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Discussion Starter · #1 ·
<p>Not sure where to post this really but I figure you ladies might be able to help me get a grasp of this. I'm starting the process of navigating the medical/insurance system to figure out our next steps with TTC and not sure what kind of doc I should be looking for really. It'll be 2 years in March that we've been trying for #2 (DD was no problem at all) including two first tri losses now.</p>
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<p>I already have a hematologist doing the blood clotting disorders testing. I'm interested in doing the rest of the basic RPL panel to rule some stuff out before thinking about TTC again. I had thought about seeing an RE because I also have had some questionable stuff going on with my thyroid plus have family history of PCOS and Hypothyroid....But have also been told to see a Maternal-Fetal specialist (Perinatologist).</p>
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<p>So I'm a bit confused about the pros and cons of each. I have the impression that an RE/fertility specialist is more about *getting you pregnant* come hell or high water, and that's really not what we're interested in at this point. We're not at all looking for fertility meds or procedures (for now at least). I really just want someone who can be thorough in the testing and explaining our options, and then supportive care if/when we ever get pregnant again. Does that make sense? Anyone with experiences or wisdom to share?</p>
 

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<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>apmama07</strong> <a href="/community/forum/thread/1284559/who-to-see-for-rpl-if-testing#post_16105123"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br>
I already have a hematologist doing the blood clotting disorders testing. I'm interested in doing the rest of the basic RPL panel to rule some stuff out before thinking about TTC again. I had thought about seeing an RE because I also have had some questionable stuff going on with my thyroid plus have family history of PCOS and Hypothyroid....But have also been told to see a Maternal-Fetal specialist (Perinatologist).
<p> </p>
<p>So I'm a bit confused about the pros and cons of each. I have the impression that an RE/fertility specialist is more about *getting you pregnant* come hell or high water, and that's really not what we're interested in at this point. We're not at all looking for fertility meds or procedures (for now at least). I really just want someone who can be thorough in the testing and explaining our options, and then supportive care if/when we ever get pregnant again. Does that make sense? Anyone with experiences or wisdom to share?</p>
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<p>Okay, if you have someone doing clotting analysis, it would pay to wait til you get those results. It might save you $$ too.</p>
<p>I saw an RE to have all my RPL testing done, with no intention of have fertility meds or procedures, so I don't see that being a problem if that's what you want to do. I know a lot of REs are a bit clomid happy, so you either need to be very firm, or get someone who doesn't have too much of a "god" complex.</p>
<p>I think your GP should be able to manage any hypothyroid issues, if necessary, and I think it depends on the severity of your PCOS as to what it will require treatment wise. It makes sense to see an RE regarding that, but if you have inconsistent cycles, or aren't ovulating, then I'd say that you will in fact need medication of some description.</p>
<p>The problem with REs is that most of them will only care for you up to 8-10 weeks pregnant, so there is no continuity of care. It is rare (here anyway), to find an RE who still practices obstetrics. If that's the case in your area, then it would be worth establishing a relationship with an OB also, so you can comfortably transfer your care when the time comes.</p>
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<p>An MFM will usually only take patients once a high risk pregnancy has been established, although some will do pre conception interviews if it is warranted. I don't know if there's anything other relevant factors in your history, but I would be doubtful that a MFM would take you on as a patient, based on your history. I am no expert, but I would say that an RE would be the right person for you to see at this point.</p>
<p>If your investigations turn up something more problematic, maybe then you could look to a MFM</p>
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<p>HTH<br>
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Discussion Starter · #3 ·
<p>Thanks Milk8shake! I'm not actually hypothyroid or PCOS, my mom and sister are and I've had some very probable cause to suspect I'm mildly hypo. So it's more the family history that makes me want to explore possible endocrine issues, whether or not they might be influencing the IF and RPL. I do ovulate but my follicular phases are long and somewhat irregular. Part of the problem is I'm now in between OBs since mine was simply dreadful, and my GP is rather....eh. So I suppose if I had both of them solid I'd not need to worry so much about a specialist, you raise a good point.</p>
 

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<p>I am having this problem. I only have 4 REs on my insurance and none of them want to do recurrent loss testing. They all just want to give me fertility drugs and do IVF. But I have had 7 miscarriages. <br>
 </p>
<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>apmama07</strong> <a href="/community/forum/thread/1284559/who-to-see-for-rpl-if-testing#post_16105123"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>Not sure where to post this really but I figure you ladies might be able to help me get a grasp of this. I'm starting the process of navigating the medical/insurance system to figure out our next steps with TTC and not sure what kind of doc I should be looking for really. It'll be 2 years in March that we've been trying for #2 (DD was no problem at all) including two first tri losses now.</p>
<p> </p>
<p>I already have a hematologist doing the blood clotting disorders testing. I'm interested in doing the rest of the basic RPL panel to rule some stuff out before thinking about TTC again. I had thought about seeing an RE because I also have had some questionable stuff going on with my thyroid plus have family history of PCOS and Hypothyroid....But have also been told to see a Maternal-Fetal specialist (Perinatologist).</p>
<p> </p>
<p>So I'm a bit confused about the pros and cons of each. I have the impression that an RE/fertility specialist is more about *getting you pregnant* come hell or high water, and that's really not what we're interested in at this point. We're not at all looking for fertility meds or procedures (for now at least). I really just want someone who can be thorough in the testing and explaining our options, and then supportive care if/when we ever get pregnant again. Does that make sense? Anyone with experiences or wisdom to share?</p>
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Discussion Starter · #5 ·
<p>Ugh Lisa how frustrating to be limited by your insurance like that! Have you investigated having your PCP and/or OB do the testing? So sorry for your losses</p>
 

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<p>Hello Megan,</p>
<p> </p>
<p>You can go see a MFM Dr and ask to have a preonception planning meeting.  That is what I did after our 3rd loss.  They did so much testing and explaned a lot.  It was really worth it.  I know my primary OB will do the initial work up for RPL but he generally sends you to MFM for more extensive testing.  After our 4th loss, we went to a RE who was exceptionally helpful and did a lot for us.  First he did some basic bloodwork and and DNA analysis work-up. Then he did some testing on my uterus, also checked all of my hormone levels and gave me progesterone supplements for a while.  Good luck to you!</p>
 

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Discussion Starter · #7 ·
<p>Thanks Jen! That was all really helpful. Unfortunately I had a terrible chain of experiences with my OB so won't go back to her even for testing. And because I have an HMO I need to get referrals and junk for anything, so most likely will end up just going to an RE I'm thinking, rather than finding a MFM and also an OB to work with.</p>
 
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