Offering you greater context to what real life problems you can encounter in the medical system throughout your fertility journey…
And hopefully highlighting the importance of adequate testing for male partners…
Here’s Lottie’s journey…
Aged 32, newly married and after 8 months of TTC naturally both Lottie and her partner went to their GP for support. According to NICE guidelines (which FYI – their fertility advice is based on research from 2014!), GP’s will not refer fertility patients’ on until 12-24 months of TTC, depending on your age and history.
So my patient went privately, intuitively knowing that something wasn’t right.
Their fertility doctor ran the basic tests on both of them – female hormonal profile and sperm sample analysis.
Female hormonal profile was normal. Sperm sample came back with low quantity, poor morphology and rock bottom mobility too.
So they were immediately referred on for fertility treatment saying that natural conception would be impossible. ICSI was the only option.
Lottie was eligible for 1 treatment on the NHS but the first round failed, resulting in an early missed misscarriage at 8 weeks.
The second round was private but was delayed due to Covid, however it did result in 3 frozen eggs. Sadly, this was again unsuccessful and they were never offered any further investigations as to why.
It was then that I encouraged them to explore WHY his sperm sample was so poor and why they kept miscarrying.
This can be due to environmental or lifestyle factors OR medical reasons, as we explored in my previous email. Feeling confident in the fact they were doing all they could from a lifestyle perspective, they sought out the help of a Urologist.
Immediately, the Urologist identified the issue.
The patient had a varicocele. A thread vein or varicose vein on the testes which can impair blood flow and create localised inflammation, therefore destroying or mutating the tiny sperm cells during their development.
This is the simplest examination which the GP could have and SHOULD have done at the commencement of their fertility journey. It also has a simple treatment to address it.
But it was only after 2 years of emotional and physical trauma going through ICSI resulting in 2 miscarriages, plus £9k lighter paying for additional fertility treatment, that thorough investigations were conducted.
5 months later, they were pregnant naturally.
This story blows my mind yet it is SO COMMON.
Luckily, this couple were strong enough to keep going, actively seeking out support when intuitively they knew something wasn’t quite right. And finally, after banging on many doors, they got their happy ending.
My point here is clear. Be thorough at the commencement of your fertility journey and ask for both of you to have adequate testing where possible. This isn’t routinely offered on the NHS but by opening a dialogue with your consultant or GP, they should be able to help you understand what is going on and why.
There is no such thing as “un-explained” sub-fertility. Your doc just isn’t looking in the right places!
I hope that this offers you a little hope and drums in the importance of male factor testing/examination.