Post # 1
Hey ladies, I have a few questions about seeking a fertility appt. am hoping for some insight.
Here’s my history. On pill for 10+ years (went off briefly 5 years ago and resumed normal cycles). Went off pill in January to TTC. Got pregnant on cycle 3, but immediately miscarried. Had to wait a little while, but am now on cycle 3 TTC post miscarriage. My cycles are “longer” with ovulation usually around days 18-23 and a 12 day LP (so cycles 30-35 days). I’m 31.
Early in the summer, after my miscarriage, my nurse told me that if we didn’t have any luck TTC again after the summer, we could talk about next steps. Well, I spoke with her yesterday and it sounds like while she agrees an appointment with a doctor would be helpful for me, she does not think we should do anything yet. I asked about getting day 3/21 labs and also about checking my progesterone levels and she seemed dismissive. Basically I’m told that because I conceived already, they know I’m ovulating and are not concerned. I have an appt with a midwife today (follow up on a yeast infection…) and was told that I should discuss everything with her.
I know my body pretty well at this point, know a lot about TTC, and know that I’m within normal ranges of TTC. But, I’m worried about my emotional health and wonder why the doctor can’t do some simple tests to rule out certain things at this point. I don’t want to seem like a crazy person, but I also don’t want to be a pushover and just go along with the doctor’s plan. I am worried about the emotional toll this is taking on me and don’t want to wait until December (6 months post miscarriage) to have this very same conversation again and finally start the process for figuring out if anything is wrong. Although this is only cycle 6 (one of which was successful), we’ve been TTC since January and it feels like forever.
Am I overreacting? Should I be pushing my doctor’s office at this point? What types of tests (if any) should I be suggesting?
Thanks for your advice and support in advance.
Post # 3
I wish I had advice for you, but I have the opposite situation. I’ve never gotten pregnant in the past year of ttc so they saw me immediatly and gave me clomid to make me ovulate after the first appointment. If you feel like you need to go to the doctor to at least put your mind at ease, go! Sorry I couldn’t be anymore help:(
Post # 4
@winniewolf: I think you are still very early in the TTC process- and the doctor is right as far as you having already concieved once so you know it is possible. I think maybe a therapist would be helpful for you. You said you are more worried about the emotional toll of TTC, which I totally understand. (we are starting our 14th cycle of TTC) I would discuss your concerns with the midwife today, and definatley start considering seeing a therapist if you are having such a difficult time that it is interferrign with your daily life.
Post # 5
You’ve been through something traumatic (m/c), so it’s normal to be a little emotional about this whole process. I don’t think you need to run to a therapist. At your appointment, maybe your doc will surprise you and listen to you and what you need. Try to make your point understood and try to understand her point, and if you don’t, ask her to explain your reasoning. Maybe she’ll say something that will make you feel better and relax about it all. If you’re still not satisfied, just consider switching practices if that’s an option. Hang in there!
When I went to my doc, she offered to do everything but the kitchen sink because she could see I was concerned about our lack of success after 6 months of actively TTC. I think because she actually heard and understood my concern, it made me feel so much better and not rush into any unnecessary tests (at this point) and have a more positive outlook on this whole process. xoxo 😉
Post # 6
I had the same~ish problem.. but with only 1 late miscarriage.. the docs. didnt help and it took me a total of 7 years to conceive on my own.. again.. and that time it stuck. The doctors told me the same thing.. OH YOU CONCEIVED ONCE you can do it again… well yes I finally did..but took forever..
I really think you should go with your gut and .. insist help …My infertility doc told me the same thing..I gave up trying to get help because I got worn down by them saying it will happen again..and let it go.. Do whats in your heart.. dont let your heart break like mine did.
Post # 7
The diagnosis of “infertility” is 1 year of trying with no luck (6 month if you’re over 35) so from your DR perspective 6 months of TTC resulting in an unviable pregnancy (which of course is unfortunate and painful but not uncommon, up to 20% end in m/s) is really nothing to be concerned about. Not everyone gets pregnant right away, and not every pregnancy makes it to the finish line.
You could try to push your DR or seek out someone more aggresive, but 90% of the time they’re going to tell you to just wait. I know it’s frustrating. My mom had a history of “unexplained infertility” (the cause of 20% of cases) and I always kinda worried I’d have trouble. After 6 months of BFN, I went to see a DR, and no one took seriously my family history or my charts showing clear ovulation & well-timed sex. They all told me to wait. Once we hit the year mark, not only did we get the go-ahead to see an RE & start testing, but once everything came back normal, I was diagnosed with “unexplained infertility” and my insurance kicked in to cover any treatment nesessary.
I guess my point is you’re your only advocate. Most doctors will tell you to wait, insurance will not cover much until the 1 yr mark under most policies, but only YOU know how you truly feel & how much longer you can truly last. After several failed IUIs, we’re finally 6wks pregnant with our IVF baby, and I’d give anything to have all that wasted time back (and maybe even be pregnant with #2 at this point!)
Post # 8
I don’t think you are overreacting, because I know it is very personal, but I do agree with the advice you got to wait a little longer. Since you are ovulating and have conceived before, things look pretty normal for you. I know it is hard, but I’d wait for the 1-yr mark to worry about infertility.
I’m kind of in the same boat as you. We stopped preventing in Dec. Got pregnant in March and had a miscarriage/ectopic/we will never really know what happened. It has been emotionally hard, but I was told that one miscarriage doesn’t increase your odds for another one. Maybe that is why she doesn’t think the testing is necessary.
My doctor has suggested that perhaps I need some extra progesterone to support a pregnancy, so I will go in as soon as I find out I am pregnant to check that out. Maybe you could ask about doing that.
I’ve decided to just not worry about TTC for right now. Obviously I’m still tracking signs, to try to make it happen, but I’m not letting it affect my daily life. If it happens, we will be thrilled, but I’m not going to live my life just waiting for a baby. I don’t want to look back on these years and realize I didn’t enjoy life while I was young.
Post # 9
Thanks ladies and thanks for sharing your experiences. I think for me the biggest thing is having a plan and knowing that my doctor is on board (and that I’m also on board). I think that I would feel immensely better if they agreed to do a day 21ish blood test on me. My biggest concern is progesterone so I am going to see if they will agree to screen for it now.
Post # 10
@winniewolf: I don’t think you are overreacting. I have been through one MC, and now that we are on our first month of TTC after the miscarriage, it is VERY tough emotionally. I wish I had answers to why I miscarried, because now I think that EVERYTHING I DO might cause one. I was working outside, and literally thought I should go inside and take my temperature because you aren’t supposed to overheat… and maybe if I overheated last time without realizing it, I might have caused the miscarriage…
And this repeats with EVERYTHING I DO. But I am doing my best not to let it consume me. After these irrational thoughts, I tell myself that millions of women get pregnant and stay pregnant so I shouldn’t freak out so much.
My doc said they will run tests after 2 miscarriages, not one. But I think that most docs will understand the emotional toll that you have undergone. Therefore, I would probably go to your appointment and talk to your doc. My plan is to see if my doc will run my progesterone numbers (and any tests they think could help) as soon as I find out that I am pregnant again. That way, we could address it if it is something that can prevent a second miscarriage. Maybe your doc would be on board with that type of plan. I think it mostlyl depends on your doc. IF they are very clinical and by the book, they might not want to accomodate this. But if your doc takes more time with you and considers all of the factors (emotional, not just physical) then maybe you can set up a plan that will help put your mind at ease but won’t be overly intrusive.
GOOD LUCK! LEt us know what your doc says!
Post # 11
Oops! I see that you just wrote back, while I was typing… you pretty much summed up what I said! 🙂
I hope your appointment goes well, and I think that you have every right to want to know as much as possible, to help you get pregnant as soon as possible!
Post # 12
Oh – one other thing to add addressing why your doctor may not be as willing to check your progesterone. A 12-day luteal phase is completely normal (mine are about 12/13 days) and able to sustain a pregnancy. It’s considered a Luteal Phase Defect when it’s anything 9 days or below. There’s simply nothing in your case history to warrant additional testing (from their perspective)
I can absolutely understand wanting answers for why things haven’t been working out for you TTC and why you miscarried, and I hope you can find the answers or at least the peace you’re looking for.
Post # 13
I can see why they aren’t overly concerned. You must ovulate at least some of the time since you did conceive once. And one early m/c is no real cause for alarm. Your cycles seem regular, and your luteal phase seems long enough. Even when everything is perfect, TTC can take some time. You are still considered quite young in the infertility world, so I would try to stick it out a few more cycles at least.
Post # 14
@winniewolf: I second counseling/therapy. I think WB is a form of therapy for a lot of us, but sometimes you need a person to just listen to every single thing you have to say for a whole hour. And maybe they can teach you some techniques to keep your mind calmer.
I also suggest yoga. I don’t do it often, but everytime I do I feel so much better. I feel like I’m doing something that is good for me and also could be good for TTC.
I have not had good luck with understanding doctors and I end up leaving frustrated. At least write down everything you want covered before you go…
Post # 15
Thanks everyone for your comments and advice.
So I went for the appointment today.
Based on my history, the midwife who I met with today suggests waiting a few more months before doing anything. She has all of my history and information, however, and is going to speak with a doctor to find out whether the doctor believes testing is indicated. She suggested that I make an appointment with one of the doctors for later this fall and hopefully I won’t need it. Until then, just going to try to continue to live life normally and focus on the other great things going on in life.
I know that the number of cycles doesn’t seem like all that long and I know that many others have had to try for longer. Knowing that, though, doesn’t make it any easier and 8 actual months feels like an awful long time, particularly when you’ve had a loss (and particularly when it’s a baby bonanza among your friends and family!) But, if no one else seems to be particularly concerns, I guess I shouldn’t be, either.
@MisGG – I am more of a runner/worker outer, but I love the idea of yoga/meditation and think it could definitely help!
@Hoping – yes, my doctor is definitely going to do that for me if/when I have a positive. It seems like a good plan!
Post # 16
While I don’t think you have anything to really be worried about at this point, I do have a slightly different perspective…
Personally, I asked to have my CD3/7DPO blood work done around the 6 month mark, mostly for my own piece of mind. While a 12 day LP does not constitute a LPD, blood work can show reduced progesterone levels within that length of a LP. I choose to see a general doctor that is not covered by my insurance, but he has awesome bedside manner and if I am concerned about something, so is he. He is also much more proactive than most, i.e. will check ferritin levels, not just hemoglobin (if anemia is suspected), vitamin D, etc. I don’t think basic blood work on two days (not a series or anything) is too much to ask at this point, if it is really important to you, and it could reveal something valuable.
Bottom line, in my opinion, is that if you would like to check out your levels now, you have the option of seeking out another physician. Although the process of seeking someone out can be a stressor in and of itself.
I am sure you will already do this, but when you do get that BFP, ask them to check your progesterone levels as soon as possible. It is such a simple way of possibly avoiding a miscarriage.
Wishing you all the best 🙂