Help?

JBALL1

So this is our second cycle ttc #2. Since we are on a timeline, DH and I decided that if we don't conceive this cycle then we are going to go ahead and try to get on some fertility meds. I have PCOS and he has testicular cancer and just had a testicle removed in November.

We have never had any type of fertility testing whatsoever. I don't even know where to begin. I know his urologist that diagnosed him with cancer and removed the testicle said that he could order sperm analysis at any time we want it done.

My question is...what about women? What options for testing are available to me? I have fantastic insurance so I'm not very worried about the cost of the testing. However, my OB-GYN is the best in our area and I called in NOVEMBER to schedule my yearly PAP and they couldn't get me in until MAY!! So, I don't want to have to wait that long, as it would be out of our time frame. (We have until April to ttc and find out then if we can continue to try or if we must stop because DH needs radiation or chemo).

Noone else understands this issue on some of the other boards and usually I get rude responses because they and this is a direct quote "have never been pregnant and you have so I don't know why you are going through this with us, you don't belong here. You have a child."

So, I was hoping that someone could PLEASE give me some info on types of testing and the types of medication available for women with PCOS. I know only my doctor can give me the perfect answer but I know nothing. I see women posting about clomid, obviously it is a fertility pill for women...but what does it do?

Sorry if I seem a little uneducated on these things, but I really am when it comes to infertility issues. Everyone in my family can look at a penis and get pregnant, so family is of no help in my situation. Thanks.

laurid75

I would either ask your OB-GYN for a refererral to an Reproductive Endocrinologist (Fertility Specialist) or find one on your own who is highly recommended and takes your insurance.  They will meet you with, you can explain your situation and they will order a bunch of tests for you as well as the sperm analysis for your husband.  I would say it is probably pointless for him to get one done on his own b/c a fertility Dr will likely want to repeat the test anyway.  As far as you, they will run a bunch of blood tests - I'm not sure exactly what they check but you can ask - hormone levels are checked (one of which is an indicator of your ovarian egg reserve), they may check thyroid, etc.  The Dr may also order an HSG (sometimes calle "dye test") to verify that your tubes are clear.  Then you can come up with a plan with the Dr.  I say if you're in such a scrict time frame make the RE appt for a consult asap.  They can usually do the bloodwork right there in the office!  Unless they want it on certain cycle days, in which case you might have to come back.  I have had all the testing done but I still don't feel like I know a lot about it, the other women on this board are a weath of knowledge and will hopefully chime in with more details but I think I got the basics

I am sorry to hear about your troubles and about your husband's cancer   I hope you can get an appointment soon and come up with a plan of action and I hope that his treatment works well also!  Good luck.

JBALL1

laurid75:

I would either ask your OB-GYN for a refererral to an Reproductive Endocrinologist (Fertility Specialist) or find one on your own who is highly recommended and takes your insurance.  They will meet you with, you can explain your situation and they will order a bunch of tests for you as well as the sperm analysis for your husband.  I would say it is probably pointless for him to get one done on his own b/c a fertility Dr will likely want to repeat the test anyway.  As far as you, they will run a bunch of blood tests - I'm not sure exactly what they check but you can ask - hormone levels are checked (one of which is an indicator of your ovarian egg reserve), they may check thyroid, etc.  The Dr may also order an HSG (sometimes calle "dye test") to verify that your tubes are clear.  Then you can come up with a plan with the Dr.  I say if you're in such a scrict time frame make the RE appt for a consult asap.  They can usually do the bloodwork right there in the office!  Unless they want it on certain cycle days, in which case you might have to come back.  I have had all the testing done but I still don't feel like I know a lot about it, the other women on this board are a weath of knowledge and will hopefully chime in with more details but I think I got the basics

I am sorry to hear about your troubles and about your husband's cancer   I hope you can get an appointment soon and come up with a plan of action and I hope that his treatment works well also!  Good luck.

Great! Thanks. Is there any way my regular family practitioner could refer me? I don't go see my OB-GYN until May and he will want to see me before he could give me a referral. My family doctor is fantastic. He knew my husband had tc before the testing! He prepared us very well for the official diagnosis, and took over all of my husband's care until the urogolgist and oncologist stepped in. He still calls regularly to check up on DH and I. DD continuously asks for a "baby broder" so I'm hoping we will be able to give her one!!!

efhoping2010

I agree with pp, find or get a referral to an RE today.  They will know what tests to run and what treatment options are available.  And as pp said some blood tests and pretests need to be run at certain times in the cycle so getting in for a consult is important because of your time frame, some clinics also have waiting lists or only cycle a certain number of people, or only at certain times so there are lots of possible variables.  Also find out if you have insurance coverage and what it covers, IF and testing and procedures and medications is a complicated and potentially very expensive endeavor, if you have any coverage make sure you go where you can use it.  We are 100% OOP and it is awful but there are ways such as donations to help.  My DH has no sperm because he does not have a vas deferens due to atypical cystic fibrosis so we can only do IVF.  If your DH has sperm and enough of it I am guessing IUI or other options might be possible, but I am not an RE.  Good luck, it may seem like a lot but you can do it!   

LaineyPaney

PAIF Response:

An Andrologist may also be able to help, given your husbands diagnosis.

If I were in your shoes I would have DH go ahead and do the SA with the urologist and you are already established as patients there. I would also go for a new patient consultation with an RE. Have your OB and urologist send over any records relating to your history prior to the initial consultation so that the RE will be familiar.

laurid75

JBALL1:

laurid75:

I would either ask your OB-GYN for a refererral to an Reproductive Endocrinologist (Fertility Specialist) or find one on your own who is highly recommended and takes your insurance.  They will meet you with, you can explain your situation and they will order a bunch of tests for you as well as the sperm analysis for your husband.  I would say it is probably pointless for him to get one done on his own b/c a fertility Dr will likely want to repeat the test anyway.  As far as you, they will run a bunch of blood tests - I'm not sure exactly what they check but you can ask - hormone levels are checked (one of which is an indicator of your ovarian egg reserve), they may check thyroid, etc.  The Dr may also order an HSG (sometimes calle "dye test") to verify that your tubes are clear.  Then you can come up with a plan with the Dr.  I say if you're in such a scrict time frame make the RE appt for a consult asap.  They can usually do the bloodwork right there in the office!  Unless they want it on certain cycle days, in which case you might have to come back.  I have had all the testing done but I still don't feel like I know a lot about it, the other women on this board are a weath of knowledge and will hopefully chime in with more details but I think I got the basics

I am sorry to hear about your troubles and about your husband's cancer   I hope you can get an appointment soon and come up with a plan of action and I hope that his treatment works well also!  Good luck.

Great! Thanks. Is there any way my regular family practitioner could refer me? I don't go see my OB-GYN until May and he will want to see me before he could give me a referral. My family doctor is fantastic. He knew my husband had tc before the testing! He prepared us very well for the official diagnosis, and took over all of my husband's care until the urogolgist and oncologist stepped in. He still calls regularly to check up on DH and I. DD continuously asks for a "baby broder" so I'm hoping we will be able to give her one!!!

Depending on your insurance you probably don't even need an official "referral." I woudl contact yoru insurance company to find out if a referral is necessary. If not, i would just search for REs in your area and speak to other people to try to get a word of mouth recommendation, I woudl hesitate to pick someone out of the phone book. Asking your primary care physician is a great option too, as I am sure they can recommend someone. i agree with the other person who responded to look into insurance first. You'd be surprised to see what they will and won't cover and it's better to know that going into it!

nawlinsgrl

gennyu:

Hi there,

I do have a couple of questions based on your post:

1) Did you have difficulty conceiving your daughter?

2) How do you know you have PCOS if you have never had fertility testing?

3) Did your DH's urologist address how his cancer and testicle removal would or wouldn't impact his fertility?

What I'm trying to get a better picture of is whether you are seeking testing because you have reason to believe there is an issue or because you want to speed up the process due to your timeline.  If your only probelm is your timeline (and I am not trying to diminish that because it is definitely a problem), fertility meds aren't necessarily going to help you.

I second this.  You didn't mention how long it took to conceive #1 or your age.  It can take a healthy couple up to 12 months to conceive, so most doctors don't recommend pursuing fertility treatment before then, and at least 6 months if you are over age 35. 

So, while I respect whatever "timeline" you have going, you do need to be realistic, and understand if there are legitimate issues preventing you from getting pregnant, fertility treatments won't fix them overnight.  It will be months before you can possibly get pregnant, between waiting for an appt., testing on the appropriate cycle day(s), and then actually starting treatment.

In my case, when TTC #1, I started seeing the RE in May, had testing, ended up having a hysteroscopy/D&C in July, and didn't start IVF until August.  This time it went quicker because we knew what we were dealing with, and didn't have any roadblocks, but it still takes a good bit of time.

JBALL1

gennyu:

Hi there,

I do have a couple of questions based on your post:

1) Did you have difficulty conceiving your daughter?

2) How do you know you have PCOS if you have never had fertility testing?

3) Did your DH's urologist address how his cancer and testicle removal would or wouldn't impact his fertility?

What I'm trying to get a better picture of is whether you are seeking testing because you have reason to believe there is an issue or because you want to speed up the process due to your timeline.  If your only probelm is your timeline (and I am not trying to diminish that because it is definitely a problem), fertility meds aren't necessarily going to help you.

1) I was scheduled for a routine check-up for my PCOS issues and discovered I was pregnant...after my doctor told me that I probably wouldn't be able to ever have children by the looks of my ovaries and my cycle history(started menses at 8 and had serious side effects from birth control).

2) I was diagnosed via internal ultrasound in November 2009 after having severe pain.

3) The urologist said that the removal of the testicle could impact his fertility if he had sperm motility or count issues(which is why he said he could test it at any time) and the radiation would definitely affect fertility hence the timeline...if he has to have radiation then we are pretty much thrown a curveball last minute. I just want to plan and he is very against banking sperm unless it is a must for some reason.

I know that fertility meds are not the answer for every situation and that if we don't conceive right now and if he wouldn't get radiation therapy then we could try again later, but I just want to be prepared and know what options are out there.

Thanks!!

JBALL1

nawlinsgrl:

gennyu:

Hi there,

I do have a couple of questions based on your post:

1) Did you have difficulty conceiving your daughter?

2) How do you know you have PCOS if you have never had fertility testing?

3) Did your DH's urologist address how his cancer and testicle removal would or wouldn't impact his fertility?

What I'm trying to get a better picture of is whether you are seeking testing because you have reason to believe there is an issue or because you want to speed up the process due to your timeline.  If your only probelm is your timeline (and I am not trying to diminish that because it is definitely a problem), fertility meds aren't necessarily going to help you.

I second this.  You didn't mention how long it took to conceive #1 or your age.  It can take a healthy couple up to 12 months to conceive, so most doctors don't recommend pursuing fertility treatment before then, and at least 6 months if you are over age 35. 

So, while I respect whatever "timeline" you have going, you do need to be realistic, and understand if there are legitimate issues preventing you from getting pregnant, fertility treatments won't fix them overnight.  It will be months before you can possibly get pregnant, between waiting for an appt., testing on the appropriate cycle day(s), and then actually starting treatment.

In my case, when TTC #1, I started seeing the RE in May, had testing, ended up having a hysteroscopy/D&C in July, and didn't start IVF until August.  This time it went quicker because we knew what we were dealing with, and didn't have any roadblocks, but it still takes a good bit of time.

I am 23, DH is 26. The reason for the "timeline" is that DH's cancer treatments affect fertility and we have 4 months to try until his comprehensive appointment (they come in 4 month intervals and we find out if he needs immediate treatment, we opted out of radiation and chemo after his orchiectomy to protect his overall wellbeing as he heals fully post-op.)