First referral to NHS infertility clinic- any ideas on what happens?

[Anonneedinghelp]

Have been referred to a fertility clinic from our GP after a year of TTC.
My day 21 tests came back as insufficient progesterone to sustain pregnancy, had a second test later in my cycle and came back with same result.
Husbands semen also came back with problem and low levels of sperm motility.
Am going out of my mind with worry .... anyone been through this first referral and can say what happens?

Hi @Anonneedinghelp, I had my first appointment about 3 weeks ago.
I guess the answer will depend on your issues (I know you've mentioned them above but they're different to mine so can't advise!)
Our issue was that I had high FSH levels- basically not many eggs left.
The first appointment was with the consultant who went through our test results and medical history. I had a vaginal scan to check how many follicles in my ovaries.
She ordered another blood test and basically said IVF was our only option.
Long story short we can start immediately- but we won't be as we're going on holiday next week so will be starting around October time.
I guess really they'll just give you a clearer idea of what your results mean and what the possibilities for you are.
PS the referral to the clinic was the most annoying/time consuming bit!
Hope that helps a little x

Thanks @jemimafuddleduck !
It really does...it seems like they were really proactive for you- not too much ‘try a few cycles doing this’.
Best of luck on your journey. I do hope all goes well for you.

The basic consultation will be exactly as Jemima has said. The progesterone test means it is not likely you are ovulating (or had a couple of cycles where you didn't) so they may have said to start you with things like clomid to induce ovulation. However, as there are male issues as well, the usual advice is to go straight to ivf, so they may day that, depending on how bad the test result was.

I had no issues but they weren’t sure they had caught ovulation properly on the test. Husband had low sperm something (can’t remember if it was motility or count). They were very quick to suggest IVF and my husband was overly keen to jump in (he was very much a if it happens it happens type person). So we declined to go on the waiting list for IVF and got pregnant about a year later. I can’t remember actually seeing the consultant, they were obviously in charge of the case but everything was done through our GP except the sperm test which had to be done at the clinic.

Our appointment she went over DH’s SA results which she said were fine, then asked me questions for a few minutes just kind of fired them at me one after the other then said we’ll need to wait until 2 years TTC to be referred for ivf then did an internal ultrasound. She then referred me for hycosy which I had 2 weeks ago. I’ve got another appointment with her in October to discuss results of that but I was already told during procedure it was clear. We are unexplained though.

For you it might be clomid to help you ovulate or straight to ivf.

Do you temp and/or use opks? Only because for many day 21 isn’t the right day for the progesterone test, it should be 7dpo if you’re ovulating.

Both of you should attend that initial appointment if at all possible; such things can and do cause considerable nerves and moral support from each other is helpful.

It usually lasts around an hour or so and they should go through your medical histories (any operations for instance) and also in your case your menstrual history.

You need a diagnosis first and foremost. Do write down any questions you want to ask ahead of time and ask them, no question is daft. Take a notebook and pen with you. Ensure that you are both fully conversant with test results and why they are being done at a set time. Its not always explained. It is vitally important that you can work as a team. You should ideally see the same set of people each visit, continuity of care is vital.

Would refrain both temp charting and OPK's; they won't take any notice of those and these can be unreliable if the menstrual cycle is irregular.

kiki - I would not have unexplained; all this means is that they have failed to find out what is wrong and is no diagnosis at all. Sometimes it is a "diagnosis" given to couples when they have not been adequately investigated.

Ours worked very differently so I suppose its whatever CCG you are with also.
I had Progesterone test and DH had two SA 3 months apart, we were then referred to a urologist and Gynae at fertility clinic. DH had bloods and US testes scan and I had TV US and all the relevant bloods. DH had his appt with urologist for results and I had separate appt with Gynae/Lead fertility consultant. Our hsitories werent checked, I wasnt asked to bring DH with me but we chose to anyway, apparently we should have been sent a letter to fill in a questionnaire. She didn't know much about male fertility apart from saying his urologist wants to refer to ICSI but the funding is so tight that its unlikely to ever happen. Our consultation together took 30 mins.

@AttilaTheMeerkat thanks I’m not happy about being unexplained either. I have a lot of the symptoms of endo so the plan for the next appointment is to really push for a lap. We kind of tried already but keep getting told I don’t have enough of the symptoms because I only get severe pain during my period, not any other time. They just seem to think it just hasn’t happened for us yet (20 months TTC, one chemical pregnancy a year ago).

I've been told un explained infertility too as all tests came back okay but I have pcos but do ovulate. they gave me 2 options of laparoscopy or ivf chose to have laparoscopy incase of endo

After trying to conceive for 5 years. And finally getting my lovely husband to do a SA. (his attitude is 'It will happen when it happens)

We have finally been referred due to low motility. All my bloods came back normal.

Our appointment is in two weeks time and I just wanted to get some information about what to expect. And help with what questions to ask.

Reading all your posts is really helpful.
Thank you x

Hi,

I've been trying for #1 for nearly a year and today I've been referred for a fertility appointment. I'm in the same position and wonder what to expect.

I've been tracking my cycles and I ovulate late in my cycles around day 21 with only a luteal phase of 4-8 days.

Blood work done on cd21 showed no ovulation but according to BBT I actually ovulated on cd21.

I know I need clomid to enhance ovulation. OH is getting a sperm test done but I know it's an issue with me.

The GP mentioned a larascopy mayb before clomid? Has anyone had this done before clomid? I don't have PCOS

Thanks xx

Gossipgirl how long are your cycles

@AniSL

On average they are 25/26 days with ovulation on day 19/20.

Obviously my luteal phase is v v short. This goes hand in hand with poor ovulation
X

We had our appointment at John Radcliffe yesterday and they were brilliant. Explained what the results of tests meant - ours is male factor so went over DH results and explained we would need IVF with icsi (which we already knew) also advised we can't have treatment on NHS due to my age (which again we knew). He advised on things we can do to help it work such as me reducing my BMI etc. They also gave DH a blood test to check for any genetic issues just to make sure other than the SA everything else is fine. They have also written to my Dr to request a prescription as apparently my thyroid is a little bit high which the Dr never advised of, but I feel like he was doing everything possible to help put us on track to help the IVF work when we get there. Came away feeling happy and hopeful, although now the long journey really begins.

Hi we have had similar experiences, ttc for just over two years now. Been through initial day 1-5/ day 21bloods then multiple scans, a hsg and finally an AMH (which isn’t under nhs) blood test to confirm my PCOS. I have just finished my three months of clomid- unfortunately no positive tests. It’s been such a long process and have lost hope a few times since we have started but currently starting a new drug called letrozole for the next three months. Everything crossed it works 🤞🏻

I'm going back a while now, but we went to the doctors because we weren't falling pregnant after I had a miscarriage.

I had the CD21 blood test and the CD2-5 blood test (the FSH one that checks the quantity - and quality maybe(?) - of your eggs). Mine came back fine. My husband had a sperm analysis, which came back slightly lower than they'd like to see, I think it was 18 million. So his count was on the lower side, but I think most of the other factors relating to sperm were ok.

So I then had to go through other testing. They did an internal ultrasound to check my ovaries, which looked fine. They did an HSG, which is dye through your tubes to check for blockages. That was fine. I had a lap and dye to check things a bit more closely, that was fine.

So basically the specialist told us that although my husband's count wasn't the best, I should be able to get pregnant, but obviously I wasn't so she put us on the waiting list for IVF. I think I was on that for over a year when I got the call to go in to get the ball rolling. By this point though, I was 6 weeks pregnant with my now 6 year old. I desperately wanted to have at least 2 children, so didn't go back on the pill after having him, and conceived first cycle with my now 5 year old.

I think my eldest son was born 4 years almost exactly after we started trying. It was a long, long wait, but all I want to say is even though you may get referred for IVF, don't give up hope of it happening naturally for you. Good luck x