How do I go about getting referred for fertility treatment in UK

[mk8]

Hello everybody

First of all, I wish you all a happy new year that brings you your BFPs!

A bit about me... My husband and I have been TTC for just over a year. I am 31 and DH is 32. I am on cycle 14 but about to enter cycle 15 (this cycle didn't work for me either). Never been pregnant, nor has hubby ever fathered a child (to our knowledge anyway!) We have regular BD (every other day throughout the cycle) and have even tried the SMEP. I went to my doctor in cycle 3 of TTC because I was getting dark brown spotting a couple of days before AF (not usual for me), doc sent me for a smear and everything came back fine. I went back to docs on cycle 5 of TTC as I had been getting pelvic pain so my doc sent me for an internal ultrasound and bloods - all came back normal - so assume no cysts/polyps/fibroids. However, my free androgen index was high, which can signal PCOS but doc didn't diagnose me because I have no other symptoms. I have regular cycles, around 27 days. I have done OPKs and temped some cycles. Got positive OPKs sometimes and sometimes almost positive. Temps are biphasic most of the time I have temped, but theyre erratic. After 12 cycles of TTC, I went to my doc for advice. DH had SA done - all great: 35m/ml count, 41% progressive, 3% non-progressive, 56% non motile. 6.3ml volume, 220.5m total count, 7% normal form). Doc refused to do an HSG until we have been TTC for 2 yrs! But he gave me clomid, even though my day 21 prog levels showed I was borderline ovulating (26nmol/l, I think they like it 30nmol/l). My LP is usually 11-12 days but I spot on day 11 and/or 12. I have taken clomid for 2 cycles - no BFP and my cycle lengths are the same, though I got an almost positive a day earlier than on natural cycles.

So my question is this... how do I go about getting referred for more tests (such as HSG). My doc has told me my PCT doesnt offer IVF and HSG is only offered when we have been TTC for 2 yrs. I am sick of waiting and just want to know what is happening. If we do need IUI or IVF then I'd rather know now and get to it. Does anybody know about the procedures, costs and what tests may be ordered?

Thank you all for reading. Wishing you all lots of luck.

 

[Traskey]

If your PCT is not offering IVF are you thinking of going privately? The costs do vary a little, depending on where in the country that you live and whether you are doing short or long protocol. IVF is about £3-5,000 ICSI is about £4-6,000 on average. If it is private then usually you don't have to have anyone refer you, you can refer yourself. The HSG should be offered on the NHS but the fertility clinic can do them as well if needed.

Good luck with the next step for you!

 

[mk8]

Thanks Traskey. I am not sure if I want to do IVF, I just want to be referred for more testing right now. I cannot get the HSG done on the NHS but I would like my GP to refer me to an NHS hospital as that is usually cheaper than referring myself to a private hospital... at least that's what I am guessing because I found a lump on my neck last year and it was cheaper to go for a scan when my GP referred me rather than going to a private clinic for it (GP wouldnt pay for it because I was "low risk" due to my age and no cancer in my family).

Hope those eggies of yours grow nice n strong and cling onto your insides for 9 months

 

[cooch]

The irregular brown spotting is a symptom of endometriosis, some women have loads of the symptoms others none at all. The only way to properly diagnose it is by laparoscopy.

The other thing is I'm doing a treatment called Napro (explained on 1st page of my journal). According to them I need to have day 21 progesterone of above 60 (UK levels) to have a good chance of conception. This month it was 48 so even though AF isn't due until Sun/Mon I know I've not conceived. You can still conceive with lower levels, but it is unlikely. The NHS set levels low as otherwise they'd be prescribing drugs left, right and centre.

It's great that your doctor had given you Clomid but I would definitely ask for day 21 bloods whilst your on it so you know whether or not it is making an impact on improving your chances.

If you have low progesterone it can mean your corpus luteum (the corpus luteum develop from the follicle after the release of an egg) isn't producing enough progesterone. This can be a result of you not developing a mature enough follicle to ovulate your egg, the follicle doesn't grow big enough. The smaller the follicle, the less likely the ovulation and the less likely any ovulated egg get fertilised.

The longer your in LTTC the more knowledge you develop, unfortunately. I hope the Clomid works and that solves everything for you. xx

P.s. check this out

https://www.inciid.org/printpage.php?cat=infertility101&id=7

 

[mk8]

Thanks Cooch. Hope Napro works wonders for you.

 

[Princess Lou]

I would go and request that you get referred to a fertility specialist, some doctors don't offer it as they feel some would be offended by the initial suggestion. If your doc doesn't refer you then I suggest seeing another doctor. There could be underlying issues and you have a right to have them looked at. A fertility specialist is obviously more qualified and after looking at your blood work will know if a HSG/Lap and Dye is right for you rather than refusing it because of costs.

 

[_Nell]

I would go back and push for the HSG - see a different Dr at the same practice if you have to.

If it were me I would say that I'm not happy taking clomid without confirmation that my tubes are clear and my uterus all sound....it could be a waste of meds, plus you're not being monitored so have no idea what's happening with your lining/follicles/ cysts forming etc.

You could also say that as IVF is not offered in your PCT you are considering private treatment (not necessarily ivf) and would like the NHS support in providing the basic tests they can offer (ie HSG) to assist you in prepping for your consult with a private clinic.

I have found a little polite pressure goes a long way with the NHS!

 

[mk8]

Thanks for taking the time to reply ladies.

Nell- are you going through ivf in the uk? I've never heard of nk cell problem. Wishing you all the best in the next steps.

 

[blueeyedgirl1]

In my area (Bristol) it's also 2 yrs of TTC before you're referred to a fertility specialist (FS) unless the tests the GP orders come back with issues. My GP won't even prescribe Clomid or scans, though, only blood tests (cycle day 3 and 21). As I've had some borderline issues come back in my bloods, the GP is referring us to a FS after 17 months TTC and only now has a SA request gone in for my OH. I guess things work quite differently in Bristol!

Perhaps speak to your GP and ask them what tests are possible and if you've done everything that's "allowed" before your referral window. Maybe ask if they'll order more bloods to get a pattern established of your hormones to see if everything is within normal limits and fluctuations (that's how my GP found out my levels weren't "normal").

Other than that, there's nothing they can do. GP explained to me that without adequate proof of issues, any FS would turn down a referral before the 2-year time period. They just flat-out won't see you.

 

[charbaby]

In my area (Bristol) it's also 2 yrs of TTC before you're referred to a fertility specialist (FS) unless the tests the GP orders come back with issues. My GP won't even prescribe Clomid or scans, though, only blood tests (cycle day 3 and 21). As I've had some borderline issues come back in my bloods, the GP is referring us to a FS after 17 months TTC and only now has a SA request gone in for my OH. I guess things work quite differently in Bristol!

Perhaps speak to your GP and ask them what tests are possible and if you've done everything that's "allowed" before your referral window. Maybe ask if they'll order more bloods to get a pattern established of your hormones to see if everything is within normal limits and fluctuations (that's how my GP found out my levels weren't "normal").

Other than that, there's nothing they can do. GP explained to me that without adequate proof of issues, any FS would turn down a referral before the 2-year time period. They just flat-out won't see you.

hi i'm in Gloucestershire so right next to you, my gp referred me after just over 11 months but that was down to me having pcos, I thought after 12 months everywhere was supposed to get referred x

 

[Buckles]

Took us two years to be referred by our gp, but you can refer yourself if you go privately. For IVF on the Nhs you have to be trying for 3 years in our area

Good luck xx