Question - How Long Before Seeing RE?

citygirl17

My husband and I are TTC baby #2 and had a M/C in April.  With our first pregnancy, I was referred to an RE due to my medical history.  At that time she told us that we could try on our own for six months (rather than the typical full year) and come back if I still wasn't pregnant.  I ended up getting pregnant on our sixth month trying so I never went back and have not seen her again.  Since having my daughter in October 2013, our birth control has been cycle / fertility awareness / pull out only.  We said if I got pregnant again any time it would be ok.  But I haven't.  So now we've really started trying.  

This time around, I got pregnant on our first cycle really trying, but that ended in a miscarriage.  We waited one cycle as per my OB's instructions, and then tried again right away.  Not pregnant.  We're going to keep trying but I just have this feeling that it will not be easy since I have not gotten pregnant in over 2.5 years with minimal being done in terms of protection.

Is it appropriate to be asked to be referred to an RE again now, or should we continue trying on our own for a few more cycles?  The testing she did the first time around of my ovarian function, etc, is now over four years old and obviously a lot can change in that time.  Also, if we have the same time frame of 6 months trying on our own, should that include my miscarriage or does that time frame start over now since I did get pregnant and it just wasn't viable?

Thanks for listening.  

BrightenMySky

Sorry for your loss. I think part of this depends on how old you are and potentially what your insurance coverage is like. I would say if you want to apply the six month time frame, start it from when you first started trying, and the loss doesn't toll the clock. I think the general guidelines are one year of well-timed trying with no viable pregnancy or six months if 35 or older (or 2-3 m/c for RPL). That said, if you want to go sooner and you have coverage/you can afford it, no reason why not, IMO. 

BornReady

I'm also TTC #2 and started working with an RE in March. We had been TTC almost a year and had taken over a year to conceive #1. We are under 35, but when I called to have a phone consultation (my insurance doesn't require referrals), they suggested coming in for a consult, even though my OB wouldn't do anything until 1 year post miscarriage (november). 

During our testing we learned that we have a sperm issue that makes conception unlikely for us without intervention. Unfortunately, I had always suspected this and we are now pursuing IVF.

From my understanding a lot of the guidelines for pursuing an RE are insurance/state based (at least in the US). In my state the clock doesn't reset with a miscarriage, it is a year trying without producing a viable pregnancy. My state also has mandatory infertility coverage, so that might impact their looser rules.

Honestly, I think it's up to you. If you feel ready for some testing, ask for it. If you would rather try on your own for a few months, do that. Testing is definitely not a quick thing either, it can take a long time to get all of the testing done, to get appointments scheduled and to develop a treatment strategy and start treatment, so I would take that into consideration as well. Also, is it possible your medical history is still a factor/concern here? Definitely thoughts to ponder and discuss with your OBGYN.

Good luck!

citygirl17

Thanks for the input!

I'm 30 and DH turns 30 this month.  My medical history is a serious concern as my condition can affect fertility.  I haven't been treated as such because I have always had a regular cycle and we were able to conceive our daughter naturally.  But at one point I was given a less than 1% chance of being able to conceive on my own.  And I am still at a much higher risk of early ovarian failure.  So I think I'm really feeling the clock ticking a little more than most.  

As I recall my testing the first time around was just some blood work, so not really a big deal.  I think I'm leaning towards calling my OB if I don't get pregnant after one more cycle just to at least hear her thoughts even if she doesn't want to refer me yet.

AandDM2014

I personally went to an RE 18 weeks and 2 days after I stopped taking birth control because I knew I wasn't ovulating and that something was wrong (I didn't know that off the top of my head , I did have to go back though my calendar and count the weeks). I had tried to do it through my Gyno, but I don't have any infertility coverage, so I pay fully out of pocket.

citygirl17

Well I called my OB and she wants me to schedule an office visit to discuss a plan.  I think that's what I'll do if I don't get pregnant this cycle.  It can't hurt and I know with my history it's just better all around if I get pregnant sooner rather than later if we truly want another baby.  I'm WTO right now; should be about 5 days out.  I told DH to prepare himself now because we'll be giving it our best shot this time around