Starting with Infertility Gyno on Monday :( What to ask?

posted 2 weeks ago in TTC
Post # 2
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2406 posts
Buzzing bee
  • Wedding: August 2017

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@Charliejeorge:  I’m also in Canada (east coast), the information of needing to see an obgyn first is false – any doctor can refer you to an RE.  

I would highly recommend skipping the obgyn and advancing directly the fertility clinic (and depending on where you are, there could be a considerable wait to see the RE anyway, I waited 8 months to get into my clinic). It’s possible your doctor may not refer you until you have been TTC for the 12 months that is typically recommended for people tro try naturally before intervention. 

ETA – to answer your question you should ask the obgyn when they can do the hsg (which is a required test for my fertility clinics that is often done by an obgyn before you get to the RE, this can take a cycle or two to schedule since it needs to be done on certain CD)

Post # 4
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2406 posts
Buzzing bee
  • Wedding: August 2017

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@Charliejeorge:  oh sorry I reversed your age. Definitely proceed directly to RE (or at least get on the wait list for the consult). Your DH can do a lot of things in the meantime to improve his SA parameters, it typically takes 2-3 months to see effects and make factor If isn’t usually diagnosed on a single sample.  

The hsg is the dye test that checks if your tubes are open.

What part of Canada are you in?

Post # 6
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2406 posts
Buzzing bee
  • Wedding: August 2017

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@Charliejeorge:  I would think the only appeal to seeing an obgyn first would be if Aurora was a big distance to travel to for treatment.

An obgyn probably will run more tests (tsh, fsh, LH, prolactin, vitamin d, AMH), screen for sti, rubella/varicella titers, may do an ultrasound (mine refused), hsg, repeat SA. They’ll probably put you on letrozole to “boost your chances” each month.  It’s not a bad option to do while you are waiting to get in to the fertility clinic.  But I would absolutely not see an obgyn in lieu of an RE.  Also make sure your pap is up to date, that could delay treatment later on and for a while no one was able to get paps done due to covid.

for me, I already had an obgyn and after about 7-8 months of well timed cycles TTC, my GP sent me to him to start the IF work up.  I so wish she had sent me directly to the RE. I saw the obgyn, he ran some cycle blood work and ordered SA. Then after those results came in, I had the hsg which showed open tubes. He diagnosed us with unexplained IF and started 6 cycles of letrozole (by now we had been TTC > 12 months). He kept assuring me that nothing was wrong and before I know it, we’d be in for ob appts.  I asked for RE referral, he said no. He told me the wait list to get in was only 6 weeks and wanted me to do letrozole first. I did the first 3 cycles of letrozole with renewed hope (the 12-18 month window of TTC was the mentally hardest on me), then after 3 failed letrozole, I went back and demanded referral (we’d been TTC 16 months by that point), he referred me and I found out it was 8 month wait to get in. I finished the 6 cycles of letrozole which of course didn’t work.  We did ivf around 24 months TTC and it took another 10 months after that to get a bfp. Also my RE repeated every test my obgyn had done, except the hsg. 

Post # 7
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1263 posts
Bumble bee

I’m not in SK but for us we were able to get a referral by my regular doctor. Before they sent the referral we needed to complete a bunch of blood tests and an SA for DH. The it took 9 long months to get an appt with the clinic. 

The annoying thing was I was told by my doc the waiting list was 6-9 months so at 9 months I called the fertility clinic and they said I was still on the waiting list and to be patient. Then an hour later they called me and said they could get me an appt. I couldn’t help but think if I’d called sooner id have gotten in sooner. 

But they helped get me my baby so I forgive them.

As for questions to ask, I think most of my questions were based on the results of our tests. Which all looked fine. We have unexplained infertility. But if you have any questions, write them down because its easy to forget!

Post # 10
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2406 posts
Buzzing bee
  • Wedding: August 2017

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@Charliejeorge:  thanks.  I’ll be 22w on Tuesday (our June transfer was successful).  I guess what my summary of events was suggesting is that it’s good to get the referral in (because you don’t know what the wait time will be like, and I’m willing to bet it will be at least a few months). If you think you are jumping the gun, having the consult doesn’t mean you have to proceed directly to ivf as fast as possible either. You could still work with your obgyn in the meantime if you wanted to. But with Covid, a lot of the clinics are reducing patient load (my clinic is booked up for ivf and fet for the rest of this year). 

most clinics will work with your local hospital for as much testing as possible (which is covered by your provincial Medicare).

I would ask about semen morphology, because it’s odd that it wasn’t included on the results. Is your consult virtual?

Post # 11
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30 posts
Newbee

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@Charliejeorge:   I’m at the same stage as you and i’m also in Canada. We had bloodwork done last month and just received dh’s SA which showed low sperm count but we don’t have any information on his morphology.. apparently not all labs can test this. At my last doctors visit, he said I will have to get a HSG and a recent pap smear done before a fertility clinic will take me.  @anev has been so helpful to me providing information I had no idea about. Seems like the best thing to do is to get ourselves on a waitlist to see a RE so we don’t waste valueable time.

Post # 13
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1456 posts
Bumble bee
  • Wedding: November 2019

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@Charliejeorge:  Hi bee! I’ve been lurking your thread and I am so happy to hear that the doc was on board and proactive! Sending you all the baby dust! <3

Post # 15
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2406 posts
Buzzing bee
  • Wedding: August 2017

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@Charliejeorge:  wonderful update! Glad your ob is being so proactive! 

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