IUI & Fertility in SSC

[solanks]

Hi everyone,

I've struggled to find any groups that are focussed specifically on same sex couples trying to conceive (that do not have any fertility issues).

My partner and I are currently on round three of IUI using donor sperm. The first two tries we did we attempted the natural route (so no medication and no ovulation trigger injection). We decided to go down the medicated route on our third try and are currently in the two week wait, waiting for our results today!

This whole process has been emotionally, physically and financially challenging, so much more than we ever expected, and we would love to hear from other same sex couples on this topic who are in a similar situation to ours. We want to exchange stories, offer each other support, give advice and also recommendations (as there is so much conflicting information out there and each clinic's protocols vary too, which we found bizarre).

Looking forward to hearing your stories; be they successful, unsuccessful, or even if you are completely new to this journey ✨

@Twomumfamily gotcha. Yeah the cost for the basic tests seems high at the beginning... but realistically in the grand scheme of things it's not so much! Just bought our first batch of supplements too... oof

@solanks just re-read this post from before - yes, please do send over or post up the questions you wish you'd asked. Although we're booked for having fertility checks with our local clinic already, I'm trying to keep my eyes wide open and keep a critical mind.

If anyone else also has a "I wish I'd asked XYZ" list I'd love to see it

Hi everyone ✨ sorry for being a bit absent the last few days but I caught a nasty cold off my partner so have been resting up and recovering. I've enjoyed reading through the comments tonight and catching up on everyone's journey.

To update you all on our situation... we actually have some bad news. Turns out we are not eligible for NHS IVF referral 😞We got out ICBs mixed up (we thought we fell under 'South East's ICB' but it's actually 'South West's ICB') and their policy is very different and states that we basically need to undergo 12 unsuccessful IUIs before getting referred. It could potentially be 6 but that's only if we then obtain fertility tests and get referred as a couple who are infertile/struggling to conceive, which I don't think would be the case. Either way it's rubbish and a LOT more attempts and a LOT more money to be spent than we initially anticipated. We feel that the NHS' support (or lack of!) for SSCs trying to conceive is well and truly outdated and 100% not inclusive. I honestly believe that everyone should have access to free fertility care, especially in a country like the U.K. and especially in this day in age.

We're not really sure what to do now tbh. We're still going to take a visit to our GP as I guess we have nothing to lose by doing so and seeing whether we can get anywhere via that route and then reassess and go from there. If we can't get IVF on the NHS we then have to decide whether to fund it ourselves (obviously a lot of money), or whether to keep trying IUIs (whether at a clinic or just taking control ourselves and doing it at home). If the latter we'd have to get married so that's something to consider when deciding lol.

A bit of a set back for us but we are trying to remain positive and hopeful!

In other news, my partner's work colleague (in a heterosexual r'ship) found out she had low egg count and the NHS even declined her treatment as the "chances were too low." Anyway, she ended up self funding (she went to CARE Fertility in London) and ended up having a successful pregnancy on her first attempt, which is just so bloody amazing. Think they took 9-10 eggs of which 3-4 were good to go. Then obvs the one they took did the job. She now has a healthy baby girl 😊It was nice to hear a success story of someone we know and hear their experiences. She said that CARE were not perfect but overall were happy with them. Not sure if any of you are with them but I will now be adding them onto our 'potential' list of clinics to check out.

In regard to the HyFoSy @ProfessorplumBilliardroomCandlestickwe both shared the exact same thoughts as you when considering it and went at the angle of "well, we're not infertile as far as we're aware so what's the point and it's also another pretty big expense that we could avoid." We decided not to go through with it (our clinic does recommend you do one, but it's not compulsory). Looking back now, after 3 failed IUIs, if we were to start things over again we would get one done just to be absolutely 100% sure everything is clear. I hope that helps! Also, how great that the clinic you like the best is also the most local. It also must have been nice to meet some other SSCs there too starting their journey! May I ask what it was about this clinic that set them apart from the others in the end? I hope the scans and bloods go well for you.

@Ivffirsttimer7 Will be thinking of you both on the 10th. Hope you have/are having a lovely time in Devon ✨We went there earlier this year and stayed in this super cute little annexe barn thing. Loved it there.

@Twomumfamily The wait is just the absolute worst isn't it. Time in general flies by so quickly but post op it seems to go by in bloody slow motion!!

@solanks 12 goes before you are able to get it on the NHS is madness. It’s just so unaffordable for so many people. Inclusive is not a word I would use for the NHS in regards to SSC.

I hope you have recovered from your cold.

Ours was also an annex/barn. It was lovely and the dog enjoyed it which is obviously important 😂. We had our scan this morning and all was well. Saw the little heart beat and have been signed off by the clinic. We were with Care in Kent and found them ok. Friendly and good service if you ignore the chasing you do. They didn’t seem to push the extras either which was nice but just talked you through them incase you wanted them.

@Ivffirsttimer7 It wasn't in Littleham, Bideford, was it?! That's where we were. We took our dog too and she had the best time!

I'm so, so happy to hear that your scan went well the other day and thank you for letting me know your thoughts on your clinic.

I wish you all the best with your pregnancy and please do keep in touch as I can't help but feel a little invested in people's journey's 🤗

We're off to the GP this week so we're hoping that goes well. We also caught up with a SSC couple who (funnily enough) live next door to us who did ICI themselves at home and fell pregnant the first time. They had a girl and she is two now. It's a wonderful story and almost too good to believe! Gave us a few tips should we decide to go down that route.

I hope everyone else is doing okay x

@solanks I am so sorry to hear your update, the postcode lottery is so completely unfair, especially to SS couples, 12 cycles is beyond unreasonable. I wish I had something helpful to offer, but I’m thinking of you and your partner.

How lovely that your neighbours conceived via ICI at home though, that is certainly food for thought (and saves some serious dollars!!)

Good luck at the GP’s and please do keep us updated on your journey! ❤️

We got our BFN today (and AF), sure is an expensive hobby!

x x

Hey @ProfessorplumBilliardroomCandlestick, just noticed that I never replied with those questions to ask the clinic(s) at the beginning, so I'll drop these in now for you.

Some q's probably seem obvious to ask or know in advance, but for us at the beginning we were just so excited to start we didn't take time to research first. We then ended up feeling a bit lost and overwhelmed and looking back, we would have liked to have spent more time and clarity on getting to know the clinic itself, the processes, etc. I feel it also would have been good to approach a few clinics, ask the same q's and then compare 🙂

• Firstly, I'd ask how many current SSC they are dealing with, or have dealt with, in the last 12 months.
• I'd find out how many days they are open. Are they open on weekends? If they're not, how do they go about dealing with ovulations that occur when they're closed.
• I'd ask for their success rates of IUI (both medicated vs natural), ideally in SSC couples with no history of fertility issues, or if they don't have many, then their stats on SSC with known fertility issues.
• I'd snowball off the above and then ask how they go about ensuring what they offer for each couple is bespoke and appropriate for them based on their medical history etc. Not an 'off the shelf' approach.
• For IUI, I'd ask what their protocols are for both medicated vs natural. So, ask for a step by step on what to expect for each. For example, "On day 1-3 we do a scan, Day X-X we do another scan, then on this day you do the trigger shot..." etc.
• I'd ask what blood tests/tests in general are carried out and compulsory to have before IUI to review health. I'd then ask for a sit down to go through the results and explain them in detail.
• I'd ask whether we will deal with the same doctor and/or nurses throughout our treatment.
• I'd ask how the clinic ensures that they stay abreast of new findings, studies and research to help them continuously improve their success rates.
• I'd ask what sets this clinic apart from other clinics.
• Obvs ask for a clear breakdown of costs for both IUI and IVF. Along with all investigative testing costs.

There are probs some more that I can't think of right now, but the above would have been very helpful for us to know before starting our journey earlier this year.

Hope this helps ✨

@Twomumfamily When I tell friends and family about these differing requirements for referral per region, they can't quite understand it. Not sure if I mentioned, but I have contacted our region to ask for further clarity. Crazy that we may have to accept spending £12K+ on IUI, but if we moved 1/2 a mile out we'd only need to spend £3K+. Totally bizarre! Hence why we're thinking of going straight to IVF, even if funding ourselves.

Will definitely let you all know how tomorrow goes ✨

If I'm reading the acronyms correctly, then I am so sorry about this news (still learning the fertility acronyms). Kindly remind me whether you did medicated or natural? Will you and your partner take some time or try again right away? xx

@solanks I know, the differing criteria is really shocking! I started researching during lockdown (I had nothing better to do) and was really surprised how drastically it differed across the boards. Have you followed Whatwegandidnext on Instagram? They successfully sued their ICB (sorry if this has already been mentioned) which instigated some changes. Maybe your GP can apply for you anyway and if you get refused maybe you can appeal on grounds of discrimination?

Glad you have contacted your region, hopefully, they will have an update for you. I know that our ICB will be funding 6 rounds of IUI for all SS couples from 2024/25 and will be doing away with the mandated self funded cycles. It won't be in place in time to help us but so glad to see some positive changes coming along, so fingers crossed that your ICB may have a better update for you.

Yes, my period showed up along with a negative test. We are doing natural IUI as I have polycystic ovaries (not the syndrome) they don't want me to do a medicated cycle as I will likely overstimulate. This means we can do back to back cycles so going straight on to the next one.

Did you do your cycles back to back or take breaks in between?

XX

@Twomumfamily Hey 😊I don't follow that page but do remember seeing their campaign success. As you said, significant changes may not be there for us during our journey, but knowing that it will be in the near future makes me so happy for future SSC TTC ✨

With the natural route do you also get advised not to take the ovulation trigger? Sorry if you have already said, but in terms of timing for you, do you do at home tests and then book in your appt the day after you show 'peak fertility?' Sending my best wishes for you on your second round ✨

We did two natural attempts (for our first and second) and did these both consecutively. For the third we did stimulated and left a few months gap. This gap wasn't an active intention, but we were away on holiday so there was nothing we could do. In hindsight, I think this gap did both of us some good as we were able to gather our thoughts, recover and review things. Studies suggest that chances increase with each attempt, which is why I was always eager to do one after the other (though I'm not the one going through the procedure so would always take my partner's lead on how she's feeling and whether she felt ready to do another).

A little update on our side, we finally visited our GP and it went well. He wasn't too knowledgeable on current requirements on SSC TTC, but said he "believed" we are eligible for one round of IVF on the NHS, so he went ahead and referred us! I'm trying not to get too excited until we have that appointment at the hospital, but will remain hopeful for now. He also put us both forward for blood tests (he put me forward too as I expressed that I also want to go through pregnancy at some point soon, so with my age in consideration (nearly 34) I guess he thought it was a good idea to get things checked out now). My partner has already paid privately for her bloods, but there's no harm in getting them again, so we are.

What blood tests have you had done so far and did your doctor/clinic run through the results with you?

We have had: FSH, LH, Oestradiol & AMH, thyroid, rubella, hep b & c, HIV combi.
The one via NHS will include all above plus also: full blood count, syphilis, gonorrhoea, chlamydia.

@solanks That is great news, all my fingers are crossed for you! Really hope they approve the funding for you both, did they say how long it would take to find out?

No, we have been advised to do it completely naturally, so no trigger or anything, we track using clear blue and the day after the smiley face we go in for insemination. We have a scan on day 10 of the cycle just to check we have a dominant follicle but that is it really. Did your partner have the ovulation trigger?

We have had lots of blood taken, I don't know what they were though, to be honest. I had the general bloods done at the GP then I had them all done again at the fertility clinic. My Wife had everything tested too which I thought was nice as she also wants to carry next too. They only ran through the ones that were abnormal, which was just my AMH which was high. I actually find it tricky to get results back!

Got day 10 scan this week so hopefully we will inseminate again next week. We may take a break after this round as it is much more emotionally draining (and all-consuming) than I anticipated!!

How did your partner find the medicated cycle, was it quite different to the natural cycle?

@Twomumfamily Hey, no I don't recall them saying, though we do have to wait for the results from both of our blood tests to come back first and providing everything is ok we'll then wait for an appt (post blood test results I will definitely ask if he can give a guestimate though, otherwise I may go a bit mad when waiting!)
I was never actually intending on getting any testing done, but in hindsight, I'm glad I am now as I guess it's better to know sooner rather than later if there are any issues or abnormalities. All being well we should have the results back in a week or two.

Do you mind me asking what your AMH result was? My partner's was 14 or 15 I think (and she's 35). I think this is on the lower end of "normal." Did your partner have hers done too? I am 33 and should get my AMH result next week as I paid privately for that one.

How did your day 10 scan go? Do you both have a day roughly set for your procedure?

From my side, I'd say the main advantage of doing a medicated cycle is that you feel much more confident in the timing of things as things are more closely monitored. In terms of the medication itself (she was on a v low dose of Letrozole and then we did the trigger shot) and aside from feeling a little more hormonal than usual, she didn't experience any nasty side effects. Out of all things, she actually gets the worst side effects from the pessaries post procedure!

Funnily enough, I have just received my AMH results... 28.1. The doctor referred to this as "normal for my age range." Will cross-check this number with our clinic too, but it seems to be okay :) I don't plan on conceiving for a couple of years yet so will likely redo the test in a year or so probs.

@solanks It all sounds very promising! I honestly can't remember what my AMH level was I feel like it was 30 but I could be wrong. I think it was just on the higher side of normal for my age (34) and so along with my internal scan I was diagnosed polycystic ovaries (not the syndrome - just means lots of follicles). I think 28 is a great AMH level, nice to know there's no rush!

Scan went well, I went back for a day 13 scan yesterday and all is looking good to go ahead this week, likely Thursday, and I am ovulating on my non-blocked tube which is exciting. I spoke to our Dr and she has recommended that if this cycle does not work we move on to IVF next due to my tubal issues.

For sure, it is great to have a fertility MOT, my Wife found it helpful as it has given us a vague timeline of when she would like to try.

Yes, the natural cycle does make it tricky to know exactly when you ovulate and it does feel like a shot in the dark! I am glad your partner reacted okay to the meds, I guess it is just like mega PMT!

I am a little worried about side effects if we do have to go down IVF route but cross that bridge when it comes I guess and feel very fortunate to even have that option!

Fingers crossed you hear back soon, keep us posted!

XX

Follicle count today. Expertly done, honestly. I was expecting to feel far more uncomfortable, like a smear test. Anyway. My follicles are within normal range, so I'm hoping the blood test has good news about AMH too. They might even have results for us tomorrow!

@ProfessorplumBilliardroomCandlestick How exciting, that is great news! Are you going to go for natural IUI as the first course of treatment?

Off for my second IUI either today or tomorrow, I annoyingly surged last night at 7pm so it is likely going to be slightly too early to inseminate today or slightly too late tomorrow gah lol - timing is certainly tricky!

@Twomumfamily best of luck for your cycle! I think we'll try natural IUI if we can - I guess it depends on blood results, and I think we'll probably opt for a HyCoSy to check my tubes are both open, just to be totally certain. We have our consultation late next week... starting a list of questions now! Like when/how do we decide when to start? We'll be using donor sperm, so I guess we need to order a certain amount and get it shipped to the clinic's cryo storage... and then ??? I'm assuming we monitor my cycle somehow and figure out a good insemination day from that. Or is it more scientific nowadays and I test daily and just sent some sort of "thunderbirds are go" message to the clinic and hope they're poised and ready...

@ProfessorplumBilliardroomCandlestick HyCoSy is a good idea, at least then you know ahead of any issues. Haha I think every clinic is slightly different, but yes, you test and when you get a positive LH surge you call/email the clinic and usually go in the next day. It's great to start tracking your cycle as soon as you can so you can get to know your body really well :)

Exciting times ahead! I currently cannot get through to my clinic to see when we need to go in which is always fun - going to be a last min dash from work I think (hopefully they won't mind!)

Hey @ProfessorplumBilliardroomCandlestick - great to hear your follicle count went well and and fingers crossed for quick results on your bloods too!
I think I dropped in a bunch of questions somewhere in this thread that I wish we had asked early in the process (you may/may not find any of the q's useful, but they're there if you need them!). And all being well, your consultation next week will be the perfect opportunity to get all of your questions answered and to also get familiar with the process of how things work at your clinic 😊 When do you think you'll get the HyCoSy?

Donor sperm wise, my partner and I ordered 8 vials, so in theory it would be 4 attempts each (we got washed vials, but check with your clinic what they recommend to order). We ordered from Xytex and they had an offer when purchasing a certain amount and they also offered storage too, then once we were ready to start the process we got the entire lot shipped over and they are all now being stored at our clinic. I know a lot of other SSCs use Danish donor banks. We just happened to find a donor we loved on Xytex, which is why we went with them in the end, otherwise we probably would have preferred a bank closer to the U.K.

@Twomumfamily I hope you managed to get through to your clinic in the end. What did they suggest regarding timing?

Sending my best wishes for when you do have your procedure! ✨

@ProfessorplumBilliardroomCandlestick Following on from what Solanks has said about Sperm, just FYI we had a terrible experience with California Cryobank. They didn't submit the paperwork to our clinic until we chased a month later, they didn't supply the correct paperwork for transport so our vials got stuck at customs and then arrived thawed. We found them really stressful and rude, we had to fight to get a refund and then they tried to pocket the custom fees which are not even due anyway. Maybe avoid that particular sperm bank if you can! We ended up using Cryos International Denmark next and they we utterly wonderful in comparison!!

@solanks Thank you :) We managed to get an appointment yesterday afternoon for insemination which I think was okay timing, I honestly cannot fault our clinic they have been great even if difficult to get hold of at first.

I went with a full bladder this time (I also had a senior Dr) and the procedure was super easy and over in minutes - very different to last time!

Have you heard anything more from the Drs?

Good news! My follicles and AMH seem good enough to go the unmedicated IUI route. CMV and chlamydia blood test next, then hycosy. Then... choosing a donor! We've already started shortlisting, but it depends on the CMV results.

Wondering how many vials people have ordered for their treatments? The clinic has recommended ordering 3, but some sites seem to say 5-7 per child. I'm guessing that's assuming a certain level of infertility, so I don't know how cautious to be as a SSC....... thoughts?

Thanks for the warning @Twomumfamily we're looking at either the European Sperm Bank or Cryos International, so it looks like we'll be okay.

@Twomumfamily So sorry you had that experience with your sperm bank, though so glad that you were able to get a refund and eventually source a better bank elsewhere. I've seen and heard good things about Cryos.

No news from the Doctor yet. All of our bloods have come back fine and we have booked a call in for Thursday 9th to briefly review the tests and to also ask for an update / next steps regarding the referral. Will also definitely be asking if they are able to give any insight into current wait times as I have a feeling it may take a while... but I could be wrong (fingers crossed).

Hope you and your partner are doing okay in your TWW. Thinking of you both ✨

@ProfessorplumBilliardroomCandlestick Hey, great news about your AMH and follicles, and I hope the rest of your bloods also come back fine for you. Idk about you, but my partner needed a CMV negative donor... and I think it was this reason why it took us a little longer to find someone who ticked all our boxes (and who were also CMV negative) as there are not as many with this status.

For us, our bank recommended 4 vials per person, so we bought 8. As you said, each clinic/sperm bank's opinion on amounts to purchase vary and it really is a tricky one to decide and know what's right.

My partner doesn't have any known fertility issues but has currently had 3 rounds of failed IUI (but for me, who knows, I could fall pregnant first time). Some thoughts/comments that may be helpful to you:

• Some banks offer buy back options so I would suggest finding this out, so if you have some left that you do not need you can get some money back.
• Some banks provide offers if you purchase a certain amount, so that may sway your decision a bit. I think ours did and we were also able to get free storage too (but we did eventually ended getting all of our shipped, so the free storage wasn't a big selling point in the end).
• Find out if the donors you have shortlisted are regular donors. Some donors donate infrequently (like our donor) so if we run out that's it for us... we would have to likely start a fresh search or be open to waiting for another deposit of his. However, if they were a regular donor we could just easily purchase more as and when required. I think knowing that ours is not a regular donor stresses me out a bit and makes me feel a little more under pressure.
• For me personally, I feel like 8 vials (4 per person) is a good starting point. A part of me feels that if neither of us get pregnant on 8 vials of this one donor then perhaps the donor just isn't right / meant to be. I really, really like this one we have found, but also know that if it doesn't work after 8 attempts then we should consider new options.