OB and fertility testing question for USA girls

[Shelley71]

Going to a FS is not an option right now with OH's reluctance to involve science. I don't want to call my OB again right now with this question, because they graciously referred me no questions asked to the FS, but I am curious about some of my options.

I know about CD3 and CD21 testing, and that there are many other tests that can be done to figure out if I really do have fertility issues.

My question is:

What kinds of testing can my reg OB do for me, if any? Do I HAVE to see a FS to get any kind of preliminary answers?

I asked for US girls to respond, because I assume (I could be wrong) that these things are handled differently depending on location.

 

[dachsundmom]

Hi Shelley-

As a matter of fact, my OB/GYN does all of the testing in his office; he will keep me under hic care until we decide to try IUI/IVF; I am almost at that the conclusion that it will be the only way that we can get pregnant.

He/she should be able to check the lining or your uterus and look around at everything else while he is looking in there, lol.

Mine did prescribe my Clomid and will also do the trigger shot if we deicde to go that route, prior to IUI.

I have found that it varies office to office with how much a doctor will do. Your doctor might also be nice enough to bill your insurance under menstrual issues vs. fertility issues, so as not to alert your insurance company.

If you go the Clomid route, my insurance wouldn't cover it, but an out of pocket script is $9 at Walmart.

I know I am forgetting things, lol!

 

[Shelley71]

Thanks for the reply! Clomid is that cheap?? I'm so surprised.

I'm definitely going to call my OB back after I track another cycle and see what they are willing to do. The biggest problem with their referral was that the FS doesn't treat single people and we have no intentions of getting married. It was ridiculous!

So, if nothing else, now that we are actually hitting the 6 month time frame, maybe OH will be ok with another FS, if I can get my OB to refer us to a different one. OH's main problem was that we were having to lie about how long we had been TTC AND that the FS would mark us as married. In Oklahoma, if you even so much as pretend to anyone that you are married, then you ARE according to our common law rules. It's stupid.

 

[dachsundmom]

That is the most insane thing I have ever heard and the RE that you saw is an idiot to have that policy! Sorry, rant over. Lol.

Do you know for sure if you ovulate?

 

[readyformore]

Going to a FS is not an option right now with OH's reluctance to involve science. I don't want to call my OB again right now with this question, because they graciously referred me no questions asked to the FS, but I am curious about some of my options.

I know about CD3 and CD21 testing, and that there are many other tests that can be done to figure out if I really do have fertility issues.

My question is:

What kinds of testing can my reg OB do for me, if any? Do I HAVE to see a FS to get any kind of preliminary answers?

I asked for US girls to respond, because I assume (I could be wrong) that these things are handled differently depending on location.

Yes, there is a lot your primary ob/gyn can do for you. Do the cd3 blood work (which should include FSH, LH, and estradiol. I've also heard that AMH is an even better test, but I haven't had one of those done and I'm not sure which day you need to be on to have it tested). Also, as opposed to cd21, I would do 7dpo testing. It all depends on when you ovulate. I ovulate cd16-19, NOT cd14, so cd21 blood work would basically be irrelevant for me because being off by 3-4 days is a big deal. I also strongly encourage you to have your thyroid checked as well.

You can have an ultrasound done in your OBs office to check and make sure everything structurally looks good.

You can also have an HSG done. This is a procedure where dye is filtered up into your tubes and an xray is taken to see if the tubes are open. It sounds horrible, but it's not that bad and the information can be very helpful.

Your husband can have his labs checked, including testosterone, and he can have a check up/physical at a urologist. We had to do this prior to going for IUI. I would also highly recommend a semen analysis. I know that we had to go to the fertility clinic to have ours done. Neither my ob/gyn nor the urologist did those.

Some ob/gyns will even do clomid with monitoring and IUI! I know that you said you weren't interested, but you could possibly avoid the fertility specialist and instead just see your doc if it's the particular doc you're trying to avoid.

In addition to all of that, I tell everyone to read "Taking Charge Of Your Fertility" by Toni Weschler (not sure if you've read it, or if you've done bbt). It is basically a guide to unlocking your bodies fertility secrets. And once you learn it, it can be very valuable in determining when you're most fertile to time bd to the biggest advantage. It shows you how to bbt, which is a wonderful way to help determine if there are any problems going on with your cycle. I actually take mine in to the FS if I'm going for treatment. She can glance at it and decide if I need progesterone/clomid, etc. It's really quite helpful.

I'll try to remember if there is anything else.

Good luck.

 

[Tysia]

maybe this is something obvious, but just in case - your regular PCP can do lots of tests for you before you even see your OB/GYN, and it may be a cheaper visit... my PCP orders all the blood tests I ask for

 

[dachsundmom]

Listen to Readyformore...she is the expert and an actual medical professional! Lol

 

[Shelley71]

I never even got so far as seeing the FS. After the phone call to set up the appt and finding out about the no singles thing, we had to sit down and talk about it. The online paperwork we were filling out had me marked as married anyway. That's when we decided to cancel the appointment.

I don't know if I'm Oing, that is the problem. I had one cycle back in Feb/Mar where FF showed an O on CD18. Then the next cycle, could never get an O. That's when I started making calls to get tested, and it all fell apart after that.

Subsequently, I got fed up with my body, with OH's attitude about not wanting to involve science b/c it hadn't been long enough, and just all the emotions, that I quit doing everything. I ended up with a 60 day cycle and it looks like now, at CD30, I could be headed that way again.

I was going to track this cycle, but we ended up gone the whole weekend I would have started, so this one was a wash. Now, I'm just waiting for AF, so I can get started again. I just need to know if I'm Oing is what it boils down to.

 

[readyformore]

The biggest problem with their referral was that the FS doesn't treat single people and we have no intentions of getting married

I'm pretty sure I just threw up in my mouth a little
Wow, find a new doc. It's actually none of their business if you're married or not. And it somehow sounds unethical to me for a doc to do that!!

 

[readyformore]

I don't know if I'm Oing, that is the problem.
I ended up with a 60 day cycle and it looks like now, at CD30, I could be headed that way again.

Your gyn should be able to figure out what the issue is, but seriously, get your thyroid tested. When I came off the pill (like a million years ago), I had 60 day cycles, and it was my thyroid. It can be a quick fix with pills.

 

[Shelley71]

Thanks Ready!

I had been doing the temping, etc. That's how I figured out I wasn't Oing. Unfortunately, that's when it all went awry, so I don't really know if it was just a one month fluke, or if it's an actual problem. That's why I'm going to get back to temping, etc. for the next cycle, then call my OB again and beg them to do the testing for me instead of referring me again right away. I just wasn't sure if an OB could even do any of the testing or if I had to see a FS.

You guys are making me feel so much better about my options! Thank you!!!!

 

[Shelley71]

And yes, I wanted to call that FS and ask them who the hell do they think they are?!?! Because we don't see the need for a freaking piece of paper, that makes us unfit to be parents?!?!

Oh the joys of living in the Bible belt. Ugh. There is another FS in town, so if it comes to that and they aren't as stupid as the last one, then hopefully my OB can refer me there.

 

[readyformore]

Thanks Ready!

I had been doing the temping, etc. That's how I figured out I wasn't Oing. Unfortunately, that's when it all went awry, so I don't really know if it was just a one month fluke, or if it's an actual problem. That's why I'm going to get back to temping, etc. for the next cycle, then call my OB again and beg them to do the testing for me instead of referring me again right away. I just wasn't sure if an OB could even do any of the testing or if I had to see a FS.

You guys are making me feel so much better about my options! Thank you!!!!

Honestly, if your ob/gyn is referring you, they might not be that knowledgeable about fertility/infertility. It's all interpretation, kwim. Some docs interpret lab results differently. Maybe look for a new ob/gyn too (call your local hospital ob department. Ask to speak to a nurse and see who the staff use as their ob/gyn. Ob nurses know who to trust).

 

[dachsundmom]

And yes, I wanted to call that FS and ask them who the hell do they think they are?!?! Because we don't see the need for a freaking piece of paper, that makes us unfit to be parents?!?!

Oh the joys of living in the Bible belt. Ugh. There is another FS in town, so if it comes to that and they aren't as stupid as the last one, then hopefully my OB can refer me there.

Do you live anywhere close to a university with a medical center? They are typically up to date with things as they are also teaching; they might have or be able to refer you to an OB that is a little more proactive on the fertility side of things. Some just want to deliver babies, lol.

 

[Shelley71]

Yeah, we have OU Medical Center here in Tulsa, but I don't know what all they do. I'm definitely going to check out all my options when/if it gets to that.

You guys have given me a LOT to think about that I never would have thought of, otherwise, so thank you!

Now, I just need a new cycle!! Or, if by some miracle a BFP on Friday. LOL

 

[readyformore]

Ohhhh, well, I'll opt for the bfp!!

 

[kchandler]

I live in the US and this is what my GYN, who is also my PCP, has done for me:

Blood work to test for ovulation (which I wasn't)
Had me do BBT and bring in for her review.
Ordered my husbands SA, reviewed my husbands SA.
Had my progesterone checked to make sure my uterine lining was where it needed to be for pregnancy.
Got me started on Clomid.
Started me on Prenatals.
Started me on progesterone cream.
Tested me for PCOS

Things she said we can do when I want, but haven't yet:

US for monitoring follies (haven't yet, since everything has been normal)
HSG (haven't yet, since she says my previous history indicates I don't have a blockage, since the last time they checked a few years back for something else)

She as also said whenever I wanted my FS/RE referral she will do so with no questions asked.

 

[BethG]

Hey Shelly 71,
I have been to drs in OK, NC and FL. The ones here in FL suck. They will only refer you for preliminary testing and then charge you for the referral. I have no med insurance b/c I am self-employed, so I am forced to approach my medical care with a more hands-on and self-taught method. I researched fertility testing that is done, and then I ordered the tests myself off an online intermediary who sent me to a Labcorp in my town. I took my results to the dr. The dr here was ambivalent b/c they just want to refer me out to a specialist. In NC and OK, the small town drs are more attentive, but also more judgmental. I grew up in NC in a very small town. And, my husband was a freak at first about science. I think it is just an excuse to put off something they are basically afraid of dealing with either the method or the cost6s. I finally, in 08, began to call around about IVF, but no dr would work with me on any payment plan - they all want you to get credit card type financing. One day, out of boredom, I found a great clinic called Interafertility in Guadalajara, Mexico. They do the whole thing, drugs incl, tests incl, all at one office, for 6K. Husband was flipped out about the whole Mexico travel idea, but I made it an adventure and now he wants to move there. You have to do the leg work yourself, and be good to yourself, and sometimes with hard-headed men, you have to keep out the irritating info - such as what the dr writes down, so that you can accomplish the real goal. I didn't even involve mine in the actual testing of me, b/c I knew he would stress more and that would carry over onto me. Now, he is involved and learning on his own about it. My first IVF cycle was terminated b/c I failed to ovulate b/c I was stressed over work. Have you always had such a long cycle before ovulating or is something stressing you? I only miss my ovulation when I am stressed. I tried accupuncture, fertility massage, special supplements, the works. What I am trying to tell you is to take charge of as much as you can on your own outside the dr and the man. But, if your mind is stressed, the body will not cooperate. So, hang in there and keep in touch with your forum friends who understand.

 

[hockey24]

Ok I thought maybe its just the specialist I was looking at that had the wierd "no singles" rule. My insurance gave me a couple names for FS and while filling out the forms for one, it stated they would only work with married couples. My initial thought was this might be a far to religous facility for my taste as I thought that was really none of their business. So I guess this might be more common if your seeing this in Oklahoma too!

Good luck on your testing! My insurance told me that I could get most everything done through my gyno and only go to FS if I need IUI or IVF.

 

[velo]

I know you have mentioned your cycles are somewhat irregular - hopefully the ob/gyn can help diagnose/improve that. If not I would suggest seeing a traditional chinese medicine (TCM) practitioner if there is one where you live - you'll be able to tell if the herbs and/or acupuncture are working by your cycles becoming more "normal".