What questions should I ask?

[notnowImreading]

I have an appointment with the GP on Thursday. It's not the first time I've been in, but the first time with a new doctor. I want to ask all the right questions and be a bit pushy.

My story so far is:
Came off the pill in Oct 2009 and started swi
Got engaged Jan 2010 and had 3 months off ttc (wedding dress!)
Started swi again Apr 2010 in a general way
Started ov tests etc and got more serious about it Sept 2010
Nothing doing so had day 21 blood and DH had sperm count Apr 2011
Got pregnant end of Apr 2011 and mc at 6.5 weeks
Got pregnant again Aug 2011 and mc at 7 weeks
Had blood tests for prothrombilitics Nov 2011 - all normal
Still nothing to date.

That means 32 cycles ttc, 2 early mc, no obvious problems from first tests but no babies either. 7 cycles since last mc. I'm 35 and my husband is 47. He has a 17 year old daughter from his first marriage.
What should I be asking the doctor? I don't want another 'there there' reaction. I know that where we are we won't qualify for NHS ivf because my husband has a child, so we're prepared to go private if necessary.

Any advice very gratefully received. Thanks.

Hi. I am not sure if you can be referred to a fertility unit at your local hospital for further tests, if you are not eligible for IVF. But I would suggest asking them. If not, then the best you can get out of the GP are tests which you would otherwise have to pay for. You can then take the results with you to the private clinic. Most accept them as long as they've been done no more than 6 months previously:

• Another day 21 progesterone
• HIV, Hep C and Hep B core
• Chlamydia and HVS (high vaginal swab)
• FSH and oestradiol (some GPs won't do this, you need to check)
• Another sperm test

You don't need a referral from your GP to start treatment at a private clinic. The GPs I have seen are pretty useless on the detail of fertility problems so you are probably best off trying to get as many tests done for free then going private. You shouldn't be fobbed off - standard advice is to start investigations after 12 months of ttc under age 35, and 6 months over.

Your first consultation with the private clinic will be able to give you some answers on the best options for you whether IUI to start with or IVF etc.

Best of luck.

Thanks very much - I checked the private price list for the tests you've mentioned and your advice will save me about £600! Much appreciated.

No problem ! I forgot to mention a rubella immunity test as well if you don't already have it.

Thanks basejump - GP was very sympathetic and I now have all those tests set up. I guess we'll see.