My annual exam is scheduled for tomorrow. When I went last August, I asked about what we needed to do to begin conceiving. I didn't think I would end up needing this year's appointment... But alas here it is. So aside from the exam itself, I have to bring up the fact that we've been TTC for some time now. I don't know how open and receptive she will be to everything. In the event she isn't, where do I begin? What do I ask? =/
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Oh gees, friend. So sorry you are here. Maybe she will take a blood test for you and tell you that you are pregnant! FX!
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@MrsMcD: Ugh, that's what I've been hoping for slash telling myself! But no point in getting my hopes up (yet again).
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@LindsayInNY: True. But at 9 DPO, it seems like maybe the office would do a test. If not, you should ask about scheduling a sperm analysis. I don't know anything about infertility, but I can imagine that sperm analysis is the cheapest place to start.
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My OB GYN has always asked what our family plans were at every annual, I think it's part of their routine list of things to cover in the meeting after the actual exam.
What information do you have? Are you regular, did you chart, have you been ill, etc? I'd bring that stuff if you have it.
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@LindsayInNY: If she doesn't suggest it, ask to do hormone blood testing (on cycle days 3 and 21). After a year, that should be the first step, so that you can at least rule out any obvious issues. I'd also ask for a semen analysis for your DH. Are you open to going to an RE? If not, you can still do all this testing through your OB, and insurance usually covers it because it's just lab work. Good luck tomorrow!
ETA: I'd also print out some of your charts to show her. Some doctors (my GYN) don't believe in charting, but others (my RE) love to see them because it helps them understand how your cycles are.
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@LindsayinNY: has she done/said something to make you think she won't be open to talking about it?
In the medical world, 7 months isn't long for TTC, although it feels like an eternity when you're ready to get pregnant! If you're under 35, she may tell you to continue trying until you reach a year. My doctor said its stats--with the 20% chance or so you have each month to get pregnant, you should expect it to take possibly a full year.
With that said, if you're ready to do testing, etc., then be prepared to ask what could be involved under her care and what the costs might be (some insurance companies won't cover things unless it's documented you've been trying for a year).
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When I first met with the OB I brought my charts and explained to her everything we'd done so far. She wasn't too open to anything other than a SA, however getting that done was a really important step. Have you thought about just talking to an RE or (if necessary) asking her for a referral to an RE? OB's, in my experience, aren't the greatest when you're dealing with infertility.
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@MrsMcD: I agree, can't hurt to do a SA! We did ours only 5 months in to TTC.
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I mentioned that we had been trying for 9 months and she ordered some tests for me and my DH. When we got the results back she called and referred us to an urologist. The next year I still wasn't pregnant (after DH being treated by the urologist) so she referred me to an RE. I'm sure I could have called and asked about an RE sooner, but we weren't ready.
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@looch: I plan on printing my charts since I've been temping for 6 cycles now (since February).
@Happygal: No, not really... I know when I brought up TTC last year, she was very brief in talking about things which kinda bugged me. And she made some sort of "you're still young" comment then too (I'll be 30 in 2 months). I also know she just had her first baby and she's in her early 40s, I believe. I guess that makes me think she won't be as eager to "rush" things? I'm all for giving it a year but that's in December so I don't want her saying "oh give it another 6 months of X first" or anything.
@marionberry: I'm definitely open to a RE if she isn't overly helpful. I guess I'm trying to be optimistic that she will be?
@Leialou: I'm open to anything but would obviously prefer in-office testing beforehand...
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It's worth telling her how long you've been trying (are you close to a year?) and seeing if you can get a SA and some tests on CD2 or 3 such as hormonal bloodwork (FSH, LH, estradiol) and if possible an ultrasound to see what your ovaries are doing. If your OB doesn't handle that, an RE will - are you open to seeing an RE to get those tests done? I know the emotional aspect can be a huge hurdle but the RE is so much more knowledgeable and efficient than an OB.
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@spaniellove: Sorta... I went off BC in December and am nearing the end of cycle #7 now (I have "longer" cycles). I just don't want to wait until next August or need another appointment if I can address any of these issues at this one. I've been temping/charting, using OPKs, PreSeed, B6 (once)... I'm open to a RE but also haven't been down the emotional side of things yet so I don't know how/if that would change things.
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@LindsayInNY: Sort of in the same boat as you! My annual is in a few weeks (at the end of cycle #9 TTC). My plan is to ask for a referral for DH for an SA. Mentally, I'm not prepared to seek further testing (for myself) at this point (I've already had an ultrasound/blood work during cycle #6). I think it would be really nice at this point (yet equally terrifying!) to rule out DH as an issue.
I'm also going to ask what our next steps would be if we do reach that 12 month mark, and go from there.
Wishing you luck! I hope your doc doesn't brush you off - worst feeling in the world!!
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@LindsayInNY: I haven't seen your charts, but saw you said you have longer cycles. If it were me I would ask for an ultrasound to see what everything looks like and a sperm analysis just so you know what you're working with.
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@doxielove: I haven't had any testing done whatsoever. I don't know how I'm managed to not get discouraged yet... There haven't been any huge sob fests during the TTC process or anything (yet...).
@Mrs. Polish: My first two cycle post-BC were a mess. Then they've been 31-33 or so days with the exception of last cycle which was randomly 40 days (I Oed on CD28, a week later than usual). A part of me has been worried about a shorter LP - roughly 10-12 days but with 2 or so days of spotting/discharge before.
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@LindsayInNY: hopefully it's just the bcp making things crazy, but it helps to rule things out early. I forgot to include that I would try to get as much done through my ob because the re in my area is more espensive and isn't covered by my insurance.
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@Mrs. Polish: I'm hoping that's the problem... Never thought BC would create this many issues. Never going on it again! And I want to kick my doctor for not giving me the heads up. "Oh, as soon as you stop you could get pregnant!" Well, yes, but the alternate scenarios would've helped too...
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@LindsayInNY: amen to that.
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At my annual in April I took my phone that had a bunch of notes and questions with me. Before I went in I really pumped myself up for the appointment that I would talk to my Dr about the fact that we had tried with good timing for 6 months and NTNP for 6 months previous to that. I am a pushover and usually let things go with doctors but this was really important to me so I stood my ground. I worried for nothing, my doctor sent me immediately for blood work and scheduled an US, he also had DH go for a sperm analysis.
Your best bet is to be prepared, have questions, take any charts/cycle history you have, and see if the doctor is willing to do any sort of testing there or if they need to just refer you to an RE. Also get in touch with your insurance and make sure the tests were covered.
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@MrsTal: Funny this is, I don't know why I'm so worried. What's the worst she can do, ya know?! I just feel like a crazy TTCer and a burden, asking all these questions as her last appointment of the day... I need to stand my ground though so I don't go home kicking myself. I'm going to print my charts out and take a look at my insurance...
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@LindsayInNY: can you just tell your doctor youve been TTC for a year? Ever since the last visit? I think thats what I would do. Whats the harm in doing that?
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@MrsMcD: That's actually not a bad idea. She have me a six month RX last August so I might just tell her I never filled it and we were NTNP at first...
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I would also ask for testing of your Thyroid levels. Best of luck!
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@LindsayInNY: I was going to suggest thyroid levels as well. It took me alsmost a year and half to get pregnant the first time. As soon as I finally got my TSH low enough, I got pregnant! It was a pretty easy fix in the end, I wish I had known about it before trying for so long!
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Please don't lie to your health care provider! Tell the truth so she has the correct picture about what is going on. I bet she'll be supportive, and if she's not, than you know she's not the right person you want to continue working with in the future.
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I don't really have any helpful advice. Just wanted to say don't be afraid to ask all your questions. I always go with a list! I hope it goes well!!!
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Good luck today!
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@LindsayInNY: good luck today lady! Don't be nervous, you've got this!
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Thinking of you-good luck today!
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@kentuckygirl: @cookie_dough: Any idea if BC affects thyroid levels? I had full blood work done last summer (when I was still on BC) and my thyroid levels were totally normal.
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@Happygal: I'm a bad liar so I don't think I'll be able to anyways... I printed my FF charts to bring with. And, like you said, if she's dismissive then I need to find a new doctor (DH said the same thing).
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@LindsayInNY: My doctor told me that it can. Also, you could have just changed since last summer. Doesn't hurt (well not a lot lol) to get another test done!
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@LindsayInNY: Good luck today! I think everyone has provided great advice, a lot of it I would echo.
I remember vividly the annual appointment I had with my OB where I said, "It's been a year now, and still no positive pregnancy tests". She replied with "Well, for some people it just takes longer". I knew at that point, I needed to move on to someone who would be more proactive. I didn't like that response. And I was 32 at the time, not getting any younger.
I did start with the day 3 bloodwork at my OB, but when I looked into my insurance I learned that for anything that is infertility related, I had to go through a special service and get "approved" in order for it to be covered. So I'd definitely recommend that you look into the details of your insurance plan.
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@LindsayInNY: No idea about how birth control would affect thryroid levels! Just to note, I had my thyroid levels tested by my GP when I had been TTC for about 6 months. She said my TSH was a bit high at 6 point something (can't remember the exact level). She said it should be under 5. In reality, when TTC-ing, it should be under 2.5 and i didn't find this out until I started going to a fertility clinic after 1 year of TTC. Once they were under 2.5, I got pregnant. All this to say, I believe that the recommendation of TSH levels being under 2.5 is fairly new, and a lot of doctors are still under the impression that anything under 3.5, (or even 5) in my case is "normal". I am no expert though, and perhaps your doctor is completely up-to-date on everything, but this was just my own personal experience!
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Good luck today! My doctor was willing to run blood tests because my cycles were long. DH was also able to have a SA after 7 months TTC. I think it is worth asking about those things. I had an RE appointment at 9 mos TTC. They took me because I had already been diagnosed with PCOS. Because of my age at the time (30), she wanted me to try for another 3 months before we talked about treatment options beyond Metformin for the PCOS and insulin resistance.
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Good luck! I think the fact that you have longer cycles to begin with would be something she is interested in....
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@sweetooth: DH is totally on board with seeing a different doctor if she isn't helpful. Hopefully I'm just making a big deal out of nothing... She just had her first LO in her early 40s so I'm just fearful she'll play the "you're young, you have time" card. But I'm really hoping I'm wrong. My insurance seems to cover anything for infertility up to a certain amount so that's a good sign!
@cookie_dough: Ahh, good to know! I googled affect of birth control on thyroid... Not a good idea, LOL!
@Sunshine1810: I haven't been diagnosed with anything (PCOS, etc.) but who knows what BC has been masking all this time... It sounds like you had a good experience so I'm hoping for the same!
@blackbird: I didn't even realize longer cycles were an issue before this... Ugh. =/
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Hope it goes well for you today!
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Can I ask a sort of related question - did anyone ask any specific questions or get any testing done before TTC? i.e. get a blood test or anything? I'm going in for annual on Friday, and we will probably start TTC in November so I'm just curious.
Good luck today @lindsayinny -- and I agree, time for a new doc if she's not compassionate to your questions - that's what you pay for!
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