Dear Professor Winston,

My Husband and I are about to embark on the NHS as a first point of call to discover why we have not been successful in naturally conceiving. We started trying to conceive in June 2014 and we were successful very quickly but unfortunately this ended in a miscarriage at around eight weeks. We were fortunate in having a scan prior to the miscarriage because I was suffering from pain in my abdomen on the left side and therefore discovered what had gone wrong. A large lump had formed in the yoke sac and as a result the pregnancy did not develop further. A few days later I had a natural miscarriage. The pain in my left side was the result of a cyst on my ovary. Two weeks following my miscarriage I had another scan to establish if the miscarriage had been clear and was told at that time the cyst was nothing to be concerned about and that the miscarriage had not left anything behind and we should start trying to conceive again when we were ready.

Well, we have been trying and no luck. My cycle has been slightly irregular, although only by 1 or 2 days and periods shorter than before I was pregnant but we have been consistent in monitoring my ovulation via tests available from the pharmacy, but this isn’t always clear. Last month my period was late by a week which has concerned us further. Therefore, we are planning to book an appointment with our GP to ask for tests to establish if there is anything they can tell us. We don’t want to think that IVF is the first answer to our plight and therefore want to know if we should continue down this path or if we need to consider an alternative. Time is not necessarily on my side as I am 34 and would like to reduce the risks associated with a pregnancy over the age of 35. What we would like to know is what we should be asking the GP? Should we be asking for tests and if so what tests should they be? What we would like to avoid is having unnecessary, and potentially intrusive rounds of tests which result in additional stress and no further information.

It would be wonderful if you could provide some guidance on what couples should be asking GP’s in the first instance and we thank you in advance for your time.

Warm regards

Mrs P

Dear Mrs P,

Forgive me if I do not repeat myself. But I rather hoped that The Essential Fertility Guide published by Quadrille which I have just launched might be a suitable way of gaining information. The royalties go to the Genesis Research Trust and it is not expensive, and I hope this may give you some initial ideas when you visit your GP.

Best wishes
Robert Winston

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