fertility questions - your experiences and info please

[beaniesteve]

Hi there.
My doctor did some blood tests on me last week and said at the same time she would test my hormone levels.

Just got them back and here's what they tested for and what they say:

FSH test = To evaluate the function of your pituitary gland, which regulates the hormones that control your reproductive system CAME BACK 'NORMAL'

LH = LH blood test measures the amount of luteinizing hormone, LH is a protein hormone released by the anterior pituitary gland. In women, an increase in LH levels at mid-cycle causes ovulation. Came back NORMAL

prolactin & progesterone = To do with stress and fertility - Came back Normal

So - my questions are... for those of you who have also had these tests... can you explain a little more. Perhaps if yours came back abnormal, what did that mean for you and your fertility and what other investigations did you have to have?

Also - if all these things come back as normal and you still had no success getting pregnant what was the next step?

[AttilaTheMeerkat]

Was the level of LH was compared against that of FSH by the GP?. If this was not done the test is meaningless. It is important to compare LH against FSH as it is only then that any hormonal imbalance can be seen (also such levels can appear okay if only looked at separately).

I would hope that the LH/FSH test was done on say day 2 or 3 of your cycle and the progesterone was done around day 21. These two tests are standard tests.

If these tests were not done around these dates then the results cannot be taken as accurate.

Your man should be tested as well to either confirm or rule out any male factor problems.

All the above tests in my case came back showing a LH/FSH imbalance and no ovulation (progesterone level was too low because of LH and FSH imbalance. My diagnosis was PCOS).

You should be referred to a subfertility unit as a matter of course; the GP can do only so much and you need a diagnosis first and foremost.

[beaniesteve]

All done at the same time unfortunately - about day 4 of my cycle. I was having other tests. I think I will ask the GP about the comparisons

Just got the tests over the phone.

BTW - I have only been trying since the end of October, the tests were not done because they think there's a problem, just that I had other blood tests done for someting else and she said she would ask for some extra tests to be done while they were taking blood anyway.

[PoppyField]

Ok... the answer to your question all depends on where you're at...

How old are you? Have you been trying to get pregnant with your partner for a while now? How many children do you want?

I had unexplained infertility i.e. all my tests came out fine but I wasn't getting pregnant.

My advice is all around how old you are. I started trying to get pregnant when I got together with DH when I was 34. I waited three years before starting to worry. In hindsight that was far too long. His sperm was fine. I got tested as per your list, went to a consultation our local IVF clinic and then we left it another year, thinking it was 'bound to happen'. It didn't. If you're in your thirties, I would say you should make further investigations into assisted fertility if you haven't got pregnant after a year of trying...then you have time to get treatment if you need it, and if in the meantime you get pregnant naturally then that's fabulous. I found it hard to accept that I was in the infertile category - I think this is one of the reasons we left it so long. It is a hard thing to accept, especially if everyone else in your peer group gets knocked up quite easily. Perhaps if you know someone who has had successful fertility treatment, you could approach them for their thoughts.

IVF finally worked for us last year and my lovely daughter is now four months old (and slightly ratty that I'm taking time out to answer your message!). I am 42 now, which means I am cutting it fine if we want to have another child - which we do.

We kept thinking 'let's give it another month' and that way the years went by far too quickly, looking back. Ask yourself some serious questions and then seize the day! Best of luck, Poppy

[AttilaTheMeerkat]

Testing for progesterone as a matter of course needs to be done far later in the cycle. The result you've therefore been given for progesterone is not accurate.

Again if the level of LH was not compared against that of FSH then this is not fully accurate either. My guess is that the levels were not compared.

Regardless of the final result I would ask to be referred to a subfertility unit for further evaluation.

Unexplained infertility is infact no diagnosis at all - what this means is that the docs have so far failed to find out what is wrong. If you are over 35 gynaes like to see people after six months of ttc without success.

[beaniesteve]

How old are you? I'm 37

Have you been trying to get pregnant with your partner for a while now? I've been trying since late October

How many children do you want? two or three in an ideal world but I would be happy with one.

I am worried about leaving it too long - but I still think I would have to wait for a year before I could expect the NHS to do any more tests.

Can I ask to be refered to a sub-fertility clinic this soon after starting to try? I was attempting to be chilled about this, after all I have not been trying for long and I have several friends who have given birth to children well into their late 30s.

[AttilaTheMeerkat]

As previously mentioned if you're over 35 gynaes generally like to see people after they've been trying for six months without success. If periods are very painful and or irregular in nature then it is best to seek medical advice sooner rather than later. As it can take a couple of months to get an actual appointment at a unit anyway there's no harm in asking for a referral now.

Generally speaking as well fertility declines with age.

[beaniesteve]

yeah

I suppose even though I know that (the age thing) I kinda hate the way everyone makes a big panic about it

I'll ask my doc.

My periods are regular and painless. They are fairly heavy, though this month my period was slightly early but then lasted the 'normal' time.

Came off mini-pill in Oct.

[DungunGirl]

Hi Beanie

I have been through a similar saga. DH and I have been TTC no.2 for the last 12 months with no success. I have a DS aged 3 who was conceived in 3 months, so I know I can get pregnant.

I have gone for all the blood tests....recently had FSH and LH levels compared on day 4 bloods. NORMAL

Thyroid function- NORMAL

Testosterone - first test- day 21 came back HIGH, so repeated the test on day 4....NORMAL

Progesterone - Day 21 came back VERY LOW first time. Second time came back WITHIN NORMAL RANGE.
I am having another test done this month.

Ultrasound scan - External scan showed Polycycstic ovary.
Internal scan showed both ovaries are polycycstic.

So go figure!!!!
Have you had a scan? I think you should as so far my blood tests have confused everyone. At the moment all is NORMAL so why no success? Well...the scans have shown there is a problem.

Good luck! Try and get reffered to the subfertility clinic. Be prepared for 5weeks-2 months wait to be seen though!

[beaniesteve]

I am having a scan soon (waiting for an appointment) because of a swollen gland in my groin area, it's not been arranged because of my trying for children but I guess I could ask them to have a check? I was scanned about 5 years ago also because I had pains in my left side - they found nothing but again I doubt they were looking at my reproductive system.

[Onlyaphase]

Agree with others esp Poppyfield

I started TTC when I was 32, waited nearly 3 years before asking GP for help. In retrospect this was a huge error, waiting this long, but I couldn't deal with the fact I might be infertile. Hormone tests showed everything fine, still no baby so referred to hosp consultant for more invasive tests. These showed blocked tubes (this is over 3.5 years after start of TTC!) and exploratory surgery recommended - 6 month wait for this and then it would have been 10 months wait after surgery for IVF if we had waited for the NHS to deal with things. Luckily for us, we decided enough delays had already occurred and referred ourselves privately to an IVF clinic. One cycle of IVF later - DD arrived when I was 36. Am now 38 and trying IVF again, but time is NOT on your side in your late 30s when going through IVF. Your hormone levels drop and there is nothing you can do about this.

You may be fine, indeed I hope you are, but please don't think that hormone tests are all that is needed to be done. If you have a physical problem like blocked tubes then this will only show with more invasive tests done after a subfertility referral. If nothing is wrong then great! But as the referrals and tests take so much time, best to start the process now and you can keep trying naturally in the meantime.

Hope all works out for you very soon

[Onlyaphase]

Oh, and re your point about the scan coming up? The test they do for blocked tubes involves shooting dye or bubbles (depends which test) under pressure in your uterus to see if the dye or bubbles comes out of the ends of the fallopian tubes, and hence to see if they are clear and open. This test can only be done on certain days of your cycle and in my opinion isn't something they can "check" whilst scanning for something else. This is one of the first things a subfertility clinic will look at.