1.5 years trying, now Doctors...

[fuzzduck]

Evening. Im not too sure where to start. Myself and the other half have been trying seriously for a child around one and a half years. After nothing what so ever, we decided to go to the doctors in the beginning of November where the doctor arranged for him to provide a sperm sample, which came back ok. The doctor also did a blood test at the first appointment, as I had just started period, and also took a blood sample 3 weeks later. At the last appointment the doctor advised us that my blood test had come back normal, with nothing indicating a problem. So, the doctor has referred me to a Gynaecologist. So, what should I expect, is this a positive step? I would be curious to know other peoples experience, and if you got the result you wanted in the end, a child? Thanks for any help or advice, its much appreciated.

Yes its a positive step on the right direction. It's a bummer that you actually have to get help but it's got the ball rolling. Yur gynaecologist will want to do more blood tests, your egg reserve and quality etc. She'll send you for an ultrasound to check your ovaries and then she'll suggest the next step depending what your results are.
We have unexplained fertility for 2 years so now she's put us on the IVF waiting list. So just waiting for that letter. You'll get there eventually with treatment or in the mean time you might have a nice little surprise.

Good luck

thanks for the reassurance. I hope we do get there, seems less likely every month. Positivity is hard at the moment. Especially reading all the stories on here that don't seem to result in anything.

My gaeno said for unexplained she personally likes to prescribe clomid/hsg/ultrasound/lap, post 35 years of age because sometimes it's as a result of undected endo. But that others may tell patients to keep trying for up to 2 years. So I think there might be room for a second opinion if you aren't happy with the advice given. We thought that was where we were heading before my PCOS was diagnosed.

so are you confident you are in a situation where you will have children right now?

Not really as I've been ttc for 2 and off contraception for 3 and have pretty much lost all hope. But I have a plan from gaeno at least. 6 months clomid/metformin, then 1 nhs ivf cycle.

Just do one step at a time and do your research. It took me many years and 6 IVF attempts. Push those limits and reach for the stars
But get a good site and fertility friends was a godsend
Good luck

Its all so worrying because we don't even have the financial resources for IVF, its a rich persons treatment.

Where are you? fuzzduck In the UK we have 1-3 cycles free depending on location, and then Access programmes to fertility that can fund IVF depending on circumstancess. Do you have something similar where you are?

I don't know to be honest, as it has not gone that far yet with having to wait until early January for gynaecologist. But my area is Wakefield/Pontefract Yorkshire.

Okay so you will prob get a minimum of 1 free nhs cycle. In my case before I was allowed to see gaeno I needed:

Day 21 blood test
Fsh/lh test (day 3)
Rubella antibody
Hsg
Pelvic ultrasound inc transvaginal.
Bmi under 35 (has to be under 30 for ivf and under 35 for clomid per my gaeno).
If cysts on pelvic ultrasound then other pcos tests

Then gaeno reviews all the results. In my case she diagnosed silent/no cyst pcos even after GP said it was unexplained, because of some slight discrepency in the way my ovary moved in the ultrasound and also one of my blood results. She Recommended 6 months clomid. Metformin throughout up to first 12 weeks of pregnancy. Review every month with day 21 blood test to measure effectiveness and adjust dose.

after gaeno it's ivf. The clinic is strict about bmi less than 30 to the point where they will reject and make you wait 6 months to get it under. Was told they will ask for all the bloodwork again. Then may put me on injections to stimulate ovaries because that works for pcos. Or may recommend ivf straight away (rarer). Not sure about this part tbh as haven't met the dr in the clinic yet.

Its all very depressing. I pay my taxes and NI same as everyone else yet some areas get 3 IVF cycles and I would get 1.............. I feel like giving up before it gets too much. It seems everything leads to IVF and I cant go down that road financially. IVF never seems to work with just 1 cycle, and everyone elses stories on here of medication, and general poking around don't really seem to result in anything. Sorry if I sound bitter.

Do you mean IVF is the next step after the gynaechologist attempts?

Yep

I always wonder what would happen if we moved to coventry before ivf. They are one of the only places to offer 3 attempts. But then they prob have really strict criteria. You're right it is really unfair. Should be the same for everyone.

It just really pisses me off that if it ever came to IVF some areas actually get better treatment than others. It should be debated in parliament! Whats that signature thing to get it discussed in parliament? Anyway, when I had my two blood tests at the doctors, and she said they showed nothing up, what were they actually checking for.....? Ovulation? And without wanting to sound stupid, because tests show that Ovulations are happening, does that mean the full process of Ovulation is ACTUALLY happening? Does that make sense, im not very good at putting things into words? And how often does the whole fertility thing end in IVF, I just get the impression that on here we only hear the less positive side of things, or does any problem usually end up in IVF as the miracle cure? IVF seems to be the be all and end all, I just hope or would like to think that it doesn't always lead to this. Sorry for waffling.

Ivf only results in a live birth 40% of the time (for women under 35) and that reduces for 35-40 and over 40s have something like a 20% chance I think. That's the statistic. It's most successful for male factor infertility (I believe that's what it was designed for) and apparently least successful for 'unexplained'. Unexplained is quotation marks because often it becomes explained during the process of IVF treatment so it's the truly unexplained stuff. So my gut instinct is that the posts you see on here prob explain the truth of the whole experience.

As for the blood test for ovulation my guess is you might have had day 21 progesterone test and day 3 fsh/lh. Day 21 has to be above a minimum of 30 to 'confirm' ovulation. Fsh I think has to be under 14 and lh under 8 or something similar - but the exact levels depend on the lab processing your results. You should get a print out of the results to take to gaene.

I was told by gane that for pcos clomid and then injectibles are the preferred approach to start with.

I didn't get a print out to take with me, I wonder if it is all done electronically...

I requested the print out as I wanted a second opinion (we have a resident private gaene at the surgery in my workplace)

Its like sex education all over agai, and I don't think looking at the interweb helps. If I am ovulating properly, or the test so far 'shows' that I am, but still cannot get pregnant, then what other things could be the cause. Most treatments seem to centre around not ovulating and clomid, but what could it be where this is not the issue. I suppose IVF is the wonder cure.... (for rich people only).