do you really need to try 1 whole year before getting help?

[Anonymous]

My OB's standard of care is to try on your own for a full year before he'll do anything. I feel like I am wasting time (I'm 33 and have tried 7 months). I'm also worried that OB is not going to be able to do much for me anyway, but think b/c of insurance I need to go through him to get to RE and I don't think he'll give me a referral until 1 year although I will ask. I just feel like this is such a waste of time and stress since continuing to just have regular unprotected sex is doing nothing. On top of it all, my always regular 30 day cycles have gone all wacky in the 7 months we've been trying. from 27-38 days. maybe i can get help early b/c that could be considered irregular periods? I will obviously talk to my docter (have appt set), but I am so stressed about this and my husband just keeps repeating the old rule of trying for a year. I'm losing my sanity.

[Anonymous]

Definitely double check with your insurance to see if you have to get a referral through your RE. Assuming you do, though, five more months is not going to be the end of the world at age 33. It might not be successful and end up indeed being a waste of time as you fear, but it's not going to make the difference between successful treatment through IUI/IVF or unsuccessful treatment.

There are a couple of upsides: five more months could also give your husband more time to wrap his head around further interventions, if you're not successful getting pregnant naturally. You both definitely need to be on the same page before moving forward.

Also, have you been charting and using OPKs to try and time your cycles? If not, five months will give you some additional time to try that. You can also use the time to look into nutritional supplements for you and your husband; acupuncture; and cleaning up your diet (if necessary). Best case scenario, all that stuff will be completely unnecessary and you get pregnant within five months. Worst case scenario, you end up having to see an RE but you'll be physically ready for the challenges of assisted reproductive therapies.

Good luck...

[Anonymous]

Yes, one year unless you are over 35 in which case they will refer after 6 months. I think you can request a sperm test sooner, but that's about it. Average time to conceive without assistance at your age is about 11 months, so don't worry.

[Anonymous]

Agree with OP. Check your insurance. With my PPO, I didn't need a referral for an RE, and we started right away. Ours was not unexplained infertility, though, so I'm not sure if that made a difference. No harm in asking for a second opinion, though, or just calling one of the big RE clinics and asking them for an initial consultation. They have people to help you wade through the insurance issues.

[Anonymous]

Although "technically" one year is often the timeline, I definitely agree with the other posters that it's worth looking further into it. If you and your partner feel like having further workup and seeing a specialist is for you, I would definitely advocate for yourselves with your doctor. And if s/he won't write you a referral (and if you need one), there is no harm in going to another ob/gyn who might be more willing to help you get the care that you need.

In the mean time, using OPKs/temp to help you time intercourse effectively, think carefully about your lifestyle- none of those things will hurt while you keep trying!

Best of luck in the coming months. I know this can be a challenging, exhausting process, and I hope that in a the near future you're sailing through a healthy pregnancy!

[Anonymous]

If you have been charting and/or using OPK's, I don't think that 7 mos is too early to see an RE, especially at 33. I don't know your birthdate obviously, but 5 more mos could easily put you at 34 when you see an RE...meaning that medically, even if you get pregnant quickly after that you are likely to be 35 on your due date and considered "high risk" immediately. And if like me, you don't get pg right away and/or you m/c, you will definitely be 35 yo.

FWIW, at my sister's urging (she had experienced multiple miscarriages) I went to see an RE at age 33 after about 9 mos of TTC and charting for about 6 mos. I wish I had gone sooner. We got back a male factor dx pretty quickly, which also meant that my insurance was willing to waive the 2 year TTC rule and covered IVF immediately. I'm now 34. I've had 2 failed IUI's, first IVF/ICSI ended in m/c (my due date was my 35th b-day just to rub it in), and my second IVF/ICSI just failed.

I truly hope you do not experience what we have, but if you are definitely ready to have a child and you have done all the reasonable things to maximize your chances naturally, there is no harm in seeing an RE. It's unlikely that you would begin treatment until you have been TTC for 1 year anyway. Also, "Taking Charge of Your Fertility" (which you should really read if you haven't already) recommends seeing a specialist if you haven't been successful after about 4-5mos of charting and timed intercourse. I know the stats say the average time for TTC at your age is 11mos, but I've checked and I don't think there are any stats available for average times with charting and timed intercourse. Logically, if there aren't problems with either the sperm or the egg, then timed intercourse should have similar success rates as IUI...which means 4-5 mos is reasonable.

I would be firm with your OB and ask for a referral if you need one (I switched insurance to get IVF coverage, but my old insurance did not require one). S/he may decide to first put you on clomid, but that's just a shot in the dark without any real logic behind it. In my case, my RE could find no indication of IF on my side at all...clomid would have been an unnecessary waste of time. OB's are good at many things, but they are not specialists in IF. The good ones will be up front about that. People associate going to an RE with pursuing ART, but it really doesn't have to be that. It's just a matter of understanding your situation. I truly hope you have no issues, but there is really no downside to verifying that through a few simple tests. And if you have issues, the sooner you find out the better.

[Anonymous]

You have the right to go whenever you want to go. My first appointment was in January and we didn't start treatment until June. It takes time to get all the testing done.

I would say go now. Especially if you want more than one child.

[Anonymous]

If you know for sure each month when you ovulate and you've had well timed intercourse before (not after) ovulation, I wouldn't wait a year. I agree with a PP that the year standard didn't assume women hitting the nail on the head each month.

[Anonymous]

7 months at age 33 is hardly anything... Most RE's will not take you seriously at this point (IMO.)

[Anonymous]

within one year of trying (started on my 31st bday) by my 32nd, I was pregnant with IVF.

I tried for about 11 cycles, but started seeing an RE about 5 cycles in. About 9 cycles in realized I had blocked tubes and by the 12th cycle we were ready for IVF. So glad I sought out help sooner. Currently expecting!

[Anonymous]

PP here. I did ask for an RE referral but was told I hadn't tried long enough, so then I lied and said it had been a year. I had been charting, clockwork cycles, etc. Everything seemed fine on paper, so I felt strongly something was wrong. Once I knew my tubes were blocked I still wanted to try a few more cycles. If I had waited teh whole year, it wouldn't have been the end of the world, but it took the 'stress' of the process rolling out of it. I was just happy to know sooner rather than later.

[Anonymous]

Unless you've been on the pill in the past year, just tell the OB you've been trying for a year or even two. That is the standard with some insurance companies for IF coverage.

[Anonymous]

If you tell your ob you've been trying for a year, then you've been trying for a year. Get my point?

[Anonymous]

Anonymous wrote:If you tell your ob you've been trying for a year, then you've been trying for a year. Get my point?

+1

[Anonymous]

I was 35 when we tried for just six months. It was working for us. So I immediately went to a fert specialist and ended up exactly one year later having a child. I then waited until I was 42 to try again. Big mistake. It took seven cycles to get pg the second time. Finally, at age 45, I had a second. I would go to the fert specialist when you feel you should go.