MFM vs RE? — The Bump
TTC After a Loss

MFM vs RE?

KyCade3013KyCade3013 member
250 Love Its 100 Comments First Anniversary Name Dropper
edited September 2016 in TTC After a Loss
Hi Ladies, does anyone know the difference? My doctor referred me to a specialist in recurring loss in NJ, he's an MFM and strongly recommends I see him for my 2 losses to determine the issue. I am also seeing a RE. I saw her today, she did blood test on myself and my husband for chromosomal issues, thyroid, testing sperm, etc. I'm going in for a saline ultra sound once I get my period. What is the difference? I noticed his (MFM) panel does something with egg quality too. I'm so confused and my husband said he only wants to deal with one doctor and he likes the RE. She's fast, smart, efficient, experienced, and based in the hospital ward that specializes in Reproductive medicine in the hospital. 

Re: MFM vs RE?

  • RiverSong15RiverSong15 member
    1000 Comments 500 Love Its Third Anniversary First Answer
    edited September 2016
    As I understand it, Maternal-Fetal Medicine doctors are specialists that deal with helping women keep high-risk pregnancies (like higher order multiples, women with lupus, women with blood clotting disorders, etc). REs specialize in getting women pregnant, but also can specialize in treating early recurrent losses. Recurrent loss is an area that crosses over between the two fields. I've seen women on this board referred to both REs and MFMs for RPL.

    From my own searching, it's actually been hard for me to find very many people that specialize in recurrent loss at all, even in my major metropolitan area. I've found one RE in my city that deals with RPL and no MFMs that specialize in it. I found a lot of REs that know how to induce ovulation, monitor IUI cycles, and design IVF protocols, but only 1 RE that specializes in RPL diagnosis and treatment. I found lots of MFMs that deal with all sorts of crazy problems that crop up in later pregnancy (12 weeks and beyond), but none that specialize in early pregnancy loss. That alone makes me think it's worth having a consult with the MFM you were referred to who specializes in recurrent loss. Maybe you can set up a consult with him/her once all the test results are back from your RE?

    I think for testing, either would be fine, though. And if they find an issue like a blood clotting disorder, you'd likely be seeing an MFM during pregnancy anyway. But for treatments that involve fertility medicines (like Clomid), I'd probably go with the RE who is better versed in proper monitoring. If it were me, I'd honestly go to a consult with both, and see how different the recommendations are between the two.

  • After my third loss my NP sent me to a MFM and I myself booked an appointment with my RE. I saw him first and didn't have to do much since I already had RPL
    testing. He drew genetic tests and chromosome testing and did a saline sono by the time o got to my MFM. Her appointment with her was not exactly awe inspiring.  Basically she said aspirin and progesterone is enough in 60% of the cases so keep that up. 

    My RE has been much more proactive in actually doing medicated cycles. I may go back to my MFM if I get to graduate from the RE, but her office is much farther than my normal OB. I know in considered high risk so they may prefer I stay with the MFM anyway 
    BFP #1: 1.22.16                 MMC: 2.29.16 ( tetrasomy 11, partial deletion 1, XXX) D&C: 3.2.16
    BFP #2: 4.14.16                 CP: 4.17.16
    BFP #3: 6.10.2016             CP: 6.17.16
    RE appt: 6.27.2016- saline sono all clear
    Progenity: + carrier Tay-Sachs, Gaucher's, hemachromatosis. DH: carrier Alpha 1 anti-trypsin
    PCOS, hypothyroid, MTHFR, hx of LEEP in 2006
    Clomid + TI Cycle #1: 50mg Trigger 8.24.2016- BFN
    Clomid 75mg + IUI#1 9.25.2016- BFP #4 10/6
    Beta #1 15   Beta #2 38    Beta #3- 71     beta #4 171   Beta # 5- 21  Natural MC 10/21
    HSG- clear
    IVF Jan 2017
    Egg Retrieval 1.22.17: 32 eggs retrieved,29 mature, 24 fertilized, 14 to blastocyst for biopsy
    PGS results: 4 PGS normal 2 XX, 2 XY
    FET: 3.13.2017 for 2 PGS embryos
    Beta#1: 3.24.2017......... 78; Beta # 2 241; Beta #3 4198
    Baby BOY due 11.29.2017

  • We are seeing a RE after my 2 losses. 
    Siggy Warning--------

    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
  • Thanks everyone. I'm going to keep up with both and work with each until I get prego and then I guess stay with the MFM until a certain point right? My OB said you graduate from MFM at certain point, I'm guessing that's 12 weeks? I think the RE is like 8 which is still so damn early. I want some hand holding from now on, a normal OB just doesn't cut it. 
  • My RE gives so much hand holding. We have a nurse case manager and I can call any time with any question. So much better than OB. But if I can ever get to 8 weeks- yes they let you graduate.
    Siggy Warning--------

    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
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