# Should I pursue fertility treatments



## berberprincess (Oct 8, 2013)

Hi, I am 39 years old and have a beautiful daughter 15 months. Me and dh (40) are ttc no2. I had mmc at 11 weeks with d and e in may. My period returned as normal for me in June and early July.  Since then my cycle has been totally out of whack which is unusual for me. I spotted instead of having a period end July &aug. in September I spotted for 10 days then bled heavily for 8 days (total 400mls!!! ) and after total of 26 days my " period" finally stopped. My GP did random bloods in August (cd 14 ish) fsh was 8 and lh was 12. An ultra sound scan in june was normal (lining 4mm at end of period) I saw an NHS gynaecologist who didn't know why his is happening but will see me in few months time & suggested I consider ocp or mirena coil. I started agnus castus 1600 mg out of pure desperation last week along with epo and omegas. 

My question is do I worry about this and pursue private fertility assessment or am I having a hormonal " blip" which will correct itself. I realise now that stress can throw things off massively so am trying to address this. 

Thanks for any guidance or pearls of wisdom


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## berberprincess (Oct 8, 2013)

Just a quick update to my thread even though no one has posted to it. I saw my nhs gynaecologist last week. I most likely have dysfunctional uterine bleeding. i definitley have cervival ectropions which cover a large area and account for some of the random spotting. He has requested day 3 & 21 bloods. Am also booked in for a hysteroscopy endomentrial biopsy and cauterisation of cervical ectropions. That won't be until mid January. Once they can give definite diagnosis of dub they will consider me for clomid to jump start my cycles again. Hope this helps someone in similar position. Not nice to have this when approaching 40 and keen to have another baby before time runs out.


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## Bubblicious (Jul 8, 2010)

Good luck, Berberprincess.  I hope the treatment in January works out for you and you get you BFP soon.


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## kezza_1980 (Oct 27, 2012)

Good luck for your treatment


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## Natasha35 (Jan 15, 2014)

Hi, Have you had the treatment yet hun?


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## Tincancat (Mar 19, 2012)

Sounds like you have got a good plan n place. Have you had your scope yet?


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## berberprincess (Oct 8, 2013)

Hi I've logged on for a quick browse of other threads and saw I've had a few messages so apologies for my very late response!! How rude of me!

So, to update. My hysteroscopy in january showed simple endometrial hyperplasia. My cervix was cauterised as i had a big ectropion which accounted for some of spotting. I had a HUGE bleed after the hysteroscopy but since then my periods have return more or less to normal 28 day ish cycle. 

I am currently under the care of coventry fertility unit. My AMH is 0.57, FSH 16 AFC 2-8. DHEA 0.06. I have positive thyroid antibodies but normal thyroid function aparently.  My consultant thinks there maybe immune issues and apparently the thyroid antibodies are causing rapid decline in ovarian function. My tubes are open and my day 21 progesterone was 35 2 months ago though so i do still ovulate.   
Overall though, Im totally gutted and at huge cross roads. 
I am hopefully going in the TABLET trial at coventry hospital. 
Ivf? If so which clinic will give me best chance/ treat with high fsh. Coventry give me a 10% chance per cycle which isn't great. 
Which clinics are best at testing / treating immunes? 
Then there's the whole donor egg thing. Does immune issues mean donor eggs won't  work 

My head is in a total spin. I looked at ARGC and it looks excellent but potentially expensive if I need lots of immune treatments. I am not sure i can justify £30k on one ivf round. 

So there it is!!! What a lot to think on...........


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## berberprincess (Oct 8, 2013)

kezza_1980 congrats on the recent birth. hope you are enjoying motherhood. Tincancat, congrats on your BFP!!! I notice your signature and that you went to prof q at coventry for immune issues investigations. I have roughly planned to see her too. Can I assume by your signature that immune issues doesn't rule out donor egg option.


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## Tincancat (Mar 19, 2012)

Hiya 
No it certainly doesn't.  I highly recommend going abroad:  double donor cost me 5600 euros with success rates ofore than 80% it's a no brainer to continue in the UK . You could consider a Tandem Cycle if you are not yet convinced about giving up on OE: gives you a chance at own eggs with donor back up.  Good Luck
TC x


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## berberprincess (Oct 8, 2013)

Ah thanks for that tincancat. It's certainly a consideration to do tandem cycle. I feel bad considering de so early in the game, i ve not even had my first round of ivf and already mentally I've given up any hope. I am definitely going to pursue the immunology investigations before going any further. Do you have any advice or pointers on this. I can see you went to prof quenby at coventry which is where I will go. PM if you prefer to answer this. 

BP x


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## Tincancat (Mar 19, 2012)

Hi BP

I have sent you a PM but here are some standard Miscarriage Clinic test which might be helpful to do before jumping into expensive immune tests particularly blood immune tests which are unproven and make clinics lots of money. Endo NK test is a sensible price with Prof B and Prof Q who are NHS/Research Consultants not inflating costs for having to fund an expensive private clinic.

DVV Test Ratio (Lupus Anticoagulant test)
Coagulation screen (Prothrombin, APTT, APTT Normal, 20/80 APTT)
G20210A Prothrombin Gene mutation
Anticardiolipin antibodies
ANA
Antithrombin Activity
Protein C Amidolytic Actvity
Free Protein S Antigen
APC Resistance Ratio
APC (V modified) Resistance Ratio
Vitamin D
Prolactin,
LH 
FSH
AMH
Thyroid (TSH needs to be below 2.5 for fertility patients)
Fasting blood glucose

You have possibility had some of these so you will only need those you have not had. More expensive tests often done are Factor V Gene mutation and MTHFR Gene Mutation but these are more expensive and I am not sure they are worth it as the treatment is probably cheaper than the test - so often it is just as well using Clexane treatment.

Male Miscarriage factor testing which are useful include:
Sperm DNA Fragmentation (SCSA)
Sperm Aneuploidy (FISH)
Infection Screen (DL12)

If you take a look at https://www.tdlpathology.com/home most of these tests can be done at this Laboratory if you get a doctor to sign your form then you can pay for these tests above yourself. In some cases you do not even need to attend the London testing lab you can have blood taken locally and post them.

TC x

/links


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## berberprincess (Oct 8, 2013)

Oh wow, tincancat what a list although I have had most of them. Really helpful, thank you very much for this.

BP x


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