Asking my MD for help

[peaches' mom]

I have made an appt with my MD to discuss fertility. We have been TTC since January, which I realize isn't the requisite year. However, I chart, use OPKs, & Maca and we have timed BDing very well....to no avail. I'm not getting any younger & starting to get antsy! (okay, downright frustrated )

Can anyone offer any advice on what questions I should be asking? Or any advice at all. I have no idea what to expect (i.e. what the medical process consists of...). I want to make sure I get as much as possible out of the appt.
Thanks in advance!!!

[Rainy229]

I would definitely take your charts with you. If you are suspecting anything specific (e.g. a reason for infertility like PCOS, anovulatory cycles, etc.), questions regarding that AND your reasons for suspecting it, as well as treatment options for the suspected issue (know what the options are). I'd also see 'bout getting an SA for dad... If you don't have anything in mind for why your best efforts aren't working, my first thoughts are CD3 labs (hormones), TSH, Free T4... and a pap if you haven't had one recently - checking for STDs (if that's a all applicable).

A friend of mine was TTC for over a year, her MD didn't do any labs or SA or anything, and she was getting frustrated, her MD wanted her to do three more cycles with OPKs in addition to her charts before doing a SA . Well, the second or third cycle, OPKs were ALL negative (as in BFN negative, not just lighter lines) and that same cycle - BFP!

I have PCOS, so when I went in, I KNEW what I wanted, and "fought" for it - the doc wanted to wait around for months, do tests, have exams, blah, blah, blah.... I consented to ONE round of labs, and then I wanted meds (I went in wanting to treat the problem - with metformin and synthroid [for subclinical-hypothyroidism]), and I got what I wanted. Um, let me clarify, that I advocated for my own care, and I received the treatment that was medically necessary (as opposed to what I just 'wanted'), but in the TIMELY FASHION that I wanted. (Now, if my ovaries would just cooperate.... )

Hope that helps! Best of luck, hope your stay in TTC is SHORT!!!!

--Rainy

[karmab]

bring your charts, and be prepared that he/she may not understand them. ob/gyns dont have a lot of training in ttc. they all do RE rotations, but a lot of that is the real high tech stuff. so unless he/she has a personal interest, they might not get this part of it.

but that's ok. we can figure out charts. we cant diagnose and treat the real complicated stuff, so that's what they are there for.

you will want to start with the basic bloodwork first off- the basic stuff includes thyroid, estradiol, androgens (for pcos) maybe blood sugar, prolactin, maybe immunolgical stuff and like the lupus and anticardiolipin antibodies- it would be rare that you have that, but sometimes people do and dont know it. based on your history that you go over with your doc, they may throw in some more. some of it may need to be timed in your cycle at a certain time (like you mention age- if you are over maybe 35, fsh and lh should be done cd3.) if your charts show anything suspect, like a short luteal phase or anything like that, discuss, and find out the next step. if you have never been pg or are over 35, you might want to get an ultrasound in addition to a pelvic exam to make sure there's not a blaring structual (anatomical) issue and to look at ovaries. at least 25% of problems conceiving are r/t sperm issues, so a seman analysis is good to look at if you have been trying for a while too. usually your doc can order it, and then dh just has to go to a lab to do it, or sometimes they go straight to a urologist. either way.

hopefully, it goes real smoothly. the good ones listen to you, understand, and follow through. the not so good ones give you a hard time, dont understand what you already know and dont know, and dont take the appropriate steps. if you dont love your doctor and feel confidant in his/her response, find a new one. it is hugely helpful to have a good relationship with your hcp, i think, and struggling with one that is not working with you is an added stress you dont need. i hope it goes great for you!

[peaches' mom]

Rainy229 & Karmab - I just wanted to thank you both for your feedback. As usual I am in awe of the knowledge possessed by MDCers! Your input & suggestions are sure to help me navigate this next step. Thanks!

[iot]

Peache's mom, I really don't have much advice, but wanted to say that your post came timely as I'm in a similar boat as you are. I too have been trying to conceive since January (in addition to two months last summer) and starting to feel quite frustrated when it does not happen. I will be seeing my MD this Friday; she is the MD who follow my first pregnancy and she has been very nice and listened to my concerns, so I am hopeful that she will be able to guide me. It hasn't been a year for me either (though if I count the two attempts last summer then I'm almost there) but my doctor told me to come see her anyway if I wasn't pregnant when I came back (we were in a different state for a year). I can let you know how it goes and what she recommends! So far I am planning to:

1. Bring the two charts I have
2. Ask for blood testing for ferritin and vit D (I was low on both of them four months ago and low levels of these can interfere with fertility)
3. Ask about any recommendations to optimize DH's fertility

I will be thinking about other questions in the next couple of days, so I will post if I think of something you might find relevant and will be checking this thread for any further ideas. Thanks for being so timely! I hope this helps...as I said, I don't have much advice, but felt I couldn't help responding as it seems like I could have written your post (except I am not as diligent as you are...not using OPKs at the moment or Maca, and just starting to chart).

Best of luck to you!

[ValH]

I don't have much to add, but wanted to say thanks for the great post! I went to my doctor a couple months ago for a spotting issue, and never did get an answer I was happy with. Now my next check up is scheduled for November, and I've decided it's going to be with a different doctor. It's important to be comfortable with a doctor when dealing with such delicate issues. Good luck!