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Infertility

Our Infertility Support forum is a space to connect with others in the same position, discuss causes, treatment and IVF, and share infertility stories of hope and success.

First Appointment (NHS) Questions?

7 replies

Nolly1994 · 20/04/2023 17:19

Hello

Had my telephone appointment a couple weeks ago and have our face to face next Thursday. Does anyone have any questions we should ask? I'd like to have them prepared for the day :)

Seems a big mix of experiences depending on location with NHS. I have PCOS and Hashimotos and looks like my tube may be damaged (private scan showed this), so will be having tests to confirm this. Has anyone been referred to an endocrinologist to discuss hashimotos/PCOS when TTC?

Any advice/info/ideas would be massively appreciated!!

OP posts:
KoraPersefone · 20/04/2023 18:48

Same as you, first appointment next Thursday so, I'm going to follow the thread. Good luck with your journey :D

Nolly1994 · 24/04/2023 09:23

KoraPersefone · 20/04/2023 18:48

Same as you, first appointment next Thursday so, I'm going to follow the thread. Good luck with your journey :D

In case these are useful I've got these so far! They're specific to my problems though so may not be relevant :) good luck for Thursday!

⁃	What is the process the NHS can support us with?
⁃	What is Chester CCG offering treatment wise? 
⁃	What is the full cycle (does it include frozen embryos)?
⁃	Do you have leaflets or any guidance information?

⁃	If my tubes are blocked, what’s next?
⁃	If tubes are blocked, do they get left as they are? 
⁃	How can I manage risk of ectopic pregnancies if tubes are blocked? 
⁃	Am I at risk from ovarian hyper stimulation syndrome because of high follicle count? 

⁃	Does a thickened endometrium cause issues?
⁃	Can I be referred to an endocrinologist to assist with Hashimotos, PCOS, endometrium impact on fertility?
⁃	Can we wait to do IVF until my body is in the best condition for it (eg lost weight or hormones to treat PCOS)?
⁃	What supplements should I be taking? 
⁃	How much time can this take up so I know whether to inform my employer?
OP posts:
Nolly1994 · 27/04/2023 09:07

KoraPersefone · 20/04/2023 18:48

Same as you, first appointment next Thursday so, I'm going to follow the thread. Good luck with your journey :D

Good luck today!!

OP posts:
KoraPersefone · 27/04/2023 23:17

Hi hon . So sorry I didn't answer you before, days have been crazy. Anyway... at the end I didn't prepare any questions at all, at the end they weren't needed, I ended up with a doctor very patient and competent that he just explained everything by the letter that we didn't have to ask any question after (just a few on our particular situation as they found a chocolate cyst on my ovary :( ) but overall no questions have been asked by us.
I just asked about egg donation and it appears I'm not entitled to that :( unless I pay for that (I'm not entitled nhs funding for that) but it was something I was considering since I have DOR but this could not be your case.
If you have any questions just let me know. It was a pleasant chat anyway

CEllenx · 26/02/2024 14:11

@Nolly1994 may I ask about your Hashimotos - what did they say about you having IVF- is it still safe to do so? Will you need further monitoring - did they refer you to an endocrine doctor ?
I have been diagnosed with it aswell and due to have IVF appointment soon! - I’m worried it won’t work now as there’s lots of negative info !

Nolly1994 · 29/02/2024 16:00

@CEllenx Hey of course. So unfortunately I've had a pretty bad experience with all of this in general... apologies for the essay!!

The fertility department (NHS) have been dreadful, 15 months since i sought help from my GP and I have literally no answers as to what's causing my difficulties TTC. I now realise why it takes people 7+ years to get pregnant with the NHS's help.... endless delays due to administrative mistakes, GDPR breaches and inconclusive procedures due to not having the right equipment available. When i chased my procedure appointment in January for the 3rd time since November, i was told the department had closed. Not much other info other and when i asked if they'd be sending letters to patients explaining what's happening i was told no. I am still waiting.

I was diagnosed with Hashimoto's 4 years ago, despite this my GP didn't check my thyroid markers when i initially went to them for help with TTC, and the fertility specialist has never even mentioned my thyroid issues. I find it infuriating that i have been offered clomid or IVF (i appreciate this is a huge privilege many would die for), when the main issue might simply be that my thyroid needs treating. Both could have been rendered completely pointless if my thyroid markers weren't where they should be (which they aren't..), causing unnecessary levels of stress for me and my body, plus wasting huge amounts of NHS money.

TSH needs to be below 2.5 when you are trying to conceive, but most GP's don't realise this. You can absolutely still get pregnant with thyroid illnesses, but managing your thyroid hormones is really important to ensuring you can get pregnant in the first place, can carry to full term and that mother and baby are healthy.

As far as i am aware, you'd be classed as a high risk pregnancy. That isn't to scare you and tbh it would be a good thing as it means you should be monitored more closely by relevant medical professionals, such as an endocrinologist. Thyroid markers can change very easily, so you'd need regular monitoring of these to see if your medication needs adjusting.

I am not a medical professional - but i would speak to your fertility doctor and demand you have an endocrinologist working with you who can discuss your concerns (if you don't already). I don't know where you're at with the IVF appointments, i haven't had any IVF specific ones so can't comment, but i would ask them about preparing your body and health for IVF to make sure you have the best chances of success. This will include your thyroid markers, but Vitamin D, b12, Ferritin and Folate are also important to monitor when you have thyroid problems. If they are deficient, it can impact your Hashimoto's Disease and Vice Versa, but also impacts how well you absorb and respond to thyroid medication. Gluten free diets are also hugely beneficial for hashimoto's.

Health Unlocked is an incredibly useful forum. I have learnt more there than from any doctor about my health, and it's been reliable & accurate information based on the latest research. Without it, i wouldn't have known TSH needs to be below 2.5 when TTC and i wouldn't have tested my iron levels which showed i am anaemic.

Every part of me wanted to just do the IVF round in case it worked, but i personally feel it makes more sense for me to address any underlying issues first (like my thyroid) before going through IVF. Treating them might even mean i don't need IVF, but if i do, it means my health is in the best possible position it could be. It might even mean it all happens quicker if it avoids multiple IVF rounds.

I know how disheartening it can all be. I was a mess at first trying to put the pieces together as it can be really scary reading about how hashimoto's negatively impacts fertility (especially when GPs are very blasé about the disease), but now it actually feels empowering knowing so much about my own health. Really wishing you lots of good luck xxx

OP posts:
LivBiv · 01/03/2024 16:59

@Nolly1994 Had the exact same experience with my GP and my Hashimotos. Had blood tests showing underactive thyroid for the past 18 months. Never once was offered a full thyroid panel to figure out what was going on, and actually went the GP in September to specifically ask about TTC with my TSH levels where they were (TSH was over 10) and was told I was fine to go ahead and TTC and shouldn't have any issues. This is completely negligent advice. As you say, best to try and get your TSH to under 2.5. I started my levothyroxine 2 weeks ago (had to go private in the end) so really hopeful that in the next few cycles I might be able to conceive but it is definitely worrying. I also have low AMH and AFC so i am super anxious!!

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