TTC age 39

[infj182]

Hi, I've been TTC for around 18months. About 5 months ago I asked my GP to refer for fertility checks. It seems the wait is extremely long and I'm anxious I don't really have the time to wait. I had my bloods done on CD3 (when I was age 38), l'm still waiting months later for anyone to look at them. Does anyone know what these mean in terms of my chances to conceive?
FSH 16.5 iu/L LH 6.21 iu/L Oestradiol 182 pmol/L
Also, how long does it normally take to see anyone for any further fertility checks? I had a chemical pregnancy last month and since then been feeling pretty sad about the whole thing.

Hi, I'm sorry about your chemical pregnancy! I am not a medical professional, just someone who has spent a lot of time researching these things and ended up explaining her blood test results to the GP not the other way around 😂 so please verify this with your own research or a doctor/privately. Don't get freaked out by the title of the link below your levels aren't menopausal 😁

https://proovtest.com/blogs/blog/what-level-of-fsh-indicates-menopause

Your FSH seems a little high but in line with your age in the article above. This COULD mean a lower ovarian reserve so fewer eggs left but as far as I know that shouldn't be a problem when trying to conceive naturally as it's only one mature egg a month anyway and I don't think based purely on your blood tests that there is a reason to believe they are critically low as your FSH isn't through the roof. So please don't panic!!! I think as a first step I would re-test them and also do an AMH blood test and a scan for your antral follicle count. It's frustrating that you have been waiting so long, if it's an option to do so privately then I would do the blood tests (day 3, day 21 progesterone and AMH) using Medichecks, Randox, onedaytest or similar, and you could do a hycosy, where your tubes are flushed to make sure they are open, which for me included antral follicle count. I think they are around £500/600 though so please also chase your GP for a pelvic ultrasound as a first step.

In my case from initial appointment it took 2 months for the pelvic ultrasound on the NHS, bloodtests were quick (but they didn't offer AMH) and then I think 7-8 months or so for the referral appointment. We ended up doing private IVF and we paid for a lot of blood tests and a hycosy as part of it so if possible financially I'd recommend it to avoid waiting around. If not done recently I would also check folate, vitamin D, iron and a full thyroid panel (again using medichecks, randox, onedaytest etc) unless your GP offers these. You could also look into supplements like ubiquinol or N-Acetyl Cysteine. I would always recommend using the active form rather than the synthetic but have a look and I appreciate that supplements can quickly add up. Again I am not a medical professional so pleasd do your research on them first 🙂 there are lots of great podcasts around as well as the books It starts with the egg and Egg Quality Diet. And of course it's super important for the sperm to be checked too, sperm analysis as a first step, potentially DNA fragmentation test/physical exam to check for varicocele. All the best!!! ❤️

A 39 presumably you'd be going private for IVF, so can I ask whether that's an option to start the ball rolling, if your GP is being slow? You could even just get private opinions on the bloods?

I think GPs aren't really that clued up on this stuff and can be a bit of a lottery - I've seen ones who were helpful but also ones who really just didn't do anything. If they've not got back to you in months that sounds pretty unhelpful.

My GP was also pretty unhelpful when I went for fertility advice, I did Hertility at home hormone testing with a nurse consult to explain results and next steps. You could also consider doing these at a fertility clinic as then they can do something with the results. I did eventually get a referral from my GP for a fertility clinic, from referral to appointment was only 6 weeks which surprised me (this is kings in london) but I ended up going private for pretty much everything including IVF to avoid wait times and be able to do the treatment I wanted (pgta testing, which rhe nhs doesn't offer)

It does depend how much you're willing to spend versus how long you'll have to wait but I'd also advise being as pushy as you possibly can be to get things moving! Best of luck xx

Chase your GP for a referral to a Fertility clinic. Your could in the meantime have a private AMH test and scan to count follicles. Your FSH level could mean a low ovarian response to IVF but it may nonetheless be worth a try. Local health boards can have hormone thresholds for eligibility though - check the criteria for yours once you also have your AMH level.

Wow thank you all so much. A lot for me to look into but I already feel better and a little less lost. My partner is finally having his semen analysis next week so I was hoping something would happen for me after this, but I will chase the GP from what you've all said. It's not an option at the moment for us, we've just lost most of our savings from needing an entire new roof. We may have to have some talks about finding some money as having a baby is pretty much all either of us want. Thank you all!

If we can help with anything else let us know. And I went to Thérapie Fertility in Dublin and had a great experience so far. Much more affordable than a lot of the ones in the UK, you can get a loan for part of it I believe, and if it helps they have a satellite clinic in London for bloodtests and scans. It's also where I did my hycosy, not sure about their new satellite clinic price if they offer it there.

look into access fertility and other affordable options, most private clinics have these and loans.
I only say this as most NHS areas only over IVF up until age 40 ( where i am it’s 38) so by the time you wait you may not meet criteria for funding. Are you taking any supplements? Good luck xx

Most NHS boards also require FSH to be under 9 unfortunately, though there is some variation. It's possible AMH could be considered instead if that gives a result in range.

@infj182 At 39 it's likely to take you longer to conceive and highly likely you'll need more than once cycle of IVF. I had my son at 40 after 2 cycles of IVF on NHS starting at 38. I produced lots of eggs each cycle but only 3 blastocysts and of those 3, only 1 worked. I used to think that because I was physically fit and healthy, looked young for my age etc, plus my mum had me at 39, that it would be more straightforward so it was a shock when it took a while. My point being - do whatever you can to start immediately. Time is not on our side at 39 though you still have time. I appreciate how financially tough it is but it's also whether you can afford not to wait. IVF abroad is considerably cheaper and not as complex as it may seem. A single cycle where you could freeze/bank your eggs could buy you some time too. Good luck.

I would agree with @Sara237 , I don't want to alarm you @infj182 but what is more worrying about your blood results is the ratio of FSH to LH. This could signify a diminished ovarian reserve: https://blog.inito.com/fsh-lh-ratio/

However, the chemical last month means that you can get pregnant, so keep trying naturally and make sure you are supporting egg and sperm health. Get on some good supplements and eat plenty of protein, colourful fruit and veg etc.

Diminished ovarian reserve is more of an issue for IVF, because that is a numbers game mainly.

You can only confirm if you have diminished reserve by having an internal scan which will look at ovaries and an AMH level blood test. You can do the second one quite inexpensively through hertility.

Please don't lose hope, but you will never be in as such a good position as today so the sooner you investigate all these things the better! Best of luck xxx