GP

[Minibow]

Does anyone know what tests the GP should do? I jumped the gun and had private tests done. They were day 21 and came back normal. But now I'm readinh that I should have had a day 2 or three done for FSH? If I never had that should my private clinic have advised me that all is normal and to continue trying?

Anyway what I'm asking is can my GP to the day 2 test?

Thanks.

Day 21 progesterone

Day 3-5 fsh, lh, oestradiol

Any time hiv, hepatitis, fbc, rubella, prolactin, thyroid.

Scan

Semen analysis

That's my standard fertility workup before I refer.

@dietcokemegafan thank you.

As they never explained anything I don't really understand the results.

Would some of what you said be the set of results above progesterone?

I don't think that's confirmed ovulation. Did you have the test 7 days before your period?

It was 6dpo.

Then I had another one 6dpo a few months later

The results were this

It needs to be done 7 days before your next period. Its possible you went on the wrong day. Are your periods regular?

Fairly regular, 28-35 days. I did have a very short luteal phase that seems to have sorted itself out.

These tests are from.last may and September. As I haven't had a sniff of a BFP and they weren't really ever explained to me I'm now totally doubting their 'everything is normal' diagnosis.

What's your GP said? If you've been trying more than a year they can start fertility tests for a referral to a clinic. Even if tests are normal at this stage that's as far at the GP can explore. A clinic can do more investigations but a lot of people end up as unexplained infertility as everything looks normal.

I've had the tests and things pretty much showed normal. Got a bfp after 16 months but am unfortunately miscarrying due to a blighted ovum.

I'd suggest going back to your GP. I think it's likely your bloods were on the wrong day but if you're not conceiving they can check you and your partner out and refer on.

Thank you for replying.

We for us this would be secondary as we already have 2 children.

It's been 18 months now and nothing with private clinic telling me we are both fine. This has lead me to doubt my test results and look for other reasons.

I had a c section second time around and now wonder if there's something linked to this preventing us from conceiving a third.

@Minibow sorry for delay in replying. With GMC social media guidance in mind, I must make it clear that this isn't individual medical advice!

Progesterone needs to ideally be bang on 7 days before your next period, clearly this is only actually day 21 if you have a 28 day cycle. I always tell patients to write down the day of the test and the day their next period started. The first one is on the low side and if I were the GP of a patient with that result, on a correctly timed test, I would worry that they weren't ovulating and repeat it the following month. The oestradiol was normal.

The next one is clearly in the ovulatory level, so that raises the question of was the first one wrongly timed and can be ignored. From the obviously limited information I have, this may turn out to be unexplained - assuming your partner's sperm is fine and so are your tubes and you seem to be ovulating.

NICE don't recommend ovulation tracking but I found it really useful to conceive number 2.

Good luck! happy to answer more questions

Thank you so.much.

The first set were a week/ 6 days before my period. I had a cyst on one ovary at the time which the consultant said may have made the numbers a bit haywire. It's not there anymore. But I do have one polysytic ovary. But not the syndrome.

I've had a hycosy since then and husband has been checked and is normal.

I have tracked every cycle since October 2017.

Totally loosing hope and now wondering about scar tissue from section.

So it's possible that the first one if it was six days rather than a week could have been just before the progesterone surge. If there were no complications mentioned at the time then I'd be surprised if it was scar tissue. Have you actually seen a fertility dr or just got the results with no help to interpret them? I think you need minimum a one-off private consultation to at least make some sort of plan.

We have both been to a private consultant. I had the bloods and husband had the sperm analysis.
His results were better than average (I can't remember the exact terms).

Consultant told me that there were no problems and as I'm 36 (37 now) it can just take longer as you get older. She didn't talk me through the results per say.

I had the bloods done again 4 months later and the cyst had gone but by then I was only having a week between ov and a period.

She gave me progesterone pessaries that I used for a month but I felt awful so haven't used them again.

Since then my luteal phase has become longer but this.month my cycle was 36 days.

I agree. I think I need to go back to the consultant.

Yes I think a review would be sensible, but it sounds like this is unexplained subfertility. very frustrating.

@Minibow did they check your AMH? That's the most reliable year for checking egg reserve.... the gp won't check for that (not in my area anyway), even when referred to an nhs consultant I had to pay for it private, think it cost £120 ish

@Minibow the hycosy should have shown any scarring from your c-section, apparently scarring is normal, but it depends how it's healed. I've found out today that scarring from a previous section looks abnormal and I've had countless scans recently and 3 failed IVF transfers. I don't know yet what the plan is or even if they think it's the problem here as nobody else has raised this as being an issue, but maybe part of me is relieved that there might be a problem that they can "fix" as the thought of more transfers just being BFN like they have been is keeping me awake at night.

In your position I would go back to the consultant with a list of what's concerning you and specifically ask about the scarring from your c-section. I've been told that everything's fine at the last 3 post fail meetings to find out today mid IVF cycle that perhaps it's not. I don't think it's malice on the part of the team's, but it's frustrating when you think there's something wrong and they "reassure" you that there's not!

Thank you all for replying.

I've made an appointment and ive started a list on my phone.

If anyone has any suggestions of what I definitely need to ask if be grateful xx

I would personally download fertility friends and start temping, you need to understand your cycles more in order to help the medics pin point what's wrong. I bought the Femometer from amazon as there's an app that it works with so that you stick the thermometer in your mouth half asleep and it uploads the temp to the app. Later when awake, I then recorded the number in FF. I tried doing it with a cheap one but couldn't see the tiny numbers at 6am so quickly found it too much effort! 7 months of temping showed me that there's no issues with my cycles and affirmed that we were having sex at the correct time.

You probably won't have any decent data for your next consultant apt, but in a few months you will have the data in FF that tells you exactly how long your cycles were, when you ovulated and how long each luteal phase was. Over time, it builds a picture for you. The medics can then spend their time (and your money) dealing with any issues that they find.

Best of luck, and if I get told anything useful about c-section scarring I'll pop back to this thread.

I have a few temp cycles recorded. I'll get the thermometer back out! Thank you again. I wish I'd have come on here sooner xx

Popping a message on to this thread as I was wondering what help I could ask for from my GP. I was on the depo injection for 2 years and since coming off it 1 year ago I have not had a period or any sign of ovulation and me and my partner want to start trying to conceive. I’m 28 so I know I have time but I have this sinking feeling something is wrong because I never had a completely regular cycle to begin with. Do I need to start with requesting hormone testing? I’m assuming my progesterone levels might be messed up? @dietcokemegafan do you have any ideas?