Meeting w/ OBGYN for results

Qzees

I had to go back to my OBGYN last night to discuss the results of my 3 day blood work (see post from about a week ago from me).  My DH came, which really made me happy since he missed the first meeting.  My OBGYN was much more sympathetic than he was last time - he was not so pushy about IVF & IUI - not that he didn't discuss those options, but he was very light on the subject.  My DH & I are not looking to do either of those, DH believes that if it was meant to be, it will happen & he does not want me taking any drugs to get prego.

The Dr told me that he did not like my Estradiol 56 combined with my LH or FSH (can't remember now) My LH was 6.1 & FSH 7.4.  He said that the 56 is high for 3 days into my period.  He said combined those two numbers can mean that I am teetering on being infertile.  He referred me to an RE - the same one PP mentioned - Dr. Miguel Damian & he wrote me a script for a hystogram (sp?) The test that they shoot dye into your tubes to make sure you are not blocked.

We did discuss my TSH (thyroid) which is a 3.76 and he said that some Drs may want to medicate me based on that number - but being I am thin, he didn't want to jump into that just yet.  He wants the RE to make that call.

I am going to call my insurance company & make sure they will cover me seeing an RE - I have Aetna Freedom Choice plan (which I think is a better plan), but it is an HMO so the $ may have to come out of my pocket first - we shall see.  I do beleive this Dr is in my plan - fingers crossed.

DH is going for a SA tomorrow - I know he is not thrilled about doing it, but he is for me.

Gosh, I hope this month is a lucky one & I don't have to do anymore testing

Llamamama

It sounds like you got a lot of helpful information.  My situation is similar as we are not planning on moving forward with IUI/IVF and I also had the test which is referred to as an HSG (Hysterosalpingogram) and it was not bad at all for me--I hope you have the same easy experience.  Good luck!

Mrs.McIrish

I just have to comment on your statement that DH doesn't want you do take any drugs/do IUI/IVF to get pregnant and that if it is meant to be, it will happen...  You know many of us are undergoing treatment, some of us massive treatment. I find the "if it is meant to be" statement offensive. It's like saying I am not supposed to be have kids.   That being said, what happens if your tubes come back blocked or DH's SA is zero?  You just walk away because it isn't meant to be?   Easier said than done. 

I guess my point is until you are in a situation where you have no choice, you shouldn't make declarations since you may be eating those words. I will step down off my platform.

I have been doing TSH research in the last week since mine came back a little higher than I'd like.  It should absolutely be under 2.0 for TTC. There is no way yours is acceptable for trying to get pregnant and I hope the RE tells you that.  Some will say under 3 is ok but it really isn't. It is still in the "normal" range but not ideal for pregnancy attempts.

Qzees

I'm sorry... I certainly didn't mean to offend anyone.  I don't see anything wrong with IUI or IVF if that is what you choose to do.  My DH is set against those procedures - even IUI which I know can be done w/o meds.  But DH doesn't want to interfere.  He feels that if the big guy upstairs wants us to have children, we will have them.  I never wanted children until I met my DH - so this is a complete 180 for me.  When I put my head into something I give it my all.  I do agree w/ my DH, I don't want to take any meds to get pregnant, but I will take them if I do get pregnant & need them to hold onto the LO.  Who knows, after meeting the RE my attitude may change - but I know it is going to be very tough to change DH mind on this.

Mrs.McIrish

So what is the point of doing the tests if you won't do anything about it? Why bother? I'm not being snarky. I am genuinely interested.

Qzees

Well who knows, maybe my tubes are blocked.  I want to know why I can't conceive.  If my eggs are gone, and they feel there isn't a chance in hell w/o meds or a donor egg - then at least I know where we stand.  Being newly married - there are a lot of life changing events that can occur - one is a child.  If a child is completely out of the question w/o a donor egg or IVF, than some of the other things we are thinking about can be seriously considered (house/car, etc). 

I, as a woman, want to know what my options are & how bad or good things are.  Once I do then I will know where we stand & can move forward with whatever we chose to do.

I can see your point - why all the tests, but I have insurance & my test results are certainly not the worst - so why not do a couple of more tests to find out better as to whether we can conceive or not.  I don't see the harm in it.

ksgsmu

Your TSH is too high... and although thyroid does regulate metabolism... you being thin or heavy doesn't really have anything to do with it. Thyroid medication won't change your weight.   The thyroid has many functions. A high TSH can greatly affect fertility. It is known to interfere with ovulation.  My Endo says you need to generally a TSH  between 1-2 to conceive. If you do get pregnant a higher TSH you are at a much higher risk for miscarriage and developmental problems ( brain/learning issues).  It is very important, I would implore you do not neglect it! Do some research!

Good luck!

Qzees

Thanks ksgsmu, I am all prepared to start the thyroid medicine.  My obgyn was leaving that decision up to RE, so I am going to push for it.  I have read about those issues with a higher thyroid level & it is very scary to think about.

I tried making an appt today with RE & they are not in - I have to wait until tomorrow. Ugh.  It is going to be tough - they are only open until 5pm M-F & I will need the last appt - which I am sure most ppl want   I know another poster also recommended this RE & her appt isn't until the beg of Nov. Yikes.

As to the HSG test - he said I would most likely have to go to the hospital for this test.  Where did everyone get theirs done?  I have the script for this test, so I don't have to wait to see the RE to get it done.  Actually my obgyn said to bring the results of the SA & HSG to the RE's office along with my 3day blood work. 

 

ksgsmu

I had my HSG done at the RE's clinic. It is a big clinic with a separate "surgery" center. Not sure if most RE's do them or not.  I know many people have them done at a hospital though.  It is a unpleasant test, but only last a few minutes.  I had to pay OP because my insurance doesn't cover "fertility" treatments/tests.  It was pricey ( $1000) but it was necessary and I am glad I did it for peace of mind.

Good luck with your new RE... hope you get a plan that works for you!

Qzees

Thanks ksgsmu - I will ask the RE office tomorrow when I get a hold of them for an appt.

robbensm

Qzees - I hope you find the answers you are looking for and can come up with a plan that is within your beliefs & can help you achieve your goal.  I can respect the fact that everyone has to make their own decisions about what is best for them as long as they can respect that my decisions are mine (which it sounds like you do).   My advice is if you meet with the RE I think you need to be very clear right from the start what it is that you will allow as far as intervention goes because that can help them decide which tests are really worth the time & money.

McIrish - I'm curious about your TSH research.  Is TSH something that fluctuates with your cycle or does it stay pretty static?  Mine came back as 2.650 which is within normal limits but I had been wondering if that was a little high and based on your pp I'm really curious now.  I haven't had the chance to follow up with my doctor yet - just saw the numbers.

Mrs.McIrish

robbensm:

 McIrish - I'm curious about your TSH research.  Is TSH something that fluctuates with your cycle or does it stay pretty static?  Mine came back as 2.650 which is within normal limits but I had been wondering if that was a little high and based on your pp I'm really curious now.  I haven't had the chance to follow up with my doctor yet - just saw the numbers.

I don't think TSH fluctuates with your cycle. It should be pretty static.  Mine was always under 1.5 so I was surprised last week at baseline when it came in at 2.09.  My RE's nurse said it was fine as they only wanted it at lower than 3.0.  Since I have been around the block with lots of other ladies doing through IF, I remembered that the top REs always want it under 2 for conception.  (note that I go to a shitty clinic but it's the only DE program I can afford so I question everything they say). I had an appt today with my reg gyn so I had her re-run TSH for my own piece of mind.  I had asked other  IF vets last week and they unianimously say under 2.0. That doesn't mean others can't get pregnant with slightly higher but when you have gnoe through as much treatment unsucessfully as I have, you want every level to be as good as it can be. If that means I take a low dose of synthroid, I will.  Note that a lot of REs will tell your level is fine. I just think it could be better for conception purposes.

HeathernSteven

Hey Qzee! It was me that reco the RE, my appointment is in Nov because that is when they start taking my Insurance, I don't know what their appt schedule it like.

Oh I also went to Monmouth Med for the HSG, I recommend you don't go alone. The people there were very nice and helpful, even the folks doing the procedure - we just all had a tough time with it.

I don't know how far I can go with medical intervention, if it is an option maybe IUI.  Money is definitely an issue, we can't afford it, I also don't think I am strong enough to handle the emotional turmoil. The women who are going through ART IMHO are very strong...Kudos to all of them.

Qzees

robbensm:

Qzees - I hope you find the answers you are looking for and can come up with a plan that is within your beliefs & can help you achieve your goal.  I can respect the fact that everyone has to make their own decisions about what is best for them as long as they can respect that my decisions are mine (which it sounds like you do).   My advice is if you meet with the RE I think you need to be very clear right from the start what it is that you will allow as far as intervention goes because that can help them decide which tests are really worth the time & money.

McIrish - I'm curious about your TSH research.  Is TSH something that fluctuates with your cycle or does it stay pretty static?  Mine came back as 2.650 which is within normal limits but I had been wondering if that was a little high and based on your pp I'm really curious now.  I haven't had the chance to follow up with my doctor yet - just saw the numbers.

Yes, I will absolutely be upfront with the RE.  When I was upfront with my obgyn (the first meeting prior to 3 day bloodwork) he shot me down instantly & basically told me "your 42, you should see an RE & consider IVF".  Without actually saying it, he was trying to tell me (I felt) your too old & there is no shot at all to TTC naturally.  This last meeting as I mentioned was much nicer & not so pushy.  I wonder if my conversation with the assistant prior to seeing the Dr yesterday was passed along.  I told her how he crushed me the last time I was there & I was not happy about being pushed in a direction that I was not considering going.

I am all for the women on here doing anything in their power to get pregnant.  I have a few very good friends who were successful with IVF (one just had her baby 2-3 days ago & I believe she is 45 or 46) & another friend who after one IUI got pregnant.  This IUI woman found out from her RE that her body was being hostile to her DH sperm & that douching with baking soda & water (I believe was the mixture) an hr before having sex would help.  I believe she only tried that for 2 mths before moving on to IUI.  This is something that I know the RE can figure out - the OBGYN just deals with women already pregnant - not getting pregnant. 

Mrs.McIrish

Just an FYI: RE's aren't interested in walking you through baking soda douches or small things to improve natural chances as it doesn't make them money. They will just tell you do IUI to avoid the hostile mucous. Everything is a business.

danieleandwayne

**siggy warning**

 I just wanted to chime in quickly on the TSH thing. Make sure you know what range the lab testing your blood uses. My sister and I went to 2 different endocrinologists from the same practice and because I'm 45 minutes north of my sister (we have traveling endocrinologists here in Maine), the labs were different and used different ranges for normal.

My TSH last year was 3.60 with the range being 0.40 - 3.80 considered normal. A year prior to that, my TSH was 3.something (I don't remember). Neither the endocrinologist nor the rheumatologist (who ordered the test last year) thought I needed any intervention. And I'm overweight with unexplained weight gain. My RE never saw my TSH level.

I would just be wary of automatically assuming one's TSH requires intervention, is too low or too high-- find out the lab's range and question your doctors. Make them explain why they are recommending a course of action (or lack thereof). Then you can make educated decisions...

Okay, I'm off my soapbox now. Whatever you decide, you will do what is right for you-- whether it was sticking to your original plan or a complete 180 from it. GL!

 

 

 

 

 

Qzees

Thanks McIrish, that is good to know.  I can understand their point.

I guess my friend's RE was very nice & not money hungry since he was the one who recommended trying that.  Of course they probably realized that she was open to IUI already.  I am not going to use her RE - he is about 1 1/2 hrs from me.

babystoli

danieleandwayne:

**siggy warning**

 I just wanted to chime in quickly on the TSH thing. Make sure you know what range the lab testing your blood uses. My sister and I went to 2 different endocrinologists from the same practice and because I'm 45 minutes north of my sister (we have traveling endocrinologists here in Maine), the labs were different and used different ranges for normal.

My TSH last year was 3.60 with the range being 0.40 - 3.80 considered normal. A year prior to that, my TSH was 3.something (I don't remember). Neither the endocrinologist nor the rheumatologist (who ordered the test last year) thought I needed any intervention. And I'm overweight with unexplained weight gain. My RE never saw my TSH level.

I would just be wary of automatically assuming one's TSH requires intervention, is too low or too high-- find out the lab's range and question your doctors. Make them explain why they are recommending a course of action (or lack thereof). Then you can make educated decisions...

Okay, I'm off my soapbox now. Whatever you decide, you will do what is right for you-- whether it was sticking to your original plan or a complete 180 from it. GL!

  

I agree with not jumping the gun on TSH levels.  Call and make an appointment with an endocrinologist who specializes in thyroid disease, or at least make sure they test free T3, free T4 & antibody levels, too.    I've been hypothyroid for a couple years, and my primary care doc always just wanted my levels within the "normal" range of under 5.   My TSH during wk 5 of my pregnancy was 11!!! yes, 11.   They upped the dose of levothyroxine immediately.  The week after the miscarriage (when I would have been 12 wks), my TSH was under 2.5.   All five doctors I've seen in the past 3 months have said that my elevated TSH  wasn't a factor, at all, in my miscarriage.    Anyway- as soon as I heard the 11... I made appointments with two different endocrinologists that my friends have seen.   One was ok-  switched me to synthroid (the name brand) versus the generic, since the actual potency of the generic can differ by up to 12% (so if you are on 100 micrograms like I am,  and you are taking the generic, you could potentially take 88 micrograms one month and 112 micrograms the next month).    The other one was AWESOME and explained that if you are on meds for hypothyroid, your TSH should always be below 2.5, regardless of TTC.  He also read my palm.

IF you are levothyroxine-  you should make sure they also test your free T3 & free T4 & check for antibodies.   Your thyroid makes mostly  T4, some T3, once TSH stimulates it to do so.  T4 gets converted to T3, which is the active form.  Even if TSH & T4 are normal...  T3 might not be.   levothyroxine & synthroid are replacing the T4.   there is another drug you can take that is a T3 analog, too, if you need to.

 Good luck!

HeathernSteven

QZees did you get an appointment with RE? keep us posted!

Qzees

Yes, Oct 29th 3pm.  They had the 17th available, but it was at 1pm & I don't want to miss too much work.  I work over an hr away from the drs office.

She said it will be roughly a 45 min meeting that includes a pelvic exam & vaginal u/s.

She also was kind enough to tell me the ph# for Aetna Ins - she said I have to sign up & let them know I am going for infertility treatment.