[chellerenee]

I need some advice about how to approach a new Dr. about my infertility. I plan on trying to find a new Dr. to go to this week. A little recap of everything...It's been 2 years since we started ttc and since I had my pre-conception Dr. visit. The last time I went to the Dr. was in Oct. '07 for the endometrial biopsy. I stopped going because she told me she wouldn't give me clomid or anything to help me ovulate because of my weight. She gave me metformin, which i took for 3 months and then stopped because it caused AF to go MIA! She wasn't concerned when I went like 120 something days without AF and said it was "normal". I had to practically beg her to give me provera to make AF come. Needless to say, I decided I didn't like her and didn't go back. I took Vitex from Jan '08-June '08 and it helped to regulate my cycles. Since I stopped taking the Vitex in June '08, I've had pretty normal AFs ranging from 30-36 days with the exception of 1 cycle in Jan. '09 that was 49 days.

The problem is, my insurance won't cover any infertility tests or anything. I plan on just making an appointment for my yearly pap, and maybe mention that I'd like to talk to the Dr. about infertility issues while I'm there when I make the appointment. I'm just not sure exactly what to do. How did you bring up fertility testing, etc.? Anything I should bring up other than what I've mentioned? And how should I go about asking if the Dr. if they are willing to work with me because of my weight? I'm so nervous about this, but I promised myself and Chris that I would go back to the Dr. if I wasn't pregnant by June, so it has to be done!

(((((Chelle)))))

I know it's easy for me to say, but try not to be nervous - if this is the right doctor then she will do everything she can to help you. I really wish you the best of luck with this. It's time you got decent support from the medical profession and you got your BFP. Just go with an open mind, you have all the knowledge about your cycles, you know what helped & didn't, so it's not as if you are clueless KWIM?

Write down all Qs you want to ask before you go so that you don't forget any. Ask Chris if he has any Qs he wants you to ask as well so he feels involved... he might think of something you haven't?

[sara~b]

Maybe you could find out if they would be able to do a sperm analysis on the cheap? I think you mentioned Chris smokes and what not so that could lower his numbers. At least that way you could rule out the easiest problem to identify! And maybe they could get you an u/s for free by saying it's for medical reasons? Like to check for cysts or something? I bet if you really talk to the doctor and the doctor is a decent person then you can figure out some way to get around some of the restrictions and obstacles! Good luck!

[*Mrs.J.2011*]

Chelle do you have PCOS? I ask because of the mention of vitex, clomid and met. Sometimes if you have a dx of PCOS drs can code things differently in your fertility treatment to be a treatment of PCOS, and most insurance companies will cover it then. NONE of my drs will let me go more than 90 days without having AF, my RE wont let me go more than 50... (I get prometrium on CD35) Not having AF for that long can cause the lining to get too thick and can cause problems down the road..

I would just explain to the dr that you have been trying since 2007 and have had no luck, they will most likely bring up different tests and such that can be done. Again, they can probably code them differently so it doesnt show up as infertility testing. Just make sure they are aware that your insurance doesnt cover anything. Also, the weight will depend on the dr's views themselves, I am overweight and have a terribly hard time losing it (no matter how much I work out and eat right.. thank you PCOS!) but my dr said he wouldnt let it stop our efforts to try to get pregnant.

I would write down any and all questions ahead of time so you dont forget!

Good luck!

[Mars]

I agree with Fiona! Good luck with everything. I hope you find someone who can really help you get to the bottom of things and get your BFP.

[IamMom]

Michelle - I second what a couple of the girls said.....Has your DH had a SA done - that is usually a cheap procedure to rule out a pretty obvious and usually a straight forward dealt with problem. Also, what Kaleigh said.... I have PCOS and all my appts with my doc regarding my cycle and regulating it she put codes down related to that instead of TTC because insurance would hassle it less. So you could always see if a doc would diagnose you with that with u/s or blood test?

Good luck girl! It's about time you get your BFP!!!!

[Mod-LadyCoconut]

I don't have any help to offer regarding talking to your doctor, Michelle... but I would suggest googling your new doctor for good reviews and see if you can find anything about them helping people with infertility, etc. so you can get an idea before you go in there. I'm glad you're going to see a new doctor, your last one sucked! Also... I feel like a year or more ago people were talking about how there's some kind of sperm analysis testing you can get for like $80 at drugstores or CVS or something -- is that true? Might look into that.

First, skip the buy yourself fertility tests at Walgreens. For around the same price you can get much more accurate results from a qualified professional, and much more information.

Second, I think the semen analysis is a great idea! Might as well, right? Most fertility places around here don't take insurance for semen analysis anyways, and it runs around $90 (here). Dustin's was more expensive b/c he had to have a double one if you remember what his issue was.

As for the rest, I would have a plan of action before seeing the doc like you were saying. Maybe it is just my luck, but most docs I have gone to are very open to me asking for specific tests and having my own plan and bouncing it off of them. If that is the case with this new doc, I would mention that you think you are often anovulatory, and that you have a history of infrequent periods. Mention that you are worried about how it affects your health and fertility (higher risk for uterine cancer, possible diagnosis fo PCOS which makes you at much higher risk for basically everything including heart disease and strokes), and that you would like to look into why your body is not functioning properly from the health perspective first before you get into fertility treatments that your insurance does not cover. So that would be *I think* CD 2 bloodwork, an internal ultrasound around the same time frame (after AF I think), a post ovulatory progesterone test, and other basic tests that check your thyroid, prolactin, LH and FSH, etc. Lots of women get AF but are not actually ovulating, or have very poor ovulation. If you did have PCOS, Metformin does not work for every PCOSer, but if the new doc comes up with actual evidence showing you have PCOS (an elevated LH/FSH ratio, polycystic ovaries upon ultrasound--if they don't let you see the ultrasound at the time you have it, be sure to look at your own ultrasound results with your doctor) then I would consider giving Metformin another chance. But that is if you even have PCOS, which you may not.

As for your weight, I think that by being proactive when you first come in, and by mentioning that after these preliminary tests are done that you would be interested in fertility drugs if they are needed, you will get your answer as to if she is open to that. If she is not, I would go straightaway to another doc. I know a lot of PCOSers have trouble losing weight and many have a lot of trouble finding docs that will treat them despite this, so they go through a lot of docs until they find one. Another idea is to go to soulcysters.com and go to their message boards. It is a site for women with PCOS, and you can ask questions about docs in your area that PCOSers have been to that are open to treating patients that are overweight. So even though you don't necessarily have it, it is a helpful resource if this doc doesn't end up suiting you. Or maybe some of them have been to her already.

Anyhoo, that is what I would do. Good luck Michelle! I can't believe it has been 2 years already. One of my biggest wishes is that all the women who started trying before me get preggo asap. And you my dear, are at the top of that list! ((HUGS))

[chellerenee]

Thanks so much for all the support and suggestions. I am actually kind of excited that I'm hopefully going to figure out what is going on and find a solution! I will definitely have Chris do a SA too. He doesn't have insurance, so how do I go about having a Dr. do a SA for him if he doesn't have a regular Dr.? I've been meaning to add him to my insurance, I'm just a very bad procrastinator. And for me, it's better for me to find an obgyn. to go to rather than a gen. practitioner right? As far as PCOS, I never got a clear answer as to whether or not I had it. She did the blood test and I also had 2 ultrasounds to check, and according to the blood test, I am insulin resistant, but on the ultrasound the first time, I only had one cyst, and when I went back for the 6 week checkup, it was gone. I was taking Metformin, so that might have worked to get rid of the cyst and my Dr. did say my lining was alot thinner, but I also went like 4 months without AF. You know, now that I think about it, I did have spotting around every 30 something days during that time according to my charts, so maybe the Met. just thinned my lining out alot and I just thought it was spotting because I was so used to having really heavy AFs before that. Who knows? I probably would give the Met. another chance if the Dr. suggests it. I'm off Wed. and Thurs. so that's when I plan on doing some research and decided which one I wanna try first.

[ShannonMVT]

I think Michelle gave you a lot of great advice! Also I'd get your medical records from you previous dr. Make a copy for you and one for your new dr. Yes, I'd go with an OB GYN.
When Dh had his S/A done, my OB actually told us where to call for the appointment. It was a fertility dr that had a lab set up for S/A. We just paid of out pocket b/c insurance didn't cover it, I think it was around $80.
I don't think they will need to do STD testing, I never had that done until I got preggo. But you might have a gameplan when you go in for testing you want done (like Michelle said). I ditto the soulcysters site, it's good, I went there when I thought I might have PCOS and there were actually some women on there from my area who had recommendations of which RE to go.
For the weight issue, I think you can find a dr who isn't willing to brush you off because of that. Especially if you are trying to lose weight, you might tell them that, but like Michelle said it is hard to lose the weight when you've got pcos or maybe some other issue. I'd get your thyroid tested as well, that can cause fertility problems as well.
KUP!!!