Fertility Testing Q&A

Bababatty

Saralee797 said:

Point is, if you think something is up and are interested in getting the testing done, it can't hurt to ask. I think it depends on the doctor whether they will refer you or not. I know mine did not start trying until she was older so that might have something to do with it. I think it is important to advocate for yourself. I am happy to be a resource on any of the testing and what to expect. Feel free to PM me too.

Definitely agree on this! Obviously don't start running off to a specialist just because, but if you have a real reason to suspect an issue, ask about it. Also note that your insurance may not require a referral per se to an RE from your OB or PCP. If your OB will not give you a name, it might be worth working around him or her.

Sugargirl1019

I can be a reference for women with Type 1 Diabetes. I have a link with some great resources and websites on my blog in my signature.

Type 1 Diabetes does not affect a woman's fertility. Doctors recommend getting your A1c as close to 6.0% as possible, preferably 3 months in advance before trying. That being said, women have gotten pregnant with A1cs above 10 and just work hard to bring it down quickly. Any trouble getting pregnant is a separate fertility issue and not from blood sugar control, since blood sugars do not affect egg quality or hormone levels.

PM me if anyone needs to ask questions and if I don't respond here.

LadyMillil

I made an appointment with my PCP after 5 months because I had symptoms that something was wrong. Since it was clear that there was a problem with me I did all the testing before DH had his SA. 

As someone that has a painfully long wait (3 months with my first RE, 7 months for my new RE after moving) I urge you to remember that impatience is NOT a good reason to skip the normal 1 year (6 months AMA)and go to an RE - unless you have a known issue, symptoms of a problem, or you doctor has recommended it. 

Becky012016

for those of you diagnosed with NIR PCOS, what's made you suspect pcos? Or what made you're doctor suspect it? 

nlwz123

Not sure if appropriate, but I used to frequent this board and may have some helpful progesterone information if needed.

pregnancy TW:

I'm no expert, but I have experience with progesterone supplementation.  My RE determined my progesterone was low post-ovulation so she had decided to see if adding in a progesterone suppository would help.  It did the trick for me, and I continued taking it until I was 12 weeks in.

Edit: To add a little info, my level was a 4.1 post-ovulation before adding in the suppository.

adirat

@nlwz123 Thank you! I will add you to the list for progesterone. It's great to hear a success story (as a person with low progesterone myself). 

[Deleted User]

Re: ultrasound gel

@linzrunz when I went in for my SHG, the doctor remarked that the regular u/s gel is not sperm-friendly.  he actually said, "gee, we really should have some preseed here." Lol and then wiped it off and I think we just did without. Not sure what type my other doctor used for my regular folli scans though.  I think it actually may have been preseed or something similar?  but anyway if you're getting pre-o scans, just thought I'd throw it out there, cos that was definitely not something that ever ocurred to me.  I'm sure it will be fine though; they do this all the time. ;)  ♡♡♡♡  I dont want to go having you worry.  if you want, I'm sure you could even call ahead and ask what they use.  (((hugs)))  just to put BusinessWife's mind at ease for you.  <3

kyersten

Got my initial bloodwork back - my nurse said my vitamin D level was too low, it's at 15 and it needs to be at least 30. So I'll start taking d3 vitamins. Any experiences with low vitamin D? I didn't realize it affected fertility! So glad to be doing these tests and learning all this new information.

Day 3 blood work is tomorrow!

sheknows6

@adirat, I can be a resource for hyperthyroidism if needed

eggplantface

@kyersten My RE told me the same thing about Vitamin D, as did my PCP come to think of it. I think most people have a deficiency, especially in the winter, but I also don't sunbathe and limit my time in the sun because skin cancer runs in my family. The supplement should do the trick. You can overdo it though so just take the recommended dose.

adirat

@sheknows6 Thanks, I added you.

@kyersten Interesting, I haven't had my levels checked but I wonder if I should. Like @eggplantface my PCP recommended adding a vitamin D supplement during the autumn and winter (she specified for both me and my husband so I've been giving it to him too) but after doing some googling the 1,000 IU I'm giving each of us is below many recommendations so now I'm curious about our levels. Thank you!

kyersten

@adirat The nurse said it is common for people to be deficient in vitamin D so I'm glad she checked it. She wants me to take 4000 IU once a day and recheck it in 8 weeks. I figure the more tests they do and the more we know, the better! I like having a plan and information, makes me less anxious. 

adirat

@kyersten Wow! 4000 seems like so much... I wonder if I should increase how much we are taking. I'm the same way -- I want to have a plan so I can feel like I'm doing something and moving forward. Good luck! I hope this is just the thing you need. 

Neikoda

**Dirty lurker**

Just jumping in because I had little to no resources when diagnosed. APS/Hughes Syndrome. 
Found during antiphosolipid and anti-coagulant panels.

Sugargirl1019

Neikoda said:

**Dirty lurker**

Just jumping in because I had little to no resources when diagnosed. APS/Hughes Syndrome. 
Found during antiphosolipid and anti-coagulant panels.

OMG I miss you

[Deleted User]

@adirat 2000 should be safe ;)

adirat

@BusinessWife Thanks! I started giving us two 1000 IUs each -- my husband said, "Why do I have to take two of these now?" and I replied, "Do you really want to know or do you want to just swallow the pills?" It was the latter! lol

swimsister

I’m feeling a little overwhelmed by all of this, I just re-read this whole thread. I’m almost definitely out for this cycle so I’ll be starting Cycle 9 here soon. I know I’m still under a year, but I feel like it’s time to start thinking seriously about this stuff. My very basic question is what kind of doctor does which tests? I currently just have a GP. Can she do any of the initial bloodwork/SA or do I need to find an OB/GYN? Or is it just straight to an RE?

(If the answer is straight to an RE I’ll put my worries on hold for another 3 months, I know it’s recommended to wait a year before going that route)

zwink1

@swimsister That may depend a bit on your insurance. I know some ladies just contacted an RE and made an appointment directly. Which, if you can do, may be worth checking out now as wait times can be long. You can always cancel the appointment of you don't need it.

My insurance coverage for infertility is virtually non-existent, and I needed a referral for even minimal coverage, so I had to get started with my OB.  She ordered H's SA and preliminary CD3 and thyroid bloodwork for me, followed by an HSG. 

I'm not sure if your GP could start some of the orders (I don't have a PCP, just my OB) but I suspect he/she could at least order an SA.  I am really kicking myself for not doing that back in June.

laurad75

@swimsister When we first started TTC I asked my PCP (who is also my gyn) for a referral to an OB for a 'preconception appt'.  The OB was able to run baseline bloodwork and immediately referred me to the RE because of my age.  An OB should be able to do your blood work and if anything looks concerning they will probably send you to a RE and if not you can keep trying on your own for another three month and then do more extensive testing with RE.  

lulu1180

I'm posting this here for better visibility.  My last 3 cycles were 15, 16 and 16 days long.  I am calling my Doctor's office (she is actually a CNM not an OB) this afternoon to schedule an appointment.  Should her office do testing or should I see if they will refer me to an RE?  Anything specific I should ask for (other than just an appointment in general)?  Does anyone have experience with a situation like this or have knowledge of it? 

This is all so far outside the realm of normal that it scares me and I have no idea what to expect from anything.  Any advice anyone can give me would be helpful.

Dilynne

@swimsister

I'm from Canada so it may be different here, and I just started my testing - but my GP ordered the initial bloodwork the RE needs so the process moves faster.  Some REs apparently won't even see me if the initial tests weren't done. Also, the RE that I'm being sent to requires a urine STI check, which I had never heard of before. 

adirat

@swimsister and @lulu1180 I have a somewhat unorthodox opinion on this (though I suppose on this board it may not be too unusual). I think it is fine to start the basic testing (Cd3, 7dpo, SA for sure) with a PCP or GYN if this is a doctor you trust AND if you are comfortable doing a lot of research on your own. If you want a doctor who will take care of things for you and just give you a plan of action, I would NOT start with them, only with an RE. But if you want some answers, want to do your own research on bloodwork "normal" levels, want to advocate for yourself, and your current doctor (who has the benefit of knowing you) is a partner in that, go for it!

For both of you, the FIRST thing I would ask your PCP for is thyroid bloodwork. Make sure to ask for TSH, T3, T4, and antibodies. Many reference ranges indicate that TSH under 5 or 10 is "normal" but know that recent literature indicates it is quite difficult to get pregnant and sustain a pregnancy with TSH over 3. My endocrinologist wanted my TSH under 2 before I started TTC.

If your doctor is familiar with CD3 and 7dpo bloodwork, you can ask for it. My gynecologist suggested it so that if I do need to go an RE, I'd have a baseline several months earlier. But I also trust that she knows what to make of these numbers. I would not trust my PCP to know. It's all dependent on your doctor. 

Also -- when you ask for bloodwork, make sure you get the numbers. Don't accept a call from a nurse that says they are "normal." Look at the numbers yourself and see what's up. My low progesterone technically fell in the "normal" reference range on the lab slip but my gynecologist took one look at it and said it was low.

And like @dilynne suggested find out what is required for your referral to an RE and the costs. My insurance makes the items I do with my gynecologist nearly free (just $10 copay) but with an RE it will be very expensive, so doing these items first saves me hundreds of dollars. But I wouldn't if I didn't think my gynecologist knew how to interpret the findings and I wasn't prepared to do hours of research on my own.

Good luck! Please let us know if we can help in any way.

Marley629

@kyersten I too was prescribed an antibiotic before my SHG & HSG. I also took 800mg ibuprofen about 45 mins before both tests at the suggestion of the Doctor. I feel it definitely helped as the tests were uncomfortable but not painful. 

LadyMillil

I'm in Canada so it's likely different but here's what I did,
I noticed a problem with my cycle starting my first cycle off BCP. Problem got worse with time not better. While I was worried about the problem impacting getting pregnant, I know it's not normal to bleed 3 weeks each cycle so I made an appointment with my GP to try to figure out what was causing the bleeding. My GP did an ultrasound to check for cysts and any other abnormalities and a bunch of blood work to check thyroid, estrogen, LH, FSH, prolactin. If something came up that she could treat (ex high TSH) then she would have treated that for me. Everything was normal so she referred me to an OBGYN where I did an HSG and 7dpo progesterone. The OB would likely have treated me for low P and potentially an abnormalities from the HSG. Everything was normal so the OB referred me to an RE and told Me to send DH to his GP for a SA. The wait was3 months. The RE ordered a blood test for DH for STIs, a repeat 7 dpo P for me and CD3 bloodwork. All testing was done by the time we went to the RE so she was able to give us treatment options at the first appointment, that we could start at the appropriate CD.

ETA - I needed a referral to see the RE

kyersten

Thank you @Marley629! My doctor suspects a previous ruptured appendix could possibly be causing issues with my tubes so is being extra safe with the antibiotic which I appreciate!

I wasn't sure about how much pain meds to expect to take before the HSG, so this is super helpful! It is on Thursday and I am very nervous!

hartmich

You guys... I'm in shock. I had my annual exam today with my OBGYN and long story short, she ordered a bunch of bloodwork (TSH, FSH, some thyroid things and prolactin), an SA for H and an HSG for me. I totally expected to hear "it's only been 6 months, relax" but she said with my age being close to 30, the loss and my late ovulation it doesn't hurt to start some tests. I'm a little overwhelmed because it all caught me off guard but maybe this is a step in the right direction. 

kyersten

@hartmich I feel like that's great news!! I love that she's on top of it. And while the idea of tests can be stressful, I know it makes me feel less anxious to have more information! Good luck on all your testing! 

hartmich

Who has advice/tips on SAs for the men? Of course my H is freaking out a little.

*TW* loss mentioned

A little backstory - H is extremely down about our loss. He has moments where he says he is terrified it will never happen for us, he can't "get me pregnant", etc etc. This has developed into him thinking the HIO during FW is work and not just for fun, and that's adding to his frustration. When we talked about all of it last night, I told him we'd take baby steps and start with my tests. I think he's on board with the SA (as long as they allow him to do it at home and then drop it off...) BUT I'm of course thinking ten steps ahead and wondering about IUIs etc. I don't know how he'll react to having to make deposits several times. He even has said he "doesn't think he can". He has never once in our 10 years together had physical issues with performance so I'm pretty sure this is all mental but obviously that's a huge factor here. 

I also tried to remind him that this all for a good cause and he said even if we got a BFP, he'd only be terrified. I totally get what he means here but I really need him to buck up as we get through this.

Becky012016

@hartmich; I don't have any experience with a SA but if he is able to do it at home then drop it off you could offer to help him. Instead of it feeling like a chore it could be more reminiscent of the early years when HJs were the end-goal. 
I agree with you that he needs to buck up about moving forward. Just keep communication open and he should come around!

zwink1

@hartmich I'm not sure what could help get him out of his own head. I know my H had some issues with it at first as well, and it actually took him almost 4 weeks from the time my Dr ordered it to actually get around to doing the SA. Luckily, I saw my Dr at the beginning of my cycle and we had some time for him to work on getting up the courage.  He also did it at home and dropped it off, but I think he would have actually preferred to do it there. I know the thought of having to rush it in there and keep it warm stressed him out.  Maybe give him some time to get used to the idea (if you have it)?  Perhaps he'll come around on his own. As for future deposits, if necessary, hopefully after he gets over the hurdle of the first one, they'll be easier.  I'm glad your Dr is getting you started though, and I hope you get some answers!

Bababatty

@hartmich Others have said what I'd say, so I'll just add that the labs, in my experience, do go out of their way to accommodate the patients so making the depotists is as comfortable as possible. Apparently, my RE office will even let the wife/partner go in to the room with the man if that will help. (We've never done that because it seems terribly awkward.) I think in the beginning it's hard and awkward, but once they get into the swing of things with IUI it becomes much easier.

hartmich

@zwink1 I'm glad to hear your H came around. I told him he can do it over Christmas break (he's a teacher) and that almost seemed to relieve him. He is the type that needs a lot of time to get used to the idea.

@bababatty That's good to hear! I don't think I could go in either - I think we'd end up cracking up and totally defeating the purpose. 

KristoKekerooni

kyersten said:

Got my initial bloodwork back - my nurse said my vitamin D level was too low, it's at 15 and it needs to be at least 30. So I'll start taking d3 vitamins. Any experiences with low vitamin D? I didn't realize it affected fertility! So glad to be doing these tests and learning all this new information.

Day 3 blood work is tomorrow!

zwink1 said:

@swimsister That may depend a bit on your insurance. I know some ladies just contacted an RE and made an appointment directly. Which, if you can do, may be worth checking out now as wait times can be long. You can always cancel the appointment of you don't need it.

My insurance coverage for infertility is virtually non-existent, and I needed a referral for even minimal coverage, so I had to get started with my OB.  She ordered H's SA and preliminary CD3 and thyroid bloodwork for me, followed by an HSG. 

I'm not sure if your GP could start some of the orders (I don't have a PCP, just my OB) but I suspect he/she could at least order an SA.  I am really kicking myself for not doing that back in June.

hartmich said:

Who has advice/tips on SAs for the men? Of course my H is freaking out a little.

*TW* loss mentioned

A little backstory - H is extremely down about our loss. He has moments where he says he is terrified it will never happen for us, he can't "get me pregnant", etc etc. This has developed into him thinking the HIO during FW is work and not just for fun, and that's adding to his frustration. When we talked about all of it last night, I told him we'd take baby steps and start with my tests. I think he's on board with the SA (as long as they allow him to do it at home and then drop it off...) BUT I'm of course thinking ten steps ahead and wondering about IUIs etc. I don't know how he'll react to having to make deposits several times. He even has said he "doesn't think he can". He has never once in our 10 years together had physical issues with performance so I'm pretty sure this is all mental but obviously that's a huge factor here. 

I also tried to remind him that this all for a good cause and he said even if we got a BFP, he'd only be terrified. I totally get what he means here but I really need him to buck up as we get through this.

@kyersten - I have an AI disorder, so my level is perpetually low, and no amount of pills will help. My vit. D is 3. just 3. I take 50,000 units a day, and the highest it has ever gotten was 12, during the summer. I can't absorb it through food, and only absorb a tad through skin. I actually was told to go tanning. That being said, I know it can be an issue when TTC but, *TW* I have been pregnant four times. Those didn't work out, but the doc suspects that's a sperm/chromo  issue, not anything related to the vitamin D. I would advise taking the supplement and rechecking. You are probably fine. Also, most prenatals have vit. D in them, so once you are up, just taking a maintenance dose through one that does have it should be fine. 

@zwink1 - Where I live, the nearest RE is five hours away. One way. So that might influence my answer. but I got all my diagnostics through the OBGYN. He ran all the initial tests (CD3, 7, US, HSG, SAs, etc.), refereed us to a local urologist when we figured it was a sperm issue, the urologist prescribed Clomid for my husband. It's only recently that my doc has said we have exhausted his knowledge and that it's time to move on. It wouldn't hurt to ask you OBGYN. With mine, insurance covered most  of my diagnostics because my OB could code them properly. With an RE, that wouldn't be possible. 

@hartmich - First, I am so sorry about your loss. My H has had to do about a million drop-offs. It helps that he has been able to do it at home. I normally leave him be and don't try to get involved. I let him watch porn or do whatever he needs to do to get it done. He said it gets easier after the first. But I know of others who have wives that would help a little. Maybe that's an option? 

KristoKekerooni

Also, just a suggestion. But maybe "fertility bloodwork" isn't the best label. We are talking about far more than blood work. Maybe something like IF testing? I know a lot of people are afraid of the "I" word, but...

adirat

@KristoKekerooni Thanks for your input. This was originally started as a bloodwork thread but you're right, it's about much more now. What about fertility testing q&a? 

Sugargirl1019

adirat said:

@KristoKekerooni Thanks for your input. This was originally started as a bloodwork thread but you're right, it's about much more now. What about fertility testing q&a? 

Sounds good to me!

NYTino24

I'm gonna jump in and give background and ask for advice / experience. I'm almost 34 and was on BCP for 10 years. I don't remember how long my cycles were before, but I do remember them being heavy and hard to predict. They have ranged from 26-37 days since coming off. I have been charting cycles for a year and temping / doing OPKs for 7.5 months. We have only been TTC for 3 cycles since we were TTA due to Zika. MY Gyn was dismissive of my concern about her recommendation to wait 6 months after exposure instead of 2 and told me she'd see me "next year" for my next annual. I called and asked about testing egg reserve before going on our honeymoon to see if we could wait 6 months. She said absolutely not and that she wouldn't do any test unless I was trying for a while. She said I could freeze embryos before going if I was concerned and could do IVF. I didn't have time before our wedding / vacation or think it wasn't necessary to go that far yet. I called my insurance company, though and IF testing / treatments are covered. SO fast forward to now. I am worried about high LH. I have had nearly positive OPKs since CD9 and I'm on my fifth consecutive day of positives on CD21 / 4 dpo. I normally get 3 days of positives. O was confirmed with temps and CM. I want to add that I often feel like crap during TWW because of what I assume is high progesterone. Has anyone had a similar experience? Should I get a new Gyn, present my case to the current one, ask a GP to do blood work, or go right to an RE? This cycle isn't over yet and maybe it's a fluke, but I was reading that high LH could mean problems.

eggplantface

@NYTino24 I could totally argue both sides to this. Devil's Advocate: You're not 35 yet, so trying for three months is not something to worry about (did I read that right? Three months?). I get not wanting to wait the full year because you're *close* to 35, but a year is the recommendation, and it can take the full year.

However, I don't like dismissive doctors. Yeah, they've been doing their job a long time and know what things are supposed to look like, but any good doctor listens to his/her patients and addresses their concerns logically and sympathetically. How dismissive was your doctor? To jump directly to "Oh, we could freeze embryos" sounds really condescending and almost sarcastic to me. I would suggest looking for a new doctor regardless, but being prepared to have to wait the year for testing.

[Deleted User]

@NYTino24 I agree 100% with everything @eggplantface said. I would give it some more time, but also probably seek out a different doctor.