What next in terms of seeking help?

[mk8]

Hello ladies

I hope you are having a good day and getting into the Christmas spirit.

I decided to start this thread to seek some advice.

By way of background, dh and I have been trying for a year, 13th cycle right now. I know this isn't that long, but I cannot help but feel impatient and would like to know my options. I'm 31, dh 32, we have been having regular bd, I opk some cycles (positive), temped some (erratic but most of the time fertility friend confirms ovulation). I had pelvic pain earlier this yr so my gp sent me off for a transvaginal ultrasound and bloods- they came back ok but I have an elevated free androgen index. I had day 21 tests and my progesterone was 26nmol/l - borderline but likely I ovulated. Dh had sa done- 35m/ml count and other nos seemed ok. Doc refuses to send me for an hsg- cost!! I have been put on clomid though- first cycle now. Not being monitored. My question is what are the next steps on the Nhs? Doc will consider sending me for an hsg in June but what then? He said no budget for ivf. We are saving just in case but how does one go about assisted conception or further investigations route?

Any help greatly appreciated and I wish you all a bfp Xmas!

 

[cooch]

Not sure other than being referred to specialist. You will then find out your wait time for IVF etc, they may also want to check your tubes are open.

I pushed for a lap ans yrs ago I was sent for a scan as I was convinced I had endo. A very understanding GP referred me for lap and this was suitable for the specialist by the time I saw them. I did actually have endo but it was so small it would never have showed on a scan.

I would not put up with your ovulation levels, they are incredibly low (if you are UK). It means if you ovulated your body isn't producing enough progesterone (possibly due to the corpus luteum).

I'm on private prescribed drugs so maybe one of the ladies who have followed the NHS route can give better advice.xx

 

[mk8]

Thanks for replying couch, appreciate it.

On the progesterone level front, I do wonder if they're low as they prefer over 30nmol/l on a natural cycle. On clomid now, which appeared to make me ov a bit earlier but temps have been dropping since 8dpo.

 

[Lawgirl]

You should be referred to a consultant at the hospital who will do further tests and order a HSG. If they find something wrong, then they will either try to fix it or send you for IVF (look at your PCT's website for their policy statement on when IVF is given). If the consultant can't find anything wrong, then they won't put you on the waiting list for IVF until you have been trying unsuccessfully for 3 years.

Your progrsterone levels do sound quite low - is this why you were given clomid?

 

[mk8]

Thanks law girl! I was actually prescribed clomid because I kept bugging my doctor. He thinks I've been TTC for 18 months for some reason (to be honest, I didn't correct Hom as he said he wouldn't do anything for two yrs). He said my prog levels were fine, that over 10 nmol/l suggests ov though over 30 indicates definite ov. I get positive opks and kinda temp spikes to suggest I ov, but my lp is 11-12 days, with spotting on day 12 and my temps drop quite early, around 7-8 dpo so perhaps I have insufficient prog?

I just feel a bit lost as my doc isn't bothered and going private is so expensive. We are saving in case we do need ivf but I'd like the Nhs to at least pay for diagnostics etc.

 

[Lawgirl]

He sounds like he doesn't know anything - 10nmol/l is not OK. Although, with 26 nmol/l it could be that it was not taken at quite the right time (I got 20 nmol/l on one of mine because it was taken too early). The fact you have positive OPKs and and a temp shift does suggest ovulation.

I got referred to the hospital after 1 year ttc post m/c, although I have heard that some PCTs don't allow referral to a consultant until you get to two years ttc. If might be work doing a bit of digging on the internet to see if you can find the policy.

 

[_Nell]

Are you getting the clomid from your GP (not sure if i'm understanding correctly?)

If so go back and ask for a referral to a gynae / fertility consultant, ie secondary care at your local hospital (tertiary is an IVF unit).
It's good he's helped you with the clomid, but it's pointless and un -necessary if your DH has a sperm issue or you have blocked tubes......you really need some basic tests ffirst before attempting treatment, even clomid IMO.

One you get to a specialist I'm sure things will start moving for you both.

 

[mk8]

Hi ladies, thank you so much for responding.

Lawgirl, my prog test was done on cd 22 but 5dpo so could have been too early, but it was 7 days before af. I had to book blood test in advance so couldn't time it perfectly.

Hi nell, doc refused to send me for an hsg, have to wait until jun. so in monitored clomid for now, which is highly frustrating. Dh had sa and numbers are ok. 35m/ml count.

 

[mk8]

That's meant to read un monitored clomid