XP: First RE appointment

tlc35

I always enjoyed reading these so I wanted to share.  Since I am 37 I followed the 6 month rule.  First they had mailed me paperwork to complete ahead of time so I gave them that as well as my FF charts.  Then I talked to the nurse who took a preliminary history.  Then the doctor came in.  He didn't seem too worried about my age but when I told him that I was on CD 28 and believed I just ovulated yesterday he was skeptical but also stated that if you ovulate later than CD 18 or so, chances of pregnancy are only about 10%.  He said that we could see if I just ovulated by getting bloodwork and an ultrasound so I went to get those things.  The ultrasound had good and bad news.  The good news I had a good number of follicles which is a good indication that my ovarian reserve isn't too bad.  It did look like I ovulated yesterday.  The bad news is that my lining was only 8 mm which is fairly low for luteal phase.  He also said that if an embryo implants in a thin lining then miscarriage rates go up.  So this is a possible cause for my loss.  They drew AMH, TSH, prolactin, FSH and LH today.

The plan moving forward is to get CD 3 bloodwork (FSH, LH, Estradiol).  HSG on CD 5-12 and then on CD 12-15 I will come in and get an u/s again to see if my thin lining was just due to a wonky cycle (since this much later than I usually ovulate).  They will also draw a LSH, estradiol and progesterone to see if my ovulation is "strong" enough.  We are supposed to have sex the night before that visit and they will do a post-coital test which seems a bit unusual compared to other RE's.  They will look at the CM under the microscope and also check the sperm in there as well.  He said if this is OK then we don't need a semen analysis.  If it isn't Ok then they will get a semen analysis to see if it is the CM that is the problem or the semen.  This will make my H happy.

I am dying to know what my AMH is but it takes 12-14 days to come back.

dawnstar898

Congrats on moving forward, sounds like you have a solid plan in place!

sunflwra

YAY for a plan!  Sounds like he's looking at various factors and being proactive.  Glad to hear things are moving forward for you!

aswedishbee

Glad your appointment went well, and thanks for sharing! 

rslh10

Your plan sounds great! I bet your H will be happy not to have to do a SA! I think my H is freaked out about it! Good luck moving forward and fx your lining issue was a fluke

jjbmstinco

You plans sounds great! I am excited for you!

meredithcarole

Thanks for sharing! Sounds like you have preliminary steps in place which is great!

Feegan

Your RE is thorough! I'm so glad it went well and you feel good about his plan of action. The more tests he runs the more info you learn about yourself and what's working/not-working. Here's to him getting to the bottom of this ish and getting you KU ASAP!

alm288

Sounds like you found a great RE and have a solid plan you are comfortable with moving forward. Yay!

tlc35

HoldingOutHope said:

I'm glad you had a successful appointment & your RE is being thorough. I have to admit that you peaked my interest by mentioning that he said ovulation later than CD18 equates to a lower pregnancy rate...? I'll ask my RE this question since I am seeing her for a biopsy today, but if he has any references I would be very interested to read them! (I normally O on CD21).

I didn't think to ask for references but I may try to search on pubmed later.  I will try to remember to ask next time I see him.

Km380

I'm glad you had a good appt, the RE sounds very thorough and proactive! Fx for good test results

MrsG80inTN

Super interesting about the post coital test.  I've never even heard of it, but sounds proactive and cool!!!!!!  I'm interested in what happens with your lining --- mine was 8.5 on Wednesday before ovulation and my RE's office wasn't concerned, but I'll be interested if they check on Monday when I'm there for a consult with the RE!

katie0919

Glad you went and have a plan in place!

I, too, am intrigued that your RE said the pregnancy rate is lower if you O after CD 18. When I first started TTC I was O'ing around CD 17-CD18....then I had the chemical pregnancy and I think stress started to get to me and I started O'ing around CD 21. Hmmmm. I might have to ask about this next time I go in (still waiting on my first post-miscarriage AF to start so I can start up Clomid again).

peregrinefalconx

tlc35 said:

HoldingOutHope said:

I'm glad you had a successful appointment & your RE is being thorough. I have to admit that you peaked my interest by mentioning that he said ovulation later than CD18 equates to a lower pregnancy rate...? I'll ask my RE this question since I am seeing her for a biopsy today, but if he has any references I would be very interested to read them! (I normally O on CD21).

I didn't think to ask for references but I may try to search on pubmed later.  I will try to remember to ask next time I see him.

This is only anecdotal evidence of course, but the last time I got pregnant (successfully until it was no longer successful) was on CD28, I believe. My cycle switched to 42 days after MC#2. It took several months to get pregnant primarily bc we weren't even remotely having sex during the right times. I used the clearblue fertility monitor, which was very helpful in telling me when I was Oing. Later found out that it is 14 days before you get AF.