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 ✨

Here is part of the response from my complaint to our ICB:

"When, on 1 July 2022, the SWL CCG became the SWLCCB e Board (ICB), the SWL ACT Policy (2020) was integrated into the SWLICB Evidence Based Interventions (EBI) Policy v4.1 (April 2023), a copy of which, I understand, has already been shared with you. The SWL ACT Policy now ensures that:

• All eligible patients across SWL now have the same access: previously, Croydon patients had no access to IVF/assisted conception.

• Access criteria for same sex couples and single women: previously not included.

• All patients who meet the access criteria have equitable access to fertility assessment.

• In the cases where no cause for infertility or sub-fertility is found patients who meet the access criteria are able to continue the pathway to assisted conception.

An important aspect of the ACT Policy development in SWL included consideration of NICE guidance and findings about who should have access to IVF treatment by the NHS. In our Policy all heterosexual couples must demonstrate 24 months of regular unprotected vaginal intercourse before they can access ACT and same sex/single women 12 attempts at Intrauterine Insemination (IUI), if not infertile. A considerable percentage of same sex/single women may not need to undergo the 12 attempts at Intrauterine insemination (IUI) with its associated costs, before conceiving.

The ICB is a statutory NHS organisation responsible for developing a plan for meeting the health needs of its own population, managing its own NHS budget allocation to support the delivery of more and better health care within that allocation and arranging for the provision of health services for which it is responsible and in its geographical area only. Fertility treatment funded by the NHS can, therefore, vary across England, including across London, and the eligibility criteria can also vary, it is for individual ICB’s to make the final decision about who can have NHS funded IVF in their local area.

Updated NICE guidance on Fertility Assessment and Treatment is currently awaited and this is expected to be published in November 2024. Please be assured at that once published the ICB will undertake a further review of the SWL ACT policy, as part of our continuing ambition to develop and publish policy which, as part of our Constitution, can provide reasonable, equitable and affordable healthcare for everyone across South West London. We will also take into consideration the Women’s Health Strategy for England (published in August 2022), which is a ten year strategy that includes fertility and infertility services as a focus area."

Hi @solanks thanks for sharing.

I too really appreciate this thread! I have had some lovely interactions with posters on a couple of threads on here, but I have always felt conscious of my circumstances being slightly different!

we are friends with three different SSC who have all have children in the last 2 years. The first had two babies in quick succession, with the first one on their very first iui! The second couple had their baby after their fourth iui and the third couple went straight to ivf and had their baby after their second embryo transfer. I obviously don’t begrudge them at all, but I don’t know anyone else in our situation who has had a such a poor outcome as us.

And really people just don’t know what to say when you tell them it’s not working. One of my friends responded to my last message explaining that our third transfer had failed with a photo of her baby being cute, which just made me feel like she couldn’t empathise at all with what’s been happening for us.

so yes it’s great to chat with others in a similar situation!

re the response to your letter - what a word salad that is!!

i think it’s a bit galling that they claim that access is equitable, but then go on to say that lesbian/SSC have to demonstrate 12 paid for IUIs! At home insemination with a known donor doesn’t count. Presumably the 24 months of intercourse required of heterosexual couples is taken on self declaration, as you can’t produce a receipt for this 🤦🏼

surely making iui more affordable would go some way to addressing this issue.

@Quickdraw23 That is so wonderful for your friends 💛 After three failed IUIs I almost started to believe that having success on your first time was a myth!! This was up until we found out about our neighbours home insemination story along with reading about other people's success stories online. These stories give my partner and I strength and hope in our journey.

Do you mind me asking whether your friends (who had IUI) used donor sperm from a bank, or was it a known donor? And did they go the natural route or stimulated/medicated route?

Regarding ICB's response... I know right?! The regional variations and equality of access are really grating. Yes, it's great that South West patients now have access when they didn't before but why is it so different to other regions? The variations are bloody ridiculous. In addition, I also asked why some groups, such as trans people, have more favourable eligibility criteria and get immediate referral, whilst other groups such as lesbians or single women have to jump through more hoops. I asked them to provide insights into how the policy ensures equality for everyone but they didn't really answer 😔

@solanks I have had 2 rounds of unmedicated IUI as they were worried about overstimulation with meds eek! Been referred for IVF under tubal issues. I am also a demon each month, so hopefully it will not be too bad!

I know, we have been incredibly lucky with how speedy the process has been since our failed IUI's. We are also lucky that South East London ICB is very LGBT+ friendly and has equitable treatment for SS couples, which shows the absolute unfairness of the postcode lottery.

I cannot believe what a load of drivel the ICB letter back was - it doesn't shed any light at all on what they are implementing to ensure equality. I am sorry you are having to go through that.

I am not surprised that your partner is feeling that way, waiting once you have actually started trying is an absolute mind f**K. Is the video consultation with a fertility clinic? Definitely call your GP and see if you can get that info and what clinic it is. We were referred directly to Guys Hospital and our first appointment was to get us logged onto the system - hopefully, that is what yours will be. About 3 months after that appointment I had a HyCoSy and then met our fertility Dr. Do see if you can get the HyCoSy on NHS (I did) and further testing!!

For reciprocal IVF the NHS won't fund it, so I have to implant all embryos into me if I use the funding. But we have signed forms so that if we have any leftover embryos in the freezer, my wife can use them in the future - we would have to pay for the transfer.. The issue with reciprocal IVF currently is that you have to also pay for genetic testing and they have to be frozen for 6 months prior to transfer - both things are currently in the process of possibly being removed as requirements as part of the new women's health strategy. We have just signed the forms and will pay for the additional testing if we get to the point of using the eggs reciprocally. (I hope that makes sense)!

@solanks & @Quickdraw23 This is such a hard journey (even without the extra costs it costs LGBT couples), I am sorry your friends haven't understood.

I think it is difficult for anyone who hasn't gone through this process to realise how draining it is, with the added inequality to boot.

I too really appreciate this thread, I don't know any other same sex couples who are trying to conceive, we are the first of our friend group. Even just choosing a donor was hard enough, let alone navigating the rest, so thank you for starting this thread up!

@Twomumfamily What we have done so far is pop to our GP and explain our situation. The doctor then put us both through general fertility blood testing, which all came back clear, so has now referred us through to our local hospital.

The letter we have got from the hospital's gynaecology - fertility clinic following on from the above is for a video consult. It doesn't say anything else unfortunately, which is why I sent them an email yesterday asking for a bit more information on what to expect/the nature of the appointment.

The pessimist in me thinks that this appointment will be a box ticking exercise and once they realise we have not met the ICB's requirements, our journey will end there. That said, what I don't understand is why the GP would do all those bloods and refer us if they knew it would be a waste of time.

Aside from the HyCoSy, what other additional tests/testing did you manage to get/would you recommend we prod them for?

@solanks Ah I see. That is frustrating, hopefully it’s a virtual booking in appointment as even if you do not qualify for any funding you would be able to go this route for self funded IUI - which is why you should be able to have all the tests/HyCoSy etc on NHS. Hopefully they get back to you soon.

I would defo push for the HyCoSy for sure, and day 21 bloods (to check for confirmed ovulation).

If your local clinic won’t offer it, you might be able to be referred to a different London clinic by your GP maybe - I specifically asked to be referred to Guys Hospital as they had good reviews.

All my fingers are crossed for you and your partner!

Progress! Had the HyCoSy confirming both sides are clear, good to go ahead and buy us some sperm! We're having a free counselling session from them first, because I figure we might as well, but that's not for a couple of weeks. I think the timings then (assuming all is well) are a bit tight to get sperm delivered in time for my next cycle at the end of the year, so it looks like our first attempt at an IUI cycle might be end of January or end of February.

How's everyone else getting on?

Omg, I just wrote a fairly long reply... then clicked onto another tab... then clicked back to finish what I was writing and my draft message disappeared!!

This has got to be the second or third time this has happened to me more now. Damn you, Mumsnet lol.

@ProfessorplumBilliardroomCandlestick That's great news about your tubes. How did you find the procedure in the end? And how are you getting on with your donor search? 😊

An update from my side: My partner and I are currently in the process of finding a new clinic to carry on our fertility journey. We have shortlisted two and had our first consultation at one of them yesterday (which went really well) and we plan to have our consult at the second clinic sometime next week. We will then decide who we prefer and make that our new one.

Procedure-wise we are still deciding/are unsure what to do (IVF via NHS, IVF private, another round of IUI?)

We have that IVF referral appt booked for us at the end of February at our local hospital (though we don't know for sure yet if this appt means we are on track for IVF via the NHS, and if we are, we don't know what the wait time is). We asked for some more information and were told that this appt is to go through medical history and to find out if further tests are needed.

Understandably, my partner doesn't like the idea of waiting 'til the end of February when there is the possibility of finding out we can't move forward with things OR finding out that the wait time for the procedure is far too long. She will be 36 next year so we do not want to delay things if we can avoid it. We are therefore considering the private route... I wish it wasn't so expensive :(

If we decide to wait and see what this NHS appt is about, we will likely consider having another go at IUI in January (my partner will need to go for that HyCoSy if we do decide to take this route).

We have lots of thinking to do and although I feel a little stressed, I am looking forward to getting things started again the new year... which I know will be here in a flash!

Sometimes I think when it's your own lives you can get a bit lost, so any thoughts/advice/suggestions in relation to our situation would be welcome ✨

Hope everyone else if getting on ok with their journeys xx

Good to hear your updates folks. Good news on the hycosy @ProfessorplumBilliardroomCandlestick

its so difficult to know what to do with all of this isn’t it @solanks you’re constantly weighing up costs vs risks vs success rate etc and grappling with bureaucracy as you say.

I don’t have much to update really. I’ve been coming to terms with the negative outcome we’ve had this time, and have an appointment next week to see if the GP can organise some bloods for me to check various immuno stuff, and save me a few hundred quid. Once I know what’s what there we can start planning for a baseline scan in the spring to see what things look like.

hoping for useful consultations and positive steps forward for all of you

@solanks in all honesty, for me the HyCoSy was excruciating. I can very much understand why some people don't actually finish it. I took the paracetamol as recommended an hour before but it was exceedingly sudden and painful. Like being stabbed - very sudden, very sharp, just all-encompassing.

Some people have no pain at all with it. The two people I had doing the procedure were very caring and understanding - one was holding the instruments and watching the screen and the other was putting the dye in and she rubbed my arm for comfort at times. Both were extremely sympathetic. I asked for the world's smallest scope and they did go gently, all good things. Getting the catheter in etc was like a mild cramp exactly as they said. But the dye was another world. I needed two lots of dye as there wasn't quite enough the first time to see if both sides were open, so I had two bursts of pain and it stays painful for a while for all the time they watch it on the screen.

However, most of the pain is not knowing when it will stop, and the surprise of it coming on. The pain stopped immediately after they stopped pushing the dye. I think in total it was painful for less than a minute. So it is horrific, but it doesn't last. During, I couldn't concentrate on the screen or on what they were saying to me. I had to ask after what she'd said and was it all fine. I had extremely mild cramps after for the rest of the day but that was it. The pain is because your tubes are just flat and collapsed and suddenly there's all this fluid, they're just not designed for it.

My wife wasn't allowed in with me and in some ways I'm glad she didn't see that. Other ways I'd have been glad for a hand to squeeze instead of digging my nails into my own palms.

If I needed to have a HyCoSy again, I would absolutely do it for the peace of mind of knowing my tubes are fine and that there's no obvious reason why IUI won't work for me. I'd try taking more pain killers beforehand! Maybe ibuprofen too, idk if you can but 1g of paracetamol was insufficient. But I can also understand why not all clinics make you do it.

@solanks for your own journey, what do you think will be the deciding factor for which procedure you choose?

Best of luck for your blood tests @Quickdraw23 and here's hoping you get some useful news

Hello everyone :) @ProfessorplumBilliardroomCandlestick I am glad the HyCoSy came back all clear, that is great news, sorry it was so painful. I found it a similar experience, they really don't prepare you for how uncomfortable it is. You must be excited to get started in the new year.

Our IVF meds were delivered today, we will be starting stims first week of Jan (eek). We are still unsure where we stand with the reciprocal legal side of things which is frustrating. Apparently, we now need to do all genetic testing prior to egg collection and it is very expensive (and unnecessary) so we are just waiting to hear back from our clinic and the HEFA as the law did change in Oct for same sex couples it just has not been implemented yet. It is all rather confusing!!!

@Quickdraw23 Nope, not easy at all😔It would be easier if we had an unlimited supply of donor sperm as we'd continue trying with IUI! Based solely on the statistical side of things, it just seems our next best shot is going through with IVF.

I hope that your upcoming appt and tests go ok ✨

@ProfessorplumBilliardroomCandlestick Oh goodness it sounds awful 😖 At least it's out the way now and it's great that your results have come back all clear. Also hope the donor sperm search is going ok for you.

My partner and I have one more consultation tomorrow with another clinic and we're keen to hear how this one compares to our last in terms of advice and next steps.

For me, deciding factor-wise, I feel it makes the most sense for us to wait and see what this NHS appt in February holds as we will then know exactly what our options are and whether the private route is the only route for us. My partner, however, really doesn't want to wait (even if only by one month) and is also more open to using credit/savings to fund it than I am. She also got a great feeling with the last consultant we saw and understandably is wanting more 'personalised' care should we go the IVF route, which I totally understand.

@Twomumfamily Keen to hear what the outcome is regarding the genetics testing / legality side of things for reciprocal IVF as it's also something my partner and I have considered!

I hope that everything goes ok with the stims. Are they fairly straight forward to use? ✨

@solanks I will certainly keep you posted. I am pretty confused at the moment. It isn't even something we had really thought about as my partner doesn't want to do IVF herself so proper reciprocal was off the table. It's just that one of the tick boxes was 'What do you want to happen if you died, do you want your partner to be able to use the embryos' and we selected 'Yes', and as we are a same sex couple I am classed as a 'donor', & we need to do these additional tests which wouldn't be needed if I was in a straight relationship!
We don't mind doing the tests and paying for them down the line but seems pointless to do it when all are going to be put back into me for now and we may not have any left for my wife to use... Also, makes no difference if it's in my womb or hers, it's still our child and genetic testing won't make any difference. Did anyone else come across this or is it easier to just untick that box?

I think the stims will be okay, we have an appointment in early Jan for a scan and they will show us how to use them so hoping it will be clearer then haha!

@Twomumfamily exciting times for you in the new year! I think our first iui cycle will likely be in February, assuming our sperm doesn't arrive sooner. Sending well wishes your way!

@solanks I can see both sides of that argument! The "let's wait until February" side and the "trust your gut start now" side. Ultimately I guess there's no harm in either approach, just depends on the impact mental health wise. I think I'd probably want to start asap and keep the February appointment - can you do that?

Had our second consultation yesterday at another clinic and knew immediately that this wasn't the one for us. It was actually rather disappointing and felt a total waste of time, but in hindsight, going there only solidified our original gut feeling of that other clinic who we were really impressed with.

Next steps for us now is really figuring out whether we wait to see what Feb's NHS appt holds for us, or just moving forward with the private IVF route. @ProfessorplumBilliardroomCandlestick One or two people have mentioned this (whether if we go private, can we still keep our appt) and this is something I need to look into tbh!

One thing I do need to do is draft up and send a reply to the ICB continuing that fight for equality for us SSC and our access to fertility on the NHS.

Aside from the above, I doubt I'll have any further updates on our journey until January tbh, so until then, I wish everyone on this thread a very happy festive season ✨🎄

If anyone is going through treatments, tests, or appts over the next few weeks, I hope they all go ok for you! xx

Sorry to hear your consultation was so disappointing 😞 hope for some more promising stuff for you in the new year!

yes agree re the sperm! If it wasn’t so expensive would have definitely tried IUI first.

got my appt with GP tomorrow, hopefully get some bloods sorted, but I won’t have any further updates til new year really either.

Hi all! I'm very new here so apologies for not knowing all of the terms on the site etc.! My wife (29) and I (27) are currently going through IUI on the NHS but having to self fund the actual attempt(s) of course, with myself being the one to hopefully carry. I had the usual tests prior to the IUI including blood tests, HSG (ouch!), ultrasound. Thankfully everything looks good apart from a fibroid that I did already know about from my early 20s due to quite heavy periods, that has grown from 1cm to 4cm, but luckily the consultant said no surgery was needed due to where it is. Does anyone else have any experiences of having fibroid(s) and any impact on fertility? I know a lot of people have them. My cycles are usually 27 or 28 days and tend to have all of the usual ovulation signs around day 13/14. I haven't had an alcoholic drink since July (since we were referred to the clinic by our GP), never smoked, healthy BMI etc. The only thing is trying to reduce stress around work but that's easier said than done!

On Monday (11th) I had a scan and my follicle and lining looked good, but negative on the ovulation test. On Tuesday (12th) I had the same, follicle and lining all still good but was then positive for ovulation so treatment was planned for the next day. I had a trigger injection on the Tuesday as a belt and braces approach to make sure that I did ovulate. I did get quite a bad headache from the trigger shot that day but then it went, I also got some nausea. On Wednesday (the 13th) we had our first attempt and I'm now in the TWW currently. So I think I'm 3DPO? Obviously it's only our first attempt so although we are hopeful we are being realistic about it due to the statistics. Currently just feeling quite bloated with a bit of cramping from the trigger injection and/or IUI probably. I'll go for a blood test next week to check my progestogen levels to confirm ovulation and then either a test or see if AF starts between Christmas and new year.

If anyone has been through the TWW do you have any advice? I've got nice plans in seeing family and friends, trying to reduce stress where possible, and trying to manage expectations.

Wow sorry that was a lot more than I planned to write but typing it all out has been quite therapeutic, as it's an exciting process but quite full on!