Meeting with MW re: infertility what to say?

[worcma]

At my last appt with my MWs for my yrly, I mentioned we were having trouble conceiving and getting concerned. My MW said I could come in for an appt to review my charts but said they don't get really concerned until you've been trying for a full year. Pretty laid back about it, but they're MWs

Here's my situation. We've been TTC#2 for 9 months. Got pgs on the first try w/ DD. I've been religiously charting for 6 and have an average luteal phase of 9-10 days. I believe I had a chem PG a few months back as I got a faint pos and have a 14 day LP, along w/ preggo-type symptoms. I finally tried OPKs this past month and could not get a positive (though I have a temp shift on all my charts).

So, I'm looking for advice on what to tell them. What I should ask for? What would you be asking for at this point?

[kristenok18]

If you are charting and using opks, that's a good place to start. I was only charting and had definite temp shifts so I assumed I was ovulating. My dr wanted me to confirm it with opks, which then indicated I wasn't ovulating. Now, I know that not everyone ovulates every cycle, but I wasn't ovulating a majority of the time. I would also ask your dh's dr to have a sa done. It is much much easier for a man to do an sa than it is to start testing us, because our tests are much more invasive, expensive, and painful. They can also be tedious because oftentimes it can be preferred that the test occurs on in a certain window of your cycle, which can mean lots of waiting if the available appt times don't line up with your cycles. An sa is relatively inexepensive, too. When dh and i first approached our family dr about our concerns a year after ttc#2, he wanted to test dh first, even though I was sure there was something going on with me. Well, it turns out we both have issues. Not insurmountable, but it's good to know what we're working with.

I think drs tend to be laid back about people's concerns about if, too, not just mw. Everyone I spoke to kept reassuring us that it can take a while, come back after a year, blah blah blah. Now we've been ttc#2 for over 2.5yrs, and I get rather angry when I think about all that wasted time. Because even though we started having dh tested at 1yr, they didn't look at me for another 9-10mo, and it's taken another 7-8mo for me to get a diagnosis. Don't let them dismiss you if you feel in your gut that something isn't right. Keep pressuring them, and hopefully they'll get the ball rolling. I keep saying this in posts (I'm sure I sound like a broken record by now!), but check out some of Dr. Elizabeth Lee Vliet's books, which are fantastic at explaining the complex hormone systems of women's bodies. It'll give you are starting point for detailed questions to ask.

[worcma]

So you were having temp shifts but not ovulating. Interesting. I didn't think that could happen...I was sort of hoping that I drank too much water for the OPK test to work last month.

So would they do testing before prescribing Clomid or progestrone (assuming it's a LP thing). Or only after IF testing?

I do feel something isn't right. My GI track has also been messed up for approx the same time period. I'm not too concerned re: that (had the requisite test and it's not serious, i.e. cancer) but I think that it might be having some effects.

I'll def. check out those books too.

[kristenok18]

I didn't think it could happen either, and I was pretty insulted that the dr wanted me to back up my charts with the opks.

Regarding clomid, I've heard so many different scenarios that I think it really depends on your care provider. Some write out a script like it's candy, some are very careful about making sure that it is warranted for your specific situation. If I had it to over again, I would look at hormone levels more closely. It turns out I have pcos, so if they had tested various hormone levels to begin with they might have noticed that the elevated androgens were keeping the follicles from maturing. I went on clomid for a few months, and it worked sometimes and not others. So we took a step back and tried to figure out what was going on before continuing on that path.

Actually, the only reason I started being seen (and taken seriously) was because I was having pretty bad abdominal pressure. After ruling out an ectopic pg, they started me on the rounds of ct scans and hsg to find out what was going on. I was convinced it was related to my cycles, but trying to get anybody to listen to my concerns was impossible. They all insisted it must be intestinal. I stopped eating grains a couple of weeks ago, and I've noticed a huge difference. If I eat a little here and there, I get the same bloated/intense pressure feelings. But I stopped eating grains because of the pcos, not because of the other stuff. It's amazing how complex women's hormones are, and how integral they are to our complete health.

Good luck!

[worcma]

Funny I recently cut out dairy (per MWs advice) and have seen an improvement (but not total subsidence) of my GI issues. I've thought about the wheat/gluten thing but I don't fully understand it yet. Need to read up on it more.

Thanks!