starting NHS testing: what should I ask for?

[sowanted]

UK ladies, I need your help!

I'm going in to start the process of testing on Tues (tomorrow). No clue what to expect. On the one hand, I'm pleased. But on the other hand, scared shitless because more information can reveal bigger trouble than I'm (perhaps naively) currently facing.

As I begin:
-What can I expect?
-What tests should I ask for (that might not be included)?

Reckon, if there's trouble, I'll be going private (b/c I think I'm too old for NHS help).

My history (in case this helps):
-I'm 41
-regular periods (only one period, when I was 14, wasn't 27 or 28 days)
-14 Feb 2012: got preggo on first calculated attempt (we were thrilled!)
-Easter weekend: I miscarried (we think fetus failed ~8.5 wks)
-mid-May: 'regular' period? came 28 days after miscarriage (didn't test ovu)
-mid-June: period, 28 days (again, no ovu testing)
-mid-July: period, 21 days (??!)
-mid-Aug: period, 27 days
-early Sept: period, 23 days (??!)
-early Sept: started ovu monitoring (with ClearBlue)
-mid-Sept: fert monitor shows ovu on d15
-late Sept: period, 25 days (so luteal phase is just 10 days, right?)
-Oct: NO OVU whatsoever according to fert monitor (??!)
-22 Oct (today): d26, expect period to start any day
-23 Oct (tomorrow): first appt at NHS, to ask for testing

Some details about my periods (which might offer a clue or two?):
-when I was a teenager, I suffered from terrible menstrual migraines. They were occasional but when they came, knocked me something fierce (aura, stroke-like feelings down one side, vomiting). Was told this all had to do with the sharp hormone changes. Estrogen.

-I managed it all with birth control for a while. But then for most of my 20s, didn't stick with it. All felt a bit unnatural. When I went on again in my early 30s (for about a year only), I was put on progesterone only pill (after telling doc about timing of migraines).

-even when migraines didn't come, I could count on having terrible cramps. One a&e doc thought I had IBS after I described shooting pain, diarrhea (sorry, TMI), and fever coming on so suddenly my hair/clothes would become damp within seconds during cramping. With loads of ibu taken before start of period, pain was much more manageable. Was told it had to do with managing prostaglandins. Another doctor once suspected endometriosis (after describing pain in my thighs, back, and general abdomen area) and told me I'd be a whiz at labour (after telling her how I got through the pain...bless her, I hope I can prove her right!).

-But that all has subsided in past 12 years or so, so I think it was a teen and 20s thing. Last migraine happened over 10 years ago and super bad cramps happen only 2 or 3 times a year (and that's without ibu, woohoo!).

We know I can get pregnant. I expect that body is recalibrating but do wonder if this ovu weirdness and potentially shortened luteal phase might REALLY be the situation I'm facing (and somehow I just got lucky in February?).

Am pleased to be starting the testing (if there's something to worry about) but also part of me is really worried...more we know, might we hear something's really wrong.

Would sure appreciate any insight you could share on how NHS testing works.

 

[nobump]

Hi,
Good that you are ovulating and are able to be pregnant, hopefully the visit today has help. Not sure what test they will do to you, be good to find out.

I have had various bloods, including day 21 tests, that prove I have ovulated. Had a laparoscopy, no issues there, waiting on NHS appointment for assisted conception... Issue is with hubby, low sperm due to issue with cyst on scrotum.

Good luck !

 

[sowanted]

Hi,
Good that you are ovulating and are able to be pregnant, hopefully the visit today has help. Not sure what test they will do to you, be good to find out.

I have had various bloods, including day 21 tests, that prove I have ovulated. Had a laparoscopy, no issues there, waiting on NHS appointment for assisted conception... Issue is with hubby, low sperm due to issue with cyst on scrotum.

Good luck !

Thanks for your reply.

Walked away from the appointment yesterday feeling quite encouraged. Here's what will happen:

1- I have to return on Day 21 to give blood samples for following tests: lh, fsh, progresterone, testosterone, full blood count and repeat thyroid.

2- If all seems okay, hub's will have semen analysed (though if tests done last year when we were considering helping a lesbian friend of ours become a mother are anything to go on, sperm's good).

3- We'll then be referred to an assisted conception clinic. It'll be a 'Choose and Book' sort of referral so I'm now looking at clinics. Nearest urban centres near me at Manchester and Leeds.

Best of all: we know that (despite my age, 41), there are some treatments that I'll have access to including clomid (to get pregnant), progesterone (to help any bean stick), laproscopy (if blockage suspected) and surgeries (to clear any blockage). But don't think endo's a problem as bad periods subsided ~ten years ago.

I do feel in my gut (and nurse-former-midwife yesterday also thinks) that the recent wacko ovu readings are all to do with body needing to recalibrate following miscarriage at Easter. Maybe I'll go on the pill for a month or two to re-set clock? We'll have to see...

She said as we left something to the effect of 'don't let the monitor threaten spontaneity' (which nearly made me bust up laughing...yeah, right) but I suppose she has a point. Nerves can't help matters...so trying to relax. Not easy (for me, at least).

Hope we both get the answers we're seeking for the outcome we want! Good luck. And thanks again for replying.

 

[Charliegirl27]

Just wanted to say good luck and look up NICE fertility guidelines. I'm a midwife and this is what uk hospitals use as guidance x

 

[nobump]

Just wanted to say good luck and look up NICE fertility guidelines. I'm a midwife and this is what uk hospitals use as guidance x

Thanks for the reference, interesting site.

 

[Pippi_elk]

Hi sowanted,

I don't have any answer for you but just thought out stories are quite similar so decided to say hello. (Although I am 42).
We started ttc a year ago, got pregnant on 5th cycle of ttc so were really pleased. Had miscarriage on 14th feb (ironically the day you started ttc) and since then no luck.
Have regular periods like you of approx 25-27 days with 11 days lp, although this month was only 7-8 days for the first time ever.

My gp has referred me to a nhs fertility clinic but she did a range of blood test while I was waiting. Hormone profiling on cd3, progesterone at 7 dpo, thyroid and I had ultrasound yesterday.
All more or less normal so far although my gp doesn't know much about interpreting them. my prolactin was a bit elevated but endocronlogist says since im ovulating and getting regular periods the slightly elevated results are not important. luckily my employer gives me private health insurance which covered a private referal to endocrinologist. they wont cover anything towards fertility but as it was an abnormal blood reading that needed investigation they covered that.
i think my progesterone is a bit too low but it still falls in the normal range.

I have my first apt next week at fertility clinic with nurse so we'll see how that goes. Dh has not had sperm count done yet.

I usually post on the ttc discussion group for those over 40, you should at least stalk there. Its been quite lately with not many bfp
https://babyandbump.momtastic.com/ttc-groups/355138-ttc-40-plus-lets-share-ups-downs-642.html

 

[Blythe]

Hi.....I'm in london and doc said no testing for me on HHS as too old...well other than day 21 bloods and sperm test. Having said that After my chemical she seemed more sympathetic and offered a pelvic examination and referral for scans...sure they make it up as they go along. Hey ho!