Infertility Hot Topic: When Is It Time to See an RE

When is it time to see a reproductive endocrinologist rather than an OB/GYN?  

Share your advice for this mom who writes . . .

We have a daughter who is 3 years old, love of our lives, such a doll. I got pregnant with her on accident. I had been off birth control pills for over a year, but had been paying attention to my cycles and we were skipping the week of ovulation. Turns out that I cycle 28 days for 3-4 months then 31-33 days for 1-2 months before I go back to 28 day cycle again.  I got pregnant with DD on one of the long months. My cycle started back when she was 13 months old, every month, haven’t missed one. No birth control of any sort since then. She was an active nurser until she was 2, then 1-2 x a day until shortly after her third birthday.  I really don’t feel this has effected my fertility in a large way, but I’m adding it in, just in case. I’ve done OPKs for a year or so, most months. We are not extremely active in the DTD department, usually just 1-2 x month, so I really was paying attention to when I ovulated, foreplay became….”when do you O? I’m Oing tonight, let’s do it.” Lovely. 

So, here we are.  I talked to my OB in September about secondary infertility.  He asked me to do OPKs for 4 more months and then call back. He is going to continue our care for the time being. (Is this normal?) He wants DH to do a sperm analysis, then we’ll do the post-coital test (so excited about that one) then dye tests. 

Given my past state of denial, I’m just starting to do my research and find out what is normal and what isn’t. This is where I need your help. Is it normal for my OB to continue my care for the time being? I’m okay with this, so long as he knows what he is doing. Most people I’ve talked to in the area go to a fertility institute at one of the large local hospitals. I gathered from talking to the nurse this week that they would refer if that is what I wanted, but that they could continue my care if I was okay with that. Is this a normal, first things first way to look at things? I don’t KNOW that I have any problems, other than I have been told previously that I have a tilted uterus, forward I think. I also am skinny, 110-115 lbs, OB suggested I might want to put on a little weight, which is not as easy for me as it sounds. And I have pretty mild periods, 4-5 days at most, I only use regular tampons and don’t have to change them but every 4-6 hours, again, at the most. I know this is TMI, but I’m really trying to figure out if this could be contributing. 

Any and all information or direction will be much appreciated. Thanks for reading!

If you have any suggestions, please post below!

{ 7 comments… read them below or add one }

TwinFlame June 23, 2014 at 11:53 am

I think you’re smart to be proactive. I got pregnat with dd the first time I tried. Two years later we decided to ttc #2 and I’m 35 cycles later with nothing to show for it. I went to my then generall practitioner (a very holistic office). They ran some blood tests and I was positive for hypothyroidism. This can affect fertility so I took my meds and got stabilized. I also extended nursed dd until 3.5 years. I don’t believe it had a thing to do with my infertility. My prolactin level was in a normal range and I could still express milk if I tried.

I had to change doctors for insurance reasons so I started seeing an OB/gyn. She took blood work, FSH, prolactin level, LP progesterone. Dh went to a urologist for varicoceles and a SA. I had been charting all along and mine are like clockwork. I started using an OPK also. Still nothing after a couple of months. I decided to see an RE because of my age.

I think there are a lot ob/gyn who do some IF work on a patient. I think it’s something that they find interesting in their studies and dabble in it. I just preferred to go directly to the specialist for IF. IMO part of doctoring is on-the-job learning. The RE sees many women day-in and day-out and has a lot of resources to pool from. The ob/gyn has a more limited scope. I think if you have options because of your geographical location, I’d move on. I’ve recently gone for a RE second opinion and am totally surprised at how different their perspectives are. And these are two doctors who’s specialty is infertility.

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Katie June 23, 2014 at 11:54 am

My story is short and sweet: 3 miscarriages, had all the tests done and dh’s sperm count is great but they have no sense of direction. Had 1 iui done and it didn’t work, then dh’s job status got sketchy (he is always getting laid off) so we are holding off on ttc while I am in school and his job is iffy.

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Chelsey June 23, 2014 at 11:57 am

I’m a very vocal proponent of going to see a reproductive endocrinologist, a fertility specialist. I completely agree with TwinFlame when she said that OBs “dabble” in infertility. It’s just not what they do, and they don’t have any specialized training. I’ve seen some mistakes made by OBs that make my hair curl (my favorite being the member who was assured by her OB that her tubes were perfectly normal when, in fact, they were completely blocked.) Even getting diagnosed from an OB can be a waste of time and money, and that’s not even talking about treatment.

Since it sounds like it’s a possibility for you to see the RE, I’d jump on it. I think the steps the OB said you’d take are correct – some blood work, a good SA for your DH, and maybe an HSG. I just think it’s really important that you have those things done by an expert. It sounds scary, but seeing an RE doesn’t automatically mean that there’s something wrong with you. It just means that you’re at the best place to get answers. It’s highly likely that something just needs a little bit of tweaking, and you’ll be on your way.

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anna June 23, 2014 at 11:58 am

I thought I didn’t really have issues either… I went to an RE yesterday and am preliminarily diagnosed with PCOS (pending blood test results) and my OB never mentioned it–He said I’d be pregnant in 6 months. It’s over a year later and I am not pregnant and looking like it’ll be a little while still.

I cannot believe the difference with an RE. It is a night and day difference. I totally agree with Chelsey–if you have the option go to an RE. I really don’t think you’ll regret it. DH was really impressed too. Knowing what we’re dealing with makes a HUGE difference. I assumed that because I am young I wouldn’t have any trouble.

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eekee June 23, 2014 at 12:00 pm

I’d kind of agree that maybe you should move on to an RE. When I had DS at 33 weeks, it was discovered that I had a septate uterus (two chambers instead of one) and would need surgery to avoid preterm babies in the future. My OB offered to do the surgery, but I was more comfortable going to an RE who specializes in problems. The surgery went fine, but 7 months later, we’re not pregnant. We’re planning on starting with the post-coital and doing the SA only if the PC shows a problem.

Hope you have great luck, whichever way you go!

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lilie June 23, 2014 at 12:01 pm

I waited almost 18 months of ttc before seeing an RE, and in retrospect, I can’t believe it. An RE’s job is to get you pregnant; an OB’s job is to deliver your baby. Although it is true that some OBs have a fertility background, I don’t see the point in waiting to go to an RE and getting all your tests run in the same place. I was just scared to go to the “infertility doctor” — but like Chelsey said, it doesn’t necssarily mean something is wrong with you. In fact, we are “unexplained” — but we did have success with the RE.

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emma June 23, 2014 at 12:02 pm

I can definitely relate to your situation in some ways! I have a 2.5 yr old daughter who was conceived by a total fluke. We tried to get pregnant for 3 years, had one miscarriage, and then ultimately gave up. We were so tired of our life that we sold our house and moved to a ski town to take a year off to reevaluate our lives. And within a month, I was pregnant without even being aware of when or if I ovulated that month (apparently I did, haha).

We’ve been trying for about a year, and I had another miscarriage in June. I have been considering seeing an RE, so thank you thank you thank you to everyone for the encouragement of going to one. It helps so much to hear people’s stories. I think I’m going to make an appointment next week!

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