Tips/Advice about NHS protocol/referral??

[noelle1979]

Hello

I am new to this forum, just got my DH's second SA back and it is even worse. He has gone from 5% to 3% morphology. Can anyone advise me whether this means we are ok to be funded by NHS? My PCT offers 3 cycles (Hertfordshire) but when looking through their contracts the eligibility is not clear. I am waiting to see my GP to get a referral but would love to be armed with as much info as possible! Dont want to be fobbed off anymore!! I think ICSI would be our best option.... so so nervous! We have been trying for less than 3 years so not sure where I stand.

Also, if any of you ladies have been to Herts and Essex Fertility Centre I would like to see what you think, looks as though it has a better rating than Hammersmith

Thanks everyone x

 

[silarose28]

Hi Noelle

I am in Herts and currently having treatment (ICSI) at Herts and Essex.

As far as I know you only have to wait 3 years if you have unexplained fertility. I didn't wait 3 years as I have endo.

I didn't get referred by my GP. I had to go through a whole host of tests at St Albans hospital first - I got referred to Herts and Essex from there. That might be different if the GP can easily identify what is wrong which wasn't the case with me. Be prepared to be firm and fight your corner in a pleasant, reasonable manner with doctors etc. I kept a written record of my cycles, medication, questions I asked and answers that I was given - sounds OTT but was invaluable when convincing people that I needed help. The doctors don't always seem to have time to read your file/problem solve so make sure that you have as much info as possible at your fingertips.

Herst and Essex are lovely! It is much better than the Hammersmith for me as I can get there in the car in about 40 min. Wth ICSI you just spend so much time back and forth from the hospital that this really matters. Oh and the staff are available to answer your calls - they always get back to me within a day. There are no waiting lists so it means you can crack on which was v important for me as I was 36 (now 37).

My first round was cancelled due to poor response. My second was successful but ended in an early miscarriage. Have all my fingers crossed for my next cycle in Jan/Feb xxx

 

[noelle1979]

Good luck to you... I am hoping with 2 lots of poor morphology we can get referred. I have had a lap and dye, ovulation tests etc and all fine... my poor hubby is devastated.

Hope you do not mind me asking you more questions!! I am pretty sure the consultant i am booking to see will refer me for IVF / ICSI as he did my lap and dye and checked through the SA. I have exams coming up at work and we are about to renovate our house (extension, moving out etc)... nothing like everything coming at once eh?! With this in mind and my exams being April/May.. how much time will I need to take out and how much will it disrupt my life? I would give up work if I could but it just so happens that we are launching a product and along with that comes a lot of work!!!! I am just wondering whether I should wait until May time or get going... I am desperate to get cracking but not sure!!

so ISCI coming for you again in Jan? Best of luck hon - how are you finding it all xx

ps.. I live in St Albans too x

 

[silarose28]

Hiya

I am sure you will get referred if you have had all of that done. They are all the tests that I had.

I am sure it is different for everyone so it is hard to say how much it will affect your life. If I am honest it impacted a lot on mine. I was back and forth from the clinic and my schedule kept changing - though the change of schedule was probably down to my body not playing ball and might not happen to everyone. I have an extremely busy job and needed to take things easier than normal - the drugs really took it out of me. Lucky I have an understanding boss who has let me be flexible with my diary - I personally really needed that. I have friends who have been through this and some found it really stressful whereas others coped better - though I don't think anyone found it easy. You will definately need time off for egg collection and transfer (I NEEDED a week as was painful!). In the week before this you will need time off for scans and whilst Herts and Essex are flexible, you will need to be able to attend them despite what is happening at work.

After being referred I had to wait about month for my first consultation. It is probabaly best to talk to the consultant about your particular circumstamces as he/she will be abe to give you a better idea about what will be involved for you.

Good luck. I am really hoping it will happen for us next time round xxx

 

[noelle1979]

I am sure it will happen, it has happened before and now you know what is coming you will prob be more relaxed aswell.. let me know how you go. 2011 I am sure will be the year you get your wish!

I am under Mr Atalla at the QE2, he has been great so far and gets stuff done quickly...

please let me know how you get on xx

ps - any tips for what you would do diff x

 

[mrs_lukey]

My hubby's tests were 11% and then 5% morphology. My PCT makes you wait for 3 years for unexplained fertility for treatment but if there is a male infertility factor and ICSI is needed then we can have the funding for that now as we've been TTC for over 2 years. The only problem is that our PCT won't authorise an advanced SA to confirm the morphology issue. My consultant has advised us to pay £250 and have it done privately and if the results come back that we need ICSI then he will approve the funding immediately.

 

[noelle1979]

thanks mrs lukey... what do you mean by an advanced? We have had 2 privately done, 5% in Sept and 3% last week... will they accept that??xx

 

[mrs_lukey]

I don't know what they will accept sorry. All I know is that my consultant said we need to have a more detailed analysis which will monitor the sperm over 2-3 days rather than just give a basic count, morphology and motility etc. I assume different PCT's treat things differently.

My consultant could only refer me for IVF with our test but says if the private one supports the findings we all ready have then ICSI is our only option!

 

[silarose28]

Hi Noelle

My DH's results were the basic ones (count, morphology, motility etc.) and they were fine for referral for ICSI from St Albans Hospital. Not sure if it's the same all over Herts but they seem to have the same policy for PCTs in South East England so it probably is. Glad you have a good consultant - that counts for a lot! When is your next appointment with him?

 

[silarose28]

I was just thinking.....I had endo too which probably helped my referral (the only good thing to come of it!) I can't remember what my DH's results were but they weren't terrible and we probably wouldn't be referred on those alone. However, we had no probs getting ICSI rather than IVF with his results. Sorry I am no good at understanding SA results but I would think it would depend on whether the results indicated that preganancy was possible or not. Best to talk to your consultant about it xxxx

 

[noelle1979]

Going to Gp tomorrow for referral back to him - he indicated with the 5% morphology that I would have a case but but now with the 3% I am sure we stand in good stead. The motility has gone down too... even though he has changed his lifestyle?!! Life us unfair.

I am so scared but ready for whatever I need to do... did not think I would have to go down this route. I was told that I would have twins by a psychic - maybe this is why!x

 

[Tinks85]

Hi

Our specailist sent our referral last week. Hubby's morpholoy was 40% but his count was less than 1M. Before we were referred I had to have some tests done to check everything was ok my end and he had to see a Urologist. We have been told we will need ICSI and will be excepted for funding as neither of us have children and there is nothing that can be done to improve the count. Our PCT doesnt make you TTC for a certain amount of time if a problem has been found. The only thing is that we may have to pay for sperm retreivel our selves as this is not always funded, hubby will not be able to just produce adqueate sperm by ejaculation

Our PCT is Lancashire so it may be different and we are being referred to St Marys in Manchester, a 1.5 - 2hr drive away so we will be clocking up some miles during treatment

Good luck hun, I know it doesnt seem fair, you are not on your own though

 

[noelle1979]

So good having this site, I cannot tell you what a support it is! I am going to post for advice on ladies that have has ICSI - would love any tips and anything that they woud do differently. Going to start weight watchers next week - not over weight but would like to shift a few pounds before all of this starts... make me feel better!

Hope you ladies are ok? Lets keep in touch and good luck to you ladies who are starting - please let me know how it goes xx

 

[Tinks85]

I will be starting a healthier eating plan to shed a few pounds after new year, my BMI is within range but I could do with shifting a stone maybe a stone and a half. Thinking of trying weight watchers as they have a new plan out. I am going to get a fitness game for the PS3.

Good idea about the advice and tips, I would love to hear from girls that have already been trough it. I need to be able to see a light at the end of the tunel, so to speak

 

[fluffystar]

Hi Noelle,

We were referred to a fertility specialist at the local hospital after hubbys SA came back with low morphology. It was initially 8% and then repeated 6 weeks later 8% again and then we were told to repeat in 3 months. This time it went down to 4% and the fertility specialist said they would be happy for us to be referred to him. He sent me to have my tubes checked as that was the only think that I hadnt had done yet.

We then got referred for IUI due to mild male factor and that we had been trying for 2 years. We picked Herts and Essex due to no waiting times. However at our first consultation at H&E, which was pretty quick to arrange, they said that a 4% morph was unlikely to be the cause and that it was "unexplained". They therefore said we would be better off with IVF than IUI and so that was what we did! Unfortunately, I didnt react well to the drugs and only had one fertilised egg which wasnt good quality.

I would definitialy recommend H&E as they are so friendly but you will have to be flexible with work. It all depends on how your body reacts as to when you will need appointments. I felt fine the day after egg collection and went to work but then after a few more days felt really wiped out, bloated and a painful abdomen. Though I had taken some time off as I had an early transfer at 2 days, even if I had a 5 day blastocyst transfer I wouldnt have been able to work in that time as I felt so ill. All women react differently and my only advice would to be able to speak to your boss, if possible, so that they can hopefully help you be flexible at work.

I wrote most of my experiences down in my blog which is in my signature so feel free to read for some info.

Wishing you loads of luck and babydust
fluffy xx

 

[noelle1979]

Thank you Fluffystar... really great advice. Glad you liked Herts & Essex, I have a good feeling about it there. Do you mind if I ask another question? How long did you have to wait to get approval for funding once the FS consultant recommended you?xx

 

[fluffystar]

I dont mind questions at all! Let me think.....

7th sep - we saw FS who recommended IUI providing HSG was all clear. We both had screening bloods taken for HIV and hepatitis on that day as he didnt think that my tubes would be a problem and so started filling out the referral forms.

9th sep - as luck had it I was at the right part of my cycle (cd5-10) and I managed to get an apointment for HSG which was all clear. We just had to wait for blood tests to come back (which they said would be 2-3 weeks) to be able to send paperwork off

28th sep (3 weeks later) - I chased the hospital again for the blood tests and they said the paperwork had just been sent off. It had to go to oxford first as H&E are partners of oxford but after some more chasing, as I am impatient and heard stories of referrals getting misplaced etc.

1 oct -track down paperwork at oxford and ask for it to be faxed to H&E who rang to say they had a cancellation for the 4th Oct which was almost 4 weeks from seeing the FS.

I was lucky to get my HSG in quick as they had originally said to wait for my next period and then ring to arrange for cd6-10. I was already on day 5 at the appointment and so tried my luck and rang the next day and got an appointment for the following day. The blood results were also something we had to wait for and there was a bit of a mess up at oxford but as soon as it was with H&E all was fine.

After our initial appointment at h&e and the decision made to change from IUI to IVF we then had to arrange a treatment information appointment (TIA) so that we could learn how to do injections etc. Since my cycles were not regular we arranged this for cd21 so they could scan me to check if I had ovulated before starting. For those women who are more regular I believe that once you have had your TIA you can start around cd21.

How did it go at the GPs on the 29th?

fluffy X

 

[noelle1979]

OK, not too long and you sound like me... I am impatient and like to keep on top of it all, you want to feel like you have some control over TTC for once!! I have had lap and dye so that side of things are all sorted. GP appointment went well, my husband did the talking and she instantly referred us to the FS that did my lap and dye- I am hoping that this will mean there will be noo questions. The morphology is now at 3% with less motility.. I don't think they could question us.

I just hope we get the funding. When are you going through the next round?xxxx

 

[fluffystar]

Sounds like it should go smoothly then!
Do you think the fs will refer you for IUI or IVF? We were not too worried about funding as they find three cycles of IVF here. I was more worried about my BMI as you needed to be under 30 for any fertility treatment and I was borderline! I lost few pounds though and was comfortably below as I had a pretty good incentive!

We have a follow up appointment on the 24th jan. Im not sure how soon you can try again and im also not sure how quickly I want to try it again. I have a long history of severe depression which im much better from now but the first set of ivf drugs made me pretty ill for a couple of weeks. If I can try different drugs I would be happier. I also didnt respond well to the stimulating drugs and would be interested to see what they suggest. I think until I have been back in a few weeks im not sure what the plan is!!!

 

[noelle1979]

Well all the best for you and thank you so much for your advice.... you will make this journey and at least you know what does not work for you.

The FS does not think IUI is worth it due to poor sperm but we need to see what he says... I am pushing to move straight to IVF- I cannot handle any more heartbreak. He took a look at my husbands SA first time around and at 5% morphology he still recommended IVF. This whole thing comes as a shock doesn't it... when you hear about other women needing IVF you feel so bad for them and just want it to work... I cannot believe it is happening to us!! Mind over matter so important so maybe you need a break and we all need to be positive and it WILL happen... I find reflexology pretty useful.

Lets keep in touch... let me know when your next one is - we may end up crossing paths xxx