Post # 1
like many others, TTC for us hasn’t been smooth sailing. But we are only less than a year in, so in the scheme of what some people go through I know this is not major just yet. But here’s where I am at.
We got pregnant first up before we actually tried last Aug, which unfortunately ended in a missed miscarriage at 10 weeks. I ended up having a natural miscarriage a couple of days before I was booked in for a D&C in October, but went ahead with the D&C on doctors advice as I had some retained material. It went well from all reports.
A few weeks ago marked when I would have been due. We haven’t had any luck trying since then, and my periods have been a bit out of whack lately. Tho cycle I’ve had spotting from DPO11 to DPO16 (today) which I thought was a weirdly light period. But today it has now turned into a proper period it seems! A couple of cycles I’ve started spotting or got my period at 10DPO, which seems to be cutting my LP short too.
I’m booked in on Friday to see my Doctor, who is a gyno as well as GP (I started seeing her on referral for my D&C, she is great but in demand so hard to get in to!) I’m there about recurrent UTI’s this time, but I think it’s time to flag our fertility issues.
my question to you guys is, what should I be asking? Any particular tests I should be requesting? I’m sure my doctor will guide me, but looking for any other input too. Thanks ladies 🙂
Post # 2
I’m sorry for your loss and your TTC struggles. It’s took us 2.5 years to get our first.
the spotting etc is unlikely to be an issue. I spot before periods for a few days (when not TTC I like it as it’s an early warning lol) every doctor we saw said it wasn’t a problem for conception.
10 days is the shortest LP you want but spotting doesn’t count as the start of a period.
Depending on your age she might ask you to wait for the full year before starting any real testing. She might even ask you to wait for a year from your miscarriage.
the first test is likely to be a hormone test and day 7 and 21 bloods. They will likely do a thyroid test as well. With the 21 day bloods, ideally you actually want 7 days for ovulation which might not be day 21 of your cycle. It’s worth temping now to get your timings spot on.
they should offer an STD screen as well. I’m not saying you have or should be worried about your partner, but some can impact on fertility and can lie dormant for years.
she should ask to see your partner too and get his sperm tested (it takes two to make a baby after all) some men get very funny about this so perhaps warn your partner in advance that this will be asked for but don’t rush him into it.
they might do an ultrasound with you now just to check everything looks ok, or they might wait until the blood tests are back.
Post # 3
- Wedding: September 2017 - California
I’m so sorry for your loss. I’m not sure a gynecologist is going to be all that helpful in terms of questions around fertility or running tests, but that probably varies as some gynecologists may be more helpful than others. If your insurance requires a referral to a reproductive endocrinologist, though, your gynecologist should be able to give you that referral and the RE will be able to help you with next steps on which tests make sense for you. With your LP, it’s not clear that it is too short, but an RE (or maybe even your gynecologist) can run hormone tests at the appropriate times in your cycle. In my case I didn’t do the day 21 progesterone tests or any tests on specific days of my cycle other than my Day 3 antral follicle count, FSH and AMH, but I had a history of miscarriages leading up to that point and we were able to test my second miscarriage (it was chromosomally abnormal). I also went straight to IVF on my RE’s recommendation based on my history and age (over 35). The tests that you will need and approach (including whether to keep trying or to pursue fertility treatments) will be tailored to your situation by your RE. Good luck with everything!
Post # 4
I agree with PPs who have mentioned various tests and also the possibility that a RE really might be a better choice than an ob-gyn. My ob-gyn ran the hormone tests but didn’t bother to check what CD I was, so it didn’t actually give much insight. It sounds like you’re temping/charting which is great. I have found that you really need to be proactive and the more information you have about your cycles the better. It helped lead to my PCOS diagnosis and subsequent RE referral. I would be prepared to give some polite push back/follow up if needed. She might say “oh sometimes cycles can be out of whack, no big deal” in which case you might want to ask “how many abnormal cycles should I have before I make a follow up appointment?” That kind of thing. And if it’s been close to a year, a RE referral might be warranted because sometimes the waiting time can be many months before you get in to an initial appointment. If you get pregnant you can always cancel!
Post # 5
- Wedding: September 2017 - California
DogAndWine makes a great point about the wait times, especially if the RE is well regarded and has good reviews. My RE has a wait time of two to three months for new patient consults (which may even be on the short side of things – he’s super busy and takes on a ton of patients), so I ended up making an appointment with him after less than six months of trying after my first MC. By the date of the actual appointment I would have been trying for six months (I was 35 at the time). As luck would have it, my RE had a cancellation and I ended up seeing him before the 6 month mark, but he was still willing to work with me right away because he said the six month thing is somewhat arbitrary. He even went as far as to say that in my particular case based on my history and everything I told him, he thought I should already have conceived again by the time that I saw him (which was around 4-5 months of trying after my MC).