# Broody "starter kit"



## Mada1 (May 31, 2013)

Hello everybody,

tomorrow big day: I will see my gp to get referrals for my basic fertility tests. Thanks to all of you I now know that to undergo a fertilty treatment I need to do what follows (not everything is mandatory everywhere but with all this info it's easeier to identify the best technique for each woman) . Could you please double check my list and let me know if I am missing something or even getting something wrong? I put in red  what I am not 100% sure myself.
Thanks,
Mada

1 ) track BBT for ovulation, everyday at home, as soon as you wake up.
2 ) track CM for fertile days, every day at home.
3 ) check LH at home with Ovulation stick test, starting few days before presumed ovulation date according to the length of you cycle.
4 ) exercise to keep my circulation healty and my weigth in the optimal range
5 ) get my tubes checked before ovulation ( HSG), any time of the month.
6 ) get my hormones checked: LH, FSH, E2, AMH and Prolactint on cd1-3, progesteron 7days after ovulation.
7 ) standard ovary/follicle scan cd 1-3.
8 ) test AMH for ovarian reserve, blood test any cd.
9 ) get a smear done, any cd but period.
10) other basic blood check such as HIV, toxoplasmosis... even if you know you're fine most clinics requires this to be proven by recent analysis so why not getting all info together at the beginning?
11) healthy fresh food + concemption multivitamins supplement.
12 ) quality sleep.
13 ) investigation on family related issues.
14 ) record other relevant symptoms such as cramps, spotting, mood... easy to be done with online application or mobile apps.


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## patiently queuing (Nov 15, 2012)

Mada,

Good list. Just a few pointers...

1) You can check BBT but you must do it at the same time each day, as soon as you wake up. You're probably getter off checking LH surge using ov pee sticks from c.day 8 of your cycle. Mid morning is the best time.
2) CM correlates with LH surge, so check in with 1) above.
3) See 1)... LH surge comes 24-48 hrs before ov so you need to start checking sooner.
5) You can get your tubes checked any time of the month.
6) Try to get your GP to check LH, FSH, E2, AMH and Prolactin. Re Progesterone check, this needs to be 7 days after ov, which won't necessarily be CD21.
7) Re follicle scan, you want to know your natural follicle count (AFC) so will need this at the start of AF (CD1-3).
 As above, try and get your GP to do with baseline hormone profile, they 'might' do this.
9) Yes, any day.
10) Get your GP to test your Thyroid function, thrombophilia panel, and anything else they're prepared to do, eg liver function, kidney function, folate levels, Vit D.
11) The best you can do re foods is to eat healthily, no ready meals, fast food, etc.

Good luck!


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## goldbunny (Mar 26, 2012)

in 'investigation' terms you could add 'ask mother/sisters/(aunts?) (if you have them) about anything that affected them' people don't always volunteer information because they don't think it relevant or whatever but it might turn out to be useful (you probably did this already I am just trying to 'complete' the list).. 

if you were being really thorough you could consider having allergy testing done - I didn't, didn't think of it really but once you are in a 2ww or early pregnancy stage, you want to try not to aggravate your immune system... so in theory it could be useful to know what to avoid.. 

in terms of 'to-do list' start taking a conception multivitamin and get plenty of good quality sleep, and keep a diary of everything. 

 good luck


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## goldbunny (Mar 26, 2012)

if you start fertility treatment i think they'll want you to have had up to date rubella injection, if you were not under a clinic but starting fertility investigations it might be worth checking your immunisation history and getting anything done that is not up to date.. 
also get anything else done that is outstanding for example, get to the dentist! (yeah I know, who wants to?) they have shown that inflammation is bad in fertility terms and that includes gum inflammation so best get all sorted before you start.


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## Mada1 (May 31, 2013)

Dear All, 
thanks a million for your help, I updated the list in my first post, hope I included all your suggestions correctly. If I did not please feel free to advise. Hope you don't mind I did not add all blood test names, and other analysis such as allergy tests as my purpose atm is to compile a basic list, that I can use to find out potential major issues in order to decide which technique better suits me. Consider that beside the fact that I am 37 and single atm I have no info at all on my fertility so if everything is OK I will consider a first shot with home insemination , with tubes issues I would go straigth to IVF.

If you think above list is not good enough to make such decision please let me know .

Thanks again for your support , I can see from your signatures your fertility journeys are challenging you and I deeply appreciate that you find the time to support me with info and lovely wishes.
Fingers crossed for all of us, hopefully our dream will become true ( miracles can happen).


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## patiently queuing (Nov 15, 2012)

Just to say that thyroid function is v important to fertility.


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## Mada1 (May 31, 2013)

Dear patientlyquieng,
thanks for the tip, Iadded it to my list for tomorrow.
Good nigth


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## patiently queuing (Nov 15, 2012)

Have a read of Agate's file, 21.3: http://www.fertilityfriends.co.uk/forum/index.php?topic=242395.msg3904740#msg3904740

Also, Vit D is important; your result should be about 90-100.


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## Mada1 (May 31, 2013)

HI All ,
I like my gp but I am a bit confused after my first chat on fertility....

I am on cd 25 and she took my blood for all basics analysis ( thyroid, HIV, liver...) but also for alll hormones... LH, progesteron, prolactin estradiol, testosterone...
She told me we will take next sample for hormones at my cd 5...
she will be able to get organised to send AMH sample to the lab not earlier than one month from now because they need to be sent to Dublin... 
She said only Histeroscopy can be done to check tubes and that no fertility clinic will do it to a single lady... she will see what se can do but she does believe nobody will check my tubes here as I am single...
I asked her about HSG she said nobody does it here... so I asked if I have to travel to another country and she told me she will do some search and let me know once she will have blood results.

I will go back to  google and do some search to see if I can find the gynaecologist willing to HSG me and then I wil  tell her the name for the referral letter myself. hopefully i can find one in dublin.
Nothing is covered by insurance, I will pay anyway so I don't understand why they make it so complicate...

do you think it is a good idea to get hormones tested on day 25 and 5 of the followng cycle ?and would you consider having an histeroscopy instead of HSG...isn't it more invasive?

Please let me know what you think of the overall too, it sounds so vague to me


Thanks for your comments.


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## patiently queuing (Nov 15, 2012)

Hi,

Sounds like your GP was as helpful as she could be, although the 'G' in GP gives a clue to everything... general, not specialist!  

My comments are:

-  No point doing LH, Prolactin or E2 on CD25 (they are CD1-3 tests); Progesterone 'may' be useful but only if you know when you ovulated.
-  Hormones should be day 1-3, not day 5; your cycle is part-way in by then.
-  AMH - well done!
-  HSG; I'd be incredibly surprised if no one does it in Ireland (imagine?!).  
-  A hysteroscopy CANNOT tell you if your tubes are blocked or not; that's a laparoscopy and it's invasive, so I'd go with an HSG if you can.


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## Mada1 (May 31, 2013)

HI,

thanks a million for your reply, these are heavy days forme for other reasons and it i s really nice to have at least your support with this.

_- No point doing LH, Prolactin or E2 on CD25 (they are CD1-3 tests); Progesterone 'may' be useful but only if you know when you ovulated._

waste of blood and money...she told me it would tell me if I actually ovulated..

_- Hormones should be day 1-3, not day 5; your cycle is part-way in by then.
- AMH - well done!
- HSG; I'd be incredibly surprised if no one does it in Ireland (imagine?!). _

I am in the west coast but found a clininc in Dublin that offers all these tests for single women, even witout referral letter! 

_- A hysteroscopy CANNOT tell you if your tubes are blocked or not; that's a laparoscopy and it's invasive, so I'd go with an HSG if you can._
ooo yes, she advised the histeroscopy is an invasive laparoscopy but she said it is the only way to check tubes and that it is only provided to married women... however no way I am going for the invasive useless check 
The clinic in Dublin has a an analysis they call SIS ( from clinic website: SIS is an ultrasound procedure performed to (a) assess the direction of the neck of the womb endocervical canal, (b) confirm that the uterine cavity is normal ensure there are no polyps or fibroids, and, if applicable, (c) confirm the passage of fluid through the fallopian tubes into the pelvis... The doctor then fills the womb with sterile water or contrast media through the cannula in the womb. This profiles the cavity to confirm normality. The absence of any fluid before the test followed by the presence of fluid in the pouch of Douglas (a space behind the womb) afterwards confirms the patency of the fallopian tubes ) . the descriprion is the same as HSG so I hope I can do it there.

Basically I will grab my first exams from my gp, get my free smear there and then will try get an appointment in Dublin ASAP.
wrote them today asking if my cd1-3 blood sample can be taken here and sent to them so I don't have to travel twice...fingers crossed.

do you think this SIS is good enough to check my tubes? sounds good to me...


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## patiently queuing (Nov 15, 2012)

No problem 

The Progesterone test will tell you if you've ovulated, but you probably want to know 'when' you ovulated, to see whether you have enough Progesterone to potentially support a pregnancy.  There seems a lot of preoccupation with whether you ov or not; is there any reason you shouldn't??  But, from your note you say you're single, so I'm not sure what kind of AR you're considering.  Presumably IUI if you want to know if your tubes are clear?  You don't say what age you are.

I'd suggest this clinic you've found will be more helpful from your GP by the sounds of things 

The description of the SIS does sound like it should do what you need it to.


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## Mada1 (May 31, 2013)

Hi patientlyquieing,

I am 37, not a single gynae issue in the past, super regular period.
clinic is sending me via post all the docs to fill out to get an appointement, I wonder why they cannot send me a file...I really hope I can get an app within the next two weeks.

I had consistent spotting for first time in my life this week ( lucky me) and my previous gp, who knows me since I was 11 but that lives in my home country which is not Ireland, told me that it could  be related to a surgery I had in december , a day ward procedure to remove a fibroadenoma (all fine). I am now putting all pieces together and I think I maybe have high prolactin due to this...that would not be a good news. that's maybe why my new gp wanted to take all hormones straigth away , to see what's going on...

Tomorrow Ill call her again and hopefully she will have my blood results, then I book exams in Dublin.
depending on all results i will decide if i will go for home insemination with cryos semen, IUI or IVF .
fingers crossed and pressure on, already


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## Mada1 (May 31, 2013)

HI All,

I just got my hormones results but there are no min max levels so I dont understand what they mean. My gp is happy, she said they are normal for day 1 but I took them at day 25!!!!
could you please help me? I am sure there are somewhere here normal values at days 1-3 and day 21 and I would like tocompare my res to them but cannot find them.

Please help


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## patiently queuing (Nov 15, 2012)

Hi,

Not sure why your op would produce high prolactin?  

Hormone levels... you want to FSH to be less than 10 ideally, and LH needs to be low too (it increases to 10+ just before ovulation, and into the luteal phase).  What results do you have?  It depends on the measurements as well.

Re IUI vs IVF, you may get lucky with IUI and it's relatively cheap to have a few goes.  I'm sure you've seen success rates, etc. and looked on the boards here.


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## Mada1 (May 31, 2013)

My doc explained that the loss of a small amount of breast tissue ( which is a gland tissue ) can trigger  an endocrinal umbalance so the body migth increase prolactin levels to try to balance.
actually I still haven't found standard values so I post mines here, and if you know if they are normal for day 25 or for day 1 I would really appreciate your comments as so far I don't know what to think...

FSH  6.7
LH 4.1 
Eostradiol 109
Progesterone 1.8 
Prolactin 322
Testosterone 0.6  

My Irish gp said this match with a cd 1, my old gp said this match with cd 25 anyome please let me know who do you agree with , I am lost.   
cd1 would mean my period suddently decide to go mad exactly when I decide to TTC, cd25 would mean my progesterone is low for an ovulation...maybe...I am lost.   
Any comment deeply welcome.
Thanks


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## patiently queuing (Nov 15, 2012)

Hi,

Can kind of see where they're coming from re the comparison so late in your cycle, with CD1, but it's not optimal really when it comes to fertility.

FSH looks great. I'd say that based on both your LH and progesterone levels you have not ov this month, unless you have a short cycle, ie maybe AF has already started now?

E2, testosterone and prolactin look fine too. 

If I were you I'd take these results as fine, but track ov next month and do have bloods for progesterone levels 7 days after your LH surge is detected.


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## Mada1 (May 31, 2013)

Thank you very much for advising. I also tracked my temp and it dropped 1.2 degree progressively in the last 12 days. period late 2 days and me completely lost This is maybe the second time in my life it is late and I have heavy spotting. given that I cannot be pregnant and spotting was not a mc I don't know what to think...


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## patiently queuing (Nov 15, 2012)

Starting down the ttc road, with all the tests and new language can be v stressful. Don't worry, I'm sure AF will turn up soon.


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## Mada1 (May 31, 2013)

you are absolutely rigth.
On top of that I am alone with this, , my close friends are far and haven't shared with anybody here people around me are strictly religious, they would not be supportive..or at least I believe they wouldn't be so...
Thanks again for your kind words and for advise


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