ED or OB?

jackiemary

Hi ladies,

We will be reaching the year mark of TTC in July, and since appointments are so hard to come by often with doctors it seems, I am debating making an appointment sometime in the next few weeks for July. 

My previous OB moved and went to a random OB after our loss, so I don't have anyone who knows my history well. With that said, I am trying to decided if it is okay to go to an OB for the basic infertility work-up or if we should go to an ED.

Opinions?

 Thanks in advanced!

imwithrebel

If you need fertility treatment, you should go to a Reproductive Endocrinologist. While some OBs will hand out Clomid, they rarely monitor you the way they should (ultrasounds and blood work on CD3, then every other day after CD8-10 until you ovulate). If they don't monitor you, you'll never know if you responded to that dose, if your lining was awful (common issue with Clomid), or if you over responded (risk of high order multiples). Considering you're only supposed to have 6 rounds of Clomid in your lifetime (due to increased ovarian cancer risk), you don't want to waste them. Even if your OB will do some preliminary fertility tests, most RE want to repeat them in their office anyways, so it can be a waste of money.

In your situation though (based on your signature), I would honestly give it a few more months. While you are coming up on one year of "trying", you have successfully gotten pregnant during that time. Some doctors say that "resets" your year of trying. While I wouldn't suggest waiting a whole year from your loss, I would consider at least giving it 3 or 4 cycles once your period normalizes from your miscarriage. Going to an RE is expensive, emotionally draining, and makes you be late to or miss a lot of work. While it's the biggest blessing if and when you need it, it isn't something I would want to do if I had the choice.

ct103

I would give yourself a little more time. Don't wait forever wondering, but also give yourself a bit longer since you have had a loss in the last year. That being said, if you do find yourself needing testing eventually (hopefully you get a BFP very soon), I suggest just researching an OB or RE for a while before you go. For example, my OB practice is a group of 5 docs, and one of them specializes in IF. Therefore I would definitely see her before an RE. Research your local doctors online, and/or you can simply call their office and ask if they specialize in IF. 

I totally know the way you're feeling. I've been TTC since August 2010 and I have one loss behind me. I've considered IF testing, BUT, I also wasn't charting for most of that time, just BD'ing a lot. Now I've decided that I'll make that appointment when I have 12 cycles of charted proof that our timing was perfect, so there's no question.

My last suggestion is, you can always schedule a PAP with your OB (if you need one) and just pick her brain with your fertility questions while she does her thing. Her answers will tell you if she's a fertility goddess or not, AND you got your PAP out of the way.

Good luck!  

DebateThis

imwithrebel:

If you need fertility treatment, you should go to a Reproductive Endocrinologist. While some OBs will hand out Clomid, they rarely monitor you the way they should (ultrasounds and blood work on CD3, then every other day after CD8-10 until you ovulate). If they don't monitor you, you'll never know if you responded to that dose, if your lining was awful (common issue with Clomid), or if you over responded (risk of high order multiples). Considering you're only supposed to have 6 rounds of Clomid in your lifetime (due to increased ovarian cancer risk), you don't want to waste them. Even if your OB will do some preliminary fertility tests, most RE want to repeat them in their office anyways, so it can be a waste of money.

In your situation though (based on your signature), I would honestly give it a few more months. While you are coming up on one year of "trying", you have successfully gotten pregnant during that time. Some doctors say that "resets" your year of trying. While I wouldn't suggest waiting a whole year from your loss, I would consider at least giving it 3 or 4 cycles once your period normalizes from your miscarriage. Going to an RE is expensive, emotionally draining, and makes you be late to or miss a lot of work. While it's the biggest blessing if and when you need it, it isn't something I would want to do if I had the choice.

Ditto. I am not sure what an ED is but if you have legitimate concerns regarding your fertility then you should skip right over the OB and go to an RE. If you can't afford an RE or aren't comfortable jumping into that right away - please make sure your OB is fulling monitoring you with multiple rounds of bloodwork and ultrasounds per cycle if he prescribes you any meds. 

buckeyebaby814

My OBGYN specializes in IF, so she was able to do the basic IF work-up (CD 3 b/w, HSG, SA for my husband) and I did two monitored clomid cycles with her.  I trusted her because basically everything I'd read about IF treatments, she was doing without me even asking.  After my ectopic, she referred me to a RE.  I love my OBGYN, but looking back, I probably would have just gone to the RE.

While you're not quite at the year mark yet, I would wait until your July appointment then ask for a referral to a RE.  Things typically move faster with a OBGYN, but a RE is the specialist in the field, so they are thorough which is necessary to develop the most successful treatment plan.

GL