# Newbie - wanting to say Hi and ask loads of Qs....



## bugsy2008

Hi everyone,

just registered 2day, however have been reading posts for about a week...

Intro: I'm 31yrs old (32 in a month or so ) ), Happily married for 15months - have been trying for a baby eversince, have had no luck, not even a hope... Never been on the pill, periods always on time and normal. I have been to see a doc and apparently all the bloodtests have come back 'normal', my husband has had himself tested and nothing wrong there either...  

I'm really worried that their is a problem, I just have a horrible feeling but the doctor just does not seem to be worried (or bothered!). Anyhow even if their isn't a problem with either of us, we still have not conceived yet and so I really don't want to wait around for a hope just... I really, really want to have IVF treatment asap as I'm desperate to have a baby and I am going to be 32yrs old - i do apologise to all those out there older than me I hope you can understand where I'm coming from and everyone is an individual case.

I don't mean to sound tooo desperate and I hope no one thinks I'm rushing into this, but I would really appreciate any comments/ advice anyone out there would like to give me.

Regards

Bugsy (no not my real name, but I like it ;o) )

ps i do have loads of Qs to ask, but I think, initially it's impt 4 me to have introduced myself and give everyone a chance to ask me Qs )


----------



## fizzgig

Hi Bugsy and welcome to FF  

I'm sure a mod will be along soon to give you some hints & tips but just wanted to say hi! This site is wonderful for info and support and just to realise you're not alone. 

Sorry to hear you are having problems, but at least no big medical hurdles so far...I think if you have been trying seriously for 15 months then referral to a fertility clinic would be entirely reasonable, but the key thing as regards NHS treatment is your local PCT (Primary Care Trust) guidelines, as these usually have criteria you have to fulfil (one of them being age) to qualify for the NHS treatment (if any) is available in your area - it varies hugely from region to region. Your GP should have access to these. I think some GPs do have a tendency to say "oh just go away and keep trying" but then months turn into years before you know it, and you wish you'd started looking into things sooner... 

Also there are many other treatments less invasive than IVF, and you may well be suitable for these. Fingers crossed you won't need any of them and will get pg naturally, but if I were you I think I would gently get the ball rolling and give your GP a nudge!

Take care and good luck  

fizzgig xxx


----------



## Caz

Hello Bugsy, welcome to Fertility Friends. 

I completely understand your desire to get going on making a baby but....woah there....slow down! IVF is a *HUGE* step to take for someone who, as yet, does not have a diagnosed problem; IVF is not always the most appropriate form of treatment anyway and there are even some potential medical conditions you could have that would make your chances of succeeding with IVF very slim until dealt with. You have only scratched the surface of what testing needs to be done before you start thinking how you treat whatever problem does exist.

15 months may feel like a long time to try but in fact most doctors are fairly reluctant to even do the basic semen analysis and blood tests until you have been trying at least 2 years.
85% of couples who are having unprotected sex about 3 times a week will conceive within the first year, 90% within 18 months and 95% within 2 years. However, after 3 years, then your chance of natural conception actually drops to 25% mostly because, by this point for anyone who has not conceived there is probably a problem.

You may well be able to convince your GP to refer you to a fertility consultant now - perhaps ask him to refer you knowing that it will take you possibly 3 months to get an appointment and longer to get all the tests done and you're age is against you - you could even quote to him that 35 is the age where fertility declines dramtically in women (supposedly) and you know this process of investigations can take a while so you would like to maximise your chances by being proactive now...and on the proviso you will cancel you referral if you do manage to conceive before you see someone. As I say, most GPs would be reluctant to do anything until you have been actively trying 2 years without succcess so don't be too disappointed if you can't convince your GP. It's frustrating but, everything about this Infertility malarky is one big long wait after another.  You could arrange to see a fertility specialist privately, possibly even get in touch with a fertility clinic (although you may still need a GP referral for that) and they may offer you IVF but, I would think any self respecting consultant would, at the very least, want to do further tests before blindly putting you forward for expensive and emotionally and physically demanding treatment.
Please don't underestimate the emotional and physical toll that IVF and in fact any fertility treatment can have. It is not an easy solution. You will be drugged up, pushed, pulled, prodded and stripped of pretty much all your dignity. You will have to life completely taken over by it and, at the end of the day there is still only a £25% per cycle average chance of it suceeding and if it does fail - you will be left utterly devastated. Of course when it works the rewards are huge and wonderful but, certainly, it isn't a process I would wish upon anyone. It's hard not to be impatient to get pregnant but impatience certainly shouldn't be a reason to force yourself through all that.

You say you have had all your blood tests done - I assume day 21 progesterone, day 1-5 FSH etc?  Do you happen to know, or can you obtain a copy of those results? It might be useful to post them here and that of your DH's sperm anaylsis just to let our members (some of whom have become mini experts over time  ) have a look and reassure you that they are ok. Also, how long are your monthly cycles if you don't mind me asking? Do you have an specific reason why you might think there's a problem (i.e. something that happened in the past) or it is just gut instinct?

Your next step now would be some kind of physical examinations - an ultrasound scan of your ovaries and uterus to check for possible issues (fibroids, cysts, PCO etc.), a HSG to check for tubal obstructions - or better still, a laparoscopy and HSG (lap and dye) and / or a hysteroscopy. You will need to be referred to a fertility consultant before any of this can take place and, I am afraid, it does take quite a bit of time but, once you have persuaded your GP to refer you, you might be able to pay privately to have the tests etc. done quicker and speed things up. If you can afford it, this isn't a bad idea as it can take months and months to get things going and, quite rightly said, you don't have loads and loads of time on your side, but bear in mind that if you do need IVF this too can be incredibly expensive (especially if you budget realistically for at least 3 cycles) and you may have no option but to self-fund if you don't meet the right criteria set by your PCT.

I am going to leave you a few links with some information that I hope you find useful:

*What Every New Member Needs To Know (includes a list of common abbreviations) ~ *   CLICK HERE

*FERTILITY INFO GUIDES ~ *CLICK HERE

*A Rough Guide To IVF ~*   CLICK HERE

*Girl & Boy talk - Community & Fun Board ~ *CLICK HERE

You can also chat live in our excellent chat room. We have a newbie night in the chat room every week (*Wednesday at 8pm*), where you can meet other new members and get technical support with navigating the site and using all the functions available here.  CLICK HERE FOR INFO ON NEWBIE CHAT  Please do come along tonight if you can. I will be there and maybe able to answer soe of your questions you have going round your head.

You can also "meet" and chat with people in your local area through the *Location boards*. This is especially useful to find people who may be using the same clinic and or in the same PCT area.

You might also want to have a look at this section:

*Complimentary Holistic & Spiritual Approaches ~ *CLICK HERE 

There are quite a lot of natural approaches that you might like to think about which you can try even while you wait for a referral if necessary. If you haven't already done so, have a look in your local bookshop for some of the fertilily books that are out there. A few of them have a lot of good advice on how you can maximise your chances of successfully conceiving.

Wishing you lots of luck!  If you have any specific questions, please don't hesitate to ask. 

C~x


----------



## Chedza

Hi 
If this help s you . I am 35 and married in Nov 06 and been trying to conceive for past 13/4 months . My Dr was brill ie referred us to local Hospital for sperm analysis within 8 /9 months of us trying to no avail.My tests were OK but at scan for first IVF?ICSI they found had a small cyst .I pushed for it -the tests-as I felt time was running out for me - The GP wasnt reluctant at all to be honest so I guess it is up to you to stress how important it is for you and also how understanding the GPis . I dont think you are rushing in but I do feel that you have more time ie you are relatively young etc . but then again I completely understand where you are coming from.
Dont know if that has helped - all I can say is go for it , dont muck about !!! 
Chedza


----------



## jnrspoon

Hello there!

I can totally understand where you're coming from about your Doctor. I think sometimes they have so many people to 'get through', they can sort of forget that you are a person trying to articulate your worries and thoughts to them. Sometimes the mistake can be made that you come out with less answers than when you went in! My philosophy is to keep going back and 'bugging' him/her. It must be hard being a doctor, distinguishing the needs of patients based only on a few minutes, but try not to get discouraged by them 'putting you off'. Just keep on regularly returning. Once they see you're not giving up, they'll probably be more obliging than you'd think. If you actually make the request to be reffered, then they need o give good reasons as to why they don't think that's a good idea and remember, you can always ask for a second opinion if you're still not happy.

Good luck to you both!


----------



## kitten1

Hi bugsy  

Welcome to FF!!

I would just like to reiterate what Caz has said. A GP who is prepared to even do minor tests such as bloods and SA after such a relatively short period of time ttc is VERY hard to find anyway. So, in a way, you are lucky to know that so far, all looks ok. 

Without being too personal, do you think that maybe trying some Ovulation predictor tests may be worth a shot?? That way, you can make sure you have  at the best time of the month to concieve. 

I know a year or so may seem like a very long time but in terms of actual 'chances' to get preggy, it's only about 12. 

Have a read of some of the complimentary therapies and vitamins etc that some people use. Your body is more likely to get concieve if you are in peak physical condition for your body. In my case it meant actually putting weight ON helped (a small part but nonetheless) me to get my dream.

Wishing you lots of luck,

Mandy xx 

p.s: Sorry if Ive waffled but it's past my bedtime now!!


----------



## bugsy2008

Hi everyone, thanks for those that have replied. Caz, I could try and get hold of the results, i will post them here when i get them.  I have a 30 day cycle and i'm always on time but the reason I'm worried is eversince I turned 30 i've noticed my periods are not as heavy as they used to be and I don't suffer from period pains like i used to either... I did consult my GP on this but again I was told it's nothing to worry about - but i AM REALLY worried. I'm now beginning to panic that I have left it too late... I am taking folic acid and all other necessary supplements. I also know roughly when I'm most fertile - so def try even harder then. But nothing seems to be working :-(

I know what you mean about IVF and rushing into it, but we can afford to do one cycle (atleast) private and to speed up the process I want to go abroad for this. Furthermore I will definitely want more tests done myself before I do go down the IVF route - however the IVF clinic I've done research about (Scanhealth in Norway) does do all the necessary physical tests that you mentioned beforehand. Also i am aware that even with IVF there's only a 25% (ish) chance of getting pregnant - therefore the sooner I start the better, isn't it?

Bugsy XXX


----------



## sweets x

hi bugsy. 
i totally feel for ya and wat ya going through. i would go back yo your gp and get refered, if he/she ain't helpful then see someone else if you can
loads of luck to you    

nicola x x x


----------



## bugsy2008

Oh I forgot to mention that I'm originally from Sheffield, however when I got married I moved in with my husbands family in Nottingham. So the GP i've joined has been my husbands family doc for a long time... the problem there is that he's also a very good friend of my father in laws and for that reason I don't entirely trust him - don't know if anyone else can understand that? I'm quite a private person and this esp. I would like to keep between myself and my husband. I would find going through any treatment difficult if everyone knew about it.... And everytime i've happened to go to the docs I've come home to a million Qs.  So apart from the doc being reluctant in pushing me for further tests, I'm finding it difficult to bug him too much either. Help, what can I do? If I wanted physical examinations done here in the UK would i still need a doctors referral or can i go private - if I can, where do i start?

Bugsy  XX


----------



## Caz

bugsy2008 said:


> I have a 30 day cycle and i'm always on time but the reason I'm worried is eversince I turned 30 i've noticed my periods are not as heavy as they used to be and I don't suffer from period pains like i used to either... I did consult my GP on this but again I was told it's nothing to worry about - but i AM REALLY worried.


I'm not surprised. I'm not sure many doctors have that many paitients coming to them to complain they are _not_ in pain and having a less rough ride at the tiem of their period! 
I do undertsand why that is concerning you though. It may be nothing significant and periods do change over time. If your blood tests have all come back ok (assume, shall we, that the doctor knows what he is doing as says they are fine and they are) then you likely haven't left it too late in terms of nearing the menopause. Might be worth some discreet questions of your mother / aunts as to when their menopause started? Should give a guide as to whether you are likely to have early menopause or not. 
30 day cycle is pretty normal. Do you know when abouts in your cycle you ovulate? This is very relevant as eggs generally only last 24 hours after ovulation yet sperm can live up to 3 or 4 days so, you might think you've timed it right but if you are not 100% sure, you might not be. Have you been charting (temperatures etc.) or using ovulation prediction kits or fertility monitor? Do you manage BMS (baby making sex) 3 time a week? Do you get obvious signs of impending ovulation? i.e. egg white (stretchy clear) cervical mucous?  What is your diet like? Do you drink? Smoke? Does DH? Are you over or underweight? When you have your period, is it smoooth red blood or do you get lots of "chopped liver" like clots? Do you get brown or red spotting for several days before it arrives or do you com on fairly suddenly?

Did your GP ask any of these questions? 

With regards to your doctor, can you not see another doctor in the practice? Failing that, maybe change GPs? You don't have to give a reason for doing so.
Or, maybe make a list of questions for your GP so, when you go again you have them all written down and force yourself to ask them.

Not sure what the situation is abroad and maybe best to contact the clinic itself to find out if they actually need a referral letted first.

There is a thread discussing Scanhealth here:

http://www.fertilityfriends.co.uk/forum/index.php?topic=119953.0

You could probably either post a question there about referral or maybe a new topic in that section of the site. Failing that, it may be worth looking in this section of the site for advice:

*Treatment Outside The UK ~ *  CLICK HERE

Forgive me for being blunt but I personally think anyone who puts themselves through IVF if they don't really need it is mad so I am pleased to see you plan on covering all the bases first and I sincerely hope that you don't need it and are able to conceive naturally soon. 

C~x


----------



## Joey_V

Hi Bugsy
Welcome to FF.
I agree with the others - you should get to know as much about your own cycle as possible before talking to specialists as you will then be in a stronger position to push them in the right direction. Make sure you know how long your luteal phase is and that you understand all the details of the semen analysis: motility, morphology as well as count. All these things will dictate which form of "treatment" you will need, if any. 
Also make sure you know for yourself if you are ovulating as this will be a huge booster for you (by measuring temp) and mean it's one less thing to worry about.
Above all, don't panic! You are very lucky that you have time on your side, and a few more months won't make any difference if it means you have as much knowledge of your own situation as possible. 
Hope I'm not being patronising!! I understand completely your feelings. Most of my family & friends haven't got a clue what I'm going through as having babies has come easy for them. (took me a while to find my wonderful DH too!).
Wishing you lots of luck and here's a big hug   from someone who understands.
Joey
xxxx


----------



## Shiz

bugsy2008 said:


> Hi everyone,
> 
> just registered 2day, however have been reading posts for about a week...
> 
> Intro: I'm 31yrs old (32 in a month or so ) ), Happily married for 15months - have been trying for a baby eversince, have had no luck, not even a hope... Never been on the pill, periods always on time and normal. I have been to see a doc and apparently all the bloodtests have come back 'normal', my husband has had himself tested and nothing wrong there either...
> 
> I'm really worried that their is a problem, I just have a horrible feeling but the doctor just does not seem to be worried (or bothered!). Anyhow even if their isn't a problem with either of us, we still have not conceived yet and so I really don't want to wait around for a hope just... I really, really want to have IVF treatment asap as I'm desperate to have a baby and I am going to be 32yrs old - i do apologise to all those out there older than me I hope you can understand where I'm coming from and everyone is an individual case.
> 
> I don't mean to sound tooo desperate and I hope no one thinks I'm rushing into this, but I would really appreciate any comments/ advice anyone out there would like to give me.
> 
> Regards
> 
> Bugsy (no not my real name, but I like it ;o) )
> 
> ps i do have loads of Qs to ask, but I think, initially it's impt 4 me to have introduced myself and give everyone a chance to ask me Qs )


Hi 
I'm a 32year old and I have been married for 6 months but TTC for 3 years, I went to the doctor after a year of trying because I was very aware of my age and wanted to rule out any problems early on.
My husband's semen is ok and all my tests came back ok too, I had an HSG after two years of trying which also came back clear. My periods are regular 28 day cycle and blood tests showed I was ovulating although I could never get a positive test myself using the ovulation kits.
We were told to 'wait and see' until we had been trying for 3 years, the 3 years is now up and I have been put on Syranel nasal spray as the first step of OI, injections start on the 19th Aug.
I hope and pray every minute of the day that this will work first time as we have three funded cycles of OI, I have turned into a horrendous crabbit woman much to my hubbies horror.
If I could afford to go private I probably would but really 32 is not that old and you may just be taking that bit longer TC 
I work in a large government department and there are constantly women falling pregnant all around me and sometimes I just feel so hard done by , no one understands unless you are going through it or have been through it 
Wishing you all the best in the coming months xxxx
Shirley


----------



## droogie

If you're GP is resistant you could gently remind them that the NICE guidelines suggest further investigation after a year, these are the guidelines that they are supposed to follow (you can print some stuff from here:http://www.nice.org.uk/CG11)

But don't panic, IVF is a way down the road yet there are lots of other things to try. It is hard and I'm sure you just want to jump in and fix it but it may be something simple.

Huge 

heather


----------



## PoDdy

Hi Bugsy (great name, even if it isn't your real on   )

I always harp on about the value of a good book and one in particular that helped me - Toni Weschler 'Taking Charge of Your Fertility'. I don't want to do a sales pitch, but I found it on Amazon (other good book stores are available!) and it had 197 reviews and 99% of them were 5 star. 

Hopefully it will help you see that IVF is a last port of call, not the first as there are so many things you can do (especially as you don't have any obvious medical hurdles).  Understanding your cycle is paramount.  I was like you, lets just cut to the chase and skip to IVF, but now I realise that the last thing I want to endure is IVF and the immense pain a BFN must cause - don't forget it's only around 30% successful.

Best of luck,
PoDdy


----------



## bugsy2008

Hi all,

I've managed to get hold of my blood test results, they make no sense to me what-so-ever so i'm posting the lot in the hope someone out there can help clarify everythings ok (or not):

A. Sample taken day 4 (of my period):

Serum progesterone 32 nmol/L
female - follicular phase 0.5 - 6.7 nmol/ L
luteal phase 7.3 - 89.1 nmol/L

serum FSH level 7.0 u/L
fsh reference ranges
female: follicular phase 1.5 - 11.4 u/L
midcycle 1.1 - 9.5 U/L
luteal 1.1 - 9.5 U/L
post menopausal 23.0 - 132.9 U/L (OHMYGOD what does this mean in particular?!)
males 1.4 - 18.1 U/L

serum LH level 3.0 u/L
LH reference ranges
female: follicular phase 0.8 - 12.5 U/L
midcycle 8.7 - 76.3 U/L
luteal 0.5 - 16.9 U/L
post menopausal 15.9 - 72.6 U/L

FBC
HB 13.7 g/dL (11.5 - 16.5)
WBCs 5.8 10*9/L (4-11)
Platelet count 329 10*9/L (150-450)
RBCs 4.92 10*12/L (3.5-5.
Haematocrit 0.416 1/1 (0.37 - 0.47)
MCV 84.6 fL (84 - 102)
MCH LO 27.8 pg (28-33)
MCHC 32.9 g/dL (30 - 35)

Differential white cell count
Neutrophil count 3.7 10*9/L (2.0 - 7.5)
Lymphocyte count 1.8 10*9/L (1 - 4.0)
Monocyte count 0.2 10*9/L (0.1 - 1.5)
Eosinophil count 0.1 10*9/L (0.04 - 0.4)
Basophil count 0.1 10*9/L (0 - 0.15

R FREE T4, FT3 and TSH 
serum free T4 level 12.9 pmol/L (11 - 24)
serum TSH level 1.7 mu/L (0.3 - 5.5)
serum free triiodothronine level 4.9 pmol/L (3.5 - 6.7)

Serum lipids
serum cholesterol 5.1 mmol/L
serum triglycerides 0.6 mmol/L (0.4 - 1.53)
serum DHL cholesterol level 2.3 mmol/L
serum LDL cholesterol level 2.5 mmol/L
total cholesterol:HDL ratio 2.2

B. Sample taken at day 22 of my cycle (should have been day 21 but that fell on a Sunday so doc told me to come in on the Monday for the blood test).

Blood glucose level 4.5 mmol/L (3 - 6)

Serum progesterone 14nmol/L 
female - follicular phase 0.5 - 6.7 nmol/L
luteal phase 7.3 - 89.1 nmol/L

ohmygod i've just read somewhere that this level of progesterone is too low and it means i didn't ovulate that month, is this true, now I'm even more worried!

  
Bugsy


----------



## PoDdy

Hi Bugsy, don't panic!

2 things on helping you to read these results.  You are in your follicular stage between D1 and the day you ovulate.  After that you are in luteal phase.  The first line on each section is your result and the ranges below are there to give you an indication of what they would expect (I presume).  Also, stuff in brackets looks to be typical ranges.

e.g Serum progesterone 32
during follicular phase (which you are in on D4)they would expect 0.5-6.7

e.g If you were post-menopausal your D4 FSH level would be between 23-132.9 

Now onto your D22 results.  These are entirely based on you ovulating 7 days before the blood test.  For example, I ovulate on D18, so my progesterone levels look very low on D21/22.  This could be the same case for you, unless you know for sure you ovulated on D14/15.  The minimum progesterone level they look for 7 dpo is 30 n/mol/L.  I really wouldn't worry unless you know when you ovulated.

Someone correct me if I'm wrong, I am a Dr, but not a medical one ;-)

PoDdy


----------



## Caz

Thank you Busgy.

Just to clarify the results for you a little. Follicular phase is the part of your cycle prior to ovulation, Luteal phase it the part after ovulation. I've just copied your post and added some comments as that's the best way to explain them.

A. Sample taken day 4 (of my period):

Serum progesterone 32 nmol/L

female - follicular phase 0.5 - 6.7 nmol/ L
luteal phase 7.3 - 89.1 nmol/L [/quote]

Progesterone is the hormone that maintains pregnancy. It is normally low at the start of the cycle and, after ovulation, your body pumps it out to maintain a pregnancy (if acheived this month). 32 seems high based on the normal ranges but I am not an expert and cannot tell you what that means, if anything.


serum FSH level 7.0 u/L

fsh reference ranges
female: follicular phase 1.5 - 11.4 u/L
midcycle 1.1 - 9.5 U/L
luteal 1.1 - 9.5 U/L
post menopausal 23.0 - 132.9 U/L 
males 1.4 - 18.1 U/L

FSH is follicle stimulating hormone. This is the hormone your body produced every month to make your ovaries grow a follicle containing an egg. The more FEH you produce, the harder your body is having to work to make an egg. Therefore, a high FSH is often indicative of approaching menopause. However, stress and other factors can cause a high FSH. Men also have FSH to help make sperm! The later in your cycle you have your FSH measured, the higher it will be (for instance, my last test, my FSH was done on day 3 and was 5, compared to an FSH of 2 on a day 2 test previously.) You can see from this yours is really good. You are certainly not looing "past it" by that result!
The "post menopausal" comment indicates what you would expect an FSH level to look like in someone who has been through the menopause


serum LH level 3.0 u/L

LH reference ranges
female: follicular phase 0.8 - 12.5 U/L
midcycle 8.7 - 76.3 U/L
luteal 0.5 - 16.9 U/L
post menopausal 15.9 - 72.6 U/L

 LH = Lutinising Hormone. This is the hormone your body produces to make the follicle pop - i.e. make you ovulate! It peaks sharply at the time of ovulation and then drops back to low levels again quickly. It is this LH surge that ovulation prediction kits pick up - once you detect the surge then you will ovulate within about the next 36 hours. Again, yours looks fine at this stage.

 
FBC
HB 13.7 g/dL (11.5 - 16.5)
WBCs 5.8 10*9/L (4-11)
Platelet count 329 10*9/L (150-450)
RBCs 4.92 10*12/L (3.5-5.
Haematocrit 0.416 1/1 (0.37 - 0.47)
MCV 84.6 fL (84 - 102)
MCH LO 27.8 pg (28-33)
MCHC 32.9 g/dL (30 - 35)

Differential white cell count
Neutrophil count 3.7 10*9/L (2.0 - 7.5)
Lymphocyte count 1.8 10*9/L (1 - 4.0)
Monocyte count 0.2 10*9/L (0.1 - 1.5)
Eosinophil count 0.1 10*9/L (0.04 - 0.4)
Basophil count 0.1 10*9/L (0 - 0.15

R FREE T4, FT3 and TSH 
serum free T4 level 12.9 pmol/L (11 - 24)
serum TSH level 1.7 mu/L (0.3 - 5.5)
serum free triiodothronine level 4.9 pmol/L (3.5 - 6.7)

Serum lipids
serum cholesterol 5.1 mmol/L
serum triglycerides 0.6 mmol/L (0.4 - 1.53)
serum DHL cholesterol level 2.3 mmol/L
serum LDL cholesterol level 2.5 mmol/L
total cholesterol:HDL ratio 2.2

B. Sample taken at day 22 of my cycle (should have been day 21 but that fell on a Sunday so doc told me to come in on the Monday for the blood test).

Blood glucose level 4.5 mmol/L (3 - 6)

 These all appear to be general blood tests - FBC - full blood count etc. None of them are directly related to fertility but, obviously if you were, for instance aenemic, that would have an overall impact on the on the health of yourr body so good to see your GP has been throrough ordering them done. And great to see cholesterol and glucose there too - well, at least that's two less things you need to worry about!  The normal ranges are all in brackets and, you can see that yours are all within normal ranges.



Serum progesterone 14nmol/L 
female - follicular phase 0.5 - 6.7 nmol/L
luteal phase 7.3 - 89.1 nmol/L

 This is the key progesterone test - I think most FFers have been told by consultants that over 20 is considered indicative of ovulation having taken place. 
The key question with this test is timing. The vast majority of women ovulate exactly 14 days before their period* (AF) arrives. If you count back from this you can work out when, in your cycle, you ovulate. The progesterone test - to give an accurate indication of ovulation - needs to be done 7 days after ovulation. Therefore, if you have a 28 day cycle you get AF 14 days after ovulation, you ovulate on day 14 and need to test on day 21 - hence why it is (somewhat mistakenly) called the Day 21 test. If your cycles are longer or shorter than 28 days you need to adjust this the suit or, if you test on day 21 the result may not be accurate. You have already said you have a 30 day cycle so, for you - assuming you_do_ get AF 14 days after ovulation like most people, you ovulate on day 17 - perhaps later in your cycle than you realised  This means your test done on day 22 may have only been 5 days after ovulation and not a true reflection of what's really going on! A test on day 24 would have been more accurate for you. I know it's only 2 days but it can make a difference.

* There is a small number or women who suffer form luteal phase defects - where the luteal (post ovulation) part of their cycle is too short - e.g. 10 days. Generally you will see they have either too short a cycle (less than 25 days) or, if not, they will ovulate late in the cycle. The only real way to tell if you are ovulating around the "right" time for your cycle length is to actually try and detect the LH surge or to look out for signs of ovulation like EWCM (stretchy egg white like cervical mucus).

There is only one result there that seems a bit high and that is the progesterone on your day 4 test, and one that seems a bit low - the progesterone on day 21 but, I think we can see there may be a reason for that. It is always best to not treat fertility blood tests as a one off but rather to repeat them a few times to build up a picure of what is normally going on. 
Perhaps you can return to your GP with your newly armed knowedge and ask for repeat day 1-5 and "day 21" tests to be done. Also, it is worth remembering that your GP is exactly that - a General Practitioner - and he/she will only be able to refer to the same normal range indications that you or I can see ont he forms and may have no real clue how to read between the lines so to speak. A fertility specialist may be able to take a better look and be able to spot a potential problem from the pattern of results and may be your best bet to get a good idea of if there are any hormonal imbalances.

Hope that helps.

C~x


----------



## mandy_1986

hi bugsy im 22yrs old & was told at 14 that i cant have chid due to the fact that i had haf my womb remove wen i was seven any ways i was refered by my gp @ 16 to a guynocologist who told me the half they left behind hadnt growen so @ the age of 21 i was refered to a fertility consultant who i still see ne ways he told me that my FSH leve was low and sent me for another blood test 3months later well i get thoughs results on the 15th august 08 but i also told him that i've been having hot flushes for the past 6month and he said that even though im ovulating there is a chance they wont get ne eggs from me well i dont have period never have done so i dont know wen im producing eggs all i no is that the im having more hot flushes which can be a huge sign of the  menopose and my mum hasnt even hit that yet.


----------



## bugsy2008

Mandy, I'm really sorry to hear what you're going through and I really appreciate you sharing that with us all inc me. 

Thank you PoDdy, Caz and everyone else who has replied - talking to you all really helps. I think i do need to have more blood tests done, when these were taken (2months ago) I didn't really understand them and esp. day 21 test is all about the timing... I'm not certain when i ovulate exactly but i do know that there is a period mid cycle ish that i am most fertile (i guess this by me being easily aroused this time of the month, more discharge etc) and judging by that, when i had the day 21 test (or 22 in my case) i had already passed that phase of my cycle.

I will keep you all posted as to what happens next.

Bugsy


----------



## PoDdy

Hi Bugsy,
That's great that your body gives you signs when you ovulate, all I get is slight cramping over a period of a few days. If I were you, I'd note when that happens!

Hi Mandy,
Sorry to hear your story - so unfair.
Do you have a plan of action? Can you try treatment, or will you go for surrogacy?  If the plan is to get eggs from you, they have methods of finding out when you ovulate!   I don't have a similar problem to you, but here is an example of my treatment. I had scans from D12 that can show the follicle growing on your ovary and the size (they burst to release the egg) and when they are the right size then they can give a 'trigger' shot to make them burst within 36-40 hours.  Hopefully, it isn't as bleak as it looks and there will be eggies!

PoDdy


----------



## bron11

Bugsy
Welcome and sorry that you are having problems getting preg. Having read your list of tests, what a lot, I have had basically none of these and have just had a failed cycle of IVF. I do know that in terms of ability to produce egges, egg reserve your FSH level is under 10 and indicates things are ok. I think anything above 15 is deemed poor egg quality and reserve - I am no expert but been told this as I have had result of 18 and and been kicked off private waiting list with one clinic. However, with high dosage of med I did manage to get 9 eggs, 7 fertilised and 2 grade a eggs (a being the best i am told).

You appear to have a lot of immune tests done, Thyroid, white cell count, I am trying to have these done at present but getting no where fast. Alan Beer book Is your Body Baby Friendly goes into these very well, (available on internet to buy).

Re your Thyroid results yours are similar to mine (mine being T3 1.7 nmol/L, Free T4 12.9 pmol/L, TSH 1.678 mu/L), this is a response I got regarding mine.

"Hi Bron, don't apologise for e-mailing me at all, I'm flattered that you have . Please be aware I am still 'learning' so to speak but will do my best to help you  Your basal temps are extremely low (the lowest I've seen on forum by far, you must feel awful in the mornings!), if you take them into account and the thyroid blood tests, they can be almost 100% sure that you have thyroid probs, if you didn't know that already! Your T4 is within the range but low, it should be in the upper third of the range, especially if you're TTC. Mine level is 12 and I am been medicated for that. Your T3 level is too low also, should be higher third too. Your TSH level looks about right, although mine is too due to pituitary damage (either due to thyroid been 'out' and affecting it or could be the other way round!). Sometimes, like in my case, the actual thyroid hormones (T4 and T3) are more important. Please read up in hypopituitarism (underactive pituitary gland) as a possible cause for thyroid problems, it's called secondary hypothyroidism when pituitary gland is cause of thyroid probs but treated in the same way (replacement thyroid hormone). The pituitary also controls hormones for cycles, has this all been tested? Obviously, if your sex hormones are not right, you will have trouble conceiving. Have you considered doing a 24 thyroid urine test to check the actual thyroid levels you are using? The thinking is blood tests show whats in your blood, salivary tests show whats in your cells and urine tests show what you've used".

This is the thread where thyroid issues are discussed http://www.fertilityfriends.co.uk/forum/index.php?topic=139078.new;topicseen#new.

I am told TSH should be between 1 and 2 for fertility purposed and yours is.

http://www.nptech.co.uk/order.html - This is a internet site that does testing for for a range of things including Thyroid, adrenal DHEA - all of which can impact on fertility.

This a link regarding infertility test http://www.webmd.com/infertility-and-reproduction/tc/infertility-tests-overview

The following is a list of tests that can be done to check immune issues which can impact on infertility - found on FF under investigations and immunology thread.

Karyotyping for DH and you (tests for any genetic issues)
Sperm assays and investigations - including DNA fragmentation testing(anyone with more info. on this as I know v. little about this)

Uterine
Hysteroscopy, HSG etc. to check for scarring, fibroids, polyps etc
Thin lining, no triple stripe etc.
Doppler - to check blood flow in uterus

Insulin resistance (fasting glucose test)
Thyroid levels (TSH)
Anti Nuclear Antibodies
Anti thyroglobulin
Anti-thyroid antibodies
Full Blood count
ESR (Erythrocyte Sedimentation rate)
RA (Rheumatoid Arthritis)

BLOOD CLOTTING PANEL (Thrombophilia panel)

Serum Immunoglobulins (IgG, IgM and IgA) 
Activated Protein C Resistance 
Factor V Leiden genotype 
Anti Phospholipid Antibodies 
Lupus Anticoagulant 
Anti Cardiolipin Antibodies 
Plasma Free Protein S level 
Factor II G20210A 
Prothrombin Gene Mutation 
Antithrombin III M
Fibrinogen level 
APTT (Activited Partial Thromboplastin Time) 
APTR

MTHFR (methylenetetrahydrofolate reductase) and connected with this is measurement of your homocysteine levels (The GP may not be able to do this one)

BACTERIAL

Mycoplasma, 
Ureaplasma 
Bacterial vaginosis
Chlamydia and any other bacterial infections
Varicella Zoster antibodies

Progesterone
Extra progesterone e.g. Gestone (injectible progesterone) may also be needed. 
Get progesterone levels checked at the same time as any beta tests (or even 1 week after embryo transfer) to make sure you have adequate levels (especially if you have had a cycle where you have started bleeding before the end of the 2ww).

Immune testing (so called Chicago or Level 2 tests) - to be done by specialist consultant:-

Natural Killer Cells
Cytokines, (TH1, TH2)
Tnf-alpha
DQ Alpha 
LAD

Time is certianly on your side for both private and NHS treatment, if I don't get to top of NHS before I turn 40 in May I am kicked off!

As other girls have said push your GP to make a referral to fertility specialist as this can take months to achieve. Or pay for a private consultation and see what they have to say. Definately get Day 2/3 Fsh , estradiol, progesterone, LH repeated (not that I know how to interpet them!) and day 21 prog test.

If referred to a fertility specilist they may undertake a diagnostic laparoscopy to check internal body working.

There are plenty of experts on FF and they will keep you right, just keep asking questions of your GP and push for things. Try not to get to stressed as this can also be counter productive (easier said than done).

All best bron.

 I just want to point out that, aside from the "Ask a Professional" sections of FF, all advice and support given here is given is by peers who may have no formal medical training or knowledge - although many members have a lot of experience in their own right, it is not professionally endorsed so always seek professional medical opinions where appropriate. Sorry, boring I know but has to be said.

/links


----------



## LuuLuu

Hi Bugsy

I'm in a similar boat to you - same age and ttc for about 18 months.  We've identified one issue so far but we are still remaining hopeful that there is a slight chance for a natural bfp.  We're trying to just get ourselves in tiptop shape - no drinking, plenty of exercise, healthy diet......

It is difficult when all around you seem to be pg!! Seems like one a week where I work!!

It's easier said than done (particularly when I can't take my own advice!) but I guess it will help to be     as possible!!

Our GP started off by saying he'd do some basic tests but then would send us away to keep trying.  However, they found male factor issues with us so quickly referred us.  

Anyway have a great weekend.

LuuLuu


----------



## Huldra

Bugsy, Hi and welcome!

Please don't put too much into one test showing you might not be ovulating. The fact is, we don't ovulate every single month! It's perfectly normal to miss a month now and again, and unless you're actually testing for ovulation, you wouldn't even know, as af will arrive as normal. I had my initial appointment for ICSI at the end of June, and the scan showed that the lining was so thin that I probably hadn't ovulated that month. The doctor wasn't the least bit worried though!

I second that IVF is not an easy route to go, as others have said. I'm having ICSI in just over a week's time, and I'm really finding the treatment hard, both physically and (especially) mentally.    All your tests have been normal so far, and I think you should focus on that. Getting worked up and frustrated about not getting pregnant is not helping you get pregnant, so try to stay positive and relaxed. Easier said than done, I know...

You don't need a referal for Scanhealth, by the way. The doctor there is very good, and he will be totally honest with you. You can always book an initial appointment there to get your "case" reviewed and give you a bit more to go from. But I do suspect he might want you to try a bit more naturally. As you will see from the Norway tread, most of us going over there are either "older" (sorry girls!    ) or have quite specific problems affecting our fertility.

All the best!


----------

