How long to 1st fertility appt?

[MsGuna]

after exactly 1 year of ttc (I am 37) and constantly badgering my gp, they have finally agreed to refer me to the fertility clinic 🤗

my bloods have shown what looks like a pcos picture (high testosterone, high lh:Fsh ratio) and I also have irregular periods, acne and weight gain.. but instead of diagnosing pcos, my gp has requested another ultrasound scan and also referred me to gynaecology to make the diagnosis and start treatment.

I’m getting very frustrated by all the waiting and pushing and things not being done and am wondering whether it may just be better for my sanity to go private.. as all I really want is something to help me ovulate!!!

I would be grateful if people would be willing to share how long they had to wait for their first fertility appointment please? So I can make an informed decision about paying privately. Thank you!

Hi there, although I am not located in the UK, I have decided to go privately abroad. There are some really great clinics at fair pricing (fair depending on what each person considers fair) with great success rates. Maybe give it a try? I'll be travelling in August!
best of luck
xx

Hiya,
oh i’ve been there. I was prescribed clomid for 6 months to ovulate but it didnt work for me and i also did the hcg test. These two were on the nhs. I then went private for ivf ( i have a ds already so wouldnt be funded). I had a scan done and my ovaries had a lot of follicles and most likely i wasnt ovulating regularly. Get what you can get done with the nhs but if you really can’t wait going private is much quicker. I was really surprised at how quick it was tbh. Have a look around at clinics some offer refund/multi cycle packages.

Thank you both for your replies! I don’t think I can take annual leave from work to go abroad so it’s definitely nhs vs private.. that age old question!

I suppose it’s just down to how impatient I am.. I feel like every month that I delay is just wasting any potential eggs and means I’m more likely to limit
myself to only have 1 child too (would love 2 but not sure how realistic this is at my age and the difficulties conceiving so far)

If you did go through ivf you don’t know how many embryos you would get. If it works once for you be confident it will work again. Its true you are young. Im 32 with a 6 year old but its taking time and im fed up of people saying oh you’re young well…. Its been a year and half of ivf and two years of naturally trying. Before i know it ill be 40!!!

NHS Glasgow we were referred to fertility in Nov and seen following Feb. They started letrozole immediately. However I had already been seen by gynaecology at that stage who had said PCOS and we paid for assessments privately to hurry along both NHS fertility and NHS gynaecology.

Thank you for your reply! 3 months is a lot sooner than I would have expected but it really will depend on so many factors won’t it. I’ve just paid for a private AMH test with Superdrug (£76 vs £115 at private fertility clinic) and it’s come back as high at 123… all my tests are suggestive of pcos so far and I feel i just wish someone would take responsibility and start treatment already! (If I’m impatient already I worry for my sanity with the whole process!)

@MsGuna NHS Glasgow requires - semen analysis, ultrasound scan, hycosy prior to ovulation induction meds. I had all this done privately as otherwise I'd have needed each of these assessments on NHS and some had long waitlists (hycosy 8month waitlist for example). I therefore did them all private just at time of referral.

Regarding GP - check your healthboard guidelines for fertility referral, 1 year should be adequate for trying. Doesn't matter if they've given a gynaecology referral, it's not the same service and you need a fertility one too. Don't be afraid to be pushy.

hi guys sorry to jump on this thread.
I just had my blood test results today and also have high testosterone, high FSH and slightly low LH. I have no PCOS symptoms so was very surprised and upset. Obviously googling it all hasn't helped. My doctor hasn't even discussed my results yet, just emailed them to me 😪
what does high testosterone mean in terms of conception? we have been tying for 9 months and nothing. All my ovulation tests i do monthly seem to suggest I ovulate. Any advice would be much appreciated. I am already looking to book the AMH blood test.

Still waiting on my first appointment, 13 months later!

@pcosandme.x 13 months 😱 whaaaat??!!

@Mofeg high testosterone on its own doesn’t necessarily signify pcos.. and it’s usually a higher lh that’s the concern with pcos (your post said high Fsh)- plus with added regular periods etc it doesn’t look like a typical picture of pcos (they need 2/3 characteristics to make the diagnosis according to the NICE guidelines)

i would probably book an appointment with your gp and discuss the results and see if they want any other investigations/imaging? Good luck with it all!

Yeahhhhhh lol I'm in Northern Ireland

I called my local fertility clinic this morning and was told the wait time on nhs is currently approx 6months. I booked a consultation privately (£200) and even that is a 4 week wait! I know it isn’t life or death but it does severely impact on mental health all this waiting 😔

Hi there, I think it depends on where you live in uk as different areas have different waiting times. I waited since summer 2019 and finally got my referral to a gynae there in March. ( I'm in Northern Ireland) waiting lists here i believe are longer tho . If I could go back in time I would have rang hospital and paid for a private initial consultation with gynae , they then refer you back onto nhs for any treatment. At the time I wasn't aware you could even do this . My advice is don't wait around , I'm 36, 37 in Dec , and having wasted all these years waiting for my appointment has seriously impacted my mental health. My anxiety is so bad that I don't sleep at night as I suffer from panic attacks and anxiety during the nights as I was told at this age my chances of becoming a mother with my own eggs are diminishing as fertility declines rapidly over 35 and nhs are certainly taking their time .
I have pcos I'm told . I have very high testosterone, low progesterone and really irregular periods . I'm told now I'm not ovulating

@pcosandme.x good luck, I'm in n.i aswell and i waited since 2019 to get from gp to gynae lol

If it’s something you really want and conscious about your age then go private. I was 28 when we started trying for our second and we tried naturally for 2 years . I went private just over a year ago Im now 32 and I’ve had 2 failed transfers, protocol changed then successful but unfortunately had to tfmr at 18,weeks but it sometimes take trial and error my consultant has already said we will stick to the same protocol as i got pregnant on it and the tfmr was a case of ‘bad luck’. Im going to transfer again now end of August/early September. Honestly and before i know it another year will pass by. I wish i went private even sooner! If only time machines existed…

I forgot to say once your on the system then everything happens quick from the first medication/ injection to retrieval to fresh transfer…. The two week wait is the longest and most difficult part of the entire process!

Was referred in May 2021
1st appointment Nov 2021
1st cycle March 2022 short protocol-unsuccessful
2nd cycle long protocol-day 9 of stims today
It varies depending on what area you are in and the reason for referral.
X

By the way I just want to add what happened at my first refferal to gynaecology . Like you , I have high androgens (testosterone ) and irregular periods.
I was diagnosed with suspected pcos I didn't have cysts on my ovaries but they can diagnose you just.on symptoms, you don't necessarily need to have cysts .
When i got my first gynae app , the gynae ordered another scan to rule out a gland issue as there's a gland around there that can cause high testosterone. That came back fine so she believes based on symptoms it's pcos I have. She then placed me on metformin at first appointment. It supposedly helps regulate cycles and lower testosterone. I then had to go do some blood tests on day 2 of my period and day 20 I think which is where they check your hormones and if your ovulating or not. Mine came back I'm not ovulating and my progesterone is low. After that I was prescribed clomid. Haven't started it yet tho

@Kris123499 thank you for that information about the first appointment- it’s very useful to know! The difficulty I’m having is the extended wait time to be seen by the fertility team or the gynae team!

I’m a doctor and I work for the nhs but the first time I access their service, I’m actually really shocked at how long the journey has been so far (I told them last September I have irregular periods/concerned about pcos) and they still haven’t confirmed diagnosis (referral to gynae can take 12-16weeks!) or referred me to fertility (needed extra bloods which weren’t done on the initial requests)!

I’ve given up and booked my consultation privately now so hopefully can at least get the ball rolling! 🤞🏽 (I need to look into starting a pcos clinic that just does everything in one go so people don’t waste their time.. it’s so common and so overlooked!)

My advice is to take a notepad with you to the appointment and write down any questions you have beforehand. I've had 3 appointments to date and each time I've came out with questions that I should have asked. Make sure you get all the information clearly explained . At the first appointment and what I see from other ladies mentioning, seems to be the same process, they will take your weight and advise you to start taking folic acid and vitamin d. They will ask alot of questions about your partner. To be honest most of the appointment seemed to be focus on partner . And again, other ladies on forums said the same thing so I'm assuming it'll be a similar experience for you. The gynae checked his medical history for a general idea of his health and told me he needs to go get a semen analysis. He then went to the gp and got a referral. This took about 8 weeks wait on nhs (although here in n.ireland lists are slow so can't say how long it is roughly throughout the rest of the UK.) If you could get that ball rolling now too that would probably help speed things along.

As you said you've only been trying for 1 year , try to relax and not worry too much. There's still a good chance you could fall pregnant naturally any month 🤞 ive scoured these forums alot and plenty of ladies with pcos in late 30s have got pregnant naturally. sometimes it just takes a little longer as most of us have ovulation issues. They do say it can even take a couple without fertility issues upto 2 years to conceive.
I havent been one of those lucky ladies and its certainly been more challenging

Thank you! That’s very helpful. If it helps anyone else, I have just had an email about tests the fertility clinic require before their first consultation:

*
AMH (12 months) (cheapest I found was on Superdrug online- GP cannot request this)
LH (6 months)
FSH (6 months)
TSH (6 months)
oestradiol (day 2-3 of cycle for all the above tests)
progesterone (7 days after ovulation - if low will need shbg and testosterone)
Full blood count (6 months)
Vitamin D (6 months)
Random glucose (6 months)
3D pre-treatment scan (6 months)

sperm analysis for partner (cheapest I found was £169 at the male fertility clinic in london)
*

They charge approx £450 to have all these done privately so asking gp to request will definitely save time and sanity! Hope this may help someone at the start of their journey 😌