# what to expect at first referral appointment as couple to gynaecology



## hle

My Dr has referred us after 18 months ttc. My husband and I have received an appointment for gynaecology. Does anyone know what we can expect?

Thanks


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## Cloudy

At ours they discussed our results so far (SA and my bloods) and also our medical history and what we have done TTC-wise.

They then discussed next steps - which may be more tests or treatment.

Good luck xxx


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## Darcy2012

Hi
They discussed blood tests my GP had done and sperm analysis. Discussed our history, I had a brief internal exam and they took swabs. Organised repeat blood tests and referred for HSG ( dye test to check fallopian tubes) and ultrasound .

Hope that helps


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## Sbarky15

Hi hle, I am jumping on your bandwagon as I also have my first gyno appointment on 6th March. 
My husband has children so im not expecting any SA, I have had an ultrasound so not hoping for any more of them. Hoping for a clomid prescription but I can imagine there being more tests. 
Can I ask what people mean by "discussed our history"


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## Darcy2012

Hi
Regarding g discussing history they asked about our medical history, any health issues etc, my history regarding my periods/cycle if they were regular, length etc.Also how long we had been trying. 
After all the tests such as HSG and scan they did prescribe 6 months clomid before referring for IVF.


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## louise48910

At ours a nurse took our height, weight, calculated bmi etc then we saw the consultant. He went over the results we'd had already by my GP (fsh, lh, progesterone) then referred my partner for further tests as he has male factor fertility problems. Then he referred me for an internal scan which was on a certain day during my next cycle. Really depends on what's already been done I guess. Good luck with it all x


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## hle

Thanks everyone! The appointment is today so I will feedback on my experience.


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## hle

Similar experience to Louise48910


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## Jax83

Hi, so how did you get on?
We had our first appointment at the end of last year. I had blood tests, internal ultrasound and swabs and husband has had blood and sperm tests. We are now waiting for a follow up appointment expected end of Feb. 
I hate waiting but also praying for a miracle to happen naturally whilst we wait!

Jax


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## hle

It wasn't great actually :-(. My blood test results were all great, they just took a blood test for prolactin and chlamydiA? Husband had a urine test for Chlamydia too. They arranged for a pelvic ultrasound and an ultrasound to check my tubes are clear. As I have been pregnant before (abortion at 24 and miscarriage at 30 they are not too concerned about my fertility, although I have a bmi of 44 so they recommend I lose weight, especially if it comes to assisted fertility, which it looks like it's going to be for us, if I can get my bmi down. My husband on the other hand has a sperm count of 3 million per Mil (should be 15ml/Mil) and his motility is 22% instead of 30% And they said it is unlikely we will conceive naturally based on this this. They did say lowering the his I Bmi might help but they said it could be linked to being born with an undescended testicle that was operated on when he was two. We are going to both cut out caffeine which they recommended and alcohol though didn't have much of either and eat more healthy and exercise more to lose weight and maybe it will improve his sperm count count, if not then I will have lost the weight for IVf, gutted though and I can't work out how many rounds of IVF you get funded on the NHS if you are under 40 and if you then can try icsi funded too and how many rounds of that can you get. They mentioned icsi as a potential option to.


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## Cloudy

Sorry you didn't feel happy with your appointment, but at least it sounds like things are progressing: and in the world of fertility the progress you have made is quite good because everything can seem to be at a standstill sometimes!

As mentioned on the other thread, you need to contact your CCG about what funding is available honey. They are the only people who can accurately provide details as to what current funding levels are. CCGs are smaller than the old PCTs so a Dr in a hospital could in theory be seeing patients from 10+ different CCG funding policies.  

With regards to ICSI: it's just like IVF and funded the same. In ivf the sperm and egg are put in a pot to do their own thing, and in icsi a single sperm is injected into a single egg. It's obviously more scientific than that, but that's the basics! When they say IVF funding they are referring to ICSI as well. Although I am sure I have seen on here than one CCG won't pay for the icsi element of the treatment, and that couples had to contribute the difference in cost between IVF and ICSI, but it was ages ago and I can't remember the specifics.

Good luck with your BMI. We have a weight management section that may be worth joining if you haven't already.

Xxx


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## hle

Thank you. Im happy things are progressing, well when I lose.the weight. However I wasnt expeciting to be told it's unlikely we will have children naturally, that was a shock x


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## Cloudy

I hate it when they say stuff like that because it's a load of rubbish.

Don't focus on that comment honey because they say stuff like that all the time and all the time people still get pregnant.

Our IVF Dr gets really annoyed that gynies say comments like that based on SA results when as long as you have some that are moving/normal forms etc then you can still get pregnant. Besides, no one knows what SA results all the men who do have children naturally would get, so really the "averages" are based on a wonky data if you ask me.

Xxx


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## hle

True, thanks ;-). Do you think bringing my husbands bmi could have a big effect?


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## Cloudy

Mr Cloudy hasn't got great swimmers and is slightly over his BMI. They said that reducing his bmi with diet and exercise, and generally being healthier could make a difference. Fortunately it did make a huge difference so it's motivated him to keep on with it!

I think doing the health kick together helps you both feel that you are in the battle together. Though I am still a big advocate of treats and couldn't cope if we didn't have nice food every now and again! 

Xxx


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## Sbarky15

How come they do blood tests for chlamydia? Seems a bit daft and a waste of time considering you can get tested for anything like that quite promply (in my area u can anyway). 
I will be quite miffed if i get asked to do this again as my husband I did these tests via swabs at the time we got together, so we know we dont have clamydia.


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## hle

I believe stds can stop you from conceiving and we haven't been tested so I guess they are covering all bases.

Thanks


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## Cloudy

MrsBarky15 said:


> How come they do blood tests for chlamydia? Seems a bit daft and a waste of time considering you can get tested for anything like that quite promply (in my area u can anyway).
> I will be quite miffed if i get asked to do this again as my husband I did these tests via swabs at the time we got together, so we know we dont have clamydia.


It's just part of a standard bank of tests that everyone has to do within so many months of starting treatment (12 months in my area I believe).

Sadly they cant take peoples word for it that they have been faithful im afraid.

You may find that they test you repeatedly for some issues: I had to have about 3 sets of transvaginal ultrasounds and blood tests which felt unnecessary but it was all part of the protocol to ensure their data is correct and their recommendations based on current facts.

Xxx


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## Sbarky15

Oh ok fair enough!
I just thought with us both having the swabs done already, that we wouldn't have to endure that part again!!  
But i suppose its a drop in the ocean compared to everything else that will be done to us.

Thanks


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## Cloudy

It's definitely the easiest bit!

One consolation may be that Mr C didn't have to have any swabs done, just me - which may not be a consolation because I have to say I love causing Mr C embarrassment  

Good luck!xxx


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