Secondary unexplained infertility - when to give up ttc?

[HM2024]

We are so blessed to have a wonderful 3 yr old DD. She was conceived quite quickly.

We've been TTC #2 almost 18 months and are getting nowhere. I'm 39 next month. DH is almost 42.

Have been to GP and NHS fertility appt and have had all the tests we can get from them. Everything seems to be normal. The only next step we have been given is IVF.

I am constantly thinking and obsessing with TTC. Trying random new things and online researching. I feel like it has taken over my life and making me so sad. I rarely let myself get my hopes up in the TWW. It hasn't happened so far, so why would it now, when nothing has changed.

IVF feels like the only option now. The chances of it working seem so low and the mental toll really worries me. But I think I'd regret not giving it a try.

In my head, I think we try for a few more months then IVF. If it doesn't work, then we draw a line under it and it wasn't meant to be.

I'm not sure if I would really be doing that or still be timing things and hoping though. The thought of giving up trying is sad. I look at pics/videos of my DD as a baby and really thought we'd have a chance to do that all again.

But stopping the emotional rollercoaster and constant disappointment sounds great.

I wish I'd started the IVF process months ago.
I've just accepted that we will need IVF if we want to have another and feel overwhelmed at the options and timescales.

We've been trying 25 months and haven't even seen the NHS yet because the GP didn't know how to do the referral. I could have been referred 19 months ago but she didn't do it.

I find secondary infertility really difficult to talk about because I know that people don't understand it or feel sympathy. MIST have some really good information and it helped me find the words.

Good luck with your journey x

Sorry you’re going through this. For me personally, ivf caused so much more stress/sadness than ttc (but I don’t have a living child). Of course it’s amazing when it works, but when it doesn’t - it’s addictive, expensive and can be incredibly hard. Like I said, it’s incredible that we have it available, but please go into it knowing the odds and the emotional toll and potential impact. Wishing you lots and lots of luck and hoping you get your miracle soon xxx

Stopped TTC a long time ago , definitely helped my mental health

ivf is challenging but it’s actually a relief to no longer even consider the whole natural business !

one appointment at a time xx all the support and groups on here a fantastic

That's so shitty of your GP. I hope you've now been referred? My GP wouldn't even consider referral until we'd been trying for a year. Despite the NHS guidelines saying to go to GP after 6 months if you're over 35. I've heard that from others too.

Good luck to you too xx

The odds seem so low that it feels like a massive gamble. I find ttc such an emotional rollercoaster as it is, that i'm really worried about the emotional toll. But also do think i'd later regret not trying. Wish we all had a crystal ball. Thank you. Wishing you lots of luck and hugs xx

When you stopped ttc, how did you 'switch off'? I feel like if I 'stopped' now, i'd have timings at the back of my mind and continue to feel disappointed.

I was thinking that - and kind of handing over responsibility to someone else in a way.

Totally agree, the support here is fantastic. I find it therapeutic.

@HM2024 Stopped buying tests , stopped tracking

went on the pill to prep for treatment so it was literally off the table !

chucked out the thermometer and all that jazz

was incredibly freeing !

It would free up so much head space!!

I was thinking we could get a kitten/puppy and use the names we had in mind 🙈

If you can afford it I’d just do it. I think for me part of making peace with your next steps is knowing that you’ve tried. The what ifs would be a lot harder for me.

I think there’s a lot of luck involved in the ttc process whether you conceive naturally or with ivf. You were really really lucky to conceive quickly the first time around but as you’ve discovered it’s not always like that and sometimes a bit of help is needed to be in with a chance. You may not have needed that extra help before but sounds like you might do now. That sucks and it’s something new to get your head around because you never imagined it would be an issue for you.

I found ivf less stressful than ttc naturally as it felt proactive and I knew 100% that fertilisation had occurred, it had developed normally/ progressed etc. that there was a reasonable chance. It felt a lot less like flipping a coin each month. IVF isn’t without its own worries but a lot of it is also out of your hands which can in some ways be a relief.

You mentioned low chances and of course there are no guarantees but statistically your chance of conceiving with ivf are higher then they are now. If you’re going to do it, I wouldn’t wait I’d just do it, it’s not like you haven’t tried.

@HM2024 my story is a little different to yours but been trying for baby 2 on/off for 18 months too... we fell pregnant January last year and had to have a termination for medical reasons at 18 weeks last summer as baby was incompatible with life. Had a chemical pregnancy in September and negatives ever since. So 2 failed pregnancies in 18 months (one extremely traumatic). I've had bloods done and mostly come back normal, plus a fertility scan all normal. Getting hubby to have sperm check asap and then not really sure when to give up or approach the idea of IVF. Every month I feel so much worse. Got my period today so just got through a lot of wine 🙈
Hope we get our positives soon. Desperately want our little one to have a sibling! (she is 2.5)

Hey, really random but did you have a c section at all with your first? I only ask because I did with my daughter and although I conceived easily last year (ended in loss due to chromosome abnormalities) I struggled to conceive after and found out I had a defect with the scar causing my fertility issues. I just had that removed and resewn up. At the same time they found stage 4 endometriosis which can also cause infertility. I am really hoping that once I am all healed this will have solved my secondary infertility.
My daughter is also 3. It's hard isn't it xx

I can relate so much with this post. We've been try to conceive a second child for about 21 months now. Multiple attempts with ovulation induction and progesterone supplementation, and no sign of a positive.

I feel so torn about next step. Somedays I just want to quit ttc altogether. Somedays I think we should start ivf asap, and other days I convince myself it'll happen without ivf. It also doesn't help that the progesterone suppositories are making me feel so depressed.

Good luck with your choices ahead! I hope you get your positive soon.

@Mummysparrow I had a c-section with my first. How did you discover you had scar tissue? I'm struggling to get GP to refer me for any investigation.

@SendmetoFlorida after my loss in may I started to get spotting for up to 5 days after my period. At first I was unsure if it was related to hormones and the loss but after a few months I decided to see the GP who referred me to have an ultrasound to check for fibroids. I was a little impatient and got a private scan with ultrasound direct which showed the potential of Adenomyosis and borderline PCOS as well as the isthmocele (c section defect) and the NHS scan also showed it. It is a very little understood area and not all NHS trusts will fun a surgery to fix it. So I decided instead of wiring to see NHS gynaecology, I went private and thankfully I have private health insurance that covered it.
You can be asymptomatic with it or it can cause infertility or bleeding in between periods. The scan with ultrasound direct was really detailed and I think cost me £145, so well worth it in my opinion. Also hertility is great for fertility tests and like £160.

Could you afford more than 1 IVF round OP? To me that would be the bigger issue - as realistically the first round is often a trial run to see how you respond to the meds (of course most clinics don’t tell you that). A few people do of course get lucky first go but there’s a reason the NHS is supposed to give eligible couples 3 cycles - because statistically that’s what many people need to get a higher than 50 per cent chance of conceiving.

Im not trying to put you off - I think IVF can be amazing and it’s how I conceived my son, but I won’t be having IVF again to try for a sibling as I can’t afford multiple rounds.

@Mummysparrow Very sorry about your loss but thanks for sharing about the scan. I had a c section too and worry about wasting my last frozen embryo when I have no idea if the c section could have done any damage. But I’m guessing the scan was a no brainer for you if you’ve got private medical insurance to fix the issues found. Do you know how much your surgery would have cost if you didn’t have insurance? The private scan cost isn’t a big deal but I’m not sure how/when the NHS has would fix any problems found 😢 Tricky one to tell whether it’s worth the scan in that case or not.

@IamnotwhouthinkIam I also had endometriosis removed at the same time so my surgery cost £7500 including the initial consultation with the consultant and a scan with the consultant, I believe just for the repair it would have been £6400. I found the consultant first and not the hospital as it then easier to get someone who you know can do the job. He was also an NHS surgeon but also worked at Nuffield Heath. Nuffield health do payment plans as well so you can spread payments. I have heard of the defect not being noticed or dismissed by fertility clinics as not being an issue but the defect makes the uterus an inhospitable environment. If worried the scan with a company like ultrasound direct should be able to tell you if anything is wrong or at least put your mind at ease. The scan will just look at your uterus and fallopian tubes as a whole.

@Mummysparrow Thanks very much ❤️

This has all made me realise that I am SO lucky to have my little one 💕

Thank you for your reply. I appreciate it. Some positive thoughts on the ivf journey to think about.

So sorry to hear about your loss at 18 weeks. That must have been devastating.

It's such an emotional rollercoaster isn't it. Some days I feel I'm strong enough to give ivf a go, and others i'm just too sad as it is.

Hi Mummsparrow,

No I didn't but thanks for sharing - keen to hear any suggestions!

Sorry to hear about your loss and all your issues with scarring. Fingers crossed for you once you have healed 💕

Your thinking loops sounds exactly like mine!

Was there evidence that you haven't been ovulating? I'm quite paranoid about low progesterone / it falling too quickly but my doctor hasn't been interested. The only people who listen to this is an issue is my acupuncturist - and they can't prescribe anything!

Jeez, that's a good question and something to think about. 😩

@HM2024 it always seemed like I ovulated on my own, but my doctor described it as "poor ovulation" - very late in my cycle, my luteal phase progesterone test was always <30mmol/l and my period started around 8/9 dpo every month.

The first fertility doctor I want to also completely disregarded my concern about my short luteal phase, so I decided to get a second opinion. The second doctor immediately flagged it as a problem when taking my history before I even asked about it. Have you gone for any testing in this regard?

Initially we hoped that inducing proper ovulation alone would be sufficient to fix the short luteal phase, so now we are supporting my luteal phase with progesterone. The whole process took a bit of trial and error, but I finally have recipe to achieve a "normal" cycle.

Was that private doctors or NHS?

I have recently had progesterone test at 9 DPO and it was 21.1. Maybe I need to try to chat with a private doctor. I was told that anything above 20 was good but I am constantly (on here) seeing people get told differently and have their concerns with short luteal phase/progesterone taken seriously.