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.

kindershlitz

Thank you for sharing. I have an appt next week myself. If it makes you feel better my paperwork had a question about past tests and post-coital was one of them. Glad you got to prove you were right too

wannabmama23

Thank you for sharing this info! I'm finally figuring out what most of it means and posts like this help so much! Please keep us updated and good luck as you learn more!

hooligans4

Wow. You certainly had a productive visit. It's good that you really can pinpoint ovulation.
I hope your lining was thin because of your long cycle and it is thicker when you go back next month. Did they say what they could do to thicken your lining?
Well I hope all your BW comes back good and you can move foreward from there

lcwed

I'm glad your appointment gave you such great information and that they seem to be very proactive.  I hope everything comes back great with your tests and DH's sperm.

URMySunshine77

That sounds like a good appt. 

Like @hooligans4: I am curious what they can do to thicken the lining if they find that it is thin across several cycles. I hope the RE's assistance propels you to your BFP.

emsmama15

Yay for a productive appointment and a plan. I hope the thin lining is due to your long cycle. Side note, when I got pregnant with my daughter, my lining was thin (probably due to clomid). My RE prescribed progesterone supps. I was so worried I'd miscarry but she stuck in there. But that's also why we're not doing clomid again.

tmorash

Sounds like a very productive and informative appointment, @tlc35! I'm still figuring out all the acronyms, but please keep us posted on your progress. Just like @wannabmama23 it's very helpful to figuring it all out, and of course we want to see you progress to that BFP! Hoping your thin lining is a simple consequence of your wonky cycle, and is thicker next month!

kelley72

Sounds promising @tlc35  I'm very impressed they did the testing they did and the suggestion for post-coital if this cycle isn't successful!  I

My understanding is 8mm is on the low side but not extreme!  Increased blood flow (natural remedies) and hormone balance will be the objective for treatment.

I would feel hopeful moving forward if I were you!  Best wishes!

Nikolie93

Sounds like they were pretty thorough for your 1st appointment, that is great!

And I am so printing out the acronym list to use as a cheat sheet lol

tlc35

kelley72 said:

Sounds promising @tlc35  I'm very impressed they did the testing they did and the suggestion for post-coital if this cycle isn't successful!  I

My understanding is 8mm is on the low side but not extreme!  Increased blood flow (natural remedies) and hormone balance will be the objective for treatment.

I would feel hopeful moving forward if I were you!  Best wishes!

Yes, he said that 8mm is borderline but is may be a red flag.  They will recheck the lining next cycle at a mid cycle ultrasound so we will see.
I was also excited that even though I didn't think I had any fertility coverage, the bill was only $71.