Reiter & Hill and TTC

[Anonymous]

I have been seriously ttc (temping, cbefm, etc.) for 7 months now w/ no luck. At my annual R&H appointment last spring, they seemed very laid back about it, said everything looked fine and that I am still young and shouldn't worry for a few more years. I'm 34 and really don't feel like taking such a laid back approach anymore. Just curious what others have experienced w/ R&H? I am due for my annual soon and am wondering if they will be more proactive (ie do they put patients on clomid?) or if I just need to go see an RE sooner rather than later? I know everyone says it can take a year on average but I'm having a hard time being patient!
thanks

[Anonymous]

I think most ob-gyns are pretty laid back about ttc issues. It's not their job to GET people pregnant, it's to keep people pregnant and deliver babies. I would make an appointment (or 3) with an RE to get a sense of your options and where you stand.

[Anonymous]

I'm a R&H patient. In my experience, they do not do Clomid---they just refer you to an RE.

Their laid-back attitude may stem from your being 34. Everything in the reproductive world seems to change when you hit the magic number 35. I was 38 when I married and started TTC and R&H told me that if we didn't conceive within 3 months, it was their recommendation that we move on directly to an RE consultation.

You have to be in charge of your medical destiny in this area.
Research your health plan (and that of your spouse) to determine which is more favorable. Find out exactly what the criteria are for RE services. (For example, many plans have criteria regarding how long you have to have been TTC unsuccessfully before they will cover RE services). Be pound-wise and not penny-foolish---if a more expensive health plan provides RE coverage---suck it up and pay the higher premiums because they are bound to be less expensive than footing the full bill for IVF (if it comes to that).

Then research everything on these boards about the various REs in the area, and then go meet some.

I like R&H and have used them for years, but they are somewhat of a factory---so you won't get a lot of help in the TTC arena from them.

Good luck.

[Anonymous]

If you've been charting for 7 months and no luck, I'd definitely go for a consult with an RE. I started TTC for #1 just after I turned 35, and ultimately got pregnant after 1 year and 1 miscarriage. But now, after I trying for #2 at 38.5 years and having to seek fertility treatments, I realize that my egg quality had probably started to go at 35 and that I should have started on #2 sooner. In the reproductive arena, some women just age more quickly then others. Not to alarm you, but if you want more than one child it may be good to get checked out now so you can do some advanced planning if necessary.

[Anonymous]

I'm 34 and now on my 13th cycle charting and seriously TTC, and have just now scheduled my first RE appointment. I don't see R&H, but another OB and he ran tests on me (which uncovered nothing) and wanted to put me on Clomid. From what I've heard it is not a good idea to take Clomid unmonitored due to the inability in an unmonitored cycle to determine how you are reacting to the medication (i.e., is it actually making you ovulate? how many eggs? is your lining thin after ovulation such that you wouldn't be able to support a pregnancy even if you ovulated, the egg fertilized and implanted? are you developing cysts?). Plus, you might have a male factor issue that you don't know about and which all of the Clomid in the world won't fix. If you're not ready to move on to an RE then you might see if R&H will run some of the preliminary testing (bloodwork) and also ask your DH to get a referral from his primary care doctor for a sperm analysis.

[Anonymous]

The problem about seeing an RE before the 1year-mark is that most insurances that cover fertility treatment only do so if you have not been able to conceive after 1 year. If you do have insurance for fertility treatment, you might want to wait b/c fertility treatment is very expensive. If your insurance does not cover fertility treatment or money is not an issue, then go ahead and see an RE now.

[Anonymous]

Yes, but a one-time consult with an RE would be less than $300 out-of-pocket, if I'm remembering what my insurance paid, so it may be worth it not to wait if she wants to have more than one child.

[Anonymous]

And just keep in mind that they have no way of checking how long you've actually been trying. . .

[Anonymous]

OP here; thanks for all of your helpful responses! Not to sound dumb, but i keep hearing this one year figure as far as insurance and am just wondering how they know or how this is measured. Am i missing something, or couldn't i just say i had been trying for one year?

[Anonymous]

You need to be consistent in your statements to medical providers---so if you told R&H that you've been trying for a few months, and then told an RE a year---that could subsequently come back to bite you. Although the possibility of that is admittedly remote.

Another insurance criteria for fertility benefit coverage is sometimes the length of time you've been married---so you should check out your plan's requirements with respect to that aspect as well.

[Anonymous]

Not all insurers make you wait a year. Ours covered a consult when we had just been trying for 4 months - but we have a $5K max for fertility treatments.