Schaffel and Sanders - Aggressive Intervention in TTC?

[Anonymous]

I am posting this in the Expectant Moms thread, since the TTC one doesn't get as much action:

So DH and I have been TTC for 4 cycles now (we are on cycle 4), and I wanted to switch to a new OB/GYN. I had heard fantastic things about Sanders and Schaffel, so I set up an appointment with Dr. Schaffel, despite the insurance hassle of getting reimbursed. I basically wanted to go in, establish a relationship, and ask a couple of questions about my potentially short luteal phase (over the 3 months I have charted, it's run 12 days, 11 days, and most recently, 9). During our conversation, Dr. Schaffel looked at my charts and proceeded to get out the infertility work-up brochure, prescribe a Clomid challenge test, a sperm analysis for DH, and then launched into all of the subsequent testing that would follow these results. I just turned 34 this month (DH is 39), and this is our first time TTC, so I admit I was pretty shocked that she was so aggressive in what she proposed we do. I have never skipped a period in my life, and from what she could tell from my charts, she seemed to think that I have indeed been ovulating.

I am torn between giving it another couple of months (everyone tells me it can take a while) and following her direction in case there is something wrong and we'd just be wasting time prolonging the inevitable. For those of you who have been down this road, could you please advise? Is this a very aggressive approach? Appropriate and worth following? Since this is my first time with this process, I am both completely in the dark and quite scared by what she told me.

Thanks in advance for any help you can provide!

[Anonymous]

Do you know that you have been having sex in the ovulation window? If yes, I would wait a few months before taking any action but that is a personal decision. If you haven't quite hit the window, I would be sure to hit it and wait even longer.

For what it's worth, my luteal phase is 10 days, sometimes 9, and I successfully got pregnant twice.

[Anonymous]

I just wanted to say that it takes time to make a baby. With #1 we got lucky and it took 2 months. With this one it took us 6 months. And that included timing everything just right.

The only thing I'd maybe consider doing is getting a SA done on hubby if you still aren't pregnant in a couple of months. It seems the less invasive and the cheapest fertility test (though I know nothing about fertility tests).

Good luck.

[Anonymous]

I have been a patient of Dr. Sanders for 7-8 years, and I credit her with diagnosing my infertility problems much, much earlier than I otherwise would have identified them. I too had never missed a period - although I had been on the pill for most (but not all) of my reproductive years - and had absolutely no reason to think anything was wrong. (Both sisters and mom were incredibly fertile, etc.) Dr. Sanders identified the problem early in my TTC, ran all the early tests (ruling out most of the major stuff), but I still ended up needing to go to a specialist for help conceiving. (In other words, trying on our own for more months would never have resulted in a pregnancy.) But, I did conceive - in 11 mos., start to finish - and I know it would have taken much, much longer if she had not caught the problem so early. (I'm now 7 mos. pregnant.) I really trust their judgment and have to believe that Dr. Schaffel saw something in your history that made her think she should do the infertility work-up now. That being said, they are both very accessible, and I am sure that if you called her to discuss your concerns about whether now is the right time to jump in vs. waiting another few months, she would give you her honest assessment. In short, I wouldn't hesitate to call her with your additional questions; being accessible to follow-up questions like these are part of the hallmark of their practice. Best of luck to you.

[Anonymous]

What is your FSH?

[Anonymous]

Anonymous wrote:What is your FSH?

PP again here. I ask this because the answer would make a big difference on whether or not her recommendations are inappropriately aggressive or not, imho.

[Anonymous]

OP here; I haven't had my FSH tested (or any tests, for that matter). DH is going for a sperm analysis, since we agree that makes sense. I know we've been timing reasonably well according to Fertility Friend.

Is it possible to get your FSH checked without doing a Clomid Challenge test?

Thanks to all for your advice and support!

[Anonymous]

Isn't there a test you can do over the counter the tests your FSH? It may save you a trip to the doctor. One other thought--go to an acupuncuturist for a few sessions including right before you ovulate and right after (obviously you should have sex in that time period). I went to an acupuncturist and got pregnant first try doing it this way. If you search the board there are a number of acupuncturists who are given recoomendations so you can figure out who is closest to you. FYI--Dr. Arthur Fann (my guy who is in Vienna Virginia)-takes insurance.

[Anonymous]

You can get your FSH tested by a simple blood test on the third day of your cycle (third day of red blood). I think they also sell over the counter versions now too, but I would go ahead and do it with a lab. A measurement of below 10 is best - the lower the better. If your FSH is 5 or below, then your ovarian reserve is great, which is good news. If your FSH is above 10, I would go forward with her testing and advice.

Btw, my highest FSH was 18.5 and I still got pg with my own egg and had a healthy db - so it is possible (this was with medicated IUI and acupuncture and traditional chinese medicine).

If I were in your shoes and your FSH proves to be below 10 and your dh shows no male factor, I would just go forward and keep trying for another 3-6 cycles - and add acupunture and/or traditional chinese medicine (which are individualized herbal prescriptions) to your efforts. There are health risks to using the medications like Clomid that hyperstimulate your ovaries, plus you risk having a multiple birth which greatly increases the health risks to you and your dbs.

Also, immediately I would go get a copy of "Taking Charge of Your Fertility" and read it cover to cover.

Best of luck to you!!!

[Anonymous]

I would give it some more time. I conceived after 9 month with DS and I was only 24 and healthy. DD was conceived in the first month. So you see, everyone is different. And don't forget how much the fun factor in TTCing can make a difference! It's not time to get all nervous and stressed out, yet, you have only been doing it for 4 months!

[Anonymous]

Visit resolve.org to find official info and great BBs about these issues.

It took me five years to have my first child, and I wish someone gave me and DH a full work-up sooner. Resolve.org gave me all the answers (and a community) while I was TTC. There's even a "getting started" board if I recall correctly.

[Anonymous]

PP here who recommended resolve.org.

I just read all the responses here. It does take time to get pregnant, but I would get the full work-up after SIX months of TTC. I wouldn't wait any longer. Most of the tests are not invasive at all, and they're covered by insurance.

"Taking Charge of your Fertility" is a good book, but it's not going to help ANYONE who has real IF problems. Take it from me - I know more than a dozen friends who had troubles like me.

Good luck to you. Please visit Resolve to get more info. It's a great site.

[Anonymous]

Anonymous wrote:PP here who recommended resolve.org.

I just read all the responses here. It does take time to get pregnant, but I would get the full work-up after SIX months of TTC. I wouldn't wait any longer. Most of the tests are not invasive at all, and they're covered by insurance.

"Taking Charge of your Fertility" is a good book, but it's not going to help ANYONE who has real IF problems. Take it from me - I know more than a dozen friends who had troubles like me.

Good luck to you. Please visit Resolve to get more info. It's a great site.

I know that the pp here offered her advice in the best of intentions. But I just want to point out that not getting pg within 4 cycles in NOT indicative of infertility. Get the FSH test and start charting as per TCOYF - then you'll have a lot more info. But I also agree with the pp re if your FSH is high or you try for a few more cycles knowing that you are trying at exactly the right time and still no luck, then you want to get a move on.

[Anonymous]

Anonymous wrote:

Anonymous wrote:PP here who recommended resolve.org.

I just read all the responses here. It does take time to get pregnant, but I would get the full work-up after SIX months of TTC. I wouldn't wait any longer. Most of the tests are not invasive at all, and they're covered by insurance.

"Taking Charge of your Fertility" is a good book, but it's not going to help ANYONE who has real IF problems. Take it from me - I know more than a dozen friends who had troubles like me.

Good luck to you. Please visit Resolve to get more info. It's a great site.

I know that the pp here offered her advice in the best of intentions. But I just want to point out that not getting pg within 4 cycles in NOT indicative of infertility. Get the FSH test and start charting as per TCOYF - then you'll have a lot more info. But I also agree with the pp re if your FSH is high or you try for a few more cycles knowing that you are trying at exactly the right time and still no luck, then you want to get a move on.

PP here. I said SIX cycles. If OP is 35 or older, that is the recommended time to move on and get a work-up.

[Anonymous]

Schaffel & Sanders are great and so accessible as another poster mentioned. You should definitely tell Dr. Schaffel what you are posting here. It may be that there was a miscommunication between you where she thought the reason you were in there talking to her about TTC is because you wanted to take a more proactive approach (keep in mind, the demographic of patients she is seeing, she probably gets more people who want to be proactive than "laid back"!) It may be that when you explain to her you want to be more laissez faire she says that's great too and she'll talk to you in 3 mos or 6 mos or whatever you guys decide makes sense if need be.

I talked to Dr. Sanders after TTC for 4 mos. at age 36 -- I didn't want to go crazy, I just wanted to make sure I had ducks in a row in case come a few months down the road still not pregnant. So we set up a roadmap together that was the right balance for me in terms of being proactive enough but not overkill. It was good to set this up early though because actually all these tests took several months as they can only be done at certain times of month. It also made me feel that I had the right doctor that she didn't just dismiss me and say "Oh just go home and try a few more months." Her attitude was that although it was probably all fine, at my age there was no reason to take a chance and a few simple blood tests could put a lot of concerns to rest and make sure we weren't wasting precious time.

I ended up getting pregnant on try no. 7 -- just a few days after our first consultation with the fertility specialist. (The tests came back very borderline for both husband and me and so we had been referred to a specialist.)