# First appointment with consultant



## sully86 (Jul 23, 2018)

Hi,

I would just like to know what questions I should be asking our consultant in our first meeting? 

My journey so far;
I have had some initial tests already - up tp date smear, TSH, immunity to rubella, AMH & chlamydia.

On Tuesday I am due to have HyCoSy and then an appointment with the consultant. 

I am in a same sex relationship. I want to go down IUI route (provided HyCoSy is ok). I would also like to do medicated IUI.

Most people have been in my situation on here and have asked questions. Please don't read and not reply. 

Thanks,
S


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## kernuack (Feb 23, 2018)

Hi there,

Not sure I can help that much - I'm only a few weeks ahead of you by the sounds of it. Also in a same-sex relationship. We had our first IUI 16 days ago and are just waiting on the result of that now (should let us know today in fact! Eek!).

Our consultant wasn't amazing to be honest. Our clinic is good, and other people we've seen have been great, but because we don't actually live in the city where our main clinic is, we use a satellite service nearer to us, and we both felt our consultant was a classic academic - a researcher rather than a clinician, and lacking in people skills. Both my wife and I work in academia ourselves, so we know the type - no major biggie there, but I'm highlighting it only because it might have affected how that initial consultation went. For instance, they noted that my prefix is Doctor and I think they then went into very high level discussion mode, using lots of jargon, and basically trying to be the smartest person in the room. This was obviously not very helpful since I have a PhD in social sciences, not a medical degree!

Anyway. We already had our AMH and HyCoSy results before going in. The consultant at the main clinic actually performed my HyCoSy themselves, and did a great job of talking us through what they were seeing. So we already knew IUI was viable, and the route we'd probably take. Although I had received a report on my AMH, and it told me my levels were normal for my age, I didn't really have a clear idea of what that meant in practice. Obviously what is normal for a 35 year old is very low for a 20 year old - so how does AMH actually affect fertility? We asked our consultant about this, and they explained it's more about how your ovaries will respond to a medicated cycle - your chances of over-stimulation and having multiple births - than anything else. We talked through the statistics of IVF vs. IUI-medicated vs. IUI-unmedicated. I knew all of this stuff before, so it wasn't really new information. The consultant recommended either IUI-medicated, but with very 'gentle' stimulation (i.e. letrazole, not clomid or gonal-f), or going unmedicated and reviewing after a few attempts. We ended up deciding we'd rather try the first one unmedicated as my cycle has always been pretty regular. There is really only one or two percentage points in it either way, and it seemed best to us since there were no signs that I wasn't ovulating normally.

The other questions we had were more about the protocols and procedures at the clinic. At that stage we hadn't even picked a donor. Our consultant advised us on who to speak to at the clinic about that, and made sure we knew to chase up our GP on rubella and recent smear test results. Apart from that, they weren't great about advising us on any of the usual arrangements, since as I explained, they only work part time and only at the satellite clinic. We ended up getting far more information from the nurses, particularly at our consents appointment further down the line.

Things I wished they could have advised us on at that stage were all about practical arrangements. I'm hoping your consultant will be more clued up than ours was! Things to ask: How often do they do the monitoring blood tests (to look for LH surge)? can you get early morning or after work appointments for those? how do we/they go about ordering the trigger drugs (or other drugs if your consultant agrees you should go medicated)? how should those drugs be stored? what are you likely to need to self-administer, and which do you need appointments for them to do? can you buy unwashed sperm and have it washed at the clinic? if so, is there a fee for that?

Little things sneak up on you. Going unmedicated I only had to inject myself with ovidrelle twice, but I needed to take time off-work to take the delivery of that as it needed to go in the fridge right away. I didn't know that until a few days before we ordered it, which could have been awkward with work, but ended up being fine. It was important to me to try to stay on top of things like this, as you get no real say over when they do the IUI (and that requires almost a whole day off for me to get over to the main clinic and back). I didn't/don't want to burn through my boss' patience by rocking up late or taking days off at short notice unless it's for the IUI itself - I haven't told work that I am trying to conceive as I am on a fixed contract that I'd like to get renewed at some point, so right now they just know I have unspecified hospital appointments every now and then. 

The only other thing I would advise is that you and your partner take advantage of any counselling you are offered. It gave us a lot of peace of mind to know that we had already talked between ourselves about the vast majority of things the counsellor suggested thinking about, and I think it's helped us to prepare better if we get a bunch of BFNs along the way. Oh, and don't panic if you walk away from that meeting and then think of a bunch of questions you wish you had asked. You will get other opportunities to ask along the way, and as I said, often the nurses are the best people to ask. You will have a good chunk of time at the consents appointment, before they do the first IUI, to ask about anything you've forgotten about. Things will come up, they always do, and each clinic does things slightly differently so reading about other people's experiences is not always as useful as you think it will be. Just don't be afraid to ask when things are going too fast or when you are unsure, and you'll be fine!


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## sully86 (Jul 23, 2018)

HI Kernuack,

Thank you so much for the reply. It helped. Best of luck with the results 

I work within the NHS so I will keeping it quiet as this area is not my expertise. I find when you have any dealing within the NHS people assume you know what they are talking about.

It is interesting the difference in percentage of unmedicated vs medicated IUI. I had not appreciated that. I too am regular, and had my mind set with medicated IUI but I will now review that.

That is a good point about the medications - where they are delivered to, storage - I hadn't really thought of that. I assumed they medications would be sent to the clinic. 

My partner and I were not so keen on counselling but when thinking about how this is affecting us emotionally already, we have decided that it may be beneficial to us - especially if we end up with a BFN.

Thanks again,
S


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## kernuack (Feb 23, 2018)

Be warned: a lot of the initial counselling is oriented towards the fact that you are using donor sperm. I think this is obviously a more sensitive topic within heterosexual couples, but for us we were like 'how else were we going to do this thing?!'.  Thankfully our counsellor was awesome and spent only a few minutes 'ticking the boxes' so to speak, and allowing us to talk about our real concerns - like raising a child who might get bullied because of their mums, amongst other things.

Thanks for the good wishes - it worked! We got a BFP on our first try. It feels very surreal! The joy has been tempered somewhat by the appearance of some pinkish spotting today, but I have a GP appointment tomorrow so I'm not too worried. I mean, there's not much anyone can do either way. I'm not in any real pain, and I've heard this is not unusual, so just trying to stay optimistic at this point. As a wise friend of mine pointed out to me today, when you choose to have a child you're signing up to a lifetime of worrying about them. There's no part of this process that's not scary or without risks.

Good luck on your own adventure!


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## sully86 (Jul 23, 2018)

Hiya,

If we do counselling, I'm hoping our counselling sessions go like yours!!

A BFP!!!!! Hope the GP visit went okay. Keep optimistic no matter what.

S


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