What Should I Expect from an RE?

meredithcarole

Hi Ladies. I made my first RE appointment for Nov. 3rd and I am wondering what to expect. I have seen discussions, but I am not totally sure of what everything is. So here's what I am wondering:

What are the blood tests and what do they measure?

Do they typically do anything on your first visit?

How God-awful expensive is the testing?

Are there questions I should be asking?

Any and all insight is greatly appreciated.

boymamaco

Its been awhile since I had  my initial consult. I"m going back for a "regroup" next week to hopefully get started on #2. So I'll be interested in this thread. But based on memory - the testing they wanted to do included mammogram (anyone over age 35), hsg, day 3 labs. I can't remember past that. The testing was all out of pocket for me the first time as well will be for the second time. I just remember paying $150 here, $150 there, .... yadda yadda. It added up BUT they were very clear with me all the expenses ahead of time. 

They didn't do anything on my initial consult - other than the meeting with the RE and then a follow on appt with the nurse. The nurse is the one that basically puts your plan in action, and the one you'll have the most contact with. So as for questions, make sure you understand who you will hear from, who you can call with questions, to schedule, for clarification on something. You will definitely have lots of questions as you enter the process and knowing all their communication policies up front is most helpful. 

Hope that helps! 

emsmama15

My initial consult was a couple years ago too, but I vaguely recall what happened.  I had all my lab work and HSG done prior to going to the RE by my OB/GYN, so I brought copies of all that along.  They sent me a packet of paperwork to fill out (mostly about me, a few pages about my husband) - I brought that in before my appointment so they could look at it.  

At the actual appointment, we talked a lot.  My RE detailed what the plan going forward would be, I had an ultrasound, we got prescriptions and instructions on what to do when, and my husband got his SA information.  I didn't have a mammogram -- interesting.  

Good luck!

kindershlitz

I have an appt made for 10-29. I know I said December but why wait if they can take me? I was told the initial consult is $290. I also was told as long as things aren't billed with 'infertility' as the diagnosis it could be covered. I had an hsg already (oop cost was around $300 this was with the infertility diagnosis so who knows). My monitored appts on Clomid have been $40. I'm not sure how much oop I'll be out right away since I've had done things done and they requested a records transfer. As @lucyspeople‌ mentioned I feel like I've been slowly $40 here, $100 there.

tlc35

I will be following this thread.  My appointment is for Oct 23rd.  The initial consult is $230 I think and then I think most labs can be coded so that they are covered.  I have heard some people have an ultrasound (transvaginal, of course) at their first appointment and other just talk and then schedule all testing.  I would expect a plan for testing (CD 3 bloodwork, HSG, SA for your H).  Some people get a SIS (Saline  sonogram) and since you have lots of fibroids I would think they might do one for you).
I would not expect a treatment plan since they will want to do testing first.
I will probably start a new thread after my appointment.

Davie813

meredithcarole said:

Hi Ladies. I made my first RE appointment for Nov. 3rd and I am wondering what to expect. I have seen discussions, but I am not totally sure of what everything is. So here's what I am wondering:

What are the blood tests and what do they measure?

Do they typically do anything on your first visit?

How God-awful expensive is the testing?

Are there questions I should be asking?

Any and all insight is greatly appreciated.

My experience was a little different than many because I was referred by my OB, who had arranged for me to get my CD3 bloodwork, DH's SA, and HSG before I went so the RE and I would both have those results prior to the consultation.

The tests I had done, which I think are pretty typical, were (and I'm sorry if you already know all of this):

• FSH--measures ovarian reserve.  The less responsive the ovaries are, the more FSH the pituitary has to produce to induce ovulation
• E2 (estradiol)--high levels of E2 inhibit FSH, so unless E2 is normal, the FSH reading isn't very useful
• Prolactin--high prolactin can prevent ovulation and is linked to miscarriage
• AMH--a substance produced by immature follicles.  The amount of AMH in the blood correlates with the number of follicles producing it, and therefore with ovarian reserve
• THS--thyroid stimulating hormone, but not sure of the details on this one, actually.

On my first visit, she outlined potential plans of treatment with estimated success rates based on my age, bloodwork, and medical history (she also took a medical history for DH).  I could have chosen a plan at that time, but we took a couple of days to think about it. 

I let her know what we'd decided, then came back on CD3 of the next cycle and got started.  They ran my bloodwork again, as they do at the beginning of each new cycle, and go an antral follicle count.

As far as questions to ask, are you thinking about questions to help you decide if this particular RE is right for you?  Questions to help you maximize your chance of success with whatever you do treatment-wise?  I never remember to ask important stuff--I hope you do better...

Good luck--it's exciting that you're getting started!

ewenner

Prior to our initial consult, both DH and I had to fill out a ton of paperwork - mine was about 15 pages, his was about 10 pages.  I also brought printouts of my charts with me to the appointment (although I don't think the RE actually looked at them).  We didn't do any testing at that appointment.  Just talked with the RE for a bit and then talked with the nurse for a bit and put together our "plan."  As far as the cost, it obviously depends on your insurance, but for me, all "testing" was covered, but any "treatment" would not have been.  When I got the statements from the insurance company in the mail, the total for billed services was in the neighborhood of $2000 for consult, CD3 testing, SIS, and monitoring of one un-medicated cycle.  We were only responsible for about $250 of that, since it was all considered to be testing and not treatment, so we were very fortunate.  Good luck at your first visit!

URMySunshine77

@meredithcarole: I don't have any experience, but I just want to wish you luck. I hope that your experience is a positive one.

meredithcarole

Thanks everyone!

boymamaco

I'm sure all REs do things different but mine wouldn't accept lab results from another provider. They say all labs are a bit different in terms of sensitivity so they prefer their own lab work. He did look at my prior labs but had me retest. I felt like it was a waste of money and time.

verdongirl

I'm going to my first on the 17th. Ill PM you with my experience if you want.

Davie813

lucyspeople said:

I'm sure all REs do things different but mine wouldn't accept lab results from another provider. They say all labs are a bit different in terms of sensitivity so they prefer their own lab work. He did look at my prior labs but had me retest. I felt like it was a waste of money and time.

Mine has me retest at the beginning of each cycle, because if something is seriously out of whack, we'll sit that month out. It did help to come in with labs already done, though, because even if there was some variation, at least we had a baseline to help us consider treatment options.

meredithcarole

@lucyspeople‌ that is kind of what I am affraid of so I am skipping testing with my OB. Plus, I don't know where mine stands on Clomid or anything, but I don't want an unmonitored cycle to be a suggestion. Plus I heard so OBs aren't great about timing tests for certain cycle days. All in all, I figured let the expert do their job.

@verdongirl‌ please keep me posted!