AMA--Is testing with an RE worthwhile if we probably won't do IVF/DE?

[Anonymous]

I'm 40. Have one child, conceived easily a couple years ago. We've been trying for about 7 months for #2 with no luck. I went to see an RE today and he went through the various tests that he wants me to undergo and said we can talk options once he gets the results. As I'm thinking about the tests now, I'm wondering if given my age there is a point in doing them if we don't want to do DE and likely wouldn't do IVF (because of money, mostly)? I don't know enough about the solutions for someone my age to be able to judge this, but originally I thought it'd be a good idea to go get checked out. Most of the testing is easy, but one sounds very unpleasant, and I worry about the psychological downer of it all. I mean, if there aren't many options at my age, maybe my husband and I would rather be blissfully ignorant? Are there things they could find that are easily fixed, and that will improve our odds (understanding we still have AMA to deal with)?

Hope this makes sense. Thanks.

[Anonymous]

Where did you go? I had a consult with Shady Grove and felt like they handed me a laundry list of tests (including HSG) and wouldn't talk to me much until I had them all done. My experience elsewhere was very different and while I may end up having an HSG, I was able to try a few cycles of non invasive treatment despite not having it done.

[Anonymous]

Would you consider NC IVF? It's about $4000, and there are no meds?

[Anonymous]

OP here--I went to GW. To the other PP, yes, maybe we would consider a $4k treatment, so maybe at this point I just need to go through the tests and hope there are some options.

[Anonymous]

I would say go on with the tests that way you can know and move one with life. Closure is a good thing and you may be surprised at what you are able to achieve with a little assistance. GW is great at working with people who have limited resources, just ask your nurse for some help

[Anonymous]

I am in a similar situation - 39, with a young child (10 months) conceived easily. I was also told to do a bunch of tests, including HSG (I guess this is the one you mentioned as being "very unpleasant"). This was at CFA. I have resisted doing HSG so far but the pressure is mounting.

Our RE is apparently a big fan of tests which I don't understand. All they can do is IUI and IVF. If IUI works, it works, if it doesn't work I don't need to know why it doesn't work because either way I will either do IVF or not.

I hate how there is this culture of testing that is expensive, takes a lot of time, is painful.. and then the REs take all of 2 seconds to look over the results.

[Anonymous]

NP here. I just wanted to add that the HSG was not at all painful for me. It was quick and I didn't feel a thing during the procedure. I had a little bit of cramping afterwards but it didn't feel any worse than light period cramps.

[Anonymous]

I understand the hesitancy to do an HSG, but your fertility is improved for 3 months after an HSG. If you don't have any other known problems, it seems like an HSG couldn't hurt. (I got KU on my first post-HSG cycle, 13th cycle overall...)

[Anonymous]

Just to second the PP, you really should at least do the HSG. If it turns out that your tubes are blocked, you have a definitive answer to your question. In addition, the process itself of shooting dye through your uterus and tubes can help un-block your tubes, which is why your fertility can improve after the procedure.

It's not a pleasant procedure (I've done it twice now), but it's quick and if you take the 800mg ibuprofen ahead of time, it should minimize the discomfort.

[Anonymous]

I was extremely stressed out about the HSG - so much so that I had bad dreams and did obsessive research. I've had really painful pelvic exams recently from my ob/gyn, which further added to the fear. Spoke to my RE, they prescribed a valium - that combined with 2 extra strength tylenols - I was A-OK. No pain, just a weird sensation, and not too drugged up either. Got it done at SG, the actual test (speculum/dye insertion) was over (no exaggeration) in three minutes. I know bc I counted the whole time to further relax myself. Get a valium, they also said they could do it with me knocked out if I was really worried. But I thought if I am going to go through labor at some point (fingers crossed), then a valium would suffice.

[Anonymous]

I actually just went through all the testing with GW a few months ago, and we knew going in that there was next to no chance we would do IVF. I conceived DS easily at 32, but at 37 haven't been able to conceive a second time. I just wanted to make sure that there was bascially nothing physically/hormonally wrong, and that DH's sperm were fine. The HSG was no big deal at all for me -- I took Advil prior and had no discomfort at all. All test results came back normal, DH's count was excellent, motility and morphology both good, etc. We were seeing Gindoff, who expressed some surprise when we resisted his recommendation to start with unmedicated IUI. He said something like "when you go through all this testing, the assumption is that you will take some further step to assist in getting pregnant." It kind of hit me the wrong way when he said that, although I do see his point (and think that it's probably the more common one in the fertility world). But, OP, if you just want to figure out if there's a particular reason you're not getting pregnant, and explore your options for increasing your chances of getting pregnant, by all means go through the testing and make an informed decision once the results come in. For what it's worth, Gindoff wanted us to start with unmedicated IUI, which would've only been about $700 per attempt. So IVF isn't necessarily the only option that you may have to consider.

[Anonymous]

If you have had kids--vaginal or C-Section, the HSG is nothing. Now, if you are not sure you WANT kids because of your age, that is something else altogether. I did all the tests and my eggs and tubes were fine and his spermcount/quality was fine BUT a mass was found in my uterus that was likely blocking implantation. It was removed and in the first Clomid/ Intrauterine Insemination (IUI) I got pregnant. I am younger than you and tried for longer to get pregnant and was convinced something was really wrong. I might have gotten pregnant using IUI without removing the mass but I wanted to improve my chances and biopsy the mass. IUI is really not a big deal and not nearly as rough as I hear IVF is. However, keep in mind that there really is an increased likelihood of multiples. I am happy mom of twins.

[Anonymous]

I declined the HSG (at 38) at SG and the doc just shrugged. Got pregnant on 2nd clomid iui.

[Anonymous]

Anonymous wrote:I declined the HSG (at 38) at SG and the doc just shrugged. Got pregnant on 2nd clomid iui.

and that should read thirty eight

[Anonymous]

Did you at least do the day 3 bloodwork and get a feel for your reserve?