UPDATE What Do I Do After Six Months?

URMySunshine77 · October 2014

I received my bloodwork results today. My AMH result was 1.31 and FSH was 5.5. Estradiol was 47.6. I did a quick search, and it looks like my AMH might be considered "lower normal"?

Please let me know if you have any opinions/experiences. Thank you so much.

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I received the results of my fertility bloodwork today and, according to the NP, everything came out normal. I asked for the office to send me a copy of my results.

So we are in our sixth cycle trying right now. I'll be doing the 7DPO progesterone test in a couple of weeks. If my progesterone comes out fine, where do I go from there? Should I have my husband schedule a SA if I don't become pregnant this month? If the SA comes out normal, should we just keep trying for a few more months before consulting a RE? I read that the average conception time frame for > 35 is eight months.

Also, my husband doesn't have a GP or any type of doctor right now, so I am curious where he can get a lab order for the SA. ETA: We do have insurance; I'm just not sure where to direct him.

Please let me know your thoughts. Thank you ladies.

SchruteBucks · October 2014

I would see about getting an SA for him and maybe give it a few more months. It took us 9 months to conceive our 3rd, I was 37 at the time.

tlc35 · October 2014

I agree with a SA. He really should have a PCP anyways so maybe he can get a new patient appointment. Have you had an AMH drawn? That will give you an idea of ovarian reserve so you know how much time you have. If not I would insist on that. Otherwise, it depends how aggressive you want to be. I am going to a RE this month. With my loss history and the fact we want 2 children I really feel the need to be aggressive.
If you want/would consider/can afford treatment I would consider seeing an RE (they should be able to order a SA for your H as well).

Davie813 · October 2014

I would definitely have him do the SA. Did you ask your doctor about the logistics for that? My DH is also currently insured but doctorless, so my OBGYN wrote a prescription for him to get it done at the hospital where she practices. We gave them both our insurance information, and it was covered.

Have you had an HSG? If not, that might be a good next step (and it's obviously necessary before you start any kind of treatment).

As far as waiting vs. starting treatment goes, that's tricky. For me, it might depend on exactly what my bloodwork results were. MY OBGYN reported my first results as "normal," too, but my FSH that cycle was 11, which I think indicated that it was time to get a move on. Then again, it was never anything like that high again, so who knows? I hope yours is lower, in any case. Did you get your AMH tested as well?

I had never heard that about the 8-month time frame. Interesting. My RE told me that chances of unassisted conception (regardless of age) go down to about ~5% / month after 6 months of unsuccessful trying. I prefer your statistic! In your case, however, I seem to remember that your 6 months of trying weren't actually 6 months of frequent, well-well timed sex. If you think your timing was off for a few, it might be worth working on that and seeing what happens...

Very best of luck to you, of course... >:D<

URMySunshine77 · October 2014

Thanks for all of the advice!

@Davie813: Do you think that an HSG is still needed even though I had a child in the last two years? I guess an RE would need one before prescribing me anything.

That's good news about your Gyn writing a lab for YH.

@tlc35: What does PCP stand for?

The labs contained AMH/FSH, thyroid, and estradiol. I wish that I had asked for the numbers, but I wasn't expecting the call, and I was just relieved that the results were normal.

Here is a brief overview of my months:

Month 1: 1x sex in fertile window and 11-day LP

Month 2: 1x sex in fertile window and 13-day LP

Month 3: 3x sex in fertile window and 13-day LP

Month 4: 2x sex in fertile window and 13-day LP

Month 5: 3x sex in fertile window and 13-day LP

I appreciate all of your support more than I can express!

emsmama15 · October 2014

This is what I would do (so do with the info what you will):

1) SA for your husband and HSG for you (if you haven't had one). HSG needs to be done at the start of a cycle (day 9-ish?) so that's another cycle you won't be doing any treatment. For the SA, my OBGYN also offered to write the prescription for my husband and said he could take it to the clinic in the same system that's near our home. Or the hospital idea is a good one too. OR, he can do it at the RE's office.

2) Get a referral and make an appt. It can sometimes take a long time to get in and you'll take the first available that works with your schedule. Who knows where you'll be in your cycle? So, they'll meet with you and do the baseline stuff, but if the RE wants to do any CD3 blood work, for example, you'll be waiting out the cycle you're in, do the blood work the next cycle, and THEN start a treatment cycle.

I guess I'm just in the don't wait camp. If you're willing to go to a RE to seek help, I'd just do it because usually you don't just jump right into a treatment cycle anyway. So, if the above timeline pans out, you would have a couple more months of trying.

I can't remember how old you are, but also remember this is coming from someone who's almost 40 and feeling the pressure!!!!

Good luck with whatever you decide!

Davie813 · October 2014

@Davie813: Do you think that an HSG is still needed even though I had a child in the last two years? I guess an RE would need one before prescribing me anything.

Yeah, I'd think an RE would insist on your having one. Mine does.

I doubt an HSG would turn anything up for you, but you never know. If you had a c-section or complications during labor, those could cause problematic scarring. I asked for my HSG because I did have a c-section. I also knew I had a small fibroid when I was pregnant with DD (the doctor who did the c-section told me it was there, but I would never have known otherwise), and I was afraid it had grown. I imagine it would be possible to develop/grow fibroids big enough to cause problems over a 2 year period. But I'm obviously not a doctor...

wannabmama23 · October 2014

I'm glad you asked this--I was just starting to wonder the same thing. We have a few months to go, but I like to be prepared just in case. My DH doesn't have a doc, either, so I was curious about that, too. (I'm still going to use it as excuse for him to get a doc...it's time.)
Good luck as you navigate all of this information and processes...so much to consider and keep track of, isn't it?!

tlc35 · October 2014

Sorry, PCP is Primary care provider (basically a GP). I forget which abbreviations are bumps terms and which aren't. Definitely find out what your AMH and FSH are.

URMySunshine77 · October 2014

Thanks, @tlc35!

Do you all mind if I share those numbers when I receive them?

tlc35 · October 2014

Do you all mind if I share those numbers when I receive them?

Definitely post them here. I will probably be posting mine after my appointment towards the end of the month.

kindershlitz · October 2014

I agree with the SA and HSG. I had a second HSG done, after trying for our first I had one done got KU'd the next cycle. This time after 6 months they did it again (I had had a c-section). They also tested DH first time around and this time again. My OB also wrote the rx for DH and ordered the HSG. I am on cycle 15 and still working with OB, which I know is not a popular route here. I am on 2nd round of Clomid but my OB monitors that as well. I will be seeking RE consult if nothing is happening by December. We do not have any fertility coverage so although the clock is ticking, I'm dragging it out.

URMySunshine77 · October 2014

I'm bumping my post because I received the lab results today (see orig. post).

Davie813 · October 2014

I think your labs look good! My AMH is 1.05, and my RE is happy with that. She says she likes to see it above .8, but even people with AMH at ~.4 can get pregnant (it's hard, though).

Niiiiiice FSH!

tlc35 · October 2014

From what I know, your FSH is great. Your AMH may be slightly lower than "average" but for our age group it is pretty good. So this removes a bit of the urgency but I would still think about at least going to see a RE and get an idea what he/she thinks.

Davie813 · October 2014

tlc35 said:
From what I know, your FSH is great. Your AMH may be slightly lower than "average" but for our age group it is pretty good. So this removes a bit of the urgency but I would still think about at least going to see a RE and get an idea what he/she thinks.

Yes, age is definitely part of the equation here. My RE would not have been at all pleased with my levels if I were 25 instead of 40. But 1.3 really is good for we AMA types, and your FSH suggests that your egg quality is good, no matter how many you have left in there. Yay!

lcwed · October 2014

I'm glad your lab results were so encouraging. Hopefully you get a BFP in the next few months.

wannabmama23 · October 2014

Yay for promising lab results!

kindershlitz · October 2014

Knowledge is power

glad you got some good numbers

URMySunshine77 · October 2014

Thank you for the knowledge and support everyone! Maybe I'll make an appointment with a RE after the sixth or seventh cycle. Does it usually take a month to get in?

TAT2MAMI · October 2014

@URMySunshine77 - I think PP have all given great advice. I just wanted to wish you the very best!! xo

emsmama15 · October 2014

I think it depends on the clinic how long it takes to get in. My first time, I got in pretty quickly but when I went back after baby, it took 3-4 weeks.

meredithcarole · October 2014

I made an appointment this past Tuesday for the first available - Nov. 3rd.

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