MFM for Advanced Maternal Age? — The Bump
Pregnant after IF

MFM for Advanced Maternal Age?

Hi, I have been trying to find a new OB since mine was very unsupportive of my choices while TTC. I am 39 and this is my first pregnancy. It was a natural BFP, but I have spent 4+yrs under the treatment of multiple REs TTC. The only real diagnosis that has been confirmed is the MTHFR genetic defect. I am a cash pay for all my maternity care. My friend had twins and loved the care from her MFM. I cannot find another good referral for someone close to me and I do not have friends that have been through IF. I called for pricing from this MFM and she is literally twice the price of OBs. ($2300 vs $5600). Am I being too picky/paranoid by wanting to be under her care instead of an OB? Are there others over 35 here further along in the process that has advice?
TTC since May 2013
Mild PCOS, Compound Heterozygous MTHFR
No Folic acid/pharmaceuticals/supplements (too many to list- private message me if interested), IVIL infusion

Re: MFM for Advanced Maternal Age?

  • I just turned 35 and this is my first also. From my understanding it is not an either/or situation. MFM specialists generally do not go tot the hospital or deliver babies (at least not in my area). It seems the MFM mainly does monitoring and looking for any complications that may arise but I still have to go to the OB for routine pregnancy care. Did your friend only see the MFM? In my area there are lots of OBs and even quite a few options for perinatologists so maybe that is why their roles are so separate.
    Either way I would definitely start by finding an OB as they usually have a few MFMs that they prefer to work with. Good luck!
    [Deleted User]Hopeful_momadirat
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  • Thanks! While my friend did only see the MFM I think you’re right that I can find an OB and then see the MFM If there are problems down the road. So much to think about and I just don’t really trust anyone unfortunately 
    TTC since May 2013
    Mild PCOS, Compound Heterozygous MTHFR
    No Folic acid/pharmaceuticals/supplements (too many to list- private message me if interested), IVIL infusion
    [Deleted User]safire3Hopeful_mom
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  • Also FTM, but I am just playing it by ear. @lablover78. I am still with the RE atm, but then the Ob I want to see also has two midwives in the practice.  The intake person told me it was a wait till May to see the Ob, but I told her I was pregnant and it would be fine to just see the midwife to start, and that's what we're doing.  I will be turning 35 in a few weeks, so if the midwife/Ob sees anything that warrants a referral, I will gtake it from there.  Otherwise I wouldn't know where to begin lookong for an MFM except try whoever the Ob knows / trusts / likes / has worked with before etc.
    lablover78Hopeful_mom
  • @lablover78 I’m currently being seen by MFM as I have gestational diabetes and that makes this pregnancy high risk. This might just be at my hospital (one of the largest research hospitals in my state), but I don’t feel that I’m getting an extra ob care from my MFM. The only extra care is diabetes related, so really just monitoring my diet and glucose levels.  I’m also seeing an endocrinologist (from my prediabetes days) and I essentially get the same care. If both you and your baby are healthy, not sure advanced age alone warrants care by MFM.  Maybe start with OB and ask his/her opinions on it?
    Me: 41  DH: 46
    Unexplained infertility/AMA, polycystic ovaries, insulin resistance
    FET#1(July 2017): eSET of first of 4 PGS-normal embryos, DS born 3/30/2018
    FET#2(Oct/Nov 2019): eSET  
    lablover78[Deleted User]Hopeful_momadirat
  • As stated above, usually the MFM is separate. I have never heard of it being a situation of only seeing an MFM, but I could be wrong
    Hopeful_mom[Deleted User]
  • @cseley321 I think it depends on the hospital group. My hospital is MFM or OB, and you don’t see both as MFM specialists are also trained in obstetric care. 
    Me: 41  DH: 46
    Unexplained infertility/AMA, polycystic ovaries, insulin resistance
    FET#1(July 2017): eSET of first of 4 PGS-normal embryos, DS born 3/30/2018
    FET#2(Oct/Nov 2019): eSET  
  • @lablover78 I saw both an MFM because I was AMA & I had a separate OB. The MFM monitored me monthly until the last 2 months and I saw them weekly. It was good because I ended up having placenta issues and needed to go on bed rest. My MFM would not deliver though, just monitored with bio-physical ultrasounds and non-stress tests. Hope this helps! 
    *TW below*
    Me: 40 DH: 38
    TTC since November 2012
    BFP IUI Cycle 2 Dec 2016
    Baby Boy Due Sept 12 2017
    Elias (Eli) born 9/2/17 at 7:07pm weight 8lbs 10oz and 20.5 inches long!!


    lablover78[Deleted User]
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