What’s the NHS pathway?

Hi. My husband and I live in the East Midlands, UK. Private semen analysis showed severe oligospermia (<1 million sperm/mL), with poor morphology and motility on the very few they could find. GP said he has to have another analysis in 8-10 weeks before they can make any referrals and referral has to be in my name, as the female. Local NHS fertility clinic said it’s 7-8 months wait for a gynaecology referral (which seems a bit bizarre, as surely he needs to see a urologist), and a 4 month wait after that to be referred to the fertility clinic. Does that sound about right? I’m really confused about the pathway and what is supposed to happen next. I think I will have to have various tests (AMH, ultrasound, etc.?) before they will make any referrals to secondary care. Even though we know my husband has a fertility problem. We obviously want to get on the NHS pathway ASAP, but have also booked to see a private urologist. Hoping if we get a diagnosis privately, we could bypass that part of the NHS process? Thanks in advance!

Show your support

It's correct he needs another test, they sometimes recommend 3 months apart but 10 weeks sounds ok, this is because factors can vary so much between tests so they always need 2 to compare. Referrals also have to be in your name as you're the one going through "treatment", I found this quite confusing as well as I don't have any fertility issues it's only male factor. Some places like you to have gynaecology testing done to ensure there isn't combined infertility, just to ensure your tubes aren't blocked etc. It's likely they will not refer to a urologist, as the "treatment" is IVF, so urology can't do anything to help. My husband has a varicocele and they said it wasn't guaranteed to improve his sperm if it was treated, as a huge portion of the population have varicoceles and have babies anyway, so they're not certain it would be making a difference. This is why we didn't pay for a privaye urologist in the end, and chose to get on with treatment anyway. Cont:

Cont: I would look at what your local ICB have agreed to fund, if it is only one round like my area it might change your opinion about waiting for NHS treatment. We decided to go straight for private treatment (ICSI) and I'm now pregnant from our first ever transfer

I think the reason you need to see a gynaecologist is because the treatment to have a child if the male partner has low sperm is IVF. So although it’s your partner that has a “fertility issue” it would be predominantly you going through a treatment. I may be wrong, but I’m pretty sure all they will do for men is check for blockages (which he presumably doesn’t have if there is some sperm present) and then recommend lifestyle and dietary changes. Good luck x

In the meantime, make sure you are aligning health markers for yourselves to give your scores the best chance. I’d recommend reading “it starts with the egg” which tells you all about supplements and improving egg and sperm quality. The nhs system can take a while and they sometimes want to do chromosome testing on the male which takes 6 weeks alone to get the results back. I’d say do your part now so you are giving yourselves the best start.

‌

‌
‌

‌

‌
‌

‌

‌
‌

‌

‌
‌

‌

‌
‌

‌

‌
‌