We have unexplained fertility and the NHS consultant left us for 6 months to see if we would become pregnant and we haven’t ☹️. In the mean time we accessed a private clinic who suggested Clomid and this has been unsuccessful too.
We have a follow up NHS consultant with them in the coming weeks and it feels like from my previously posts that IVF is the next step for us. We’ve been trying for 3 years and feels like we just want to get things moving now. We will have to pay for IVF. I would like to be prepared as possible as to the questions to ask to move things to the next stage and worried they will try and fob us off. I should of had a Hycosy but due to last lock down it was cancelled. We are healthy (apart from some chocolate and the off glass of wine in the month) and taking fertility vitamins. Can you provide any suggestions of what we should ask or even explore with them?
Many thanks 😊
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Sdegirl_09
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I'm sorry to hear that the clomid hasn't worked. I think you're right that you should be pushing for IVF at this stage. However, I don't think most (if any) clinics will do IVF until your tubes have been checked. So I would get the hycosy scheduled asap and aim to have it done before you meet with the consultant (if possible). That way, you can go into the meeting with all your ducks in a row.
Separately, I assume that your husband has already had a standard sperm analysis but I would recommend having him get a sperm dna fragmentation test as well. We were also diagnosed with unexplained infertility and it wasn't until after an unsuccessful IVF cycle that our consultant recommended my husband have further testing (his standard sperm analysis had come back normal). As it turned out, he has very high fragmentation which would have been very helpful to know beforehand. Knowledge is power, especially in the IVF roulette!😛
Good luck, I hope you guys can get started soon xx
Did your husbands high fragmentation change anything in the IVF process? I think my husband might have this as low testosterone, only 1 testicle and small varicocele. His semen analysis was all just within normal range (low normal)
It did, yes. Our first cycle was standard IVF but now that they know about the DNA fragmentation any subsequent cycles will be ICSI. Our consultant also told my husband to start taking a supplement to try to improve the fragmentation before our next cycle (we were recommended Impryl) and he also had some further testing done (ultrasound to check for varicocele and semen and urine tests to check for infection) to try to determine the cause of the high fragmentation.
If you already know that your husband likely has some things affecting his fertility, I would self refer to a urologist for some guidance before starting IVF - Dr Ramsay in London gets high praise from lots of people on here.
I know it's really frustrating having people tell you to do more tests/ consultations before just cracking on with IVF, but self-funded cycles are expensive so you really want to maximise your chances of success by doing all your investigations and treatments before starting. xx
We’ve actually been pretty lucky. We have done one cycle got 15 mature eggs and got 5 blasts from 7 that fertilised. I’m currently 12 weeks pregnant from our second transfer but I’m thinking about if I decided to do again in the future would ICSI be better especially as I’m not likely to respond as well to IVF when I’m older.
It’s very frustrating when all my tests are bang on normal for age with regular cycles but the focus has been on me and nothing at all on my husband but I think this is just how IVF clinics are. I guess it’s more me trying explain the ‘unexplained’ fertility label. To understand why it has happened.
Ah, congratulations on your pregnancy! Yes, the "unexplained" label is so frustrating, especially when I realised after the fact that there was a simple test that my husband could've had done which would have explained things. It just seems so ridiculous and sexist that women undergo a battery of blood tests and invasive ultrasounds in the course of fertility investigation, whereas most doctors ignore men after their initial semen analysis, even when there are advanced, non-invasive tests (like dna fragmentation) that are easily done.
If I were in your shoes, I would probably have the dna fragmentation test done anyway because I'm curious and would want to try to clear up the mystery of the "unexplained" diagnosis. Plus, if you find out that he does have high dna frag you could always start him on supplements/ lifestyle change now in the hopes that you could try for number 2 naturally 🙂 xx
Thank you for your reply. Yes we’ve had all the standard tests done and all fine. They’ve identified a cyst on my ovary but they are not worried about size. I should of had Hycosy but due to second lockdown it got cancelled. I will look to pursue that when speak to consultant. We’ve also enquired privately about the DNA fragmentation and infection for husband as we weren’t aware of this test, so thank you.
If you are certain you are paying for it yourself, I don’t think it is absolutely necessary to have a consultant referral. I was advised about IVF by a gynaecologist when I went to see them about Fibroids.
The referral within the clinic failed and in the end I ended up referring myself to their Assisted Conception Unit. I wasted almost 4 months waiting for their internal processes and was told to self refer as I was a private patient.
I agree that you should conduct as many tests as possible prior to IVF. Our inability to conceive was seemingly obvious. My partner had a vasectomy years ago.
Thank you. I also have a fibroid lump and they are not worried about the size/position. We’ve found out our local NHS IVF clinic are not accepting private patients because of the backlog so we now have the job of trying to find a suitable clinic ☹️ Which will be another stress could do without with..
Sorry to hear that. Yes finding private IVF clinics can be a minefield. The HFEA website is always a good place to start. On the positive side, private clinics have shorter to no waiting lists so you can start treatment sooner. All the best 🙏🏾
I was put on clinic by the NHS and was in it for 12 month, I equate it to an NHS fob off as they don’t bother doing any other checks apart from the Hycosy.
From memory our clinic you didn’t need to have already have egg one done, they will do it but it’s very expensive so I would try and get that out of the NHS beforehand.
Like soccerkt6 my husband had DNA fragmentation done, but we had it done straight away when the clinic check his sample normally, this was due to my husbands age, he was over 50 when we started. It costs about £500 ish to have done.
We’ve had 2 failed rounds of IVF/ICSI with my eggs. So this third round we have used a donor egg from my youngest sister who’s 30.
I have to say the donors routinely get more throughly checked then I did when doing our rounds. Donors are automatically genetic tested where as if your not on a donor cycle you done get offered that unless there’s a history of issues with you or your families. Another thing you get with a donor cycle is a medicated monitored cycle, with is a dummy run to check progesterone levels etc before you do a live transfer, this identified I was low on progesterone do needed extra.
On our own cycles we were never offered this and it’s left me wondering if our first embryo that implanted failed because of low progesterone, we will never know as e hospital didn’t check my levels after transfer 🤷♀️
Personally when we started if I’d been offered a full genetic testing package (£1500) and a medicated monitored cycle (£580) I would have taken it - but we weren’t offered it and only learn these things as the rounds have gone on.
As I said to my consultant - “there is no such thing as unexplained infertility, there’s a reason behind it and you just haven’t found it” and she agreed - we were told that by not only the NHS but a private clinic - again it’s fob off.
If your clinic allow you to do the thinks I’ve mentioned from a donor cycle I would take it! It could save you a lot of emotional heartache and money further down the line!
I am now 8 weeks pregnant, still not out of danger yet and I’ve got a subchorionic hematoma, so need another scan next week to check everything is okay
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