OMFG how do I make this stick?

[Fallulah]

More than four years of nothing, GP refusing to refer me anywhere because of my age (now almost 45), BMI and the fact my partner already has a fully grown adult child. Deciding that we would stop after this summer…

and this morning I have a very definite BFP!!! We’re off to get a digital but I can’t believe it.

If digital confirms it, how do I make this stick? Do I need to ask my GP for progesterone? Take baby aspirin? This is my one chance, I feel.

OMG.

Get into an ob or early pregnancy unit asap. Congrats and I hope someone can help .

Congratulations!!

Get a private Drs appointment. GP will not be likely to prescribe progesterone, as there are parameters around certain amount of losses and testing etc.

Personally I would take a really good pregnancy vitamin with methylfolate rather than folic acid - like the Zita West or Proceive. Re your weight, will you need extra folic acid? Really sorry to ask but you mentioned weight, and a higher dosage is sometimes prescribed based on weight.

Thank you! Yes I imagine my weight would be high enough to warrant extra folic acid. I will check. I have Bupa so could get a private GP apt - good idea!

Still can’t believe it!

Gently, you can't make it stick. Fingers crossed for you that it's a viable pregnancy.

I know; I should have worded it as ‘what’s the best way to give it the best chance?’

Digital test also says Pregnant so it’s starting to feel real now!

Good luck!! I hope it works out for you! I got progesterone from the telephone gynae Dr Morton's. I had recurrent miscarriages so they were happy to prescribe. I booked a consultation and had the progesterone within a few days. They were also really helpful with other advice in general. They have fertility specialists on call.

Best of luck - definitely ask for the 5mg folic acid (should be prescribed at BMI over 30), and speak to GP about if you can get referred to EPAU for additional support if they won't prescribe progesterone. It's proven to not do any harm and can help. Fingers crossed!

Its pricey, but go private. Theres literally no reason why you couldnt see a specialist, theres people who's hitting 50 who are getting pregnant granted menopause hasnt kicked in for them at that age (my mum started around 45ish)

Go private and ask for progesterone pessaries, as far as im aware baby asprin doesnt do much (according to my midwife when i asked after having 3 miscarriages) i started progesterone 3 days after testing positive (i had to fight for this although the recurrent miscarriage team has said i could have them🙃)
Im now 23 weeks and 4 days with a baby boy and we're over the moon!

Prescribing progesterone would be the remit of a specialist so if you want to go down that route I'd make a private appt with a fertility specialist, but I'm not aware of any evidence for the indication of age (just for post miscarriage).

Good luck!

(PS I'm sure you didn't mean the GP bashing tone, but the GP didn't 'refuse to refer you', the GP was not allowed to refer you because it would have been turned down by local fertility services).

I have no advice but so pleased for you.

Hi Op, I was in a similar situation, I couldn’t be referred due to my partner I having grown up children. My Gp was super helpful tho and did as much as she could within her powers of testing. I managed to get progesterone prescribed in my last pregnancy which was successful.
I’d had a previous loss and during which I should have been offered progesterone at the initial bleed and wasn’t, so when I finally got my BFP I contacted my GP who was helpful and she managed to prescribe, she actually said although technically it falls out of their are of expertise but she was able to! I had to have the pregnancy confirmed at epas first to ensure in the right location etc

I shared these links to support https://www.tommys.org/baby-loss-support/miscarriage/taking-progesterone-early-pregnancy#:~:text=NICE%20guidelines%20say%20that%2C%20as,but%20it%20is%20worth%20asking

good luck! 🤞🏼 xx

We struggled to conceive our first. Tried for over 3 years. Never fell pregnant, never had a miscarriage.
GP did all of the tests they could within their remit and eventually found i had excessively low Progesterone.
Referred us for fertility care.
Somehow magically fell pregnant before the appointment, finding out an hour before I was due to see the consultant.
Still had the appointment anyway, explained the issues and the low progesterone.
Asked for supplements to help the pregnancy stick as Id been advised it was unlikely to end well as pregesterone levels were too low to allow me to get to full term.
I was refused Progesterone as it 'isnt standard policy to prescribe Progesterone now unless you have already had 3 or more miscarriages'.
I was devastated as just expected the pregnancy to end.
I felt I had just been kicked in the teeth because of new policies within my trust.
I was sent away with a hope for the best send off from the consultant.

Somehow the pregnancy stuck and I now have a wonderful 3 year old.

Id advise going private if you can as they may have a different take on things compared to the NHS.

The GP should have referred me when I was 40 and first attended saying we were trying and nothing was happening, but the referral was never actually done. By the time I followed it up again I had aged out and that combined with BMI meant the fertility team said ‘we’re happy to see her but we’d be unlikely to offer anything’ which wasn’t passed on to me by the GP practice, so I didn’t even get to talk to the fertility team and hear the limitations for myself. So I think my criticism of the GP practice is quite valid. (I’ve had a long running complaint about this, which one of the GPs himself told me to raise because he was so disappointed in the communication I’d received, in which they’ve apologised and promised they would update their systems for checking that referrals were actually done.)

I did an econsult today asking about the current medication I take and whether things like progesterone / junior aspirin would be recommended. I haven’t had a response yet but will make sure I ask about the higher dose folic acid. I will also look into private. Thank you.

That is a really helpful link - thank you!

I've never known an NHS service where it wasn't the case that both the age and BMI criteria had to be met, so a referral woth BMI over their criteria would likely be bounced.