when to seek fertility testing?

[Anonymous]

My husband and I have been actively trying for 7 months now. We are both very impatient to conceive, me especially (he needed a whole year longer than I did to feel ready for kids, so it feels like I've been at this forever).

I'm wondering when it's the right time to seek testing. I know in the grand scheme of things 7 months is not long at all but it's getting so frustrating seeing month after month go by. I've personally never known anyone who has taken longer than 6 months to conceive that didn't have a fertility issue requiring treatment, so I'm starting to suspect something might be going on. Obviously, that is just my personal experience and has no bearing on the actual probability of us needing treatment. Still, its freaking me out!

Is it too early to go in for some testing? Am I silly for suspecting problems too soon? I will add that my regular healthcare provider is a midwifery practice that I love (birthcare) and I don't think they handle any of that stuff, so I'm anxious about being referred elsewhere.

Any advice or support?

[Anonymous]

After 12 months if you are under 35, 6 months if you are over.

Coming from experience, months 6-12, but 90% couples conceive within a year in their own.

[Anonymous]

How well are you timing things? If you're, say, following the methods from Taking Charge of Your Fertility, temping, charting, etc., and you're timing intercourse well, I'd see someone now. If you're more haphazard then I'd give it more time, but also work on the timing (reading TCOYF is a great place to start).

FWIW, I don't think you're silly for suspecting problems at all. My best friend always had a hunch she'd have trouble getting pregnant, and she did. She was able to conceive with help, but she was also aggressive in seeking consultation.

Aside from TCOYF, The Impatient Woman's Guide to Getting Pregnant is another great one, if you've not read either book yet. Lots of good stuff in there. Good luck, and hang in there.

[Anonymous]

I'm on cycle 13 so I totally understand your frustration. I agree with 11:23 - it depends on whether you are temping, charting, timing well. If you are, then I see no harm in scheduling a consult with an RE. I would also recommend you have DH do a sperm analysis. We did this around month 9 because I was starting to panic. A urologist, GP or RE can order a SA. My DH had his GP order it since we hadn't yet seen an RE. He had to have an appointment with his doc, but it was pretty straightforward. He had the SA done at Dominion Fertility, since it was close to our house, and got the results the next day - all normal. I also scheduled an appointment with Dominion to see Dr. Gordon. He recommended all the initial testing, including blood work and an HSG (tons of posts on the infertility forum about this, so I won't get into it). I decided do everything we could on our own to get pregnant for the next few months before we started to get involved in intervention - and also because for me that stuff wasn't covered by insurance until we had been trying for over a year. I started back with Dr. Sacks at CFA (found out my benefits go further there than at DF) and started my testing in January. My HSG was normal (and luckily not painful) so our diagnosis is unexplained infertility. I am still hopeful that this cycle is positive on our own, but if not, we will do clomid + IUI next month. It takes awhile to schedule testing because it has to be done on very specific days of your cycle, so it doesn't hurt to start the process early. I would just encourage you to keep trying the old fashion way with as much you can do to maximize the fertile window (temping charting OPKs/Monitor, etc). I would also definitely encourage you to understand your insurance coverage. It varies so much and I had a heck of a time getting Carefirst to tell me the full story about my benefits. I did not need a referral to see any specialist, so I could go straight to an RE without a referral. All of the appointments, monitoring, and testing for me are covered with a copay and they cover up to a certain amount of IUIs but no IVF (so I am very glad we don't have male factor - since generally IUI doesn't help much with that).

None of this is fun and it has been especially hard to see seemingly everyone I know become pregnant and have babies during the time we've been trying.

Good luck to you OP! I hope you have a bfp very soon.

[Anonymous]

It often takes several months to get an initial appointment from the time you call, so check with your insurance company about which local clinics are covered and call the clinic. If your insurance says that you have to wait 12 months (often if you are under 35) then make an appointment for just after that date.

[Anonymous]

It can take up to two months to just get an initial appointment and then to get all the results from an initial workup. So if your insurance will pay for it, no harm in getting that part out of the way.

[Anonymous]

OP here. Thanks for the recommendation on the books - I've read both and they were really helpful. My DH went ahead and had a SA at Dominion last month - we took the advice from the Impatient Women's Guide to Getting Pregnant and just got that out of the way. No issues there, which is a relief but still only 50% of the equation.

I haven't been temping up until this point, just using OPKs. Knowing my personality I thought it would make me even more obsessive and crazy about the details of babymaking than I already am and I didn't want that. I figured we could probably conceive on our own just knowing my ovulation days from the OPKs. Now that 6+ months have gone by I'm going to start temping (just got my thermometer) next cycle and plugging it into the fertility friend app. I've considered buying the ClearBlue fertility monitor but it's so expensive and I'm not sure it's better than temping and charting. I remember the Impatient Women's Guide really pushing the fertility monitor.

I am 27 and my DH is 34, so we have time but I think I will see how this cycle goes and if I end up with another bfn I will start the process of making the initial appointments with an RE. I've heard mixed things about Dominion but the location in Arlington is good for us (we're in Alexandria). Any other recommendations?

[Anonymous]

Yeah, if 6 months have gone by I think you are right to start temping. It's the only way to pinpoint ovulation and know if you are timing everything right. CM and even OPKs can be sporadic. I use the monitor and I prefer it to OPKs but if OPKs are working for you then I agree it's not worth the money. I had a hard time timing the tests for the surge and getting a true positive on OPKs, though I would get a sort of positive for days and days so it was just too confusing. The monitor is much more straightforward for me.

You will see mixed reviews for all REs and tons of info on the Infertility forum. If you are near Arlington, Dominion, CFA (they have an Arlington location at Virginia Hospital Center) and Shady Grove are closest to you. People find Dr. Dimattina at Dominion hard to deal with, but people swear by him and the other docs in equal numbers. Same with CFA and Shady Grove - plenty of fans and detractors. Bottom line I think is that people love the RE who got them pregnant and the whole process is really rough to deal with, especially for those who unfortunately never do get a baby at the end.

Best of luck to you OP!

[Anonymous]

I would say to start NOW. Waiting does you no good as far as I can see, and the Reproductive endocrinologists make you get a zillion tests which takes along time, so the whole process takes awhile. better to start right away. Check the infertility board for a lot more info on all of that.

[Anonymous]

For your age, wait till 12 months unless you have something in your personal history that would make you think you could have an issue. I was like you, didn't temp but did OPK's off and on, trying for 12 months. The OPK's didn't really work for me - didn't always see the LH surge. In month 11, made appt with fertility specialist. We had our consultation and were waiting to schedule the tests until I got my next period. That period never came – now I have a healthy 10 month old. I’m starting to think about #2, so I just read TCOYF (yah, should have done that before) and started temping. Hopefully this time it won’t take as long.