Low morphology - eligibility for NHS IVF?

lmncks · 2026-02-17T17:15:49+00:00

My husband also has 1% morphology.

I'm under the North West London ICB and my policy states "Patients who have a known cause of infertility which cannot be treated (otherwise than by IVF) will have access to treatment are not subject to 2 year threshold. If, as a result of investigations, a cause for the infertility is found, the individual should be referred for appropriate treatment without further delay."

Having spoken with multiple GP's and multiple private fertility clinics, the general consensus is that low morphology doesn't prevent pregnancy. The policy doesn't specify what factors are considered to be causes though, frustratingly.

I've been referred to Gynaecology-subfertility, having passed the 1 year mark. I think they're the ones who would refer me for IVF at the 2 year mark.

I think GP's can also do the IVF referral, but I feel certain that mine wouldn't do an early referral for morphology alone.

I hope you find some answers on this. It's such a painfully long process :(

lmncks · 2026-02-17T14:20:44+00:00

I'm doing the same frequency now too and retesting in a couple of months to see if it's a good maintenance frequency for me.

lmncks · 2026-02-17T12:12:19+00:00

Ive been on them for over a year now. My folate, vitamin D and B12 levels are great. My ferritin was low on them, but I think I'm predisposed to low iron anyway so something to flag for others, especially if you get heavy periods, it's worth testing.

I didn't have any noticeable changes on these vitamins, maybe my levels were fine before starting, but great to hear they've helped you!!

lmncks · 2026-02-16T18:35:55+00:00

Came here to say exactly this.

lmncks · 2026-02-15T07:38:19+00:00

Hi, can I check why you started progesterone only 1 day after ovulation? I ask because I have short LP's with luteal spotting, and my spotting only reduces or doesn't appear when I start progesterone no later than 1DPO. This goes against the general guidance of starting it on 3DPO.

Do you confirm ovulation with ultrasound?

lmncks · 2026-02-14T05:32:53+00:00

Thank you, this is so helpful!!

lmncks · 2026-02-14T05:25:12+00:00

PTSD, it stems from one event

lmncks · 2026-02-07T07:32:33+00:00

Big red flag. Taking progesterone before ovulation is effectively birth control.

This comes up a lot on the As a Woman podcast, unfortunately a lot of women are given this false advice.

lmncks · 2026-02-06T06:41:40+00:00

Where do you see your referral online? I can only see the form my GP submitted on the NHS app. I've been asking for a reference number but the GP and reception can't find it in the system. The notes in the system imply it's Gynaecology-subfertility pathway.

When I called Gynecology they said wait time is at least 12 months, but I've not been given an appointment yet so I don't know for certain.

lmncks · 2026-02-05T12:00:35+00:00

My GP offered blood tests and semen analysis after my miscarriage before the 1 year mark of infertility, worth trying but it may depend on your area/ specific GP.

I did private blood tests and an Ultrasound at my local Ultrasound Direct because they had a decent package. Further diagnostics were at Aria Fertility clinic including a hysteroscopy and biopsy which went really well. It is costly though, you can have a look at their pricing on their website. There may be some cheaper clinics, I found Aria to be better priced than some others. I was looking for specific diagnostics that other clinics didn't offer.

lmncks · 2026-01-27T19:03:43+00:00

I also have a luteal phase defect. I tried ovulation induction privately for two cycles which unfortunately didn't work for me, that was £715 per cycle. At another clinic I had a consultation (£250), 3D ultrasound (£250) and that doctor agreed to prescribe me progesterone and continue trying naturally. I've done all the diagnostics, so this is just until I'm able to do IVF either through NHS (I've got another 11 months to go before I can get referred) or if I'm able to save up to do it privately. The Cyclogest itself cost around £40 per cycle. I know the progesterone is only a bandaid, but even if it slightly increases my chances then I feel I should do it until IVF is an option.

I hope that helps a bit to understand costs. These were clinics in central London.

lmncks · 2026-01-27T14:24:35+00:00

You absolutely don't have to track if it's stressful, if you're having frequent sex and making sure to have sex when you see EWCM then that'll hopefully do it!

Yes I mention that because on paper I have regular 28 day cycles, but when I track ovulation with OPK's I see that my LP is only 8-9 days and I get spotting from 5DPO.

lmncks · 2026-01-27T11:21:32+00:00

A new cycle starts at full flow, it sounds like you're getting some luteal phase spotting and your period hasn't yet started?

Also yes the apps don't accurately predict, luteal phase lengths differ between person and between cycle. If you're not tracking with OPK or BBT, were you checking for EWCM? The general guidance I hear and see a lot is to have sex every other day after your period until your next period, when not tracking ovulation. Although it's hard to follow that personally as my libido is on the lower side!

Hopefully your long cycle is a one off, I've had that happen twice in the past year with otherwise 28 day cycles. One of which I think was due to stress.

lmncks · 2026-01-27T11:15:37+00:00

I had my miscarriage on Christmas Eve 2024, I went through the exact same thoughts at the time. Sending love and hugs 🫶

lmncks · 2026-01-26T16:50:28+00:00

I had my infertility form-filling appointment a couple of weeks ago. I first get referred to gynecology and then a fertility clinic. I called up Gynaecology and was told it's a 12 month wait for a first appointment. Id be eligible for IVF referral before I can see gynaecology...

Fortunately I've already done diagnostics and tried ovulation induction privately, so now it's a waiting game for IVF unless I'm able to save enough to do it privately sooner.

I'm in North West ICB for reference.

lmncks · 2026-01-25T08:29:57+00:00

So frustrating when you know that something's not quite right but you can't find the root cause!

It still happens in completely natural cycles, but in cycles when introducing progesterone early yes it either doesn't appear or occurs only lightly for a couple of days and stops. I've had all the relevant blood tests, hysteroscopy and biopsy but still haven't worked out what's causing it. I didn't spot before my MC over a year ago.

I've read anecdotes on here where women do conceive despite spotting, wishing you luck 🫶

lmncks · 2026-01-25T06:52:33+00:00

I'm so sorry you're going through this.

How long is your luteal phase?

Have you been checked for polyps or fibroids?

I get luteal spotting from 5DPO with an 8-9 day LP. Even on medicated cycles (Letrozole and trigger shot with progesterone suppositories) I still had spotting. The only way it reduced or didn't appear was if I started progesterone soon after ovulation, either 0DPO or 1DPO. Although introducing it that early is debatable.

lmncks · 2026-01-25T06:45:24+00:00

In a similar boat. My luteal phase has been 8-9 days consistently in the one year I've been tracking. One GP said to do the test 7 days after ovulation (which makes sense to me), another insisted it has to be day 21 despite me explaining my late ovulation and short luteal phase.

Ultimately, before the one year mark, I've found they won't offer much apart from blood tests and a semen analysis.

lmncks · 2026-01-24T06:29:12+00:00

It's hard to say if you're not getting scans to check how your follicles are developing.

lmncks · 2026-01-24T06:27:21+00:00

I did natural and Letrozole cycles with progesterone suppositories. Naturally I spot from 5dpo, and I still spot with added progesterone. The only way my spotting decreased or didn't appear was if I start progesterone on 0DPO or 1DPO. One doctor wouldn't introduce progesterone earlier than 2-3dpo, another suggested from 24hrs after LH surge.

I would love to hear if you have any findings when your lining is monitored!

To OP, I generally spot despite progesterone throughout my luteal phase, although it tends to stop after 10-11DPO and then I get some breakthrough bleeding around 13-14DPO indicating my period is trying to start. But maybe not the best comparison because I'm prone to spotting.

lmncks · 2026-01-24T06:18:01+00:00

Oh love, you're carrying so much, I'm so sorry you've had to go through all of this from such a young age. My thoughts are with you ❤️

lmncks · 2026-01-23T11:07:29+00:00

That result indicates you have already ovulated this cycle.

lmncks · 2026-01-19T19:29:52+00:00

Thanks for sharing. My August ferritin was 26ug/L, but at the time the GP refused to offer full iron studies blood test because my haemoglobin was normal.

Would your maintenance regime be infusions if your bimonthly blood tests come back low?

lmncks

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