Is it time to see a fertility doctor?

[Anonymous]

I’m 39 now. Had my first at 37, got pregnant on the first try. Now we’ve been trying for 3 months (“well-timed”) and nothing! I’m not interested in IVF (I guess I don’t want a second *that* badly), so is there anything a fertility doctor could do for me? I guess I’d just like to know if there are any “easy” fixes. I’ve seen too many friends go all out in terms of time, money, and stress for a baby, and I’m just not willing to do that. I have a regular gyn appointment next week, and I’m weighing whether to ask for a referral. (Posted also at TTC)

[Anonymous]

A reproductive endocrinologist can run tests to estimate your ovarian reserve, then can use that info to (often) estimate your chance of success with IUI, IVF, or doing timed intercourse with the help of fertility drugs like Clomid or injectables.

In my experience, unless your insurance specifically requires a referral for specialists, you can just call the fertility clinic of your choice and make an appointment. (There are hundreds of posts on this forum about the differences between Shady Grove, GW, Dominion, Columbia, and CCRM, assuming you're in the DC metro area.)

Often the advice given to women over 35 is to seek additional help if no success after 6 months of well-timed TTC. However, I'm not sure if that recommendation is revised for women close to, or at/over 40. No sense is wasting time, in my opinion.

FYI-the fertility testing is timed around your menstrual cycle and can take a month or more (after your appointment and decision to move forward w/ the testing), so my advice in the meantime is keep TTC!

[Anonymous]

If you want a second even slightly or think you may regret not having one, go to an IVF doctor asap.

[Anonymous]

First, 3 months may be a bit premature. The "rule" is after 6 months if you're over 35, and after 3 months if you're over 40. So obviously you're straddling that line, so I think it's up to you whether to try for a few more months or schedule an appointment now. (It may also take a month or two to actually get in, since a lot of REs book decently far out.)

Your regular gyn could run basic bloodwork to make sure your hormones are good. Things like thyroid or prolactin can impact fertility and are treatable with medication. I think you should think through what, if any, interventions you'd be willing to try. There are other options aside from IVF; would you try Clomid or another medication? IUI? IUI with medications? If the answer is "no" to all of those, then I'm not sure what a fertility doctor could really do for you. But if you want more information about your options or want to do the basic fertility workup (bloodwork and a few tests), then a consult with a fertility doctor couldn't hurt.

I'll also add that I applaud and am jealous of your certainty in your decision. I started that way, then second guessed myself and, surprise, am now doing IVF for #2. It's not where I thought I'd be at all, and I sort of wish I could have felt more certain in not having to try "everything" before accepting having one child.

[Anonymous]

Anonymous wrote:First, 3 months may be a bit premature. The "rule" is after 6 months if you're over 35, and after 3 months if you're over 40. So obviously you're straddling that line, so I think it's up to you whether to try for a few more months or schedule an appointment now. (It may also take a month or two to actually get in, since a lot of REs book decently far out.)

Your regular gyn could run basic bloodwork to make sure your hormones are good. Things like thyroid or prolactin can impact fertility and are treatable with medication. I think you should think through what, if any, interventions you'd be willing to try. There are other options aside from IVF; would you try Clomid or another medication? IUI? IUI with medications? If the answer is "no" to all of those, then I'm not sure what a fertility doctor could really do for you. But if you want more information about your options or want to do the basic fertility workup (bloodwork and a few tests), then a consult with a fertility doctor couldn't hurt.

I'll also add that I applaud and am jealous of your certainty in your decision. I started that way, then second guessed myself and, surprise, am now doing IVF for #2. It's not where I thought I'd be at all, and I sort of wish I could have felt more certain in not having to try "everything" before accepting having one child.

Thanks, PP! I started out only wanting one. The whole experience has been going better than I expected, so I’m open to a second. But I don’t feel like I need a second for our family to be complete. Obviously, that’s just my perspective - I can understand why others don’t feel that way.

[Anonymous]

Anonymous wrote:First, 3 months may be a bit premature. The "rule" is after 6 months if you're over 35, and after 3 months if you're over 40. So obviously you're straddling that line, so I think it's up to you whether to try for a few more months or schedule an appointment now. (It may also take a month or two to actually get in, since a lot of REs book decently far out.)

Your regular gyn could run basic bloodwork to make sure your hormones are good. Things like thyroid or prolactin can impact fertility and are treatable with medication. I think you should think through what, if any, interventions you'd be willing to try. There are other options aside from IVF; would you try Clomid or another medication? IUI? IUI with medications? If the answer is "no" to all of those, then I'm not sure what a fertility doctor could really do for you. But if you want more information about your options or want to do the basic fertility workup (bloodwork and a few tests), then a consult with a fertility doctor couldn't hurt.

I'll also add that I applaud and am jealous of your certainty in your decision. I started that way, then second guessed myself and, surprise, am now doing IVF for #2. It's not where I thought I'd be at all, and I sort of wish I could have felt more certain in not having to try "everything" before accepting having one child.

Thanks, PP! I started out only wanting one. The whole experience has been going better than I expected, so I’m open to a second. But I don’t feel like I need a second for our family to be complete. Obviously, that’s just my perspective - I can understand why others don’t feel that way.

[Anonymous]

OP, I'm a fertility counselor/coach and would be happy to chat with you about things you can do to increase your chances of conceiving. We can hop on the phone for a quick call (no cost/obligation) to see if we're a fit for working together. If you're interested, let me know and where I can send you more info. xo

[Anonymous]

3 months is nothing

[Anonymous]

Anonymous wrote:3 months is nothing

Agreed.
Pregnant with #1 after one month, and now worried after 3 months TTC for #2? In no way does this meet the standard for an infertility workup, unless you have a known issue (PCOS, MFI, endo, etc).

[Anonymous]

I don't think you need to stress about it yet, but maybe book a consult with an RE or fertility clinic for the 5 or 6 month mark so you have that in your back pocket if you still needed it at that juncture. There are other interventions less intensive than IVF. Clomid with timed intercourse, medicated or non-medicated IUI, various supplements.

[Anonymous]

Anonymous wrote:3 months is nothing

I think though if it goes beyond 3 months then it is possible that there is an issue. That's what happened to me. Pregnant on the first try at 35, easy pregnancy and delivery. I never thought I would have infertility problems after that. Started TTC #2 at 36. After 4 months I started wondering. Went to an RE after 6 months, they found severe DOR. I have been TTC #2 for 5 years now, zero pregnancies.