At what point did you seek out an RE?

toesinthesand-2 · July 2017

Curious for those going through IVF or other treatments, at what point did you decide to seek out an RE or fertility clinic? What was your experience? Did you do any treatments with your OBGYN prior?

I always assumed you had to exhaust every option possible with your OB first, and then get a referral. It seems OB's are super quick to pass out Clomid as a "first step" but the more I've been reading it sounds like the majority of people feel like that's not necessarily the best route to go through. All of the facebook groups I'm in keep saying the same thing....that OB's are great at what they do but are just not qualified to discuss infertility. I definitely can see that point of view, I guess I just wonder how long before you put your foot down and push for other options?

DH and I were NTNP for 2.5 years with no pregnancy, and actively TTC a year before finally getting a BFP, but it ended as an Ectopic. Prior to that all my blood work came back normal, as did his SA. Both were done at the recommendation of my OBGYN - and they started throwing around "unexplained infertility".. I was treated with MTX, but everyone was really unconcerned about it, like it was just another day. We waited the required 12 weeks / 2 cycles to TTC and the first month got a BFP, but it was a Chemical.

Here we are pretty much 16 months since we started TTC with one EP and one Chemical and the last conversation I had with my OB office said that they consider my EP to be totally separate, and essentially I have to have 2 more miscarriages before they'll consider doing anything. That just seems INSANE to me. Even still their only suggestion would be Clomid. I ovulate, and have charted my cycle and used OPK's since the day I came off my BC over 3 years ago. She did tell me the next step would likely be an HSG and gave me the name of two Fertility Clinics, telling me I could do the HSG through them so that it would be one less step if I needed treatment.

Am I crazy to think it's time to start looking into other options?

ReesaAnne16 · July 2017

I would definitely look into making an appointment with an RE; it can sometimes take months to get into one.

My OB actually refused to give me clomid alone ( I asked for it even though I knew the risks). She recommended getting a work-up with an RE (some labwork and imaging of the uterus to look for polyps ect) and starting IUI's, which is what we did. (we did the work-up after 9 months of charting & TI and started IUIs after about 13 months of TTC)

LadyMillil · July 2017

If you've been trying for a year (6 months over 35) then you should see an RE. Where I live it's pretty standard for an OB to do basic testing to see if there is an issue they can treat (thyroid issues, etc), but to be referred to an RE for IF treatments like clomid or IUIs/IVF.

My journey is a little different because I had symptoms of a problem and went to my PCP who couldn't find anything wrong and sent me to an OBGYN who also couldn't find the cause of my symptoms and sent me to an RE.

helloworld9 · July 2017

I waited the 12 months advice and wished I hadn't. I think going at around 8 months should suffice. By that time, we should've gotten pregnant naturally anyway. And got the ball rolling on tests and such earlier.

I didn't bother with the OBGYN. We went straight to an RE. We chose the largest fertility clinic in our city for convenience reasons.

I think the "2 more MC" advice is crap. I personally wouldn't want to go through loss again, just to begin some sort of treatment plan. So you are totally not crazy for thinking of other options. I would too in your shoes.

mockingjay1 · July 2017

I would definitely seek out an RE at this point. OBs don't usually monitor clomid as they should which comes with serious risks. I didn't ovulate on my own so my OB didn't mess around in referring me. After an ectopic you probably needed to have an HSG to make sure that tube wasn't damaged. An RE will order further testing and come up with a plan moving forward. I am so sorry for your losses. Best of luck to you.

[Deleted User] · July 2017

Our situation was a little different... we were NTNP for about 6 months, and encouraged by our family doctor - who also practices Napro medicine for fertility, and Creighton method of cycle tracking for NFP - to come in right away and get started. We waited still another 2-3 months while getting perfect timing.... but then it was a six month process before we finally got our S.A. and found the source of our trouble.

So it was maybe 16 months total by the time we got our S.A. and were even able to follow up with the right specialists. My advice: Don't wait to get started with the RE. Everything else will still be such a process even once you do. Like for us, it will work out fx to be about a year between getting our dx and finally making it to FET. So I mean everyone's situation and everyone's timeline is different, but I personally feel very frustrated looking back on the time we spent under the care of the wrong professionals. :/ GL

suchaglencoco · July 2017

One of my bigger regrets in life was not doing more research seeking and out an RE earlier. My old OB handed out clomid like candy and I was on it way too long. When I told my RE how long I was on it, she was pretty furious and mentioned calling the ob to give her a quick lesson on why that's not ok.
Another thing we found out from our RE was that the SA test my old ob did for DH was not as thorough as the one they would and did perform. The ob only looked at numbers, not morphology and morphology issues were found by our RE.

If I were in your situation, I would request a referral to see an RE. To me, there is just no comparison between the 2 in this field. And the others are right. It's a long process. I was completely surprised at how much goes into the whole process when you factor in tests, bloodwork, timing, ultrasounds, and everything else. We switched to our RE in April, did 2 failed iuis, before doing our first ivf transfer in November of that year. And honestly, I think that was pretty quick compared to other's stories.

helloworld9 · July 2017

I echo how long it took for us too! We saw the RE end of January this year. The tests were done and my HSG was scheduled in March. Then we decided to wait 3 cycles to try naturally after the HSG. Obviously nothing happened. So we scheduled the IVF for July. So all in all it took me a half year to finally get some treatments done. Granted, we could've done it as soon as April, but hindsight is 20/20.

LadyMillil · July 2017

It took a long time to get an RE appointment, but I started clomid for an IUI my next AF with my first RE and was done my ER and transfer within 3 months with my second RE, so things can move quickly. My RE ordered all the tests while I was waiting for my first appointment, which sped things up.

toesinthesand-2 · July 2017

Thanks everyone!

My OB did give me the name of two fertility clinics she normally refers to. Mostly because she said that if we try for 3 more months with no pregnancy the next step will be an HSG and since we are 100% out of pocket we should do it with the fertility clinic in the event we do need to go that route for further treatment.

My one holdup and how far to take it with them. I have reviewed the clinic's website, and looked over their initial costs. I'm leaning pretty heavily towards going out of the country if we need IVF. Is it still worth it to have a consultation with a local clinic?

mockingjay1 · August 2017

How many months have you been on clomid? You are only supposed to be on it so many months so if you use your 6ish months with your OB an RE likely won't prescribe it anymore. I would be hesitant to continue clomid cycles with your OB especially without an HSG to confirm your tubes are open and not damaged from the ectopic. If you have a damaged/blocked tube and you're ovulating on that side then your odds of getting pregnant are greatly decreased and you're also at risk for another ectopic. Doing what you have been with your OB may be cheaper, but starting to work with an RE who does the proper testing and monitoring is better for your reproductive health and will likely get you pregnant sooner. You can check with your insurance but even if you don't have infertility coverage some things may still be covered (the hsg and lab work for example). None of that has gone toward my infertility coverage though each insurance company is obviously different.

toesinthesand-2 · August 2017

@dmo1371- I have not been on Clomid at all. At this point I have not done any fertility medications. My OB has said the HSG and Clomid would be the next step with them, should I not opt to go right to an RE.

CowgirlK39 · August 2017

We have been TTC for 4 years and my only regret is not getting to the RE I have now years ago. After a year of TTC my OBGYN had me "tested" for PCOS. I had bloodwork and an u/s and she informed me all those indicated I did not have it. I did get pregnant once out of the blue but it was chemical, so we started leaning towards "maybe we just weren't charting right." Make a long story short, after burning through time and options needlessly, I contacted the group I am with now and they found out quickly that I DO have PCOS. I encourage you to be results-driven and work through this with someone who will help you get answers. Don't waste time with an obgyn, just get to the RE.

adirat · August 2017

toesinthesand-2 said:

Thanks everyone!

My OB did give me the name of two fertility clinics she normally refers to. Mostly because she said that if we try for 3 more months with no pregnancy the next step will be an HSG and since we are 100% out of pocket we should do it with the fertility clinic in the event we do need to go that route for further treatment.

My one holdup and how far to take it with them. I have reviewed the clinic's website, and looked over their initial costs. I'm leaning pretty heavily towards going out of the country if we need IVF. Is it still worth it to have a consultation with a local clinic?

Yes. There's a lot that can be done short of IVF, and at the very least, you want a real diagnosis and thorough testing for both of you before you would head overseas for IVF.

mockingjay1 · August 2017

toesinthesand-2 said:

@dmo1371- I have not been on Clomid at all. At this point I have not done any fertility medications. My OB has said the HSG and Clomid would be the next step with them, should I not opt to go right to an RE.

Gotcha. Sorry, I misunderstood. Good luck moving forward!

Polythene Pam · August 2017

I'd get on the waitlist at an RE. If you can get in right away FANTASTIC, if you have a waitlist keep doing tests with your OB. I had a blocked tube and my OB just put me on clomid without monitoring, where an RE would've monitored which side I was ovulating from. In the end we did IVF but had I gone to an RE sooner I might've tried more options with them... we just waited too long, then had a long wait to even get in, we were impatient and wanted the option that might give us success. I'd do a consult with them either way, it cost about $500 but they did have options and did every test possible. Then you have all paperwork in hand in case you travel to do IVF. Best of luck!!

latvaughanash · August 2017

I would go straight to the experts ASAP, you will not regret it!

I was with 2 different OBGYNs for a couple years before I realized it was going nowhere. Honestly, in my experience they specialize in women and pregnant women... not troubleshooting infertility.

I absolutely wish I had done it sooner. Even if you don't go with them, I think you will feel so much better after a consultation.

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