TTC After a Loss

What testing do you need prior to seeing an RE?

Ready for a long one? Ok, go...

Background:

- DH 32, Me 29 (next month).

- TTC: just over 2 years. (Which translates to probably 12 or so cycles, how I wish I had been charting all this time!) One BFP --> one m/c last December.

- I have had MIA cycles since high school. I've never been on BC.

 Current Situation:

I had a progesterone injection after a 117 day cycle. At the same time, I had some bloodwork taken after I convinced the Dr. I wanted to find out what was wrong with my cycles. I went in again for CD21 bloodwork (which, after reading Petra's reply to a post below, I think might be useless.)  I went in again today to go over test results.

Testosterone came back "normal." Some other test showed that I'm at an increased risk for diabetes, so Dr. said he wants to try Metformin. I asked him if he figured out what was wrong and he said he "thinks" it's PCOS. He then looked at my FSH and LH levels and said that I was "classic." Then he suggested Clomid.

I asked about moving on to an RE, but he said they usually don't refer until there's an SA done, a bunch of other tests, and a round or 2 of Clomid. I told him I most likely want to bypass that and get it done with an RE, but that I'd think about it.

Long story short, for those of you who see an RE, did you get all of that testing done first? Or did your RE do it? None of this would be covered my insurance, so I want to make sure that I go to an RE at the appropriate time (i.e., not jump the gun.)

If you read through all that, you're sweeter than your reward: :)

ice cream! ice cream! ice cream!

 

Lilypie Angel and Memorial tickers
BFP#1 - 11/13/11, Natural MC - 12/24/11 at 12 weeks
BFP#2 - 10/2/12, Please be our rainbow.
BabyFruit Ticker

Re: What testing do you need prior to seeing an RE?

  • I'm sorry for the troubles you've had conceiving and for your loss.

    My obgyn did initial testing (day 3 and 7dpo bloodwork, HSG, and SA) before sending me to the RE.  Many REs also do the testing themselves, or will want to re-do some of it anyway (my RE re-did all the testing except the HSG, and also added an additional blood test).

    As you know, most of us here will recommend against doing clomid without an RE, or at the very least without proper monitoring from your obgyn (which, frankly, if they're doing CD21 bloodwork instead of 7dpo, I'm not sure I would trust them to do the monitoring anyway since ovulation day is sort of important...)

    Does your insurance require a referral?  If not, you could always just call the RE's office directly to set up a consultation.  I may be wrong about this, but the fact that your doctor thinks you may have PCOS should be enough of a reason for him to refer you to one.

    Good luck with getting some answers! 

    PAIF/SAIF, PGAL/PAL welcome.
    TTC since March 2010 ~ Dx Unexplained IF September 2011
    2011: IUI + Clomid = CP#1
    2012: 3 more IUIs + Clomid = 3 more CPs. One on-our-own pg, also CP
    2013: BTB IUI + Lupron/Follistim/Prometrium/PIO = CP #6
    IF testing, RPL testing, Autoimmune testing = all normal
    So lost.
    imageimage
    imageimage
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  • My OB ran a blood panel, an HSG, and a SA for DH.  DH's initial SA turned up abnormal, so we were referred to a urologist specializing in MFI.  After my blood work and HSG came back normal, she suggested I move on to an RE.  She said doing some of the tests ahead of time would speed up being able to start treatment. 

    Once we went to the RE she ordered some additional blood work for both DH and I, and we were ready to roll.


    TTC started Oct '10
    Me: AMA w/RSD, atypical PCOS w/IR, LPD and High Prolactin. Controlled HP post-loss.
    DH: Low-T and borderline morph
    18 cycles, 3 medicated w/RE to get to a BFP!
    EDD 9/7/12, Saw HB @7w3d,missed m/c 1/30 @8w3d, d&c 2/8
    11 AL cycles, 9 medicated/IUI cycles. All BFFN!
    Moving forward with IVF
    BFP#2 our little cycle break surprise on AL cycle 12! EDD 10/27/13
    Beta #1: 41 Beta #2: 398; perfect u/s 3/11 hb @133bpm
    u/s 3/25 one perfect hb @183 bpm, adjusted EDD 10/23/13
    MaterniT21 and carrier screens normal. It's a girl!!!
    Severe Pre-E, HFpEF, PE, AMA & IF= OAD

    imageimageimage
    Lilypie Premature Baby tickers
    All IF/AL Welcome!
  • I didn't have a single test done before seeing an RE. He has done all of it. My OB did call to get me in but the RE didn't require referrals to be seen but having that referral got me in to see him a lot sooner, so that might be something to think about if the RE has a long wait to get in. I see nothing wrong with going ahead and doing the SA and any other tests the OB wants to do while you wait but I'd still get in with the RE as soon as I could too.

    [spoiler] My Blog: Grow Baby Grow

    BFP #1: 12/2009 m/c 1/2010 BFP #2: 6/2010 m/c 8/2010

    BFP #3: 10/2011 ectopic 11/2011 (right tube removed, learned left tube was probably nonfunctional due to scar tissue from infection after m/c)

    3 failed IUIs, IVF #1: 18R, 12M, 10F, 3 poor quality 5d embryos transferred= BFP #4!!!!!

    Betas: 9dp5dt: 64 ~14dp5dt: 91 (expecting miscarriage, doubling time of 236 hours) ~16dp5dt: 200~18dp5dt: 500

    First Ultrasound at 6w2d revealed two sacs, only one with a heartbeat

    LK arrived after 42 weeks on August 14, 2013! Beautiful, healthy, and happy!

    TTC#2: IVF booked for April 2015

    Surprise BFP#5 February 19, 2015 EDD: November 2, 2015

    Betas: 10dpo: 10, 14dpo: 77, 17dpo: 270

    First Ultrasound at 5w1d showed a miracle UTE baby! And right ovary ovulation to left fallopian tube.

    JD arrived at 38 weeks on October 20, 2015.

    TTC #3: Since October 2017. BFP #6 July 2, 2018 EDD: March 16, 2019 [/spoiler]


  • My OB wants to some very basic blood work on CD3 and have my DH get an SA before referring me. In the meantime, I'm going to attend an open house with the RE office and ask what they would like me to do first and how they can help be get a few things covered using strategies like Rosie described above. 

    If there is an RE you want to go to, you might see if they can answer some of these questions for you first. I'll keep you posted with what I learn on Thursday at the open house.  

    TTC #1 since January 2011
    BFP#1 April 12, 2011, EDD December 24, 2011, strong heart beat at 7w3d, d&c at 10w6d
    BFP#2 Oct 24, 2011, natural miscarriage, EDD unknown
    After RPL testing my losses and subsequent infertility are considered unexplained.
    Cycle #22: Femara, TI, and progesterone = BFP!! 
    BFP#3 Dec 21, 2012. Beta #1 @14dpo = 134, progesterone 67.8. Beta #2 @ 17dpo = 664! Team green, EDD 9/1/13, healthy baby boy born 9/12/13!
    imageimage  My chart.


    Congratulations to the fabulous KGS2003! Her sweet boys are here! Grow boys grow!!!
  • I do not think you need to do a lot of testing with your OB before seeing a RE as they may want to do the testing again - will your insurance cover the testing through an OB?  If yes, maybe you could have a consultation with a RE and get his/her recommendations & work with your OB to get those done if they will be covered.  I know RE's understand the costs and are willing to work with you in any way that is needed as in the end, it is their job to help you get pregnant.    

    In my experience, my OB did do the HSG & basic hormonal testing so my RE did not need to do them again but he did do a SA again. My OB thought I had PCOS but both the REs I have gone to did not and took/kept me off metformin.  I would suggest getting your thyroid checked by either dr.  I was 35 when we started with the OB and waited almost a year to see an RE.  I wish we had gone earlier as I feel like I wasted time with the OB. An RE specializes in helping women with infertility issues.  

    I wish you the best!  I know it is not an easy decision to make on when to move to a RE!!   

  • My primary physician referred me to an RE, didn't get any testing done ahead of time.

    **Warning: Losses and living child mentioned**
    BFP#1 1/31/12, EDD 10/6/12 Harrison Gray born sleeping @ 18w6d. You changed our lives little guy.
    BFP#2 EDD 10/29/13, C/P 2/25/13, Bye little Ish, we barely got to know you.
    BFP#3 EDD 12/21/13, Baby Boots born 11/23/13 My rainbow baby!
    image

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    January PAL Siggy Challenge: Good Advice
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  • Thanks so much, ladies! After a long talk with the hubs, we're planning on setting up a consulation with an RE (that came recommended to me by a friend.) Rosie, my OB told me he could do tests and send them to whatever RE I end up choosing, so I may go your route if I can. Onwards! :)
    Lilypie Angel and Memorial tickers
    BFP#1 - 11/13/11, Natural MC - 12/24/11 at 12 weeks
    BFP#2 - 10/2/12, Please be our rainbow.
    BabyFruit Ticker
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