Questions re: 1st IUI/RE appt

mrs&mrsk · April 2014

I am CD3 with our first RE appointment scheduled for tomorrow.

We have looked into DS but have not purchased yet, as we were told by DWs insurance (my secondary) that they pay for it-- but they guy seemed confused.

We are thinking we may want to start right away/ this cycle, if possible

2 questions:

If we do not do any fert drugs, is it possible we could try the first IUI this month with this timing (cycle timing, testing and timing for results, getting the DS, etc)?

What do I expect @ the first RE appt? I know it's a lot of talk about options and financing, but can you tell me more about it, especially more about what the testing includes? Ultrasounds & bloodwork? Can you tell me what to compare the bloodwork/needles too? I am (more than) worried about fainting.

TIA!

mrs&mrsk · April 2014

Thanks! Hmmm.... that donor info means we are probably not going to be able to do an IUI this month-- we have one "picked" but we want to get more info on him, and havent submitted any paperwork yet. We are really waiting on the insurance card and exactly what is covered before paying too much OOP unnecessarily.

2momsinCA · April 2014

Our first RE appt did not include any tests or exams. We met with the RE to discuss our plan and to figure out next steps. She ordered bloodwork (just go to the lab and have maybe 3 or 4 vials of blood drawn) for day 3 of my cycle. They drew estrogen, thyroid, FSH, AMH, a CBC panel, and maybe some assorted others. We also set up an appointment for a week later to do an HSG to check the shape of my uterus and if my tubes were clear. At our next appointment after all the results were in we reviewed the results and made a plan for what meds I would take for the first cycle.

You might be able to just jump right in though and have your blood drawn and also get that baseline transvaginal ultrasound to check your antral follicle count. You would go back in maybe a week or so to see how your follies are doing or even later if you are taking no meds so they can see if you are ready to trigger. Do you know when you typically ovulate?

To order donor sperm you do typically need the doctor to sign off in some form from the sperm bank... We just got that done at our first appt too and faxed it over to the bank.

KH826 · April 2014

Our first RE appointment went as follows:

sit down discussion with my wife and I about who wanted to carry and what our medical history looked like as well as expectations and planning for logistics of starting IUIs, etc.
an exam for me (since I am carrying) that included a pap smear, internal ultrasound (I was on CD 7 I think on the day of our first appointment), weight and BP and all that jazz...
then the RE wrote me an Rx for bloodwork and an HSG. I had both done that week, and then we had a follow up appointment two weeks later to discuss results of all tests

We did not do our first IUI until the cycle following the one I was in at the time of our initial consultation with the RE. RE wanted all test results, and also wanted me to do at least one cylce of monitoring my ovulation with an OPK at home before we started trying.

Based on where I was in my cycle, our first IUI was about 6 weeks after our first meeting with the RE. Even still, it felt like things moved quickly. With the testing, follow up consultation, ordering sperm, monitoring with OPK at home... it felt like we were doing something that whole 6 weeks and the time before or first IUI went quickly.

This was just my experience, and I think others have had much different experiences, so I think the take-away from that is that every doctor and every clinic is a little different. Just go into the appointment asking lots of questions that will help you to manage your own expectations in terms of timing.

Good luck!

holdingThumbs · April 2014

Our experience was similar to what has been mentioned already. The timing of the various tests required vary by where you are in your cycle, so it took a full month/cycle to go through them all, and then we had to set up another meeting with the RE to discuss.

Our RE also wanted my partner S to start pre-natal vitamins and to practice with the OPK for at least a month before our first IUI - although ideally 3 month. As it turns out, we had some serious peeing on a stick issue - who would have guessed!? - so we were happy to have the extra practice.

Hands down, though, my favorite part was signing the consent form for S to be inseminated! WTF. I have mentioned it here before --- the text was something like, "I acknowledge that pregnancy is a possible result of this procedure, and that any resulting child may not be biologically mine." Love it! But indeed, getting all the forms signed and sent to the Cryobank took some time too.

It's all so exciting!

mrs&mrsk · April 2014

2momsinCA said:

Our first RE appt did not include any tests or exams. We met with the RE to discuss our plan and to figure out next steps. She ordered bloodwork (just go to the lab and have maybe 3 or 4 vials of blood drawn) for day 3 of my cycle. They drew estrogen, thyroid, FSH, AMH, a CBC panel, and maybe some assorted others. We also set up an appointment for a week later to do an HSG to check the shape of my uterus and if my tubes were clear. At our next appointment after all the results were in we reviewed the results and made a plan for what meds I would take for the first cycle. You might be able to just jump right in though and have your blood drawn (although if you aren't pland also get that baseline transvaginal ultrasound to check your antral follicle count. You would go back in maybe a week or so to see how your follies are doing or even later if you are taking no meds so they can see if you are ready to trigger. Do you know when you typically ovulate? To order donor sperm you do typically need the doctor to sign off in some form from the sperm bank... We just got that done at our first appt too and faxed it over to the bank.

They said we would be getting tests, O should be 4/29 based on a couple months of tracking w p tracker light. I guess we will have to discuss it tomorrow. I am so damned impatient! lol

mrs&mrsk · April 2014

KH826 said:

Our first RE appointment went as follows:
sit down discussion with my wife and I about who wanted to carry and what our medical history looked like as well as expectations and planning for logistics of starting IUIs, etc.
an exam for me (since I am carrying) that included a pap smear, internal ultrasound (I was on CD 7 I think on the day of our first appointment), weight and BP and all that jazz...
then the RE wrote me an Rx for bloodwork and an HSG. I had both done that week, and then we had a follow up appointment two weeks later to discuss results of all tests
We did not do our first IUI until the cycle following the one I was in at the time of our initial consultation with the RE. RE wanted all test results, and also wanted me to do at least one cylce of monitoring my ovulation with an OPK at home before we started trying.
Based on where I was in my cycle, our first IUI was about 6 weeks after our first meeting with the RE. Even still, it felt like things moved quickly. With the testing, follow up consultation, ordering sperm, monitoring with OPK at home... it felt like we were doing something that whole 6 weeks and the time before or first IUI went quickly.
This was just my experience, and I think others have had much different experiences, so I think the take-away from that is that every doctor and every clinic is a little different. Just go into the appointment asking lots of questions that will help you to manage your own expectations in terms of timing.
Good luck!

This is great info, thanks. I will be carrying as of now due to DWs medicine and age. (she would have to take time transitioning meds & she has plenty of it! more than me!)

I was planning on them saying May, but then we have to wait out June & July due to a trip we are nervous to only be a few weeks along. So we wanted to have 2 tries before that... not that big of a deal tho!

I thought REs usually do most of the monitoring there.... I was hoping so, to help me out because i am nervous to screw up tracking! I guess that depends on insurance coverage too... another thing we have to wait to "see" on . (waiting on 2ndary member # to see what exactly they cover, should be a lot of it)./

mrs&mrsk · April 2014

holdingThumbs said:

Hands down, though, my favorite part was signing the consent form for S to be inseminated! WTF. I have mentioned it here before --- the text was something like, "I acknowledge that pregnancy is a possible result of this procedure, and that any resulting child may not be biologically mine."

This is too funny!!

gothammattox · April 2014

Our first RE appt was blood pressure, weight and temp for me (I will be carrying). Much paperwork and questions by nurse. Quick meeting with RE with generals about our plan and procedures. Doctor went over options available with my previous endometriosis diagnosis ie natural cycle, fert meds, u/a monitoring. RE gave a folder with vitamin/do not take list, office's preferred banks, clear upfront pricing and FAQs. We both got scripts for blood work. Then we set up the rest of appts.
We then had a nurse appt where we signed all the needed paperwork and went over the blood work results. Spent a major amount of time going over my medical history. Asked all the questions we could think of.
We had to meet with a conselor, which was a bit of a joke. Basically they screened us for that too crazy vibe.
My RE wanted an HSG aka dye test due to the endo. When everything was clear we where able to go ahead.
All and all it was six weeks from first appt to IUI but that included getting married and going on a two week honeymoon. Our RE was comfortable moving quickly because I had been charting and using OPKs for two months previous.
My insurance has limited infertility coverage but the office is very familiar with it and they bill whatever they can.
As an insurance rep I can tell you that you will save yourselves a lot of headaches by getting a hardcopy of both primary and secondary insurance coverage of infertility with the applicable billing codes.

Amber&Reva · April 2014

As PP have mentioned you will most likely need to meet with a counselor. Which is a joke but can be a pain to schedule. As far as passing out due to blood work by the end of all this you will feel like a pin cushion. I used to pass out whenever I got blood drawn twice in one day now I am a total trooper. However I did pass out with the HSG so if you are a fainter I would be more worried about the HSG.

holdingThumbs · April 2014

For a slightly different take on things - of course, every situation is unique: But, I really enjoyed our session with the counselor (required part of the 1st visit). We were in the midst of dealing with the fact that our IDEAL plan (partner IVF) was unrealistic, and that my partner, who declared at 5 yrs. old that she would never, ever, ever be pregnant, would be the one to carry. We were wading in a sea of emotions (kinda still are...), and it was really nice to have a frank, non-judgmental and open conversation with someone "in the know." Given that most healthcare in the US is so cold and perfunctory, it was nice for us to have this personal component. It made it all feel so much more organic.

mrs&mrsk · April 2014

I have that question on my list as I read it on here? or another site? (IDR) -- Will we have to meet with a counselor and is it "included" in the price. the money part was more when we did not have insurance coverage, as they had given us a "flat" fee for IUI.

I pass out if i hear medical. it's mental. i am so scared. i passed out watching 16 & pregnant on TV because they were going to do a c-section. I passed out when someone was talking about a root canal. I passed out when my gyno got too in depth with talking about stuff.

The bigger issue when I pass out is that the more it happens, the worse it gets.... I currently pass out for 5-10 minutes and during that shake to the point where people think I am having a seizure.

Does everyone get HSG?

gothammattox · April 2014

Our counseling was included, as was the required nurse appt. I'm glad to read that others had a very positive counseling experience and they may be able to give you guidance on the anxiety toward medical procedures as well. My HSG was required because of endometriosis and for some strange reason it wasn't done with the laparoscopy in Nov. From my understanding most REs will provide as much or as little intervention as you request. Ie if you tell them I want to get pregnant ASAP they will do more testing and monitoring such as HSG, fertility meds, or u/s checking folicles. If you don't have any known fertility issues REs can just be your sperm professionals.

mrs&mrsk · April 2014

So far, so good! For anyone interested and for people asking the same question as me, here is how it went yesterday:

We arrived early and waited about 1/2 hour before seeing the doctor, but they were basically running on schedule to our appointment. They took my blood pressure and weight in the meantime. It was about an hour appointment.

We then sat with the doctor and went over the steps of IUI, basically he talked & we listened and asked a few questions. I feel like reading up on everything prior & reading the boards was a good & bad thing. It did make me ask questions that were a little too far in advance LOL. Basically the initial appointment was to figure out what WE wanted as far as timing and what was possible based on tests. Our Doctor was super nice & we liked him a lot.

Then, we had an internal sono which I didnt really realize would happen (thought we would have an external one...) All good.

Then, we spoke to the Doctor some more, yes we will need 2 vials per month. We have to think about if we want to do Clomid, we are thinking maybe the 2nd IUI if necessary

Then, we BOTH had blood taken. I had like 7 vials as they test for genetic stuff as well. DW had 3 ish vials just to test for stds and stuff like that. it was a breeze (surprisingly!!)

Next steps: I have to get clearance from the neurologist or cardiologist due to vaso vagul (should be a phone call, i hope), i have to get an HSG because whats the point of wasting $/time if my tubes are blocked, i have to get all the ppwk from my last annual at the obgyn, then we go back for an appt with the nurse practitioner and learn more about the process, how to choose the DS, etc etc. We didnt get too into details of the process (other than general overview) -- probably for the same reason- need to get the medical go ahead first!

and, here we go!!

:-)

2momsinCA · April 2014

Sound good! Yeah no external ultrasounds until the baby is a few weeks old- I had all transvaginal both with the RE and the OB until I was maybe 9 weeks along. For RE appts/ follie checks you will get real use to them sticking the wand in there. Good luck with everything!!

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