Have mental health problems so no fertility treatment

[Keziahhopes]

Hi
worst fears realised today. Turned up at fertility centre (nhs cycle, pct agreed funding, taken 11 months to get to this stage) for injection training and today is the first day injetions for ICSI (male factors)and the clinic says "sorry, at the meeting this morning we decided due to your gp writing to us and phoning the consultant we can't treat you." Failed welfare check.
- emoticon I want not available!!

If my dh not have antibody problems we could conceive naturally. Am mid 30's after years of ttc naturally.

I don't deserve children everyone agreed. No one to support me. I work with children, help run charity residential events - but clinic said that didn't count, it was gp. Changing gp not help, as (a) I would need them to know me for at least a year before they would be allowed to overrule this gp and this gp sent copies of letters from my psychiatrists - including the one that I am complaining about at official level (told to). Lost advocate, as he changed jobs.

They worried about how I would cope if the treatment failed, but no support offered for me to be childless. No treatment on NHS ever been given apart from 5 sessions when I was told I was suitable for that help.


Can't express how I feel. Hurting so mcuh.

[Keziahhopes]

FN - glad you said it was you and not your dh! RE: staying calm, I have no option - as any emotional reaction would be more opportunity to deny me treatment!! Yes, it feels such a long time - knowing need ICSI, but can't get it, glimmer of hope of treatment and then face losing all hope!! If that makes sense - want treatment, that is all - if it not work, or uses all our money that is our choice and I read others struggle with FT/IVF so why should I be any different.

Thanks for listening!

[FrozenNorthPole]

Good job in staying calm - I think I might be facing charges for assault in your position (this is FN not her DH now). Good news re: the psychiatrist having the chance to turn things around, really hope he sees sense. I can imagine that two months is going to feel like a really long time to wait - hopefully during this time you'll receive an apology from your GP surgery (well, I guess that's optimistic, but I hope that you can make sure that this specific GP takes this as a learning experience).

[Keziahhopes]

Thank you very much FN's Dh. Yes, I and my dh have stayed calm throughout this (even the clinic's practice manager who saw us said this!)

[FrozenNorthPole]

Hello,

FN's DH, responding at her request:

1. Written complaint to practice. This will bring practice manager/senior partner +/- relevant GP(s) to the table to put across their side. Probably worth stating that you are seriously considering referral to the GMC AND that, given the circumstances, time matters and you will hold practice/GPs responsible for further delays.
   

1. State, clearly and in chronological order in this letter what has happened and where you believe you have been ill-served. In particular, highlight any factual inaccuracies. Question the evidence being used about ADs/pregnancy, as it seems to make little sense. In particular, question decision to refer followed by subsequent decision to undo all of this.
   

1. Contact PALS. Never hurts to have someone with knowledge of the system looking out for your interests.
   

1. At all times, be clear, calm and determined. Be polite but make them aware that there may be serious consequences (eg. complaint to PCT/GMC referral) should you not gain satisfaction.
   

1. Push ahead with the psychiatrist opinion also - if they say ok, the GP's opinion becomes a lot less relevant.
   

Good luck, and hope this helps.

FN's DH

[Keziahhopes]

Ok, am now going to ask the psychiatrist who oversees me ADs to write to the clinic - but have to wait for about 2 months to see psychiatrist to have that option.

What annoys me is no one at the clinic has "assessed" me. The consultant I saw was happy and sent me the medication, and the next thing I know we have to wait for gp's letter. Gp not say I would cause significant harm or neglect in his letter. I asked to meet the doctor who has turned us down at their team meetings, but he will not see me - so no negative assesment from clinic.

All I can think of is that I am not worth the hassle, it is big money business FT, adn they have people queing for treatment so dont need to bother with me.

sorry for typo's - not on laptop!

[FrozenNorthPole]

KH - posting again to say that you haven't been forgotten, our internet was out for several days and we've got it back but all my old cookies etc. had been wiped. Anyhow, other half is asleep next to me in the living room but I am going to put this thread in front of him tomorrow morning and he'll offer an opinion about possible next steps. I am so sorry that there has been such a delay on this and can only blame TalkTalk and also DH's tendency to fall asleep in front of the TV.
Thinking of you and really, really hoping there is a way out of this. You HAVE to be entitled to a second opinion on such a life-changing thing, I feel convinced of it - the first step is probably a meeting with the practice manager, and a representative of PALS, and hopefully the GP / another senior GP at the practice. I know the last thing you feel up to right now is yet more struggle - but I really hope DH can suggest a path to give you some hope back.

[Keziahhopes]

Oh emptyshell - so sorry to hear you in a similar situation to me. Totally agree with angry exercise at the gym, it helps gets things out of the system!!

And you are right - we are having to be strong people ... a few that know more have said to me they'd be a real mess by now.

Never heard of having to have a coil fitted to have antidepressants - that is appalling. There are quite a few mums on ADs, but they don't take the children away. And some psychiatrists prefer people to stay on ADs when ttc (my last supportive one did,not that I can use that support anymore as it is complicated!!) ...

It is ridiculous - we are both teachers, both would be allowed children if we had functioning bodies (ie no problems with infertility) yet we can't even pay thousands to have treatment that others can have!!

So - have you managed to tell the gp you would use alternative form of contraception (eg pill, condom - not coil) to get AD's - that is what I would do!!!!!!!!!!! Have control. Could you ask for referral to a psychiatrist - that is who gives me my ADs, and they have never told me to use contraception!!!

Oh, feel for you x

[emptyshell]

Just wanted to sympathise - and friends with children can be incredibly insensitive without meaning to be (always love the way they think babysitting is a subsitute). I'm kind of the reverse to you - I can't get help for my depression because I refuse to throw in the towel and give up on working through my fertility/miscarriage issues. I have to agree to have a coil fitted in order to be given anti-depressants.

It's crap - considering if our bodies worked right we'd be able to be the most screwed up people in the world and still have as many kids as you like. If your plumbing is in the least bit wonky though - you're judged so harshly and have to prove your worth, almost as a human being - it's desperately unfair (we're completely ineligible for any fertility help too so I feel for you there as well). Like you I work with kids - I'm a teacher and you occasionally get the smug idiot who insists that you shouldn't be one unless you're a parent yourself.

I try to explain to friends my reaction after the latest run of miscarriages that it's grief for a bereavement - you're having to grieve for what you thought your life would be like, for your hopes and dreams for the future and it takes a heck of lot of courage to be able to kick out on the childless path which is the road less travelled by far. It doesn't quite get it through to them - the other way I try to explain it is that the pain of it all is like toothache in that it's incessant and not one you can rub better or get relief from in any way - but it's inside your heart.

I find things easier if I turn the grief feelings into anger - anger's disposable of at the gym, grief just lingers. I may sound totally mad doing that - but if I can turn my upset at the whole situation into a healthy dose of "pissed off" I can then vent that on a bike or treadmill for half an hour or so and come out vaguely human for a day or so - it's just my way of coping with it all, but I still don't sleep, drink too much on occasion and cry myself to sleep at night - it's normal, it's natural and you're bloody entitled to feel as sad or pissed off as you like and don't let any of the lucky crowd tell you otherwise. Because of me stupidly begging the GP for help, telling him I'd considered sucide etc - I'd fail any mental health checks for fertility problems or adoption myself too.

Wish I had some answers for you but I don't really - just wanted to let you know you're not alone. I try to tell myself I must be a bloody strong person because many others would have cracked completely after what life's chosen to throw at us - it helps a bit as well.

[KnackeredCow]

Keziah I am so very sorry for you.

Perhaps your friends are silent because they simply can't think of anything constructive to say and feel awkward about approaching you? They are very aware they have children and maybe they think that you don't want their company? Is there anybody you can call? Perhaps they've misinterpreted the situation and think that you want to be left alone?

Are you able to appeal the decision? It might be worth going back to birdietimestwo's post further up.

[Keziahhopes]

Ok, so I jumped through their hoops and a dr that never met me says "no treatment" ....

it is making me feel I am such a bad person that I can't have treatment - floods of tears at this thought. Noone to talk to -as all friends have babies etc and can't cope with me, not that I would inflict myself upon me, but very noticeable silences from them. Oh, apart fromt he one who wants to go out and socialise and needs a babysitter

[FrozenNorth]

KH - just wanted to say thank you for responding and I'll point DH in the direction of this post tomorrow. I am not going to say that I know what you're going through (because it drives me nuts when someone says that to me) but we faced several losses on our road to have children and if someone had implied that I didn't deserve children because I struggled to cope with this grief then I think I would have wanted to hit them. Or alternatively, to give them a taste of what it feels like to want the chance to be a parent and to have the chance taken away from you by circumstances beyond one's control.

Flower, so sad to hear of your loss :(

[Keziahhopes]

Flower, thank you for that. It is good to remember those figures, 1:4. And yes, people without problems struggle with infertility and having children. It is good to put things in perspective sometimes, which I have needed today.

Am sorry for your own situation. Hope you get support and treatment also that you need x

[flower11]

Kezia,
I just want to say im so sorry for you and the situation you find yourself in. Its not fair and awful how badly you are being treated. You deserve to be a mother as much as anyone else does and their arguments for you not having treatment are ridiculous, plenty of people with mental health problems have babies and make good parents. 1 in 4 people have mental health probems a good many of them will be rasing children!
I have past mental health problems and have recently lost my baby, had abnormalities that were incompatible with life, I know how painful it is to want a baby so much. If someone had said to me you cant have a baby becuase you might not be able to cope I would have thought them crazy, plenty of people without mental health issues find coping with ivf and babies difficult.
I hope you find the strenth to keep fighting, take time to look after yourself, and remember your good qualities. I hope you get the support you need and treatment, and to have your much wanted baby, I wish you lots of luck x

[Keziahhopes]

Yes, clinic will offer counselling for IVF but as I currently cannot have treatment can't have counselling there. Don't feel I need it for ivf - nothing has failed there adn I realise ivf is not guaranteed to work and almost have a "it is not likely to work" approach.

Gp not referred me ever for talking therapy of any kind, not signed me off work so this has been a total shock.

[Unprune]

AFAIK counselling connected with IVF is not the GP's responsibility (or in their budget). I understood it is provided by the clinic giving treatment.

[Blef1974]

If your GP is refusing you counselling then you have to change your GP. Why is he so unhelpful to you, you should write to the practice manager if he is refusing you basic treatments such as counselling.

[Unprune]

Keziah it's ok to break down. IVF is very damaging in lots of ways and all this on top of it must be incredibly stressful. Crying is a natural response to something that runs so deep.

[Keziahhopes]

Mind seems a good idea, thank you.

I think the problem for me is I have spent so long getting to the stage where I feel I could be an ok Mum, as I didn't want any child of mine to be brought up like I was etc to find out we are infertile has been so cruel.

FN
Your points work well. The only reason we saw GP2 was my own Gp was unavailable to be seen for 4 weeks - in actual fact there was a GP3, as GP2's letter got "lost" by the admin staff somewhere (building work etc!!)
However GP1 has everything on his files and admits he was fully aware of what was going on, as I had seen him for physical problems after these referrals.



Yes, 2 letters and 2 sets of phonecalls. First letter stopped treatment, as Hospital said treatment would go ahead unless Gp contacted them, which he did. Then hospital rang them Gp as he had written but not answered hospital's letter. We also spoke to Gp on the day of actual treatment, when he said some very upsetting things to me on the phone. My Dh saw him twice, and only after this did he contact his union, then write the neutral letter. However neutral letter talks about my mental health.

Blef - I know children are not a right - 6 years of ttc#1 tells me this. And I am totally aware that FT costs thousands and may not work, hence I have been saving so hard and going without and getting myself to this position over the last few years. My Gp refused to refer me for any talking help!

No, your questions are really helpful FN as they take the emotion away from what has happened and is happening. A formal meeting sounds a good idea - I am just so scared of breaking down in tears, I have kept going on since these events and worked etc, but feel so rejected and less than a human being if that makes sense.

[electra]

This is awful. I can't believe you're being discriminated against in this way.

[missmoopy]

I really believe you should seek some advice from a mental health charity - MIND for example - as to me that seems to be a huge case of discrimination. Don't give up xx

[Blef1974]

I am so sorry that your GP has refused to back your treatment, especially at this late stage. That must be so heartbreaking for you. Has he stated why implicitly he wont support you, and yet has no qualms with you having contact with children in your work life?

I think that you must change your GP as soon as you can, whether your fertility treatment goes ahead or not. The trust between you and the GP has been lost, and how will you ever be able to go to him again with a problem (medical or psychological) if you cannot trust him. You definitely could do with some counselling to talk about your depression and how being unable to conceive has affected you, in my opinion. How can you ask your current GP for this help if you cannot trust him?

Unfortunately children are not something that we have a right to. It does seem unfair that you have been denied a right to treatment by another person. But you have to make a decision with your DH, are you going to wholeheartedly fight this together, or is there another way you can go to achieve what you desire. Or do you have to accept that there is nothing that can be done. I do hope you get the child you so wish for, but even with fertility treatment nothing is guaranteed. Good luck.

[FrozenNorth]

Hi KH, thanks for responding. Would you mind if I tried to reflect back my understanding of events to make sure that I've got the details correct? I'll number the events purely so I can make sure I've got them in the right chronological order - I hope it does not come across as insensitive or reductive.

1. You saw GP1 to request fertility testing following several years TTC. GP1 referred you for testing.
   

1. Following your unhelpful meeting with the first consultant, and your discovery that you could be treated at a centre of your choice within reason, you went back to the GP to help with this where you saw GP2 (the nice one) who helped you find a clinic that the PCT would fund.
   

1. All went along nicely 'til you arrived for training in use of fertility drugs and discovered that the letter re: mental health issues meant that the treatment couldn't go ahead.
   

1. This letter was written by GP1 and said that he did not support your treatment due to mental health issues.
   

This is where I get slightly uncertain of events, so would you be able to fill in the gaps?

What exactly did the letter say? Is this letter the same one as the one that GP1 refered to as neutral? Or were there two letters - one negative, one 'neutral'? At what point in this did GP1 speak to his/her union?

What meetings and telephone conversations with GP1 took place after this point and what, if anything, has been agreed?

I would say that, at a minimum, you need a formal face to face meeting with GP1 and the practice manager. You can initiate this with a written request - at the very least, the practice manager should meet with you because this concerns the probable breakdown of a relationship between patient and doctor. Beyond this, DH can't say at the moment until he's sure he understands events properly.

I am so, so sorry to keep asking you to relate aspects of this and fully appreciate that it may be painful to you . By all means, do not answer anything if you don't want to - I hope DH can be of some help regardless.

[Keziahhopes]

Hi Frozen hope this helps - 12months ago I went to Gp after several years of ttc#1. I have recurrent depressive disorder, on venlaflaxine and have a psychiatrist (well see occasionally) never had any talking therapies offered. Work with children, do residential charity camps in holidays - Gp knows this and not stopped me! Had basic tests, dh a SA, then referred to FC in local city and underwent rest of tests. Having found out there were male factors preventing us from having a child, both mid30's and getting frustrated when top consultant told us to try for another 6 months we looked up guidelines and learnt that at point of treatment we had right to choose where treated. So went to gp's, saw a different gp as ours on hol (this gp now left!) who did paperwork, got PCT funding for a private clinic that accepts our PCT. My own gp aware, he admitted he knows this - it is in my files!! Saw consultant, had more tests which eventually revealed the exact problem with dh meaning we need ICSI. Filled in paperwork honestly including welfare of child section. Ticked form to allow them to contact gp, obviously. Told could start treatment 6 weeks later, drugs arrived and we turn up for our injection training on first day of injections needed to be told " you can have training but no treatment." Our consultant not there, he was a locum we now find who my gp wrote to and spoke with. Saw letter. Clinic decided to not allow treatment until gp had written saying no issues with welfare of child.

We rang gp - he said lots of horrible things on phone to me but not support me or admit to those things. Seen him since, he said he didn't know HFEA guidelines and 2 weeks from clinic not long enough for him to respond. Letter sent to him said if he ont respond they assume no issue, hence he wrote but said nothing really. Don't know phonecall contents.

We saw gp together after dh saw gp separately twice!! First time gp defensive, 2nd time dh gave gp the guidelines!!!!!!!!!!! End result is Gp contacted his union who said stay neutral, so he written what he thinks is a neutral letter and what I think is not neutral. He writes that the clinic have decided to treat me after talking with me about my mental health problems. That I think is not "neutral!"" I told him I wanted support, he said his position is not of support. I told him he referred me for testing, has known all along - if he was concerned about me why not block my job or get me help?? Guess what, no comment on that either. Years of seeing gp, all he cares about is his own position and defending himself.

Sorry that is not so brief, but not sure how to do it less briefly. Clinic were great, manager spoke with me but said they are waiting on gp and the consultant moved quicker than they are used to. Well, now have 3 month delay due to Christmas closure and my dates even if get treatment. Gp not say anything positive to me, just timing was unfortunate. I cried, I never cry.

Any ideas welcome. Just wish the other dr was still there, he was great - but moved on sadly. Lots of new dr's at gp practice so only know one other who I don't like.

[FrozenNorth]

Hmm, KH, this sounds very much like your GP and your fertility clinic haven't followed protocol - could you (briefly) explain the chain of events, and I will run them past my GP husband? It may be the case that you can complain to the GMC about this, but I'll need DH to have a read of it. Would that be okay? If not, that's fine too ... I just hope DH can offer some ideas or alternative paths for you to investigate.

[Keziahhopes]

We just want a baby together - hard enough to accept that we can't achieve this naturally