Thoughts from my OB

Jlavonne23 · September 2011

I went to the OB this morning for my annual and we talked TTC. I thought I would pass along her insight even though its mostly everything we already know, it might be helpful to the newbies. I told her all about what I was doing, how my cycles were, and how we were almost to a year mark.

She said if I'm having fairly normal cycles every month to not even worry about fertility issues. In her opinion it can take up to a year and a half for healthy couples to conceive. She reccommended pre-seed since I don't see EWCM and not getting up for about 10 mins after sex. Also that BD ED is ok but by the 3rd day in a row sperm count could be lower. She swore by OPK kits and reccommended I do those for 3 months with her as my OB. I'm going back CD 21-23 for blood work to test progesterone. Although I'm not excited about having to give blood I'm extremely happy that she wants to test for that, just for my peace of mind. And if still nothing in 3 months, we go in for SA (hope it doesn't come to that.)

Although I didn't learn anything new it was nice to be told I'm not doing anything wrong, that she knew how I felt, and wanted to help. Pretty sucessful appointment.

On a side note: I thought it was pretty funny when the nurse asked me if there was any chance I was pregnant. I said no and she asked if I was sure since I'm not on BC... haha yep 100 % sure

BearWombat · September 2011

Jlavonne23:
I went to the OB this morning for my annual and we talked TTC. I thought I would pass along her insight even though its mostly everything we already know, it might be helpful to the newbies. I told her all about what I was doing, how my cycles were, and how we were almost to a year mark.

She said if I'm having fairly normal cycles every month to not even worry about fertility issues. In her opinion it can take up to a year and a half for healthy couples to conceive. She reccommended pre-seed since I don't see EWCM and not getting up for about 10 mins after sex. Also that BD ED is ok but by the 3rd day in a row sperm count could be lower. She swore by OPK kits and reccommended I do those for 3 months with her as my OB. I'm going back CD 21-23 for blood work to test prostogen. Although I'm not excited about having to give blood I'm extremely happy that she wants to test for that, just for my peace of mind. And if still nothing in 3 months, we go in for SA (hope it doesn't come to that.)

Although I didn't learn anything new it was nice to be told I'm not doing anything wrong, that she knew how I felt, and wanted to help. Pretty sucessful appointment.

On a side note: I thought it was pretty funny when the nurse asked me if there was any chance I was pregnant. I said no and she asked if I was sure since I'm not on BC... haha yep 100 % sure

Do you mean progesterone?

Also, I don't agree with your OB's timeline of a year and a half. If I were you, I would want to get not only my progesterone checked, but my prolactin levels as well, and at least an ultrasound, and preferably an HSG. I would DEFINITELY get an SA done ASAP, as I came back all clear, but DH had low count, low motility, and low morphology. The overhwelming consensus for most women who have IF (and IF is defined as 1 year TTC and no pregnancy, so you fall into that group) is that they wished they had gotten tested sooner. I definitely agree with that. So, why waste another 3 months not getting pregnant? Get the SA done. It's super fast and easy, and you get the results within a couple days.

Jlavonne23 · September 2011

BearWombat:
Jlavonne23:

I went to the OB this morning for my annual and we talked TTC. I thought I would pass along her insight even though its mostly everything we already know, it might be helpful to the newbies. I told her all about what I was doing, how my cycles were, and how we were almost to a year mark.

She said if I'm having fairly normal cycles every month to not even worry about fertility issues. In her opinion it can take up to a year and a half for healthy couples to conceive. She reccommended pre-seed since I don't see EWCM and not getting up for about 10 mins after sex. Also that BD ED is ok but by the 3rd day in a row sperm count could be lower. She swore by OPK kits and reccommended I do those for 3 months with her as my OB. I'm going back CD 21-23 for blood work to test prostogen. Although I'm not excited about having to give blood I'm extremely happy that she wants to test for that, just for my peace of mind. And if still nothing in 3 months, we go in for SA (hope it doesn't come to that.)

Although I didn't learn anything new it was nice to be told I'm not doing anything wrong, that she knew how I felt, and wanted to help. Pretty sucessful appointment.

On a side note: I thought it was pretty funny when the nurse asked me if there was any chance I was pregnant. I said no and she asked if I was sure since I'm not on BC... haha yep 100 % sure

Do you mean progesterone?

Also, I don't agree with your OB's timeline of a year and a half. If I were you, I would want to get not only my progesterone checked, but my prolactin levels as well, and at least an ultrasound, and preferably an HSG. I would DEFINITELY get an SA done ASAP, as I came back all clear, but DH had low count, low motility, and low morphology. The overhwelming consensus for most women who have IF (and IF is defined as 1 year TTC and no pregnancy, so you fall into that group) is that they wished they had gotten tested sooner. I definitely agree with that. So, why waste another 3 months not getting pregnant? Get the SA done. It's super fast and easy, and you get the results within a couple days.

Yes sorry that is what I meant, I'll change it. Thanks for the advice I'll being that up at my next appointment.

ccam · September 2011

Jlavonne23:

I went to the OB this morning for my annual and we talked TTC. I thought I would pass along her insight even though its mostly everything we already know, it might be helpful to the newbies. I told her all about what I was doing, how my cycles were, and how we were almost to a year mark.

She said if I'm having fairly normal cycles every month to not even worry about fertility issues. In her opinion it can take up to a year and a half for healthy couples to conceive. She reccommended pre-seed since I don't see EWCM and not getting up for about 10 mins after sex. Also that BD ED is ok but by the 3rd day in a row sperm count could be lower. She swore by OPK kits and reccommended I do those for 3 months with her as my OB. I'm going back CD 21-23 for blood work to test progesterone. Although I'm not excited about having to give blood I'm extremely happy that she wants to test for that, just for my peace of mind. And if still nothing in 3 months, we go in for SA (hope it doesn't come to that.)

Although I didn't learn anything new it was nice to be told I'm not doing anything wrong, that she knew how I felt, and wanted to help. Pretty sucessful appointment.

On a side note: I thought it was pretty funny when the nurse asked me if there was any chance I was pregnant. I said no and she asked if I was sure since I'm not on BC... haha yep 100 % sure

I don't agree with this at all! Your cycles don't determine if YH has a problem. Some stats I've read show that 1/3 of infertility is due to the male, 1/3 is due to the woman and the other 1/3 is due to a combo of the two or is unknown (or something like that, don't know the exact numbers). Just remember that infertility is not your OB's specialty and most REs recommend making an appointment if you're not pregnant within a year, although it's still a personal decision. Just take what your OB says with a grain of salt. Good luck to you - hopefully this isn't anything you have to worry about!

Mrs.Umm · September 2011

Show your OB my siggy. Then, explain to her that I had "fairly normal cycles" for well over a year. I had temps and OPKs that showed O. None of these things mean squat to me. Now, I'm not saying that's the case with everyone, but I'd be pissed if my doc brushed me off after a year of ttc because my cycles were "fairly normal".

6to82010 · September 2011

I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

saratrying · September 2011

I think it's great that she reassured you that you're doing things right, but I don't think she's doing what's in your best interest.

TTC for 12 months without results could simply be a timing issue, and that would be great, but it could also mean there's something more. I know getting checked out is difficult, but the longer a doctor puts it off, the longer any problems may go unchecked. And it may not even be you - your DH could have a low sperm count. You won't know unless you are both examined.

My point -- if there's a reason, you want to know now.

Good luck.

ccam · September 2011

6to82010:
I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

I almost missed it, too, but she actually said in the first paragraph that she's getting close to the year mark. I think that's why a lot of us made the comments we did.

Jlavonne23 · September 2011

ccam:

6to82010:
I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

I almost missed it, too, but she actually said in the first paragraph that she's getting close to the year mark. I think that's why a lot of us made the comments we did.

We are on month 11 and I am 24. Wow I thought the appointment went well I did not go in for a IF appt that was just her advice. Maybe she was brushing me off because she thought it was too early to have that conversation, i don't know.

callingyouout48 · September 2011

Jlavonne23:
ccam:

6to82010:
I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

I almost missed it, too, but she actually said in the first paragraph that she's getting close to the year mark. I think that's why a lot of us made the comments we did.

We are on month 11 and I am 24. Wow I thought the appointment went well I did not go in for a IF appt that was just her advice. Maybe she was brushing me off because she thought it was too early to have that conversation, i don't know.

I'd see about at least getting a second opinion and visiting a different OB. It sounds like she may not want to take your situation seriously until you get closer to the year and a half mark and IMO there is no reason you should have to wait that long. I'd want testing closer to the year mark.

fyziksgirl · September 2011

The year and a half mark is crazy. I was an engineer/analyst and also have a math degree, here's the breakdown on odds:

Assuming you have a 20% chance each month to get pregnant (the low end of what I hear for everyone being healthy) that means you have a 0.8 ^ 12 = 0.068 = 6.8% chance of not getting pregnant within one year if everything is OK. That means that over 93% of couples will be pregnant if they are healthy and try for one year, assuming the fairly low but reasonable odds of 20% liklihood each cycle.

Increasing that to a year and a half with the same odds means you now have a 0.8^18 = 0.018 = 1.8% chance of not getting pregnant within 18 months if everything is OK. That means that over 98% of couples will be pregnant if they are healthy and try for 18 months.

Is that an increase? Absolutely. But it's not a big increase, especially if you've been actively trying and timing things well for a year! It is not worth waiting another 6 months for the chance that you will be one of the 5% of couples who don't get pregnant in one year of trying but do in 18 months when there are super easy things like a SA that can be done!

For reference, here are other odds if you assume a different probability of pregnancy each month. You can see that no matter what you assume, it doesn't make much difference. The biggest difference is if you assume 15% each month, but that is still small and that is a very low assumption! If you assume a 25% chance each month (definitely reasonable, I usually hear 20-25%) your chances only increase by a measly 2.5%! If it's been a year, you should be getting at least simple testing if you want it.

Odds each month: 15%
Odds at 1 year: 86%
Odds at 18 mo: 95%

Odds each month: 20%
Odds at 1 year: 93%
Odds at 18 mo: 98%

Odds each month: 25%
Odds at 1 year: 97%
Odds at 18 mo: 99.5%

Odds each month: 30%
Odds at 1 year: 99%
Odds at 18 mo: 99.9%

Remember, OBGYNs don't always know everything there is to know about fertility. Mine told me not to bother temping as it didn't work, and to just know that I ovulated 14 days after my last period started. When I looked at her funny she added if I really wanted to confirm it, I could use an OPK. Trust your gut. Good luck!

ccam · September 2011

Jlavonne23:
ccam:

6to82010:
I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

I almost missed it, too, but she actually said in the first paragraph that she's getting close to the year mark. I think that's why a lot of us made the comments we did.

We are on month 11 and I am 24. Wow I thought the appointment went well I did not go in for a IF appt that was just her advice. Maybe she was brushing me off because she thought it was too early to have that conversation, i don't know.

I don't think anyone is trying to make you nervous, or trying to say that the year mark is "the end". There are plenty of people who get pregnant naturally after 12 months of trying. There are also lots of ladies here that didn't want to see a RE at the year mark. My OB brushed off my questions at 9 months, but when that year mark came, we made the decision to move onto an RE. It just sounds like a lot of the things your OB is telling you are not right and you might want a second opinion.

saratrying · September 2011

OBs are not experts on IF issues, and some won't encourage testing unless they are certain that's what the patient wants. Given your age, she probably assumes you're not in any hurry and that it's all a timing issue. If you want to stay with this OB, sounds like you need to ask her to recommend testing.

jessican08 · September 2011

Jlavonne23:

She said if I'm having fairly normal cycles every month to not even worry about fertility issues.

Yeah, I have to take up an issue with this. My cycles are clockwork and have been since the first month I came off the pill. I ovulate with no issues and all my hormone levels are perfect.

My regular cycles don't know if my tubes are blocked, if my egg quality sucks, if I have endometriosis or if my H's sperm suck.

As the PPs have said, if you DO hit the year mark and still aren't PG, I would move on to a RE and not deal with an OB/GYN for any fertility issues. GL!

bwe1100 · September 2011

fyziksgirl:
The year and a half mark is crazy. I was an engineer/analyst and also have a math degree, here's the breakdown on odds:
Assuming you have a 20% chance each month to get pregnant (the low end of what I hear for everyone being healthy) that means you have a 0.8 ^ 12 = 0.068 = 6.8% chance of not getting pregnant within one year if everything is OK. That means that over 93% of couples will be pregnant if they are healthy and try for one year, assuming the fairly low but reasonable odds of 20% liklihood each cycle.

Increasing that to a year and a half with the same odds means you now have a 0.8^18 = 0.018 = 1.8% chance of not getting pregnant within 18 months if everything is OK. That means that over 98% of couples will be pregnant if they are healthy and try for 18 months.
Is that an increase? Absolutely. But it's not a big increase, especially if you've been actively trying and timing things well for a year! It is not worth waiting another 6 months for the chance that you will be one of the 5% of couples who don't get pregnant in one year of trying but do in 18 months when there are super easy things like a SA that can be done!
For reference, here are other odds if you assume a different probability of pregnancy each month. You can see that no matter what you assume, it doesn't make much difference. The biggest difference is if you assume 15% each month, but that is still small and that is a very low assumption! If you assume a 25% chance each month (definitely reasonable, I usually hear 20-25%) your chances only increase by a measly 2.5%! If it's been a year, you should be getting at least simple testing if you want it.
Odds each month: 15%
Odds at 1 year: 86%
Odds at 18 mo: 95%
Odds each month: 20%
Odds at 1 year: 93%
Odds at 18 mo: 98%
Odds each month: 25%
Odds at 1 year: 97%
Odds at 18 mo: 99.5%
Odds each month: 30%
Odds at 1 year: 99%
Odds at 18 mo: 99.9%
Remember, OBGYNs don't always know everything there is to know about fertility. Mine told me not to bother temping as it didn't work, and to just know that I ovulated 14 days after my last period started. When I looked at her funny she added if I really wanted to confirm it, I could use an OPK. Trust your gut. Good luck!

this is the best use of math skills I've ever seen.

jenk84 · September 2011

bwe1100:

this is the best use of math skills I've ever seen.

And I SWORE I would never use math again.... now this chic has me wishing I'd listened a little more!

canthardlywait426 · September 2011

GhostMonkey:
I'd be looking for a new OB or at least someone else for fertility advice. 1 year is IF. Preseed is not EWCM replacement- it's lube. That's it. The sperm comment is insanely ignorant. OPK's don't work for everyone, it's easy to miss, and they don't confirm. The progesterone test MUST be done at 7 dpo to be accurate- CD is irrelevant. SA is super simple and the least invasive- that is where you should be starting.

Completely agree with all of this. As well as adding that there is no need to lie there for 10 minutes after sex unless you want to up your chance for a UTI as well.

canthardlywait426 · September 2011

fyziksgirl:
OBGYNs don't always know everything there is to know about fertility. Mine told me not to bother temping as it didn't work, and to just know that I ovulated 14 days after my last period started. When I looked at her funny she added if I really wanted to confirm it, I could use an OPK. Trust your gut. Good luck!

Oh lord. not good advice at all. Haha.

staycee · September 2011

even at 18 months I bet this is the type of OB who'd hand out clomid with no monitoring.

mrstolsen · September 2011

fyziksgirl:

The year and a half mark is crazy. I was an engineer/analyst and also have a math degree, here's the breakdown on odds:

Assuming you have a 20% chance each month to get pregnant (the low end of what I hear for everyone being healthy) that means you have a 0.8 ^ 12 = 0.068 = 6.8% chance of not getting pregnant within one year if everything is OK. That means that over 93% of couples will be pregnant if they are healthy and try for one year, assuming the fairly low but reasonable odds of 20% liklihood each cycle.

Increasing that to a year and a half with the same odds means you now have a 0.8^18 = 0.018 = 1.8% chance of not getting pregnant within 18 months if everything is OK. That means that over 98% of couples will be pregnant if they are healthy and try for 18 months.

Is that an increase? Absolutely. But it's not a big increase, especially if you've been actively trying and timing things well for a year! It is not worth waiting another 6 months for the chance that you will be one of the 5% of couples who don't get pregnant in one year of trying but do in 18 months when there are super easy things like a SA that can be done!

For reference, here are other odds if you assume a different probability of pregnancy each month. You can see that no matter what you assume, it doesn't make much difference. The biggest difference is if you assume 15% each month, but that is still small and that is a very low assumption! If you assume a 25% chance each month (definitely reasonable, I usually hear 20-25%) your chances only increase by a measly 2.5%! If it's been a year, you should be getting at least simple testing if you want it.

Odds each month: 15%
Odds at 1 year: 86%
Odds at 18 mo: 95%

Odds each month: 20%
Odds at 1 year: 93%
Odds at 18 mo: 98%

Odds each month: 25%
Odds at 1 year: 97%
Odds at 18 mo: 99.5%

Odds each month: 30%
Odds at 1 year: 99%
Odds at 18 mo: 99.9%

Remember, OBGYNs don't always know everything there is to know about fertility. Mine told me not to bother temping as it didn't work, and to just know that I ovulated 14 days after my last period started. When I looked at her funny she added if I really wanted to confirm it, I could use an OPK. Trust your gut. Good luck!

WOW! This is really depressing. We're in cycle 12, so we're in the 6.8% of couples who don't get pregnant within a year. Time to make a RE appointment.

fyziksgirl · September 2011

jenk84:
bwe1100:

this is the best use of math skills I've ever seen.

And I SWORE I would never use math again.... now this chic has me wishing I'd listened a little more!

Thank you, thank you, I'm here all week...

And my students ask me why they'll ever need to know math! HAH!

fyziksgirl · September 2011

mrstolsen:
fyziksgirl:

WOW! This is really depressing. We're in cycle 12, so we're in the 6.8% of couples who don't get pregnant within a year. Time to make a RE appointment.

Sorry, didn't mean to be depressing :-( I'm just one of those who would rather know than have to guess. It is definitely still possible that everything's OK, and remember, your odds do stay the same every month! Your body doesn't know it's your 13th month trying, so it could still be your time! It's just like rolling a die; odds are you won't roll a die a dozen times without getting a 3, but you still have a one in six chance of getting a 3 for each individual throw.

GL!

6to82010 · September 2011

ccam:
6to82010:
I think OP said she went for her annual OB appointment, not that she has been trying for a year. We also don't know how old OP is.

I almost missed it, too, but she actually said in the first paragraph that she's getting close to the year mark. I think that's why a lot of us made the comments we did.

Ohh! Thank you. Reading is hard.

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