Anyone else finding this to be a road block?

[WildDoula]

We haven't started any testing for infertility yet, going to try the next few cycles and see where we're at then, but I was wondering if any one else here might be in a similar situation or know someone who is.

I am against pelvic exams for personal reasons, and pretty much won't get one for any reason. Please skip the lectures, I know the pros and cons and have made my decision an educated one.

I know this is an obvious road block in testing for infertility, but I'm wondering if there's anyone else who didn't consent to pelvic exams and still got somewhere in their testing? Right now, my struggle is finding a doctor who will do an exploratory laparoscopy to check for suspected endometriosis without a pelvic. 

If anyone has any stories, or knows any doctors who may be willing to work with me, I would greatly appreciate it. We travel a lot, so almost any location within the US is useful. 

[marsupial-mom]

Our infertility could have been diagnosed without any pelvic exams.

If I were you, I think I'd do the blood tests and other diagnostic testing and go from there.

[AdinaL]

You can do blood work. But if nothing shows up there, they have to look at things. At the very least you are looking at a transvaginal ultrasound.  Conditions such as PCOS or other ovulation issues can't really be diagnosed without that. Sometimes the blood work comes back normal, but the ovaries aren't doing their thing. I have alos known of a couple of women who discovered uterine defects that were causing problems, which also required a transvaginal ultrasound, and eventually an HSG.

Even doing a clomid challenge to see about egg reserves would require an ultrasound.  I asked about doing an ultrasound on the belly, and was shown what you could see on that vs. a vaginal one and truly the vaginal one showed the problem, whereas it was hard to get a good image of my ovaries from the belly.

So, you can certainly start without having any pelvic exams or other intrusions, but after a point, if you want to continue, you will probably have to do slightly more invasive things.  I would be happy to give you a better picture of the testing if you want. We ended up doing IVF, so I went through a bunch. :)

[WildDoula]

Thank you for your thoughts ladies.. 

AdinaL, if you care to elaborate about some of the things you went through on your journey/what I can expect, I would love to hear.

[monkeyscience]

Like Adina said, you will almost certainly end up with transvaginal ultrasounds at some point in fertility testing. Do you consider those the same as pelvic exams? (Not trying to pry into your business, but since I don't know exactly why you're opposed to it, I don't know what else you could consider too invasive.)

I was diagnosed with PCOS, which does NOT require an ultrasound for diagnosis. My diagnosis was based on bloodwork (elevated testosterone and high LH to FSH ratio) and menstrual history (very rarely got spontaneous periods, and knew from charting I almost never ovulated).

My RE did a hystosonogram as part of his standard infertility work up, to check for uterine anomalies. There, they stick a catheter through your cervix (not too bad), and fill your uterus full of saline (instant menstrual-like cramps - ouch!), and then do a transvaginal ultrasound to look for polyps, fibroids, etc. They also check out the ovaries. In my case, they found I had the classic "pearl necklace" pattern of partly-developed follicles that's often found in PCOS (but you can have PCOS and not have this), but everything else looked good. They did say that this type of test would not have detected endometriosis. They said they could see some fluid that appeared to have leaked out through my fallopian tubes, so they assume at least one tube is open, though technically you need an HSG test to verify that. I also had a transvaginal ultrasound before they would start me on ovulation induction medication. After starting the meds, I had two ultrasounds to check follicle development. Of all of those, the only one that was unpleasant was the hystosonogram - the rest were really not that bad. YMMV, though, based on your personal history and anatomy.

Honestly, I don't think a normal pelvic exam is going to be diagnostically useful for you. But doctors are pretty much trained to always start there (my RE, or rather his NP, did one before my hystosonogram), so it may be more a matter of fighting the system as opposed to opting out of a medically advisable procedure.

[monkeyscience]

Forgot to add... having about 1 million vials of blood taken around CD 3 was actually one of the first steps of infertility diagnosis, so expect to have all of your hormone levels checked first thing.