Vague fertility referral letter

[goldflakepaint]

Just after a bit of advice. My partner and I are 35. Following GP tests last year, we were told that we had mild male factor infertility. We hit the two year ttc mark in March, becoming eligible for an NHS fertility referral. We then became pregnant naturally in April but sadly the pregnancy ended in a missed miscarriage four weeks ago.

I assumed that we were no longer eligible for anything on the NHS until we have been trying for another two years as we had 'conceived'- our CCG criteria seems to make a distinction between conceiving and having living children. My GP thought it was best to make the referral again regardless, making our current situation clear.

I received an 'e-referral appointment letter' today asking me to choose a fertility clinic for 'further assessment'. I chose one and was told on the phone that I should hear about an appointment date in about 4 weeks. I was pleasantly surprised by this and thought that I may have misunderstood the criteria- perhaps we are eligible for assessments but not eligible for treatment? We had already reconciled ourselves to having to pay for IVF privately if it came down to it (its not like we are getting any younger) but also assumed that we would have to pay for tests/further assessments.

But then my partner pointed me to a vague bit in the letter which basically says that referrals 'will be checked by a specialist' and one option may be that they pass you back into the care of your GP. Does anyone know if this means that we still may be rejected on conception grounds even though we have been put on an appointment waiting list? I thought that that would be part of a triage process before sending us this letter but that part of the letter has me wondering.

Any help or insights from previous experience will be much appreciated. I have an appointment with my GP on a related issue on Thursday so will ask her then but just looking for some reassurance or advice not to get my hopes up. I feel like this letter has thrown me right back into the rollercoaster of ttc whilst still processing my loss and whilst it has helped me feel more hopeful, it has also brought its own anxieties!

Thanks x

I would also read that as if a specialist doesn't think you meet the criteria you'll be sent back to the GP to make the referral again when the criteria are met. But it is confusing. Also now you are 35 you don't have to wait 2 years you only have to wait 6 months before qualifying for referral

I conceived naturally at 35 which sadly ended in a miscarriage, I was already in the infertility 'system' at that stage they were doing tests/investigations to see what my issues were. I was still seen by the fertility specialist (a week later in fact) and treatment still commenced.

Hi @goldflakepaint my experience was similar to @Pinktruffle, I had a loss whilst waiting for my first appointment (after trying for over a year) but had a fertility appointment a month after and we were able to continue with investigations.

Everything takes so much time, hoping that you can stay in the system and have some investigations x

@ivfgottostaypositive Thanks for your reply, yes, the more I think about it, the more I read it in the same way as you. I feel like I heard someone else tell me they thought it should only be six months. But when I was in the hospital due to the miscarriage, the consultant (who also happened to be the medical director of the local fertility clinic) told me that it would have to be another two years before we became eligible again. Considering our age, we really can't wait that long- he agreed and advised that we book in a private appointment with his service after trying again for 3-6 months. This letter made me think perhaps he had it wrong somehow but probably not, being realistic.

@Pinktruffle @VenusStarr thanks for your responses, I don't think we were actually in the system as our GP put referral on hold in response to COVID-19 and then put in a new referral recently. It feels only right and fair that people continue to get access if they miscarry- its not like anyone in the world only wants to get pregnant rather than have a baby and it doesn't mean that there are not still fertility issues remaining. But I am aware that this whole thing is such a postcode lottery and I'm trying not to get my hopes up- I've had enough disappointment recently. I'm glad you are both commencing with investigations/treatment and hope it all goes well.

I will ask GP about this tomorrow x

@goldflakepaint

It does vary by area - I'm in the West Midlands and both miscarriages and ectopics "reset" the clock as it were so the timeline started from the beginning again but you should definitely tell your GP you are aware of the NICE guidelines about the 6 months and force him to refer - I think sometimes GPs fob us off because for lots of women they will get pregnant within 2 years but there are also lots of women for whom that won't be the case and for whom time is critical x

I'm West Midlands too @IVFgottostaypositive, had all my treatment at BWH and they never told me I had to re-refer, we just carried on with the consultants plan for treatment. I was on Letrozole 2 months after miscarrying and on the waiting list for IVF 6 months later.