Fertility Workups [UK]

So I thought I’d write a bit about the process of getting fertility testing here in the UK, in case it helps others. It also helps me to get it all out.

NB:  This information is based on my own personal experience in Scotland. Your experience may vary, and I’m by no means an expert.

 

WHEN

Basically, the recommended time to be trying (if you’re under the age of 35) before they’ll start testing is now 18 months. Most couples conceive within a year, with almost all conceiving within 18-24 months.

However. If you have any other obvious issues going on (erratic periods, painful periods, no periods, very long cycles, etc) they will test you from 12 months. If you are over 35, they will test from 12 months if everything seems as it should, or 6 months if you have any of the aforementioned issues going on.

 

HOW TO GET THE BALL ROLLING

First port of call is your GP.  You’ll need a basic idea of your cycle history, notes of any issues you’ve noticed, any vitamins you’re taking, etc.  They will ask about your sex life, so don’t be shy.  Some GPs aren’t as knowledgeable on your options, but they’ll know how the referral process works at least.

 

THE REFERRAL

Your GP will then organise to refer you to your local Fertility clinic or centre. NHS centres are hospital-based (well the ones I’ve come across) and will send back a letter to you and your Dr explaining how the process works and what tests they need run by your GP.  My GP knew what they’d ask for so prepared me for it ahead of the letter, but your letter will most likely ask for the below:

  • A chlamydia swab test (self-swab, you do this at home and drop it in)
  • A blood test early in your cycle (between CD1-CD5) measuring levels of LH, FSH, E2, Prolactin, Testosterone, TFTs (I’ll explain what these are shortly).
  • A blood test around CD21 to test your hormone levels to see if you are ovulating
  • A Rubella test (immunity, rather than whether you actually have it!)

If your partner is also at the same GP they will get him sorted at the same time to get an SA – sperm analysis.  If it’s not at the same GP, his name will be noted on your referral and he will have to go to his own GP and give your name/mention the referral to get the ball rolling on his side.  Note: SAs are done “at least” a month apart, so that will hold things up – nothing will happen until both are done. Get your man on it ASAP.

After all of these tests have been completed, then you will go on the waiting list.

 

THE TESTS

LH –  Luteinising hormone:  Early in your cycle this hormone stimulates your ovaries to produce E2 and then surges before ovulation to get your body to release the egg.

FSH – Follicle-stimulating hormone:  Like LH, this is released by the pituitary gland to stimulate follicles to release an egg for ovulation. It is the main hormone involved in producing mature eggs in the ovaries. This test will help to assess your ovarian reserve.

E2 – Estradiol:  Estradiol is a form of the hormone estrogen. The ovaries, breasts, and adrenal glands make estradiol. During pregnancy, the placenta also makes estradiol. This test can indicate how well your ovaries are working/if there’s any cyst issues. Low levels of it can indicate PCOS.

Prolactin:  This is another hormone released by the pituitary gland. This test ultimate helps to rule out problems with the pituitary gland or hypothalamus. Increased levels of this can mess with ovulation.

Testosterone:  Too much going on can indicate PCOS. Too little means you’re not likely to get ovulation going.

TFTs:  This is a thyroid function test.  Your thyroid can play a big part in how your body regulates everything, and needs to be at an optimal level to get pregnant. If your thyroid is over or under-performing, conceiving can be difficult.

 

THE WAITING LIST

In Edinburgh right now the standard wait is 12 weeks. This means from GP to Clinic, you’re looking at 14-18 weeks before you’ll see anyone.  The tests need to be done (including the spaced-out SAs for your dude) and then the clinic needs an available appointment that you can both attend.  So don’t think it’ll be quick and that you’ll get assistance immediately, you need to just keep trying, unfortunately.

 

WHAT HAPPENS THEN

Well, I don’t personally know but I know the possibilities – they could want to scan my ovaries, they could take more blood, they could organise an HSG (dye/scan of your tubes), they could end up doing an op to see what’s going on in there.  I’ll do another post/update this one once we’ve had the appointment.

 

YOUR OPTIONS

There are many! From IUI to IVF. And I plan to go over them at some stage in future, after our appointments.

 

AND OF COURSE

You may not need any of this. My hope is that we will fall naturally before any of this shizzle happens. At the moment I appear to have one issue which I will cover in the next post.

 

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Coming up next: My results and where we stand.

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