How to prepare for pregnancy journey

[Emzzzn10]

Hi, we are two lesbians and will be looking to start the fertility journey roughly this time next year. My partner will hopefully be the one carrying first. She is 34 and healthy. Is there anything we can do to prepare? E.g. go to the GP for tests, start/stop eating certain things etc. We live in Wales so I’m not sure what kinds of things we can get on the NHS, but I am hopefully she’ll be able to have scans to see how fertile she is?

I don't know about Wales, but we didn't qualify for any fertility checks/scans on the NHS except the 12 week scan once DP was pregnant. I don't think you would unless you had known fertility issues? But definitely worth asking!

I don't think there's any lesbian-specific food advice I know of! But get her to start taking folic acid asap, etc.

Good luck!

Get your weight in a healthy range, take vitamins otherwise what were you hoping for? Scans etc are for when you are pregnant.

You won’t get scans on the NHS without proven fertility issues.

They’ll advise you to start taking folic acid ASAP, to get your weights to healthy range, and consider a conception vitamin.

Otherwise it’s down to you, or private treatment. The NHS will get involved when you’ve been trying for a year with no success prior to 35, or 6 months after 35.

I’m pregnant now and it’s been a bit odd - I’ve never seen my doctor, did a self referral to a midwife for booking in which was some questions over the phone; and then nothing until 12 weeks… then a scan, and a midwife appointment at 16 weeks but they don’t listen to the heartbeat anymore; and it wasn’t with my midwife, so it was a bit odd. Just urine tests, basically. Then a 20 week scan!

It’s oddly hands off.

The f/f specific advice would be don’t assume you won’t change your mind about who gets pregnant first (or have it changed by circumstances). So many of my friends have switched up who is having treatment and/or whose eggs are being used mid-way through, often with little notice. So anything you do in terms of diet, both do it.
High protein diet for egg quality if you think you might do ivf. The earlier the better since you need more than 3 months to make a difference.
There are scans and other things that you can have but blood hormone levels will be the most important, FSH and AMH. Possibly consider doing you both for the reasons mentioned above.
It’s also a good time to talk a lot about what you want re. donors, set limits of how many tries, think about treatment abroad etc. Think about whether you would risk twins (it’s a nice idea but a risky pregnancy). It’s good to have a nice long time to think about it.
Also there’s non-gestational-parent breastfeeding to consider as there’s some lead-in with medication.
Possibly consider getting married, the f/f couples I know who haven’t have had some paperwork issues.

Thanks everyone for the advice, I really appreciate it. Especially the part about not assuming that my partner will be the one to go first. We are waiting to be married before starting, which will happen in August 2022. By that time she will be 35 and I will be 32, so it makes sense for her to try first. I think we are going to try IUI to begin with as it is much cheaper, but obviously that comes with the risk of having a lower success rate.

Any stories anyone has about how long it took them to conceive and the method they used would be much appreciated

We decided against IUI due to the poorer success rates and when you factor in buying donor sperm the cost of it seemed to rack up quite quickly. Whereas ivf is more expensive but you've got the possibility of getting multiple embryos from one round (which requires only one vial of donor sperm).

Agree that being married does seem to make all the paperwork/legal stuff easier.

It's worth visiting different clinics to see what they are like and where you feel suits you the best. Factor location into this if you might do ivf as you'll need to get there multiple times a week once the cycle is underway.

We didn't visit enough - found one place we thought we liked and started treatment there but then quickly came to dislike it. The warning signs were there from the start, we just didn't see enough places to have a point of comparison. We did one failed cycle at the first clinic, changed to somewhere we liked a lot more and had a successful cycle.

If you do end up considering ivf rather than IUI, it's worth looking at Access Fertility and the multi cycle or refund packages they offer. There's also loads of helpful threads on the infertility board on here :)

Ooh, just one thing - if you are open to egg donation (and I know it's a very personal thing), keep that in mind both in terms of whether you do IUI or IVF, and what your timings are.

Lots of clinics will offset costs for egg donors, but you can't donate once you're over 35.

@gogohm, when you say 'Scans etc are for when you are pregnant,' I wondered if the OP means things like hysterosalpingograms? The scan for your fallopian tubes. The clinic DP and I used wouldn't treat without having had that. I got mine (or rather, an equivalent) on the NHS as I have known fertility issues but DP had to pay. Worth knowing about as they're not cheap!

Oh, sorry, and to answer your question about personal experiences:

DP and I went private as she was nearly 35 and we wrongly assumed we'd be ages waiting for an appointment. She had her AMH/tubes checked, no obvious problems. The clinic's protocol was low-dose medication for IUI and she did that, and she got pregnant the first time, very simple.

I tried later on (I was 33 by that point), and had more problems (but that was expected as we knew when starting I'd a history of miscarriage). We were going to do IVF when the pandemic started and that's stalled things for us for various reasons (I'm nearly 37 now).

FWIW, we found the paperwork all perfectly straightforward and unproblematic, both during the treatment and subsequently when doing things like getting DD's birth certificate. DP and I are not married; in fact when we were getting treated I have a feeling I still hadn't got my decree absolute through from my divorce, and I didn't feel being unmarried made it any more difficult.

Would also say - there is a massive lesbian ttc community on instagram. Can be a bit twee, but harmlessly so, and I wish I'd know about it when we were trying as these boards can get a little quiet!

Our clinic advised people in our situation to go straight to ivf. We did 2 IUI anyway while waiting for ivf then one round of ivf for baby 1. Then 3 rounds of ivf (2 conventional, 1 mild) for baby 2. So 3 months trying for first baby, 5 for second.
It would have been better to skip the iui. It’s with injected hormones too so it’s not as easy as it seems. Since the success rate is lower, you use loads more sperm, which is expensive. The thing with ivf, though, is that there’s little data on women in our situation, so with me the doses they used were way too high and ruined the eggs. Mild ivf worked amazingly.
I wish we had done the egg collection for both of us at the same time and frozen one lot of embryos. You feel a bit ropey with the hormones and procedure and sleeping it off all afternoon is a great option. Additionally the eggs are that bit younger.
Bureaucracy issues were around travel and multiple nationalities. If you are sure you won’t ever live abroad with your child and you aren’t eligible for another EU nationality that you might want to pass on to your child, marriage might be less relevant. We also thought it would be useful for decision making in hospital in emergencies but luckily didn’t have to test that out.
BTW we made the decision on who do go first based on the ages of our mothers and grandmothers at menopause. There was a big difference — 38 vs 55 — so it was clear.

@3womeninaboat

Our clinic advised people in our situation to go straight to ivf. We did 2 IUI anyway while waiting for ivf then one round of ivf for baby 1. Then 3 rounds of ivf (2 conventional, 1 mild) for baby 2. So 3 months trying for first baby, 5 for second. It would have been better to skip the iui. It’s with injected hormones too so it’s not as easy as it seems. Since the success rate is lower, you use loads more sperm, which is expensive. The thing with ivf, though, is that there’s little data on women in our situation, so with me the doses they used were way too high and ruined the eggs. Mild ivf worked amazingly. I wish we had done the egg collection for both of us at the same time and frozen one lot of embryos. You feel a bit ropey with the hormones and procedure and sleeping it off all afternoon is a great option. Additionally the eggs are that bit younger. Bureaucracy issues were around travel and multiple nationalities. If you are sure you won’t ever live abroad with your child and you aren’t eligible for another EU nationality that you might want to pass on to your child, marriage might be less relevant. We also thought it would be useful for decision making in hospital in emergencies but luckily didn’t have to test that out. BTW we made the decision on who do go first based on the ages of our mothers and grandmothers at menopause. There was a big difference — 38 vs 55 — so it was clear.

That's really interesting! (Sorry OP, I am slightly me-railing about the paperwork side). Glad to know.

FWIW what you say about maternal menopause age came into it for us too - I'd forgotten - but DP's mum was late 30s, mine mid 50s, so the same. DP's AMH was 13 point something at age 34, which is totally normal; mine was about 52, which is sky high. Interestingly poor DP is now definitely into perimenopause at just 40 and presumably it would be harder for her to get pregnant now.

All of that is a long-winded way of saying yes, and especially yes to the point there isn't enough research into fertility treatment on women who don't have fertility issues. Our clinic wouldn't do unmedicated IUI (some will) and DP thinks it was probably not great actually. They give you things that thicken your womb lining, which is probably very sensible that's the reason you've been miscarrying for years, but perhaps not so great if your body is doing perfectly healthy things with your womb lining already!

The lack of research into fertile women having fertility treatment is even more surprising given that around 50% of women in relationships with men are treated for male factor infertility and are mostly fertile themselves as far as is known.

I would say the only advise I have is don't wait until you're married if possible, conceiving can take longer than you might think, and the process of getting the treatment takes a bit longer than a quick 😉😉

In England you would get treatment on NHS as a lesbian couple as you don't have any sperm. You don't have to be infertile. You just go to GP, they do initial bloods, then you ask to be referred. But you may not be able to choose the clinic.
As said before, don't wait. If you are going through a clinic, the child will be legally your partner's as well as yours regardless of marriage, the clinic sorts out all the legal paperwork.
And don't bother with iui, but also don't just say yes to medicated cycles. We did, on the assurance it would give the best results, now post egg retrieval, with only one or two embryos in the running and the distinct feeling that all the meds mucked up my perfectly good natural fertility.
Good luck whatever you decided, be prepared for long waiting times for all appointment s, feeling rubbish physically for a couple of months and emotionally for several months, so be kind to yourselves.