Introducing Myself (children mentioned)

margorita30

Hello! Someone from the TTC group recommeneded I come on over here as you are all very knowledgable. I'm 35 (I turn 36 in December). DH is 33 and we were married in June. I have 2 children from a previous relationship. They are 6 and 4. DH has a son from a previous relationship who is 9. We are at the end of our 5th cycle TTC (AF is due in two days and my boobs just stopped hurting so I'm guessing she's a comin). We have already been referred to an RE. We just filled out the questionaire and tests have been ordered. They ordered a semen analysis for him, and a blood draw on CD 3 for me plus I'm supposed to call and schedule an HSG on CD 1. We're nervous. I didn't have much trouble concieving my other 2 children which makes me wonder what on earth the problem is. DH does only have one testicle and his Mom isn't clear on what exactly happened with that. All we know is that he had surgery when he was 2 and that one testicle was underdeveloped. She didn't even know that he only has one testicle and thought the surgery was to re-attach something.. so his medical history is questionable. Now in the back of our minds we are all kinda wondering if his son is biologically his (he looks nothing like him, and his Mom was a bit of a party animal when she got pregnant) and if he's even capable of getting someone pregnant at all which adds a lot of emotions to the situation. 

What should we expect with these beginning tests? What kind of information will we get from these? What will happen after all the blood draws and HSG? What's the next step? 

tosh24

Hello. There are the basic things that REs tend to check and then some REs may do more. I can give you a run down of my initial tests:

The initial testing is usually done on CD3 so that the RE can get a hormonal baseline for you, which is important for diagnostic reasons. All of the other stuff (iron, vitamin D, blood sugar, AMH etc.) doesn't have to be done on CD 3 but they generally just throw everything on the same requisition form. 

complete blood count
ESR
Blood/Rh type
Blood type antibody screen
Iron
B12
Vit D
HbA1C
Thyroid (TSH, Free T4, thyroid antibodies)
FSH
Estradiol
LH
Progesterone
AMH
Prolactin
C reactive protein
A bunch of tests for the kidneys
A bunch of public health tests (STDs, Rubella, Hepatitis, etc. etc.)

On CD 3, you will also go for an ultrasound which measures your antral follicle count (AFC; how many resting follicles you have on each ovary) as well as your uterine lining thickness. Your AFC along with your AMH and FSH levels from your blood tests will give your doctor an idea of your remaining ovarian reserve. You'll also likely go for an SHG or HSG - one is better for tubes, the other for uterus, but it will give the RE an idea of your uterine and fallopian tube anatomy and whether any abnormalities are seen (blocked tubes, fibroids, polyps..).

Your DH will have a semen analysis which will look at his volume, count, motility, and morphology. He'll also likely have a bunch of blood tests as well. I can't remember off the top of my head everything that DH was tested for, but a lot of it was the same as mine (CBC, Thyroid, HbA1c, FSH, public health tests, etc.) plus testosterone. 

Once you get all the results from your testing back, the RE will likely want to meet with you again to go over results and formulate a plan. The plan will largely depend on your ovarian reserve results as well as your DH's SA results. If one or both of these are very poor, they might suggest going straight to IVF. If you have satisfactory results, they might suggest starting off with medicated TI or IUI. It will also depend on how fast you and your DH would like to move through the process and what you can afford. 

There are probably things that I'm forgetting, but hopefully some others can chime in with their experiences. Good luck!