Seeing doctor about unsuccessful TTC

[Goose365]

DH and I stopped using protection around 6 years ago and thought we’d leave conception up to chance, at first. We’ve had a few spells of actively TTC, and a few spells where that hasn’t been possible (illness/work/surgery). There has been a lot of upset and disappointment, but over the last year I thought we’d kind of accepted the “if it happens, it happens, but if not we’re still happy” kind of attitude.

I’ve found out this week that someone close to me is pregnant following a very short period of TTC, and my laid back attitude has gone. I’m finding it hard to pretend that I’m not devastated that it’s happening to her and not me, after all this time. At the start, DH wanted kids much more than I did, but over time it’s become me who is upset that it hasn’t happened and DH doesn’t mind either way.

My question (and I’m hoping I’ve picked the right place...wasn’t sure if conception would’ve been better) is what happens if we go to the doctor about struggling to conceive? What would they do? What questions would they ask? What tests etc? I know DH isn’t keen on investigations, and we’re both very certain that IVF isn’t for us. One thing I’ve always been concerned about admitting to doctors is that we don’t really have sex often enough. I don’t want to look like I’m blaming DH, because I’m not, but he does have a lower drive and it’s rare we do it more than once in what I think is my fertile window. Once a week is pretty normal for us.

I don’t know what we’d achieve by seeking help if we know we don’t want IVF in the long run, but maybe it’d be easier to accept if we knew that natural conception wasn’t possible? Sorry this is a long post. I’m not even sure I know what I want from it really

You absolutely deserve answers to if there is anything going on fertility wise, knowledge is really helpful.

I was pretty sure I didn't want IVF but I didn't say this to my Dr. I would go and say you've been trying for years and would like some investigations. I wouldn't mention that you haven't been actively trying month to month (we were the same), just say that it's not happened.

You'll have blood tests for hormones, based on that you may then be referred for an ultrasound and your partner may be asked to do a sperm sample.

My hormones were good, but scan showed issues and sperm sample showed issues so then we were referred to a fertility clinic. DH then had to do another sample and I was operated on (laparoscopy) and tubes tested etc.

No journey is the same it really depends on if anything is found. We were offered IVF but declined, and this was fine as lots of couples decide it's not for them. But knowing what our issues are has been a huge help in coming to terms with it all, hope any of that is helpful you.

@OffForARun it is very helpful, thank you so much. It’s a relief really to write this down and have any kind of response.

I’ll have a conversation with DH about how we move forward. We have the unfortunate issue that I work in the hospital department next door to where a lot of these tests might be sent, and DH might have to hand over a semen sample to someone I know...but I think we might be at the stage where embarrassment is put to one side!

Thank you again.

I think I was pretty naive about sex and the fertile window - sex education lessons seems to suggest you only had to look at a boy and you'd get pregnant. The reality is something totally different. Once a week sex is absolutely not enough - It might be ok if you were using OPKs and had narrowed your fertile window down to about 48 hours but doesn't sound like you are.....I have a very regular cycle and ovulate anywhere between cycle day 12 and 17.

You need to decide how seriously you want to commit to TTC? if you really don't want to go down the IVF route then you need to up your game - I personally don't think it's time to see a GP yet - I'm pretty sure they asked us how frequently we had sex and really you need to be doing it every other night during your fertile window - so about 3x in that period of 6 days. There is probably nothing wrong with you that OPKs, timing and a couple of extra nights of sex wouldn't fix? X

I’m not knocking your advice and you’re right, but it’s not as easy as just saying we need a couple of extra nights of sex. It’s hard when that doesn’t come naturally. It’s something we’ve tried to push at various times, and it’s had the opposite effect of making it a chore and damaging our relationship.

I guess the big thing that’s put me off relying on opks is the stress of making our entire lives about TTC. I guess you’re right that a lot of people do up their game a lot more than we have, but the idea of doing all of that and still not conceiving is unbearable to me. My cycle is pretty regular and I have done a couple of opks (and use an app to track) in the past so I do know roughly when I ovulate...but I suppose that’s not really enough. I guess this is something else I’ll try and discuss with my husband later.

Me and DH weren't really a couple that had much sex similar issue to yours - would go weeks/months inbetween. But we knew we had to do more if we wanted a family so both put the effort in so to speak. Yes it did become a chore at times yes it was organised and scheduled but needs must?

You do need to do OPKs every month though - apps on their own aren't reliable. Your ovulation day will still change by a couple of days every month. Unfortunately if you want to stick at the once a week then you do need to schedule it according to OPK tests - it just is what it is?

In the end I had to have discussion with DH and laid it all out - humans are one of the most infertile mammals on the planet. There is a maximum of 6 days but Its more like 2-3 days out of the whole month that actually conceiving is possible. Therefore if we are both committed to it then we had to fully commit.

If he can't manage that one or two nights out of a whole 30 then he needs to look at increasing his sex drive (viagra?) - a few blood tests for you at the doctors and a sperm test for him isn't going to make a difference and actually you'd be better of doing IVF - getting one sample out of him and freezing it for future use

(I have to say that it was a nightmare getting DH to commit the first time. After we had DD and we wanted to try for a second he was much more enthusiastic - surprisingly so)

How old are you @Goose365? If you started trying when you're reasonably young I'd have thought six years of regular weekly sex would be enough to cover you. I know a lot of people who got pregnant that way, without using opks etc, but they were all late twenties early thirties.

My OH really struggled with the forced, timed sex so you're not alone. I could just about get 2-3 times out of him with carefully planned opks etc. I would definitely get a full checkup for you both. If he doesn't want to hand a sample over to where you work, go private. We had a fertility assessment independently in a clinic. It would at least let you know if you're going to all that effort for nothing. If you're starting to feel resentment, it's just going to keep growing.

Ivf really isn't that bad. I've just done my first and probably only round (with nhs) and it was three weeks of faff, and that's it. No big deal at all. The fallout will be in two weeks when I find out the result.

6 years unprotected is definitely time to see your GP. Even if it is only once a week you are dtd

They could narrow down the issue for you and help you conceive naturally. Would you try IUI would that be something to consider?
Is there a reason IVF would be off the table?

@Goose365 I totally get what you’re saying. It became a regimented chore very quick and DH would get quite stressed if for some reason we couldn’t a particular night - in-laws visiting, DD won’t go to bed, DH working away, etc.

In some ways the IVF has taken that pressure away, I’m not trying to figure out ovulation and work the best days to ‘do it’ just to find out DH is away working at the best time. Of course, not saying IVF doesn’t come with its own set of stresses.

I’m 34, DH similar age. It’s not been weekly for the whole 6 years. Without going into outing details, there was a period of maybe 6 months where we had to use contraception or abstain due to a planned surgery (nothing that would now stop us conceiving) and a few busy work periods where weekly hasn’t been possible, but it still feels like a long time.

We just feel that ivf isn’t for us. The stress involved in success or failure isn’t something I would cope with well. I think it would be easier to accept that babies wouldn’t happen for us than to put all of hopes into that. We decided this together a long time ago and still stand by it. I’m a stressy and anxious person at the best of times.

We’ve had a discussion this afternoon and we think we will get checked out at the GP, but I have also taken on board that if we do want to do this we need to plan better and use opks. We’ve also talked about how we make regular sex a part of our lives again. The burden of TTC has definitely affected us, as it has been more regular in the past.

It’s just really hit me that I’ve been told by yet another person that “we couldn’t believe it, happened first time we tried!”

Just thought I should add, another reason for not pursuing ivf (or iui I guess) is that we would be limited to what we could have on the NHS. Private isn’t an option for us. We couldn’t afford to pay for multiple cycles.

Hi @Goose365
I would definitely go to see a GP to have some tests done. It could be a simple hormonal imbalance with an easy fix you never know. Don't be embarrassed because you work there, look at it positively maybe you could speed the process up or get some good contacts?

I'm a very anxious person myself and I do understand how you feel about treatments but the way I look at it I don't want to be in my fifties and regret it for not trying. I look at it as a project, I give myself a time line and the money I'm prepared to spend. I want to give a best shot and that's it.

Don't punish yourself about the past what you should have been doing etc. Get you test results and have another conversation with DH. Good luck X

"we couldn’t believe it, happened first time we tried!”

most people exaggerate - they were most likely at it like bunnies 3 times a day and militantly temping and doing OPKs

With regards IVF not going to lie it is hard emotionally and physically. I've done 5 rounds and it has cost a lot of money. But it CAN be affordable - it's more affordable than actually raising a child - I did 3 rounds for £13.5k and took a loan out over 5 years. The monthly cost is less than 1/3 that of what full time childcare costs for my DD (£900 for a childminder not even a nursery) or If my lower earning partner had given up work to be a STAHP it would have cost £1300 a month In lost earnings. So if you said to yourself for the next year we are going to live like we either have a STAHP/paying out for childcare/even going part time and having help from family and put that money aside in the bank by the end of the year you'd likely have enough for at least one full cycle of IVF if not more of you did a multi cycle natural modified IVF like mine

@ivfbeenbusy unfortunately I do know these people well and I know that they actually did get pregnant without temping and opking very quickly. They’re actually panicking because they didn’t expect it to happen so soon and had thought they had a lot of time to prepare!

Thank you so much for all of your advice and sharing your stories. I’ve had another positive chat with DH this evening and we’ve decided that opks and “targeted” sex will be easier for us than the “we should be doing it more!” pressure we’ve put on ourselves in the past. We’ve decided to try that more seriously than we have been, and just have fun without pressure for the rest of the month. We think it would be better for me to change GP so we’re under the same one (he’s been registered at the same place since birth, I moved here more recently) so once I’ve done that we’ll look at getting tests etc.

With regards to IVF costs, that would still be a hell of a lot for us financially, but the stress of knowing there’s a limit (even if we took a loan, couldn’t go on indefinitely) is the biggest deciding factor. Not wanting IVF isn’t a decision we’ve taken lightly, but we’re pretty sure it’s a final decision.

@Chicasimona unfortunately me working where I work will make no difference to contacts and speed. Confidentiality in the nhs means that any colleagues could get in serious trouble for talking to me about my own results. You’re right that embarrassment shouldn’t be an issue though.

Hey OP definitely worth going to your GP who should refer you both to a fertility clinic for tests. From there what assistance you are offered for free depends on what your local clinical commissioning group (CCG) will fund. This can include all the tests, Clomid, IUI and/or IVF. It is a complete postcode lottery and IVF can get very expensive privately but what your CCG offers you could be all you need to get pregnant so worth finding out.

Yes some people are very fortunate just like my sister. She indeed got pregnant three times at first try. Is life fair? Probably not. I did punish myself for not being fertile like others but on the end of the day it is not my fault I have different genes/anatomy.

I also wanted to share a story of friends of ours who had sex maybe once or twice a year and still managed to get pregnant twice. So I would agree what was already said before that timing is very important.

Good night ladies and best of luck X

We were in a very similar position 6 years ago, I echo other posters in advising to get some tests done and get a referral to a fertility clinic. I have just been re-referred to our NHS clinic where we conceived DD with a view to #2 (as private patients) and there’s a big backlog with Covid, we may not even get an initial appointment this year.

I felt very much like you did and the pain upon hearing other’s pregnancy news was what convinced me to seek further help, and focus on ourselves and not others.

WRT IVF I felt similar, I did not want to do it but in my mind if nothing happened I would consider it further down the line. Clinic diagnosed motility problems so ICSI was the only treatment, and I delayed it twice as I wasn’t ready. Finally did first round after about 18 months and the second (successful) round the following year. It’s stressful but only a very short period of time, on short protocol it was under a month to a BFP.

In the meantime take a a look at “It Starts With The Egg” for advice about supplements and egg quality.

Thanks again. Just posting this has helped a lot, to be honest. OPKs ordered and we’ll start with that this month. DH and I have talked a lot and are on the same wavelength. I’ve contacted the GP this morning and I’m waiting to hear back on whether it’s best for me to register with DH’s GP before continuing. It’s a start though. We’d obviously have the conversation about IVF etc if it came to it, but still not feeling like it’s for us. As some of you have though, obviously open to changing our minds later on.

Sleeping on it and talking about it, I also think I could be closer to the place where I’d be okay if it never happened for us. Generally feeling a lot more positive for having a bit of a plan anyway.

This is what happened when I went to the doctor after 1 year of trying:
He ordered a blood test - hormones and an HSG which I did privately the day after (I couldn't wait). It showed both my tubes are blocked. Now I know IVF is our only option and we're still deliberating whether it's for us or not. Bummer but I don't regret knowing this.
I wish you good luck!

@Goose365 omg I could have written your post! The only difference is we’ve been trying for 2 years and we’re now 36 and 35.

Totally get what you mean about once a week sex! Sometimes it is twice but that is rare. We’ve had tests done and docs can’t see anything obvious. Don’t want to do IVF I’m not good with invasive stuff!

We don’t do OPK I really can’t be arsed - lazy or what but I do log periods on Ovia so have a vague idea of FW.

Good luck to you 😊

Hi OP, just wanted to throw my two pence in as well.

It’s totally normal for TTC to become a chore very quickly so try not to worry about that. Easier said than done though, I know.

I moved GP too, (partly because mine were crap) and the new ones said it would be easier to be at the same one as my partner but it wasn’t strictly necessary. They also told me that if we were to be referred to a fertility clinic (for further tests I mean, I respect your stance on IVF) we had a choice of two in the local area. So in terms of work perhaps you could ask for the tests to be done/sent to a different hospital? I don’t know how big your town is though so it might not be possible but maybe worth a try?

I would also echo what PP have said that it’s much more difficult to get pregnant than we think. I’ve heard that even if we do all of the obligatory horizontal dancing there’s still only around a 25% chance each month of it actually resulting in a baby. Hence why it can take couples a year or two (or more) even when they’re at it every few days. So even if you do the OPKs or temping etc. Don’t be too disheartened if it doesn’t happen in the first couple of months.

It great that you have taken charge of the situation and that it’s opened up communication with your DP.
Good luck on your journey and baby dust to you.

Thanks! My GP has said there’s no need to change, so I’ve stuck with them for now and got a telephone appointment for next week. Feels good to be doing something about it and I think it’ll feel like a relief whatever the results of any tests are.

Good luck to all of you on your own journeys.

@Goose365 it’s no harm having a MOT to see what are your chances of naturally conceiving. The initial test is a few blood tests and semen analysis. You are not committing to anything by having this check.

I have secondary infertility and have had 2 miscarriages. I’ve been using the Clear Blue Advanced Fertility monitor. It’s like OPKs but gives you a wider window. All bought on Amazon so was €100 and €20 per month. This machine has helped me in the past to get the timing right as there really is a limited window to conceive. But lately it has not been working.

It’s been a year and a half now without success and because I am 41 I went for the initial fertility consultation. I was told that if your ovulation peak is day 11, we needed to have sex on day 9, 11, 13, 15. That day 11+13 is just not enough and you might be missing ovulation. I also had to compare basal temperature to the monitor which matched. I used to think with my unusual sleeping pattern that basal temp was nonsense but it was recommended by the clinic to get the right days for the blood tests. We actually had some success last month by managing days 11, 13, 15.

There are lots of things that can be checked and treated. And IVF is not the only option. There’s IUI that is less invasive for example.

The first check is making no commitment. You can step back at any time.

Best of luck with the decision you make.

@goose365 hi, just wondering if you had your appointment and how it went? What did they ask exactly and what's the plan going forward?

Just about to hit the 1 year ttc mark and nervous for the initial appointment (That I am yet to make!). Just called the doctors and an unimpressed sounding receptionist said this to of appointment needs to be over the phone and can't be booked in ahead, so to ring every morning at half 8 to try and get a same day call with the gp arranged! So that is what I shall do..

@dogmam yes I have. I sent a message through my practice’s online services asking about whether DH and I needed to be registered at the same GP. They called me later that day, and arranged a telephone appointment for the following week. I spoke to the doctor, one I didn’t know, but who was very nice and seemed to want to get things moving fast when I said how long it had been. She asked how long we’d been trying, whether either of us had kids already, told me what DH would need to do (call his own GP to arrange semen analysis), and she arranged to see me in person for a pelvic exam the same week.

You need STI swabs, and I chose to have mine at the GUM clinic because as I said earlier I’m concerned with privacy at work. I’ve done that already. DH has his appointment with andrology the week after next, and I’m waiting until cycle day 21 for my progesterone levels as this month was a Sunday and there was nowhere I could get it taken.

It’s not been as bad as I thought it’d be really and I’m glad we’re finally doing something about it.