Trying to Get Pregnant

OB, RE or Fertility Clinic?

After a year of trying, DH and I are starting the process of getting our workups. My DH spoke to his PCP and sent his swimmers off for SA (results don't look good but we don't have the specifics yet. He goes to the urologist in October.) My OB/GYN is sending me for lab work and an HSG (which I did yesterday - left tube appears blocked.)

I saw in the threads here that going to your OB for fertility is a waste of time and that several of you recommend going directly to a reproductive endocrinologist. I have a follow up with my OB/GYN scheduled for November, but now I'm questioning it. Should I seek out an RE to consult once we have all our work done and cancel with my OB? I also found a fertility clinic in my city - they obviously specialize in fertility treatment and even offer acupuncture and yoga on site! I'm overwhelmed by the options and not sure which direction to go in (and I certainly don't want to waste any time!)

Any advice from those who have been through it?
Married 9.29.2012
TTC Since September 2013

Me: 29  DH: 29, congenital adrenal hyperplasia
dx: azoospermia
Treatment: DH on decadron.
Benched since Oct 2014

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Re: OB, RE or Fertility Clinic?

  • With male and female issues, I would certainly go right to the RE. Best not to mess around.
    TTC #1 since May 2014
    3 failed IUI cycles
    Oct '15 - IVF 1 - 10R, 3M, 0F
    Sept '16 - IVF - 12R, 11M, 5F and 3 perfect day 5 blasts - MMC 7w5d
    Jan '17 - FET 1 - BFP, EDD 10/14

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  • Run to your RE. I think that once you have all your results in you should cancel with your OB and go to the RE. Your OB is there to help you during and after your pregnancy as well as regular well woman stuff. An RE specializes in GETTING you pregnant.
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    *Your friendly resident herbalist.  Ask me for facts about herbs--maybe I can help!*

    TTC #1 8/2012~Chronic Pelvic Pain Condition began 10/2012~Told I was crazy by many doctors until a good specialist DXed a labral tear and bone impingement in left hip 4/2013~Surgery on left hip: 5/31/13  SUCCESS!!!  Pain flares to continue indefinitely (but mostly gone).

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    Resumed TTC 7/2014!  Third time's the charm....8/2014 Visited the RE~DX: MFI/low morph~Straight to IVF with ICSI! 9/2014~Transferred 1 perfect beautiful 6AA blast with 10 to freeze!!!~10/8/2014: BFP!!!!  EDD: 6/17/15 STICK LITTLE BEAN!!! IT'S A BOY!!!!! 

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  • I think you should switch to an RE before you do any more testing. My OB took 6 months to get all the testing done that my RE did in one. Your husband should see a urologist specializing in infertility. See this website. Maledoc.com
    My TTC History:
    2009: missed miscarriage #1 at 9 weeks (trisomy 16)
    2010: Infertility
    2011: Diagnosis and treatment (low sperm count, anastrozole for DH, clomid for me + IUI)
    2012: Baby #1
    2014: Baby #2
    October 2015: missed miscarriage #2 at 11 weeks (trisomy 22)
    March 2016 BFP#5, due November 2016.

    My Charts since 2009

  • I did a round of clomid + IUI with my OB and in hindsight it was a waste of time and money. He did the proper monitoring (at my request), but I am convinced that he really didn't know what he was doing. He also wouldn't prescribe hcg triggers so IUI was based of OPK, which I felt was kind of iffy. I don't recommend doing more than basic testing with an OB and even then you have to be careful since they sometimes mess up the testing.

    As for a RE or fertility clinic, it doesn't really make a difference.  My last RE had his own practice at a local hospital where he did testing and  TI or IUI cycles, but did his IVF cycles with a local fertility clinic.  I recently switched REs and now see the RE that is the medical director at the clinic.  For me I feel that the RE at the clinic is more progressive than my last RE and since we are also seeking treatment with a Reproductive Immunologist, I wanted someone who had more of an open mind.  My recommendation is to do some research and make an appointment with a RE, if you don't like that RE then you can always find a new one.  Over the course of IF treatments, I have seen or consulted with 7 different doctors (OB, 5 REs, and 1 RI).  It is important that you find someone you trust.

    imageimageimageimageimage

     

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    TTC #1 since August 2011

    My Blog

    September 2012: Start IF testing

    DH (32): SA is ok, slightly low morph, normal SCSA  Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA

    October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos

    November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues.  Converted to freeze all due to lining issues.  2 blasts frozen on day 6!

    January 2015: FET #2 Cancelled due to lining issues

    April 2015: FET #2.1


    PAIF/SAIF Welcome!

  • definitely RE!   I did my HSG with my OB, and he was going to perscribe me clomid (even though one of my tubes is blocked, so it wouldn't have helped at all), I know this because he gave me all the info on it - luckily I knew better than to take it (although I never got to that point, as I got pregnant on my HSG cycle).
  • *ignore bad spelling...I haven't had enough coffee yet, and my browser freaks out when I try to edit a post :-p
  • I did a round of clomid + IUI with my OB and in hindsight it was a waste of time and money. He did the proper monitoring (at my request), but I am convinced that he really didn't know what he was doing. He also wouldn't prescribe hcg triggers so IUI was based of OPK, which I felt was kind of iffy. I don't recommend doing more than basic testing with an OB and even then you have to be careful since they sometimes mess up the testing.

    As for a RE or fertility clinic, it doesn't really make a difference.  My last RE had his own practice at a local hospital where he did testing and  TI or IUI cycles, but did his IVF cycles with a local fertility clinic.  I recently switched REs and now see the RE that is the medical director at the clinic.  For me I feel that the RE at the clinic is more progressive than my last RE and since we are also seeking treatment with a Reproductive Immunologist, I wanted someone who had more of an open mind.  My recommendation is to do some research and make an appointment with a RE, if you don't like that RE then you can always find a new one.  Over the course of IF treatments, I have seen or consulted with 7 different doctors (OB, 5 REs, and 1 RI).  It is important that you find someone you trust.

    Yes, it absolutely does. Many "fertility clinics" are run by OBs with God complexes.


    @ghostmonkey I guess I should have added that as long as the fertility clinic is run by a RE. In my area I don't know of any "fertility clinics" run by OBs, although we do have a slew of OBs advertising themselves as specializing in infertility, my former OB included. We do have different options for REs, some have practices affiliated with hospitals, or the clinic I go to that is a stand alone clinic not affiliated with a hospital.

    OP I think it boils down to see a RE for infertility issues and an OB/GYN for pregnancy or general gynecological issues.

    imageimageimageimageimage

     

    image

    TTC #1 since August 2011

    My Blog

    September 2012: Start IF testing

    DH (32): SA is ok, slightly low morph, normal SCSA  Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA

    October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos

    November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues.  Converted to freeze all due to lining issues.  2 blasts frozen on day 6!

    January 2015: FET #2 Cancelled due to lining issues

    April 2015: FET #2.1


    PAIF/SAIF Welcome!

  • Thanks for all the input!!! I looked into it and the fertility clinic IS run by an RE. I really think I'd like to go in that direction since they seem to offer a more broad and inclusive approach. But I will definitely be doing my research as suggested!
    Married 9.29.2012
    TTC Since September 2013

    Me: 29  DH: 29, congenital adrenal hyperplasia
    dx: azoospermia
    Treatment: DH on decadron.
    Benched since Oct 2014

    image

  • edited September 2014
    I have nothing new to add to this thread but I'd like to reinforce even further that you should see an RE.  My OB's office encouraged me to see their "fertility specialist" first and holy crap, what a waste of time.  

    I saw an RE this week for the first time and they diagnosed me with PCOS after talking to me for about 60 seconds (later confirmed with US and blood work).  The difference is amazing.  I would forgo any further testing with your OB, you will potentially just have to have it redone once you see the RE anyway.  I'm seeing an RE at a fertility clinic and I just can't say enough good things about them.  



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