as it was bit too low and what my prolactin level is. Hate high prolactin - gone up 6bra cup sizes but still they will not give me any meds to lower the level till it reaches 1000!!

Oh - if they not ordered blood test for day 2/3 you can get the gp to do it for you. I fully intend on asking for another cycle of bloods this week - whilst wait to see consultant, to compare 3 sets of bloods! Then they cannot say need more - would recommend the same!

Sorry, I've not been on here much lately. Sick of seeing threads where people are moaning about being pregnant or deciding if they should abort their unplanned pregnancy. Thought I'd better distance myself for a while.

I'm still in limbo really since my next appointment isn't until mid July. Might ring up and see if they've had any cancellations.
Have you looked on the net to see if you can get anything to reduce your prolactin levels? Not that I'm advocating buying dodgy meds off the internet but sometimes just knowing that it's an option helps. Why won't they do anything until it reaches 1000? Is it a money saving exercise or are there health risks associated? (sorry, don't know much about it)

Keziahopes

I've just been reading your posts on this thread and wanted to say that I am being treated with bromocriptine to lower my prolactin, even though I have only had one reading over 1000. Most of my readings have been between 600 and 850 I think. So I'm not sure why you aren't being treated as it can't be an across-the-board rule in the NHS that treatment is only available once your levels are over 1000.

I am being treated by an endocrinologist because I have very low cortisol levels and raised prolactin due to a benign pituitary cyst. I was really struggling to ovulate - although I did occasionally manage by myself. Now that I am being treated with hydrocortisone (to raise cortisol levels) and bromocriptine to lower prolactin I am managing to ovulate every month - though I haven't got my BFP yet. If I were you I would enquire if you would get treatment elsewhere. Otherwise you may have to look into going private. I really wish you loads of luck because I know how frustrating it can be to keep getting raised prolactin readings.

chubbymummy - can totally empathise with your feelings about posts of others. I know what you mean about looking elsewhere.

CelticStarlight - so glad to hear youo are receiving treatment for your raised prolactin... my levels have been similar to yours, apart from none over 1000 - but they are not testing it now, so that is the issue. I think you are right - I need to raise it as an issue and then hope I can afford to go private, eek. My cortisol level is just under the top ok level.

I see fertility consultant for 2nd time,or rather another junior dr, mid June. So frustrating to find others get treated by same dr as mine so much quicker - makes me feel am not worth it. Definitely ask to see if can have cancellation chubbymummy - I have had to wait 3months for this time but did ask to go on cancellation list.