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First baby conceived using Metformin and Clomid at Fertility Clinic due to PCOS, would I get help if I struggled to conceive no2 due to PCOS?

9 replies

YouBoggleMyMind · 29/04/2019 10:10

Just that really?

I was under the care of the fertility clinic for 18 months to conceive DS1. We now want to try for baby no2 and will obviously do the whole trying for a year to see how we get on but does anyone know if I'd get nhs support if it didn't work out again? Or would I have to go private this time?

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AttilaTheMeerkat · 29/04/2019 15:46

As you are now parents it may well be that you will not qualify for any assistance with conceiving a second child under the NHS system.

re your comment:-
"We now want to try for baby no2 and will obviously do the whole trying for a year to see how we get on"

Do not wait a year. I would seek help sooner rather than later given also that you have a PCOS diagnosis. PCOS does not go away of its own accord. View private clinics with due diligence before committing yourselves to their services and ask questions of them. It is fair also to say that some private clinics are far better run than others.

physicskate · 29/04/2019 16:29

Check your local ccg guidelines. Some will offer non-ivf assistance to couples who have a child. Some don't help beyond very basic blood tests.

Teddybear45 · 29/04/2019 16:38

You wouldn’t be able to get ivf but may qualify for iui which is probably less effective overall than clomid/metformin. As you got pregnant with clomid/metformin can’t you just get this prescribed again by an nhs gaene?

FlipKat · 29/04/2019 17:06

Even if you don't meet the criteria for NHS IVF, as others have said there are other treatments the NHS can provide, including clomid and metformin. It may be different in different parts of the country but I would say most NHS GPs in my area would consider referring you to gynae/fertility clinic if you had not conceived after 6 months of trying, or sooner if your cycles were >2-3 months long

YouBoggleMyMind · 29/04/2019 19:54

I guess cos I know I have PCOS I want to know that I can be referred through my GP and get clomid/metformin again at the Fertility Clinic through the NHS like the first time. Not necessarily the IVF part.

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YouBoggleMyMind · 29/04/2019 20:06

Is this what I should be looking at? It mainly talks of IVF? Rather than fertility drugs?

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FlipKat · 30/04/2019 09:19

You are right, that document is mainly about funding for IVF so not applicable to you as you are not eligible due to having had a child already. In your situation with known PCOS and having required fertility clinic in the past, the GP should be able to re-refer you if you've been TTC for 6 months with no success. The NICE guidelines have the following criteria for fertility clinic referral (for any fertility treatment, not necessarily IVF), which usually would require the GP to perform some baseline investigations first:

When should I refer a couple presenting with infertility?

For woman younger than 36 years of age:
In general, consider referral (for further assessment and management), along with her partner, if history, examination, and investigations are normal in both partners and the couple has not conceived after 1 year.

Consider earlier referral if the following factors are present:

In women:
Age 36 years and older (refer after 6 months).
Amenorrhoea or oligomenorrhoea.
Previous abdominal or pelvic surgery.
Previous pelvic inflammatory disease.
Previous sexually transmitted infection (STI).
Abnormal pelvic examination.
Known reason for infertility (for example prior treatment for cancer).

In men:
Previous genital pathology.
Previous urogenital surgery.
Previous STI.
Varicocele.
Significant systemic illness.
Abnormal genital examination.
Known reason for infertility (for example prior treatment for cancer).

From what you say, you fit these criteria for fertility clinic referral, even though you won't be eligible for IVF. Your local area should have some sort of referral pathway including tests you might need before referral if you've not had them already, which will look something like this:

clinox.info/clinical-support/local-pathways-and-guidelines/Clinical%20Guidelines/Fertility%20IVF%20Referral%20Pathway%20part%201.pdf

www.oxfordshireccg.nhs.uk/professional-resources/documents/clinical-guidelines/gynaecology/fertility-IVF-referral-pathway-part-2.pdf

YouBoggleMyMind · 30/04/2019 13:31

Thank you Flipkat Smile

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