* In this post I will be discussing my first appointment with my fertility specialist. I will be going into detail of things done during the appointment, so please be aware that very little will be filtered. If you are not comfortable reading this about me, or my life, please stop reading now. Also, please note, I am only discussing what I experienced. This does not mean your appointment will be the same, nor should you make any medical decisions based on what I have experienced. I hope in some way, me sharing my journey helps you during yours. Xo
For those who don’t know my back story, after almost a year of trying to conceive our first child I experienced two miscarriages, which happened within six months of each other. As a result of our recurrent pregnancy loss, my ob/gyn has referred me to a fertility specialist. Today was our first appointment. I haven’t fully digested all that happened today, but here is a rundown for anyone who may be beginning their own similar journey.
Thankfully, we arrived at our appointment early because we had a stack of forms to sign. This was in addition to the thick packet which was filled out and already handed in. The packet mailed to us covered everything from our attempts at trying to conceive (know as ttc), both of our family’s medical history (including grandparents, aunts/uncles, cousins, etc.), our social behaviors (caffeine use, alcohol consumption, exercise, chemical we may be exposed to, questions about our sex life, our personal history, etc.), and a lot more ultra-personal information.
We were led into an exam room and my vitals were taken (blood pressure, height, weight) and we were asked some questions regarding our miscarriages. We were also asked if we wanted the tissue from our miscarriages to have genetics testing done. (We decided we would.)
Next, a one of our doctor’s residents came in and went over the packet of medical history we had previously turned in. He asked specific questions looking for further detail on some of our answers as well as reviewed our answers to make sure nothing was missed. (Side note: our practice is part of a teaching school, so in addition to our doctor, there will often be a Resident in the room with us.)
Shortly after the interview ended, we were brought into the doctor’s office to discuss our plan, our new way of life. Being that we have gotten pregnant twice, we are not considered to have infertility. Instead, we fall under the category of Recurrent Pregnancy Loss (RTL). We can get pregnant, we just can’t stay pregnant. The first steps of our plan to figuring out why this happens included lots of bloodwork for the both of us, which included the Counsyl Genetic Carrier testing (I was only tested), a hcg panel (only because my most recent miscarriage was only 2 weeks ago), and other factors such as my thyroid function and a condition which causes blood clotting.
Next, I had an evaluation of my reproductive organs via a 3D transvaginal ultrasound and then the doctor and I discussed the results. Only mildly uncomfortably, this procedure took about 15 minutes as various measurements were taken and my reproductive organs were inspected. One of the things being ruled out was a misshaped uterus, which could lead to miscarriages. Luckily, we learned that this is not a concern for us.
There are several tests which I could not have done yet because my body has not regulated since the most recent miscarriage. I will be tracking my hcg level via weekly bloodwork until it reaches zero. Once that happens, I will have additional bloodwork on specific days of my cycle (days 3 and again sometime between 6-12). I will also have a Sonohysterogram, which is an ultrasound used to evaluate the uterine cavity. According to my doctor, this special type of ultrasound uses fluid which is injected into the uterus, via a catheter, to view the lining in greater detail.
Due to the fact that we are able to get pregnant, my husband has had it easy so far in terms of exams. He will not need a semen analysis and he dos not do any of the genetic screening unless it is found that I am a carrier. He did have some general bloodwork done today, but he only had three small vials drawn as compared to my 8 (3 small and 5 large vials). He also had it fairly easy during the initial paperwork, having fewer questions to answer than I did.
Due to our recent miscarriage, it will be at least 3 months before we can start ttc again, and that length of time may be extended depending on what we find from the tests. We will not have results from our genetic screening for 2-3 weeks and the genetic testing being done on the tissues from our miscarriages will not give us results for almost a month.
After our exams and discussions with the medical team, we met with our Financial Advisor. Luckily (unluckily) I have already hit our insurance deductible for the year so outside of a copay all the tests and bloodwork being done in the is first stage are being covered. My husband did spend a lot of time researching what our insurance covers so there would be no surprises at this point in the day. I would highly recommend doing the same.
Here are some tips to help your first appointment go smoothly:
1) It is ok to be emotional, allow yourself to feel the various emotions you will bounce back and forth between.
2) Communicate with your husband! I spend so much of my time trying to act like I’m strong and completely ok with this that he sometimes forgets I’m one baby related commercial from completely falling apart. As a result, I then get snippy and upset with him for not realizing what I’m going through (a situation I completely created by trying to act tough!). Anyways, this whole situation can be avoided with some simple communication. I’m making more of an effort to talk to him about how I’m feeling (which seems to change often based of completely random things) and he is getting better at seeing through my “tough girl” mask.
3) Research questions to ask, as well as come up with some of your own. My hubby and I were given lots of time to ask our questions, and all of our question were answered without the feeling of being rushed.
4) Ask about support groups, most fertility specialists know of several but they do not always bring them up during the appointment unless you ask.
5) No matter how long they tell you as a time estimate for your appointment, add another hour to that.
6) Don’t be afraid to advocate for yourself. If there’s a specific test you’re interested in having done, don’t hesitate to ask about it. Yes, they are the medical professionals but this is your body so don’t be worried to speak up. For example, my doctor wanted to wait to do all the testing and exams later when my hcg levels were at zero. I asked to do whatever tests we could today (the thought of waiting was awful to me) and he has happy to do so.
Until next time,