• Rose Unwin

What to ask your GP at your first NHS fertility appointment

Updated: Sep 11, 2021

You've been trying to conceive for several months, or even years, and you've finally plucked up the courage to book an appointment with your NHS GP to seek help. Well done for getting this far - you've taken the first proactive step to understand your fertility and find a way to conceive that baby you dream of. It's always best for both partners to visit the GP as fertility problems can affect either or both partners.

You've got a mere 10 minute appointment to discuss a hugely detailed, complex and emotional topic.

What should you tell your GP and what should you ask your GP? Let's break this down to help you maximise those 10 minutes.

What you should tell your GP

  • how long you've been trying for

  • how long you've been off all methods of contraception

  • your health history and lifestyle

  • your partner's health history and lifestyle

  • what your menstrual cycle is like: length of cycle, regularity and consistency of cycle, length of period, when ovulation occurs (if you know), any pain or other symptoms

  • sexual activity over the ovulation period

  • details of previous pregnancies and possible miscarriages

  • any tests you might have done

If you don't know much about your menstrual cycle then now is the time to start tracking. It's very easy and using an App like Fertility Friend or Clue will help you. You should be tracking BBT (basal body temperature) and cervical mucus every day, yep every day. And tracking energy, mood, exercise, sleep, libido, acne and skin etc help to build a good clear picture. Usually women find it fascinating to see the trends, when they have most energy, when their libido is highest or lowest etc. For me, energy and libido increase steadily from day 1 of my cycle up to ovulation and then start to wane. My skin is bright and clear over weeks two and three of my cycle but then I'll get some acne in the days before my period is due. There are also two different regular points in my cycle when my sleep is disrupted and now I know that, I relax when it happens and I enjoy reading more of my book in the night instead of fighting the sleeplessness.

What to request from the Doctor

Tests for the woman

  • blood hormone analysis on day 2-3 and day 21 of your cycle

  • thyroid test

  • AMH test

  • general blood tests

  • STI screening including chlamydia

Tests for the man

  • sperm analysis

  • sperm fragmentation (often the NHS say no to this so you'll probably have to go private for this one)

  • general blood tests

  • STI screening including chlamydia

Physical examinations

For the woman

The GP may weigh you to see if you have a healthy body mass index (BMI) because being overweight does decrease the chances of conceiving quickly and naturally. The GP may also examine your pelvic area to check for infection, lumps or tenderness, which could be a sign of fibroids, ovarian tumours, endometriosis or pelvic inflammatory disease (PID).

For the man

The GP may check your testicles to look for any lumps, varicoceles or deformities, as well as your penis to look at its shape, structure and any obvious abnormalities.

After a physical examination, you may be referred to a specialist infertility team at an NHS hospital or fertility clinic for further tests.

Referral to a fertility Doctor

When it comes to getting a referral to a fertility Doctor, it’s likely you will be told to have tried for 12 months+ if you’re under the age of 35 or 6 months+ if you’re over the age of 35. It's up to you whether you're honest about how long you've been trying to conceive for. It can be a stressful and upsetting journey so there s no judgement passed from me if you say you've been trying for a little bit longer than you actually have in order to get the referral process underway.

Top tip

From reading this blog you can see how much needs to be covered in that 10 minute appointment. For this reason I recommend that you write or type and print out the information you need to share with the Doctor. You can hand this piece of paper over on arrival. You can also print off a list of the tests you need and any other pressing questions you'd like to ask. The NHS GPs vary in how up-to-date they are on fertility protocols so you absolutely must advocate for yourself. It may feel pushy, but you can be nice whilst insisting on the tests above. The results of which will build your fertility profile and help to diagnosis a possible underlying issue. Only then can you move onto step 2 - the action plan.

Good luck!

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