GP refusing to refer me to fertility specialist

[CupcakesAndCocktails]

Hi I'm hoping someone here can give me some advice on how to proceed.
I've been ttc for 18months with a ?Chemical pregnancy a few months ago. I went to the GP after a year and had day 3 and 21 blood tests. I've had a pelvic ultrasound and DH has done 2 sperm samples. My ultrasound showed polycystic shaped ovaries, my bloods however were in normal limits so GP says no PCOS. I was found to be anaemic and have vitamin b12 deficiency. The GP has corrected this.

Anyway to get to the problem, at my last visit to the GP he said he would refer us for NHS IVF but he thinks we are unlikely to be accepted. He says that he will not refer me to a gynae as it is not necessary and advised me to go private. When I asked about a HSG he said he didn't see the point as it would not get me pregnant!

Neither me or my DH have children and I think I'm at least entitled to be referred to a gynae. I'm so angry at my GP, he has been totally unsympathetic during this whole process. I'm planning on going to see a different GP at the same practice and am worried about getting the same spiel from them. Can anyone advise me of what my rights are?

Thanks and sorry for such a long message!

Did he say why you wouldn't be accepted for IVF?

Also curious as to why ?

Surely a GP doesn't decide whether ir not you need IVF?
When he says he's referring you for IVF does he not mean he is referring you to the fertility clinic?
We were referred to the hospital by our GP and went along to the fertility clinic and met an obs/gynae and he decided what tests etc we would need.
We did go private for the treatment as would have been waiting 3-4 years in our area for NHS.
Whereabouts are you?

Thanks for the replies. I'm under Bury PCT and apparently they only fund IVF for women between the ages 39-40 which is completely ridiculous. I'm 30 btw.

I asked him what would happen if they didn't accept us for IVF and he said that I would not be seen at all and that would be the end of NHS treatment for me.

We've been ttc for 18 months. I was completely shocked when he said that as I was expecting to be at least referred to a specialist. I already expect that we may have to pay for IVF if we get that far. I'm still hopeful that we can try other things instead.

This happened in the middle of march. He said the IVF board meet at the end of march and if we were successful we would hear within a couple of weeks. I'm assuming we have not been successful. I really need to go back to the GP to find out either way. I just feel like I can't face it at the moment.

It's Not HIS call, he shold be refering you.

((((((((((((((Hugs))))))))))) btdt didn't need IVF but did need a tubal cleanout each try as i had some weird sort of blockage going on. Yes it took foreever to find that puzzle out.

This seems crazy! I kind of agree with the GP that there is no point referring you for NHS IVF if you dont fit the criteria but there should be some other investigations/treatments that they can offer?! Given that you have PCO-type ovaries and have recently had an early pregnancy, it would seem that ovulation induction (ie clomid or similar) would be a sensible first step even if they wont refer you for a lap & dye or HSG.

At my GPs there is one doctor who has a special interest in fertility issues and has always been very helpful. Maybe you should check if this is the case at your surgery, otherwise there must be an NHS fertility specialist somewhere around and if this involves being referred to gynae then start making a fuss! Maybe it comes out of the GP surgery budget & they dont want to spend the money.

Cupcakes - sorry if this is off-the-wall but have you been tested for coeliac disease? Adult women with undiagnosed coeliac are at risk for infertility - and anaemia and B12 deficiency are symptoms of coeliac (many people and many GPs wrongly think that you have to have stomach problems to have coeliac).

If you had coeliac, you would (I think) have a definite case to be referred to a fertility specialist - as well as, obviously, the required specialists to manage your coeliac condition.

My bloods are always normal even though I has PCOS. My GP wasn't interested. I went privately to a gynacologist and was pregnant within 3 months. No fertility treatment, just metformin which the GP wouldn't prescribe.

If you are strong enough I would go back and demand a referral to gynacologist more strongly, perhaps take someone with you for support.
If you have the means then private will be quicker.
Good luck

See if you've got a fertility clinic near you that you can self refer to?

They should be doing more, much more. Or ask for an appointment with someone else within the practice.

Thanks for the replies, I think I just need some other people to say my GP is wrong to get me motivated!

I'm going to see a different GP and see how I get on from there. Hopefully making some noise will get things moving. If not I think we will go private. I'm sure we can afford the initial few consultations. Thanks for all the advice.

Hey cupcakes. He is definitely being unreasonable. He doesn't have the expertise to establish what kind of treatment would work for you. You clearly have problems causing your fertility issues and if you've been ttc aged 30 for 18 months you need to see a Gynae expert. My first inclination was to suggest you see a different GP. Be bold, you're in the right. Hope you get more success with the different GP.

It's possible that he's abiding the acceptance criteria that the fertility clinic set, for example in my area you won't be accepted if you smoke, are over a certain BMI or either party ttc has a child already. There really isn't any point sending you to Gynae as your problem is specific and best dealt with in the fertility clinic.

Are there any other GPs at your surgery that you could ask for a second opinion on referral?

Cupcakes definitely make some noise at the GP's. Good to hear you are going to see a different one. Make a formal complaint to the practice manager if you need to. I had such bad advice from my GP over the course of about 6 months (which I am still quite angry about if I think about it...) but educating myself (mainly through MN!) on fertility issues helped me to question some of my GP's initial answers which turned out to be wrong.

I was shocked to discover quite how little some GPs know about fertility issues, I had assumed that they would have more knowledge than they did!! Definitely don't take the first answer as a definite.

Good luck!

Stickybean were you ovulating before the metformin?

"He says that he will not refer me to a gynae as it is not necessary and advised me to go private."

Why would you need to go private for care that is not necessary?

How fucking dare he refuse you a referral for something he accepts you need.

I would be making a complaint about him.

Do go and see another doctor at the surgery. I really hope you get the referral you need.

Is this the future of the NHS? GP (who commission our care) refusing to refer us for treatment while advising us to go private?

He is a disgrace.

I was expecting this to be a thread from someone expecting unreasonable care.... it's not.

Either Bury PCT have a policy of no fertility treatment or they don't. Find their policy if you can. Freedom of Information act means the PCT/hosp have to share it with you.

You do need basic investigation including HSG. It might be that a simple tweak sees you pregnant. Many people do just take longer to get pregnant so it may just happen for you. Your GP is wrong though

Hi sorry for late reply. Just wanted to say thanks for all your comments. I had to wait ages for an appointment. Saw a lovely doctor yesterday, I have to get some swabs done, once we get those results she will refer us to a specialist.

I went in with all sorts of evidence to support me but didn't need them. I've also changed to a different GP in the practice as I really don't want to see that crap doctor again.

Thanks again

great news.

i was your age trying for dd (ten yrs ago +), and had the blood tests, all fine and then the hormone tests at hospital, along with ex dh having the sperm test.

Nothing wrong that they could find, i finally conceived naturally after 3 yrs.

Best of luck.

I'm really pleased you've been taken seriously and have got the ball rolling. I hope you get some answers and a bfp soon.

cup cakes

same as you - but my bloods were normal then not normal then normal, i was refered to consultant and put on metformin, a previous doc had offered me this too...but didnt tell me much about it - so was sceptical until the consultant told me all ins and outs.

also i lost about 9 pounds, took agnus castus and wild yam - and also by chance had about two jars of manuka honey, fell preggers after 5 months of all this - had been tyring for over two year.s

ring gp practice and ask to speak to the practice manager. explain story to them then tell them you want to complain about gp and then ask to be seen by another gp. then if you dont get anywhere put the complain in writing then ring pals team at local hospital who will help you and change gp to another practice. basically every referral a gp makes the money comes out of their budget so thats why some gp's are slow to refer for things. basically its a money saving thing at times with them.