Internal Fertility scan test and fertility blood tests

[Phoenix2022]

Hi all,
I'm 39 and went to see my GP who is sending me to do some infertility blood test and an infertility scan at in the radiology department at a London hospital due to having tried for more than a year and not being successful. My gp asked me to liaise directly with the radiology department to see when is the best time to come to do the internal fertility scan, as I understand it should be on ovulation day or a bit before. I called the hospital 3 times to get more information on the type of scan as well as when I have to do it and I have got 3 different responses:
1 - first receptionist told me it's a fertility scan and that it's not their job to tell me when to do it and that I should get in touch with my GP but the GP told me to check with them
2 - second receptionist told me that it's an internal fertility test and that it needs to be done on ovulation day
3 - third one said it's internal fertility scan and that it does not matter when in the month I do it.
I checked on the internet and there are several types of infertility tests (follicular, ovulation) and they all require you to do a scan on different data after the start of the period.
My cycle are usually 28-30 days (last 2 cycles were 30 days) and the scan is scheduled on the 13 days after the first day of my period (from the clue app, it says my ovulation day should happen on day 16).
Did anyone go through this and could please help me know what type of fertility test are done through the nhs and when I need to do the tests?

Another question is when to do the infertility blood test? Is it a few days after the start of your period as well?
Many thanks
Em

Hi @Phoenix2022 I've just been through these tests and hopefully can help... my initial blood tests were done twice. My GP asked for day 21 bloods but as my cycles are longer I did them 7 days after ovulation. It may be worth asking for day 3 bloods also although I didn't need these.

For the internal scan, I don't believe it matters but I might suggest waiting until your bloods come back - I say this because my blood results showed hormone imbalances suggestive of PCOS so my internal was to check my ovaries and was done two days before my period was due.

Could you ask for a copy of your referral? I wonder what they mean by 'internal fertility scan' are they checking for cysts? Follicles? That would help you decide when is best. It's not helpful that they aren't giving you much info there. Good luck 🥰 x

They should also be testing your man in tandem with your initial investigative tests. I would certainly be asking them about this if this is not being done. Its little point solely testing you at this early stage without him being investigated as well (and such tests often have to be repeated for both of you).

Has the GP not requested a referral to a subfertility unit, instead waiting for these test results?. I would be asking why re this as well because you should be referred now. You do not need a GP faffing about with sending you for initial tests because these can be done anyway by the subfertility unit. Read and print off a copy of the NICE guidelines.

Re blood tests I would be looking at getting a day 2 test done; this will check and compare your LH level (luteinising hormone) against that of FSH (follicle stimulation hormone). If these two are out of sync then ovulation will be affected.

It does not matter really when an internal ultrasound scan is performed but these can be done through the month.

I am due to have the same scan ordered by a consultant and she didn’t specify any point in the cycle to have it. I also had bloods day 2-4 and then having days 21,28 and 35 to check for ovulation (I have long cycles).

Thanks a lot everyone.
I did call the gp practice again and they confirmed the blood test is a day 2 test and the internal fertility scan is a pelvis scan so can be performed anytime but I got confused with the ovulation test.

My boyfriend was tested and he tested fine.

Thank you I will look at the NICE guidelines.

I am a foreigner and back in my country we usually have a gynaecologist who can follow you during the conceiving process. Is it not common in the uk?

Many thanks!

@Phoenix2022 Ive ended up going private so I have a consultant with me through the whole process. Im not sure about NHS!

@AttilaTheMeerkat I could not find the NICE guidelines it gives me something very generic, would you have a link by any chance?
@xoJellyBean when you went private, is it a gynaecologist you saw and does the private insurance covers the costs?

Thank you

This may be helpful:-

www.nice.org.uk/guidance/cg156

I would try and ensure that you have continuity of care and see the same staff members each time you visit the subfertility unit.

Ensure that the level of LH is compared against that of FSH for your day 2 test; if that is not done then the test result could give you a misleading result. Both these hormones kickstart ovulation so both should be tested.

You need two sets of blood tests:

LH/FSH/E2 on Day 3 (in practice, days 2-4 are ok)

Progesterone on Day 21 (in practice, it needs to be 7 days after ovulation so may not be on Day 21.)

I’m having my scan next week and my letter says it doesn’t matter where I am in my cycle, even if I’m on my period I will be having it atilk

*still

Thanks everyone for your precious help!