# Clomid on the NHS?



## alittlenervous (Apr 28, 2014)

So today I went for my first gynae appointment.  I had swabs taken, 2 vaginal and 1 cervical. Can't remember what for other than Chlamydia?    I've also been offered a Hycosy which I really don't want.    The only problem is I'm not ovulating after so long on the pill so I was expecting at the most ultrasound and swabs.  She knows I am going via the AI route and she said usually we would just give Clometaformin but as I am single there is no point in that?

I thought because I am trying to get pregnant via AI and not ovulating that is what I would get!  As I am going to be trying to get pregnant.  She's given me loads of forms for blood tests, some day 2 - 4 for LH, FSH, Thyroid, Oestradiol and Thyroid and then day 21 and 28 progesterone and offer of the Hycosy.  Then she said going off that I would be referred private and they would pay for the initial consultation but I would have to pay for all other treatment?

So because I'm single can I not get any drugs to help ovulation on the NHS?  Would I have to go private?  I've also been told not to buy sperm either as if it didn't work I'd get no help from the NHS. I need to go via a private clinic and have 2 cycles of 6 inseminations of IUI via the clinic.  No way I can afford that!  As I'd need to pay £200 for initial bloods that the NHs don't do then £680 per IUI and the £££ for the sperm to each insemination.  Just way beyond my needs.

So now I feel at a loss as I was so sure I'd be given Clomid on the NHS and as my only symptom is not ovulating it would be pretty soon


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## Me Myself and I (Dec 30, 2012)

Firstly how do you intend to source the ds?

If via a bank, would cost circa £850 a month for ai and tbh to have sufficient vials for ai would be over 1k. So that versus the cost of iui is not that different: At a one off cost fir six vials and only one transportation cost plus the iui at 650. Reality being this would be far cheaper than you self funding ivf
Obviously if via donors.on the www then this is Imo quite risky, no guarantees health wise and genetics nor of sperm quality etc. Let alone STDs risk etc. 
If I were you I'd read the guidelines for treatment for your health authority and if it says you qualify for clomid etc return to go etc.
Aa.fir not wanting hycisy I'd advise you took any test offered on nhs as you just don't know what's going on with your gynae bits and if there's an unknown issue any sownsing in treatment would literally being throwing money away!

Hth


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## alittlenervous (Apr 28, 2014)

Me said:


> Firstly how do you intend to source the ds?
> 
> If via a bank, would cost circa £850 a month for ai and tbh to have sufficient vials for ai would be over 1k. So that versus the cost of iui is not that different: At a one off cost fir six vials and only one transportation cost plus the iui at 650. Reality being this would be far cheaper than you self funding ivf
> Obviously if via donors.on the www then this is Imo quite risky, no guarantees health wise and genetics nor of sperm quality etc. Let alone STDs risk etc.
> ...


I would be getting donor sperm via Cryos and it would cost around £800 a month for 5/6 inseminations over 2 days with the donors on my shortlist. That is the max I can afford. I couldn't afford that then the £650 on top for IUI and also if private the Clomid drugs and scans I would need while on them cost £120 per scan so each cycle looking at £1.5k which is something I just could not afford unless I won the lottery 

I wouldn't go with donor sperm on the internet unless I get so desperate and run out of money then I will try anything lol. The hycosy I don't really want as I admit I am a wuss but also because I know I've nothing happened to me that could cause tubes to be blocked ie no pregnancy, no sex, no infections, no endo etc

My problem I am certain and my GP thinks so to is I have been on the pill to long at almost 12 years and it's just put my ovaries into hibernation and they need a kick start. I had an ultrasound a couple of years ago and everything was clear, healthy womb, clear ovaries. Came back saying bulky cervix so gp gave me a smear and that was clear. It's just my periods have been all over since stopping the pill and this last 3 months I have finally got into a regular cycle with positive opks day 13/14 and period day 29/30. They have one normal day flow then virtually stop.

My progesterone at best been 19 and my AMH bloods are 13.4 which is low end of ok for my age of 36.

I was just so sure I'd get Clomid on the NHS so am surprised I haven't been offered and told I after all these bloods back at my next appointment in a few months be referred private. Not something I want nor can afford as I should be entitled to Clomid on the NHS. I really want to do AI not IUI as not a fan of IUI and read it's not very successful 

Thank you for your help xx


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## Calluna (Jun 14, 2012)

It's quite usual for the NHS not to pay for treatment for single women unless they have a proven fertility problem and it sounds like that must include not funding clomid as well as IUI/IVF. I think they would usually require you to have had 3-6 failed IUI cycles to prove a fertility problem (not sure whether you misunderstood what they said but there would usually only be one or at the most two inseminations per IUI cycle - definitely not six). The advantage of doing IUI is that if it failed you would then have a proven problem and could be eligible for IVF on the NHS. 

However, even if you stick to your original plan of AI, it's great that they will pay for your first consultation. You could ask for prescriptions for clomid and thyroxine at that consultation and pay for them yourself (they are very cheap, especially if you go to Asda and tell them it's for fertility and then they sell it at cost price). If you ask them to write to your GP you could continue to get the thyroxine from them. 

Personally I would have the hycosy while it's free. Many women have endometriosis with no symptoms. Can I ask why you were on the pill for 12 years if not having sex? If for heavy and/or painful periods that could be a possible sign of endometriosis. 

Hope you can get what you want from the consultation x


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## alittlenervous (Apr 28, 2014)

Calluna said:


> It's quite usual for the NHS not to pay for treatment for single women unless they have a proven fertility problem and it sounds like that must include not funding clomid as well as IUI/IVF. I think they would usually require you to have had 3-6 failed IUI cycles to prove a fertility problem (not sure whether you misunderstood what they said but there would usually only be one or at the most two inseminations per IUI cycle - definitely not six). The advantage of doing IUI is that if it failed you would then have a proven problem and could be eligible for IVF on the NHS.
> 
> However, even if you stick to your original plan of AI, it's great that they will pay for your first consultation. You could ask for prescriptions for clomid and thyroxine at that consultation and pay for them yourself (they are very cheap, especially if you go to Asda and tell them it's for fertility and then they sell it at cost price). If you ask them to write to your GP you could continue to get the thyroxine from them.
> 
> ...


Thank you Calluna, it's definitely 6, she showed me the ruling for our CCG and I had a look for it online when I came home and found it online:

The CCG will fund treatment for same sex couples and single 
women provided there is evidence of subfertility, defined as no live birth 
following artificial insemination (AI) of 2 courses of 6 cycles proven by 
clinical investigation as per NICE guidance. AI must be undertaken in a 
clinical setting with an
initial clinical assessment and appropriate 
investigations

She then looked in her book and said it would be IUI I'd be referred for to get this done at Hewitt Centre in Liverpool and she showed me the price list for it and would be so expensive. She recommended I save for another couple of years as I can IVF for free if paid for the above upto 42 but I can't wait that long as my AMH test cameback low for my age. 13 and for my age shouldn't be under 15 so I'd not feel good waiting 2 years.

I was on the pill from heavy periods from my very first period at 12. Started the pill in my 20s because of them. Since stopping over a year ago my periods are now last 3 months regular and all the signs of ovulation but only last a day then spotting or gone till the following month which I think maybe due to the low progesterone?

I am thinking I will get the hycosy done. I've been checked for stis and not sure what the other swab of the 3 were for. Upto date with smear so that's all ok. Armed with bloods to get done over the next few months before I go back in December too

Thank you again hun, I am hoping if I do have to go private and I cannot afford IUI I will at least be able to get Clomid without having to pay for many tests first private and I am thinking Thyroxine needed to with a tsh of 5.8 and free t4 at 13 but NHS says I am fine!

Thank you xx


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## Me Myself and I (Dec 30, 2012)

Given the heavy periods hycosy is wise. It could I'm afraid be something or nothing!

Yes the amh is lower but not hugely given I know women with 0.6 now with babies though obviously higher is preferable.

In your position I would buy six to eight vials for iui. So one lot of postage costs. Try to find the iui even if takes all year so every other month. Perhaps trying ai at home if financially viable over a longer timescale.

Given amh is lower you need to be practical that this may make ivf more probable a news so managing to ttc and possibly get free Ivf has to be a consideration. Yes things will be tight but to be blunt children are expensive and if you cannot manage what amounts to a maximum of only a few hundred more for iui then can you afford a child? I know that sounds harsh but it's reality I'm afraid. Perhaps by some practical  savings you will manage to cover the difference. Eg not eating out, packed lunches when going out and work, no holidays, change utilities and broadband providers, shop around for insurance etc get rid of sky etc. This sounds obvious but is honestly what makes the difference for me and my lo - I was SO lucky; told over a decade before I'd never conceive, but a miracle took place and fourth attempt I was so lucky! And now I'm penny pinching buying clothes for next summer in sales lol on this wet Saturday! 


Truly hope that helps. 

Ps clomid isn't always prescribed if got low amh.


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## alittlenervous (Apr 28, 2014)

Me said:


> Given the heavy periods hycosy is wise. It could I'm afraid be something or nothing!
> 
> Yes the amh is lower but not hugely given I know women with 0.6 now with babies though obviously higher is preferable.
> 
> ...


Thank you for your reply 

I do nothing now where I can cut back, don't go on holidays, don't eat out, don't drink, don't smoke, currently out of work so no lunches, no insurance etc, only buy clothes if really needed and usually from Primark lol so can't cut back much more. I can afford a child just not the fertility treatment each month for it as I am having to save alone and on a low income too. Took me a few years to save what I have now 

I am hoping my amh as not really low wouldn't stop me getting Clomid on the NHS and if I don't mention it to them too as they don't test for that anyway so wouldn't know.

I think all I would need is Clomid to kickstart everything as my periods since stopping the pill are lasting little more than a day and normal flow, all my other tests ok other than testosterone low side of normal and oestradiol slightly low but getting them done again on day 2 -4 as I went wrong time last time.

I'd rather try myself as to be honest not read a lot of good about IUI and it's success rates. Seen it happen better for people self inseminating but obviously I can't do that if I can't get Clomid. Bloody annoying lol

Thanks again and so pleased you've got your little one hun


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## Calluna (Jun 14, 2012)

Ok, "2 courses of 6 cycles" makes more sense than "2 cycles of 6 inseminations" although the "2 courses" makes it sound like it might mean 12 cycles! (But then why wouldn't it just say "12 cycles"?!) Not very clearly worded. 

If your testosterone and AMH are on the low side you might consider DHEA supplementation. There's a book called 'it starts with the egg' which is useful if you want to make use of the time while you're waiting to try to improve the quality of your eggs. The steps you can take are most effective if you can start at least 3 months before you try to get pregnant. 

x


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## alittlenervous (Apr 28, 2014)

Calluna said:


> Ok, "2 courses of 6 cycles" makes more sense than "2 cycles of 6 inseminations" although the "2 courses" makes it sound like it might mean 12 cycles! (But then why wouldn't it just say "12 cycles"?!) Not very clearly worded.
> 
> If your testosterone and AMH are on the low side you might consider DHEA supplementation. There's a book called 'it starts with the egg' which is useful if you want to make use of the time while you're waiting to try to improve the quality of your eggs. The steps you can take are most effective if you can start at least 3 months before you try to get pregnant.
> 
> x


Thanks Calluna  I'm not sure if that means I need 2 cycles of 6 inseminations or 6 cycles of 2 inseminations? As the 6 cycles would be way out of my price range as be nearer 8k!

I have heard of DHEA so will definitely look into it more and that book heard good things about so will download it on my kindle 

I contacted the Hewitt Centre and they said if referred they can do me consultation, one scan and Clomid for £450 approx and NHS have said if they would fund initial appointment so hoping all hope not lost. I'll get a recent AMH as well before I go to for my next appointment, not that the nurse had any idea what an AMH test was

Thanks again x


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## alittlenervous (Apr 28, 2014)

Got a quote and for the 2 round of 6 cycles plus the sperm and drugs etc will be around 11k! Never can save that up so pinning all my hopes on getting Clomid and Cryos 5 goes working now


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## Me Myself and I (Dec 30, 2012)

alittlenervous said:


> Got a quote and for the 2 round of 6 cycles plus the sperm and drugs etc will be around 11k! Never can save that up so pinning all my hopes on getting Clomid and Cryos 5 goes working now


Sorry I don't understand! 
Is this for six separate months of iui including sperm equals eleven thousand?
By my calculations which are possibly out of date I'd have got twelve months of iui. Anymore than six is not recommended as doesn't improve success rates.


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## alittlenervous (Apr 28, 2014)

Yeah that's what it equates too.  I chatted to the clinic and was told it was £710 per iui.  I said is that per round as in 1 round of 6 cycles and she said no its per cycle and said it would cost £710 each cycle per round so I asked her to clarify and she said 1 round would be £710 x6 and then on top of that the drugs for each iui is £120 to £190 per iui, Clomid £450 which includes one scan and each scan after that £170 and £300 per vial of sperm needed too  

That's what I have to have to get any NHS help here.  I was told at my subfertility appointment last week.  Also a report was in the local paper yesterday they are changing funding rules as of next month as NHS overspent by 6.4million in our area and one of the main things they are getting stricter on is assisted conception.  Gutted. So looks like I'll have to pay for Clomid and pin everything on Cryos as it has worked for many so trying to remain positive.  And I've been told to cur my stress levels as my Cortisol has come back high.  Yeah right lol.  Easier said than done.

Below is a snippet from the local paper:

Health bosses plan to strictly enforce guidelines for procedures it classes as of ‘low clinical value’, including grommets — a type of surgical hearing aid — for children under the age of 12.


Others include cosmetic surgery, such as breast implants or tattoo removal, bariatric operations for obese patients, caesarean sections, and assisted conception procedures such as IVF.


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## Me Myself and I (Dec 30, 2012)

Yeah that's what it equates too.  I chatted to the clinic and was told it was £710 per iui.  I said is that per round as in 1 round of 6 cycles and she said no its per cycle and said it would cost £710 each cycle per round so I asked her to clarify and she said 1 round would be £710 x6 and then on top of that the drugs for each iui is £120 to £190 per iui, Clomid £450 which includes one scan and each scan after that £170 and £300 per vial of sperm needed too  

So are you saying your authority requires 12 cycles? I would seek absolute confirmation from them directly. I know you can have gas treatment with any hfea recognised clinic to qualify for ivf if your authority offers it. So shop around! 

Fwiw asda sell prescriptions far cheaper I think £30 mark for clomid. The vials from cryos can be used so you'd buy in bulk and save that way so wouldn't be that costly either. 
You don't need to have other drugs than clomid for iui and can have no drugs full stop! Which if having twelve attempts would be as worthwhile tbh! Given they only suggest 3 unmediated iui and three medicated.


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## alittlenervous (Apr 28, 2014)

Thank you Me, Myself and I.  I did think it was a lot of IUI, 2 rounds of 6 cycles.  I think it's because if single they like you to have been trying a year so that would I guess equal the year of it not happening.  I think I am going to have to give up on the IUI idea as no way can I afford that much money even if I saved for the next 10 years as 11k is so much money.

I think it'll probably be getting all my bloods done the subfertility clinic are doing and any other tests like ultrasounds then if all ok and it is just the low progesterone I will have to go via the Clomid Cryos route.      My egg reserve is slightly low at 13 (american terms 1.9) but apparantly even low not terrible so hoping I can achieve my dream one way or another.

RE Asda Clomid.  Do I just need a prescription from my gynae to be able to get it for that price?  Would I be ok if not scanned on it as I know you can overstimulate?

Thank you again hun xx


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## Me Myself and I (Dec 30, 2012)

alittlenervous said:


> Thank you Me, Myself and I. I did think it was a lot of IUI, 2 rounds of 6 cycles. I think it's because if single they like you to have been trying a year so that would I guess equal the year of it not happening. I think I am going to have to give up on the IUI idea as no way can I afford that much money even if I saved for the next 10 years as 11k is so much money.
> 
> I think it'll probably be getting all my bloods done the subfertility clinic are doing and any other tests like ultrasounds then if all ok and it is just the low progesterone I will have to go via the Clomid Cryos route. My egg reserve is slightly low at 13 (american terms 1.9) but apparantly even low not terrible so hoping I can achieve my dream one way or another.
> 
> ...


Private clinician can prescribe clomid - get 3-6 months of prescriptions! 
It's hit and miss tbh. I only needed half doses. Some women need maximum doses. Ultrasounds are ideal but NHS doesn't offer fur majority of women. Private clinics wound as wouldn't let you have iui with more than three large follicles due to 10% chance of multiples on clomid. 
It's a risk but only you can decide whether to take it it pay for scans 2-3 days after last clomid tablet...


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