Pre-Conception Visit -- Suggested Qs to Ask My OB/GYN

rooonilwaazlib

Hi All! 

My wife and I (a gay couple) will be starting the journey to conceive our first sometime this summer or fall -- I intend to carry and be pregnant.  I've got my yearly checkup this Friday with my OB/GYN.  Aside from the usual exam, etc., I want to start the conversation with her about how I should be preparing myself.  We will be using ICI, IUI, or IVF...and I know I will be seeing a specialist for that, and the referral will likely come through my OB/GYN.  I'll probably get a script for bloodwork to assess what genetic carriers I might have, and ask about prenatal vitamins which might boost fertility.

Do you lovely beings have other suggestions for  questions I should be asking my doctor, and/or conversations we should be having?   They can be in relation to conception and pregnancy in general, more specific to assisted methods of conception (because I know we will be using one), LGBT pregnancy, etc. Looking to benefit from the wealth of knowledge available to me from all of you!!  TYIA!  

wabash15

@lala2moms2be Really just a routine exam to make sure your healthy... An RE will want CD3 blood work, an ultrasound, thyroid levels and routine blood work.... your OB can get this stuff started or you can just ask for the referral... though you may not need a specific referral to get into the RE. Questions for the RE might be would they do a medicated IUI or non medicated... GL

also once you do start the process there is an IF thread which may be helpful for you. 

LoveInDC

lala2moms2be said:

Hi All! 

My wife and I (a gay couple) will be starting the journey to conceive our first sometime this summer or fall -- I intend to carry and be pregnant.  I've got my yearly checkup this Friday with my OB/GYN.  Aside from the usual exam, etc., I want to start the conversation with her about how I should be preparing myself.  We will be using ICI, IUI, or IVF...and I know I will be seeing a specialist for that, and the referral will likely come through my OB/GYN.  I'll probably get a script for bloodwork to assess what genetic carriers I might have, and ask about prenatal vitamins which might boost fertility.

Do you lovely beings have other suggestions for  questions I should be asking my doctor, and/or conversations we should be having?   They can be in relation to conception and pregnancy in general, more specific to assisted methods of conception (because I know we will be using one), LGBT pregnancy, etc. Looking to benefit from the wealth of knowledge available to me from all of you!!  TYIA!  

QFP

rooonilwaazlib

@wabash15  thank you so much for those suggestions. I was tempted to post in the IF threads, but since I haven't actually started I thought this might be the more appropriate place. 

rooonilwaazlib

PLEASE DISREGARD THIS - I replied to her actual comment.  TY!
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@LoveInDC   What does "QFP" mean? Did I do something wrong?!  I'm a relative newbie to Bump life!  

rooonilwaazlib

@LoveInDC  -- oops sorry, should've commented here. What does QFP mean?  Thx!  

dragonfly87-2

@lala2moms2be: QFP means quote for posterity....it is to make sure newbies/drivebys don't do a dirty delete later.

rooonilwaazlib

lala2moms2be said:

@LoveInDC  -- oops sorry, should've commented here. What does QFP mean?  Thx!  

Nevermind -- I'm dopey and still learning the ropes here!

rooonilwaazlib

@dragonfly87 Got it! IDK why I would delete it when looking for the information...but maybe others would? Should I not have posted it here? Is there a reason someone would delete a post like this? 

LoveInDC

@lala2moms2be - "QFP" stands for "quote for proof/posterity". When we have a newbie-ish or first time poster start a thread, someone will usually quote the post in case something happens and OP edits the post or disappears. You haven't done anything wrong! It's just a habit - You'd be surprise how even the most tame post can turn sideways.

Welcome though! It sounds like you are already up on a lot of what you'll need to know heading into a "pre-conception" conversation with an OBGYN or RE.

In the meantime, take a minute to read the Newbie Guide pinned to the top of the board and lurk a bit on our daily/weekly threads. It will help you get a feel for the way this board works and help you feel more confident jumping into the conversation. I see that you intro'ed back in January and posted on one thread in TTGP, but were more active on other boards. Whenever you're ready, feel free to post and get to know us all better

rooonilwaazlib

Phew!  I'd hate to be THAT new kid on the block.  Thx for the support and I'll definitely commit to becoming more active here!

kiki75

Welcome @lala2moms2be I'm not sure you'll even need a technical referral to an RE since I think that's usually an insurance requirement and since you probably won't be covered by insurance, you probably don't need the piece of paper, even though it would still be good to ask your OB/Gyn who they would recommend if there are multiple options since they will be able to give you better info than the reviews you can find online. That said, you might be able to save some money if you can do some of the testing through your OB/Gyn coded under nearly anything other than fertility treatments. You should be prepared to do an HSG. I know they had my friend who (also SS couple) do that before starting IUIs.

Once you do get to the RE with donor sperm, unless they find anything during your testing that would indicate sub-optimal fertility, you should be good to go with the IUIs. I doubt they would do ICI unless there's something out of the usual. If you're already down there, you may as well go clear to the uterus, you know? I would still ask how many times they expect to go with the first protocol and when they would change protocol. 

I would ask what you could be doing now to increase your chances of success. What supplements s/he recommends, any lifestyle changes, etc. A lot of us have read all or parts of "It Starts With the Egg." If I were you I'd start there and go with the lowest level or second level. Things like adding CoQ10, avoiding phthalates, avoiding BPA, etc. I think that this part would actually go best with your RE. OB/Gyns are more used to people who get pregnant easily. Since this is costing you money from day one, you want someone who is used to more of a next-level approach. For example, my OB/Gyn said that the only thing that H needed to worry about as far as alcohol was concerned was to avoid drinking so much that it causes a performance issue. Where we are now, since the normal isn't working, he's cutting back to just a few a week since some studies indicate that even if it's not causing performance issues, it could cause sub-par semen.

As for my friends, it took them five cycles and they say that looking back on it now, they would have started medicated cycles sooner. I think they did the first two or three without. I think the max they were going to let them do with that donor was six cycles and then they were going to have them switch because sometimes that does the trick. 

Personally, I'm completely fine with you participating in the IF thread. I'm somewhat new there myself so forgive me everyone if I'm speaking out of turn, but it only makes sense to me that if you're doing IUIs and meds and HSGs and stuff like that, that you're participating in the thread where that stuff is more concentrated. The one caveat, and I think that you seem pretty aware and sensitive but I just want to put it out there early on, is that when you're in that thread, you take an extra minute to think about what you say. You know? 

You seem to give a hoot about the rules and becoming part of the community so, welcome.  

Bababatty

@lala2moms2be Welcome! I'd also suggest thinking about how you'd want your pregnancy and labor to go and ask your doctor about their feelings on the subject. For example, if you want a birthing center, are they affiliated with a hospital that has one? If you're concerned about being forced into a c-section, ask about their c-section rate and decision-making process. Always good to know in advance if you and your doctor are on the same page or if you should consider someone else. If you google, there should be a list of questions you can ask in this regard. Good luck!

Even though you haven't started your treatments yet, definitely join the other weekly threads which are mostly for fun (TW Tuesday, for example). 

eggplantface

You're starting at the right place, telling your OBGYN you want to get ready to conceive. At my pre-conception appointment my GYN ordered blood work to check for infectious diseases, rubella antibodies, and thyroid levels. She gave me samples of Rx prenatals to try (but if you search the Bump you'll find a ton of threads about prenatals so you can pick you that's right for you; the Rx ones are expensive and usually not necessary).

Check your insurance to see if you need a referral to see an RE or not. I'd recommend doing all testing/procedures with an RE rather than your OBGYN because they are the experts at getting women pregnant. If you need a referral, get one from your doc at your appointment. Also check to see what coverage you have for testing and things like IUI and IVF. One thing I found in my insurance plan is that it does not cover IUI or IVF if donor sperm is used (not that it covers IVF at all anyway).

Even though you're not technically infertile, you'll have to go through some similar experiences as those of us with it, so the IF thread will probably be helpful and informative about tests, treatment, and medications.

KristoKekerooni

I echo PPs, It's goof to consider what your OB is like once you do get pregnant, so ask the questions @Bababatty recommended. As far as other stuff, you probably won't need a referral, but make sure you like your RE. It's hard to break up with them later. Start with IUIs, those are a good bet, barring any issues. You are welcome to join the IF thread, since you will be doing all that stuff, even if you aren't technically IF. but like @Kiki75  said, just be mindful. That thread is full of women that have been trying every thing to get pregnant and haven't so we can be sensitive sometimes, and, frankly, tired, so we aren't as patient as others sometimes. 

I hope your stay is short. 

LadyMillil

Welcome! If you're not taking any hormonal birth control to regulate your cycles I would suggest temping to see if you are ovulating and if your LP is long enough, which might give you an idea if you want to try natural or medicated cycles with IUI. 

In addition to my normal physical exam bloodwork my PCP tested immunity for rubella and chickenpox when I mentioned I was planning to TTC soon. 

In terms of preparing for TTC the main thing is to start taking a prenatal vitamin and make sure your lifestyle is relatively healthy.

rooonilwaazlib

Wow, thank you for all that information , ladies!  And YES @Kiki75, I give many hoots!!!   All of your support and suggestions are so helpful, and are definitely affirming my participation on this community as something that will be very beneficial to me.  I'm not usually so involved/active on social media, but becoming more active on here seems a worthy habit to practice.

Regarding the IF threads, that was another of my concerns...I'll definitely lurk around there because I'm sure the information is relevant, and will certainly be extra considerate of what I say/post.  I would never want to offend anyone, especially women and families sharing these intimate details about their own lives.  

Bababatty

@lala2moms2be Over on the IF board there are also treatment-specific threads you can participate in (in addition to this board). They get into more of the nitty-gritty everyday details and I recall that other women in same-sex couples have been welcome there, too.   

rooonilwaazlib

That's great to know -- thanks!

justkeepswimming8

I recently switched gynos and have told them both that we are going to start or have already started TTC and neither of them asked me to do any tests. Is this normal?

AlohaKumu

@justkeepswimming8 - If your docs don't have any immediate health concerns for you and you haven't been trying to conceive for over a year (or 6+ months if you are over 35), there's not really a reason you would need testing.

kiki75

I think the move towards testing for immunity to Rubella and Varicella is kind of a new/growing thing now that we have decreased herd immunity. You can request it but I don't think it's necessarily bad to have not done it.

haylsbayls-2

@justkeepswimming8  I feel the same way about my gyno. I'm jealous of the ladies that got actual pre-conception care! I've been looking for a new doctor and I may call a couple and ask what they go over in their pre-conception visits considering I'm about to begin my 7th cycle.

redheeler

Kiki75 said:

I think the move towards testing for immunity to Rubella and Varicella is kind of a new/growing thing now that we have decreased herd immunity. You can request it but I don't think it's necessarily bad to have not done it.

***lurking***

These are routinely tested during pregnancy so it isn't an immediate issue to not have them tested beforehand.

hartmich

Just sharing my experience re:rubella... in order to start IF treatments, they tested my immunity to rubella and varicella (and as @partiallydomesticated said, they will test this again during early pregnancy). It turned out that despite getting the vaccine as a kid, the immunity had worn off and I had to get it again (at least it was strongly recommended by the RE to get it) and you cannot get this vaccine while pregnant. So if you work with small children or would somehow be at risk of being exposed to rubella during pregnancy, it doesn't hurt to check your immunity. Otherwise you just have to be extremely cautious throughout your pregnancy, because rubella can cause a lot of issues.