Fertility referral with children?

[Hannah1589]

Can we ask to be referred to a fertility specialist even though we already have two children? I understand we may not be eligible for IVF but can we still be referred to someone more specialist on the NHS to discuss options / further tests if appropriate or do we have to do everything privately. It’s frustrating only having advice from GP.

[Purpledoggy]

You should be able to get a referral for an assessment-there is no NHS funding at all in my area for fertility treatment but we still got an assessment and a couple of preliminary tests (baseline FSH and LH). Anything further you’ll need to pay for. TBH a consult is a tiny fee compared to treatment so if you want to expedite just pay to see someone-ask GP for referral and wait times. Xx

[Ivfgotadream]

if you are considering ivf privately I would just go private for everything. The cost of the tests are a drop in the ocean of the overall cost of fertility treatment and you’ll wait a long time via the NHS

[NemoFish]

Echoing what others have said. You’re best off going directly to a clinic yourself. Consultations don’t usually cost very much (I paid £180 for my most recent one when I changed clinics), and the tests aren’t expensive either, especially compared to the cost of ivf. You could be waiting over a year for an NHS referral appointment, whereas you could have a private appointment next week x

[Tnthketnf]

Isn't the GP able to answer whether they can offer some tests? I agree that some costs like amh, ultrasounds, sperm analysis etc if you have private treatment are only a fraction.

But it will depend what you need done. For laparoscopy or hysteroscopy in Scotland for example that's easily £2000-£3000 per procedure. So maybe if you need these you can check if NHS can offer them for secondary infertility and waiting times. These procedures are not standard fertility check ups but often needed during the process

[Hannah1589 in reply to Tnthketnf]

I actually already had a laparoscopy done privately as ultrasound showed large fibroid which has now been removed. Hysteroscopy was done as part of that so I know all my tubes etc are fine. Not sure if we would pursue IVF as we do already have two children. Just wondering really if there are further tests that could be done to help explain our infertility or any other treatments that would be tried before IVF. We had sperm analysis and morphology was low so could be that’s the problem. I had ultrasound which found the fibroid but I was told by consultant that the position of that was such that it was not the cause of infertility and I likely had it there when I was pregnant with our 2nd child (though smaller at the time). Not sure what other tests or treatments are available prior to considering IVF. I had all the blood tests and was advised to do ovulation tests to check I’m ovulating which appear to suggest I am. I suppose I was thinking to get NHS referral since we don’t necessarily plan to pursue IVF. Will see what the GP says next week. Any ideas what other tests I should ask for? Or any other possible treatments we should be asking about?

[Tnthketnf in reply to Hannah1589]

I don't really know to be honest. I don't think there's much more to find out. You seem to have checked what you could.Generally speaking if you have good AMH, partner has normal sperm count and motility, even with low morphology, your tubes aren't blocked, you don't have severe endo, problematic fibroids or polyps you aren't going to get definite answers as to why you can't conceive. As frustrating as it is fertility doctors aren't interested in identifying a cause and correcting it, all they do is put you through ivf process. In my experience the cause of infertility is pretty much irrelevant, definitely for NHS. So I wouldn't think you can get anywhere with them if ivf isn't what you are after.

In terms of treatments in conventional reproductive medicine ivf/icsi is the only thing. There's intrauterine insemination as well but I think in UK it's not as common as in other countries where it's pretty much a step towards ivf.

There are some add ons that sometimes help the ivf and consequently people think that was the reason for their infertility. Some of these can be looked into even when trying naturally. Reproductive Immunology for example, sperm dna fragmentation tests, endometrial microbiome assessment tests etc but these aren't widely accepted or proven. And definitely not NHS funded.

Did you have your thyroid hormone, blood sugar, vitamins etc checked? That's something the GP can offer.

Good luck!