Questions following miscarriage

[Maikai]

I appreciate everyone's support following my post earlier today about my sad loss of my little miracle. I have a question burning in my mind though. Obviously this cannot be considered "successful" IVF as it has not resulted in a single healthy baby. Would I be able to go back for my second funded round or would I have to go back into the waiting list and wait 18 months again like when I was first referred. Does anyone know? I know that I obviously need time to heal physically and emotionally and wouldn't plan to do this anytime in the immediate future but I just am looking for even the slightest glimmer of hope.

[Hidden]

Phone your clinic and check, but my understanding is when your ready you ring your clinic to make arrangements to start again. Maybe book a follow up appointment so they can answer your questions and decide if they will do anything differently on your next try xx

[Maikai in reply to Hidden]

Thank you - that makes me hopeful that we get another try without the year long waiting time

[E_05]

So sorry for you loss, I miscarried last year after my first cycle, I had frozen embryos so had my 2nd cycle after 3 months. My consultant said it's 3 months between cycles for frozen embryos and 6 months between with fresh but i guess it would depend on your clinic x

[WeeJacs]

So sorry for you loss. I have had 2 mc with both our NHS attempts. We had a review around 8 weeks after our 1st and they said just phone whenever your ready. We waited around a year and then attempted again. Take time to look after yourself x

[Hidden]

Oh Hun I'm so sorry to hear of your loss. Diane has a list of questions that she can email you if that would help. Take time to allow yourselves to grieve this huge loss- you will know when you feel ready to start again. Be kind to yourselves. Thinking of you during this difficult time. X

[DianeArnold Partner Nurse Fertility Network UK]

Hi Maikai. I'm afraid you would have to check the criteria with your CCG (Clinical Commissioning Group). Some take a miscarriage as a cycle of treatment, some don't, so you need to ask. I do hope you are getting loads of support after suffering this, as it's something not to bear on your own. I do have a couple of lists of questions I can email you in confidence, if you want me to. Too long to add here, but if you email me at [e-mail] I will send them to you. Diane

[Maikai in reply to DianeArnold]

I would love the list and I'll get an email sent to you in the coming days. We don't have that CCG thing here in Scotland I don't think but I need to phone the Aberdeen clinic as the website doesn't really give much info on this kind of situation. I'll do that some time next week. Thanks for your support x

[DianeArnold Partner Nurse Fertility Network UK]

Hi Maikai. OK. Meanwhile, I copied this for you. Diane

NHS Funding in Scotland

Updated from 1st April 2017 all Health Boards in Scotland must follow the same criteria, as detailed below.

•Eligible patients who are new referrals from 1st April 2017 may be offered up to three cycles of IVF/ICSI where there is a reasonable expectation of a live birth. Eligible Patients referred before the 1st April 2017 may be offered up to two cycles of IVF/ICSI where there is a reasonable expectation of a live birth. The definition of infertility for couples is: ◦Infertility with an appropriate cause of any duration or

◦Unexplained infertility of two years – heterosexual couples

◦Unexplained infertility following six to eight cycles of donor insemination – same sex couples

•Fresh cycles of treatment must be initiated by the date of the female partner’s 40th birthday, and all subsequent frozen transfers must be complete before the woman’s 41st birthday.

•One Partner has no biological child.

•Both partners must be non-smoking

•Both partners must abstain from illegal and abusive substances.

•Both partners must be Methadone free for at least one year prior to treatment.

•Neither partner should drink alcohol prior to or during the period of treatment.

•BMI of female partner must be above 18.5 and below 30.

•Neither partner to have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded.

•NHS funding will not be provided to couples where either partner has already received the number of NHS funded IVF treatment cycles supported by NHS Scotland regardless of where in the UK they received treatment.

•No individual (male or female) can access more than the number of NHS funded IVF treatment cycles supported by NHS Scotland under any circumstances, even if they are in a new relationship.

•Couples must have been co-habiting in a stable relationship for a minimum of 2 years.

•NHS funding may be given to those patients who have previously paid for IVF treatment, if in the treating clinician’s view, the individual clinical circumstances warrant further treatment. However if there are any Frozen Embryo’s remaining in the private setting these must be used prior to NHS treatment commencing.

•Patients should not be placed at the end of the waiting list following an unsuccessful treatment cycle.

•Normally, there would be a gap of 6 to 11 months between cycles of IVF, for patients who remain eligible.

•Couples where the woman is aged from the day after her 40th birthday to 42, who meet all other criteria, one full cycle of IVF should be offered if: ◦They have never previously had IVF treatment

◦There is no evidence of poor ovarian reserve and if, in the treating clinician’s view it is in the patients’ interest

◦There has been a discussion of the additional implications of IVF and pregnancy at this age.

•It is essential that patient consent is sought for the freezing of embryos and, if given, couples are informed at the outset that once they have exhausted their NHS quota of IVF, or have a successful live birth, or no longer meet any of the eligibility criteria, self-funding for any future transfers will be required.

•Patients should also be advised at the outset of any constraints to storage time and costs that may apply.

Early Referral Pathway

A pathway was developed and sent to all GPs in 2014 outlining where consideration should be given for early referral. The criteria includes

Female

1.>35

2.Amenorrhoea

3.Oligomenorrhoea

4.Previous ectopic pregnancy

5.Previous proved PID/STI

6.Previous pelvic surgery

7.Any significant relevant abnormality on history, examination or investigation

8.Previous investigations have revealed a problem

Male

1.Abnormal results in semen analysis X 2

(WHO levels to be used)

If you have any queries on NHS funding or any other issues in Scotland, please contact our Scotland Branch Co-ordinator - Gwenda 07825 827865