RE consult, what to expect

[Deleted]

I haven't made the appt yet, but looking for insight/experiences on what to expect?

The office I am planning to go to the website says that they will schedule an ultrasound for after your appt and the doc will decide if it's necessary that day.

Should I expect and exam? Ultrasound is internal I assume? Did your H go with you? Is it weird if he doesn't? (Lol just thinking of scheduling issues).

I'm guessing he will ask history, should I bring chart details on my wacky cycles?

I'd love to hear everyone's experiences.
Greatly appreciated, TIA

[wannabmama]

My first RE visit was just talking to her in the office. I explained our history as I knew it and she explained the types of testing she would want to do. (CD3 blood work and and hsg initially.) MH wasn't at that consult or any u/s actually...he's only come once, to sign IVF paperwork. It's just too hard to coordinate schedules. And, tbh, MH deals better if he hears things from me sometimes. The clinical setting stresses him out.
My RE will listen to me talk about my cycles and knows that I chart and temp and she's generally interested in what I say about them...but she's not very interested in the specifics, if that makes sense. She based most of her opinions on our blood work, SA, etc.

[doodler]

My consult was for RPL but went much like I would imagine any other consult would. There was no physical exam. It was all sitting in the doctor's office and talking. My husband couldn't attend mine but I wish he could have and at my office I think it is expected that husbands will.

I shared my history and the doctor did a basic anatomy lesson. He explained some of the reasons why I could be having issues. At that point he went over all of the different tests that he thought I should get and asked me if I had any questions. He then left and sent in my nurse. She went over the specifics of scheduling the tests because most of them are cycle day specific. Then I was taken the office of the financial consultant who had already ran my insurance and figured out what my costs would be for the testing.

After all of the testing is done I will have a second meeting with the doctor to review all of the results and determine next steps.

[caer]

I'm sorry you find yourself at this point. I know it's overwhelming and scary. I did not take DH with me to our consult because he needed to watch DS (most RE offices ask that you don't bring children with you). My RE wasn't particularly interested in my charts but I also had very regular cycles so they didn't really tell you much.

Here are the tests my RE scheduled for me at the consult:

- Two sets of bloodwork for me. One at CD 3 and one at any point in the cycle. One set of bloodwork for DH.

- A baseline ultrasound, which had to be done at the beginning of the cycle. It is internal. I was able to get it done the same day as the consult.

- SA for DH.

- HSG, which needed to be done between CD 7-12.

- Counsyl, which is a blood test for 100 genetic conditions.

Overall, I've had a very, very postive experience with my RE. They are kind and responsive and invested. It feels nice to have someone on my side in all of this. If you ever want to talk about any of this, please feel free to PM me.

[Rama]

At our consult/intake appointment, I was CD 5. We talked about history, treatment protocols, what I was comfortable with, what I knew, briefly glanced at my charts, then got my first experience with the dildocam.

It's a lot of talking and some paperwork, mostly. My husband came with me and got his SA that day, too. He had to abstain from ejaculating for 2-5 days, I think? We were right at the max of 5.

Dildocam was weird because I wasn't sure what to expect. Mostly it's a bit of pressure as they look around at your ovaries and follicles. We were done in ten minutes, tops.

[ironbaby]

I just went about a month ago, so it's fresh.

My doctor spent an hour with us just going over our histories and briefly outlining clomid. She had made notes on our extensive history paperwork we had to complete and reviewed those notes with us, which helped a lot to feel like we weren't just another statistic, but she was actually paying attention. She also went over all of the available testing she would recommend and how/when we would schedule those.

I did not receive an exam that day, but I had an U/S with my OBGYN, so we omitted that from my testing protocol. That U/S was vaginal.

My H did come, though I heard that happens only about 50% of the time. MH was invested in hearing for himself and understanding everything, but there wasn't much discussed that I couldn't have just come home and told him. They called MH directly to schedule the SA.

I brought my charts, but the histories we had to complete were very thorough, so the info from my charts was already conveyed. It couldn't hurt to bring them, but they may not need to see them.

So, all in all, my initial consult was just an office meeting. No exam. I did do the AMH bloodwork that day bc it took longer to get back. The remaining testing was scheduled for CD 2-4 of my next cycle, and the HSG on day 6-11.

One thing I did not prepare for was how long it would take to actually do treatment. We met just before O during my cycle, then testing all the next cycle, so it won't be til the NEXT cycle before we actually have any treatment. That was hard to swallow. We have a followup consult now that all testing is on to really discuss those results and what our treatment options are.

GOOD LUCK!!

[sleepymonkey]

My first RE appointment was just a consultation. There was no exam or u/s at the time. I met with the RE and we went over my history, how long we’ve been trying, etc. He even asked why we waited so long (5 years married, when I was 36) to have our first child which I found a bit invasive. He didn’t have much interest in my charts but that could be because I’m pretty regular. He did tell me at this point to stop temping because it wasn’t really telling me much since I knew I ovulated. Then he discussed various testing he wanted done. He then gave me an rx for bloodwork and scheduled MH’s SA for a few days later. I had to come back to discuss the results a few days later and then I just called when I started my next cycle so I could get my baseline internal u/s and CD3 bloodwork. He has never done an exam, he has only done ultrasounds (2 per cycle). MH actually never went with me to the RE until this past IUI. The way his schedule is, it is hard for him to take off work. He has dropped off samples a few times but never goes to my appointments. I always wonder if the RE and his nurses find that odd, especially when most of the people I see in the waiting room are couples. But it is what it is and I try not to think about it too much.
The one thing I recommend is something I regret. My RE did not recommend an HSG right away, I think it had something to do with the fact that I had no problem conceiving DD so he didn’t think it was a tube issue. But here I am, 4 cycles of treatment later, with no known reason why we haven’t been successful. I am getting the HSG done next cycle if this one doesn’t work and if my tubes are blocked, I’m going to feel like a fool for not insisting it be done earlier.

[kleigh]

Hi @irish , I'm so sorry you find yourself having to consider this.

My first consult did include bloodwork and an ultrasound, and I've referred a friend to this same practice and her consult included that too (she was CD10). I was in the luteal phase (I believe around CD19, approx 5 dpo). So I think that part varies by practice but I'd be prepared to have those.

I did print out my O charts and we discussed them briefly but he was more concerned with mine and H medical history (mostly mine) so be sure to get details (if you can) from family. On any medical conditions, losses, etc.

PPs already did a good job of outlining the testing schedule.

I did have H there because for us I needed/wanted to support and he wanted to be a part, and we wanted two sets of ears because it can be a lot to take in.

[kawaiikitsune]

My consult was mostly medical/ttc history. I had my vitals taken and they had me step on a scale to check my weight. I also had a transvaginal u/s in the office and a quick pelvic exam. My dr. ordered a whole mess of blood work. He didn't ask to see my charts when I told him I had been temping/charting my bbt. Since MH & I had had some initial testing done through my gyn and another practice, he wanted to see the results before we discussed further testing/treatment. I was only there about an hour or so.

[siouxsieq]

Reading this it's interesting to see how different practices/doctors do things, but the basics do seem to be consistent.

I would make a couple suggestions. First, if you are charting, they may not be interested in actually analyzing your charts, but they may be interested in your findings. For example: I've been charting and my charts are always/sometimes/never biphasic; my luteal phase is short/long/inconsistent; I always/sometimes/never have inovulatory cycles; my cycles are regular/irregular.

Also, information will be coming hard and fast. Familiarize yourself with some of the potential testing/treatments/medicines beforehand, so you're missing info because your brain gets caught up on a word or procedure you're not familiar with.

And finally, I would think long and hard about how aggressive of an approach you'd like to take if it were up to you. I think I saw you mention in another thread that you were making some healthy changes to your lifestyle and were feeling good about it, so maybe a more conservative approach at first is where you'd be more comfortable, or if you're AMA, maybe you'd want to be aggressive at the outset because you feel like timeliness is key. You do have a say, to an extent, as to how you want things to go.

I hope your RE experience is a good one! For me, I really feel cared for and listened to at my practice, and I feel very comfortable calling throughout the month to ask questions.

Have you found an RE yet? Sometimes they have websites with a lot of good info on it about what to expect. And I know that first phone call is hard to make, but (for me at least) it was a great feeling once I got that ball rolling. GOOD LUCK!

[daisy818]

Sorry you find yourself at this point; I hope the RE can help get you some answers and a plan in place very soon!

At our consult it was just talking, going over history, and him explaining the testing he would be conducting and the reasons for each test. DH went with me, for a combination of moral support, to answer any questions the RE might have for him, and to help me take in all the info. I was CD6 that day, and he told me to call his office as soon as I got a positive OPK to set up an u/s for around O day. RE also told us to have sex before that appointment, so he could also do a post-coital test the same day. This was both good (two birds, one copay) and bad (dildocam was first, and since we had to do the post-coital test as well, no lube allowed). DH came to that appointment as well (full disclosure - DH has come to every appointment I've had with the RE, but he also lost his job in December and was unemployed at the time, so scheduling was not an issue). At the u/s appointment we set up plans for the SHG and HSG. I'm very glad DH was there with me for the HSG - I was one of those people for whom it hurt like a bitch, and I squeezed the shit out of DH's poor hand during the procedure.

[teachermomtobe]

If you haven't read the newbie blog on 3T/IF I strongly recommend that: gbcb3tif.wordpress.com/what-to-ask-at-your-first-re-appointment/

I am sorry you find yourself here. I found that once we met with the RE things got moving quickly. If they move too quickly for you speak up. Remember, you are in control here even when it may not feel like it. I would recommend having an idea of what options may be available and how you feel about them.

My H came to our consult appt. They said if he couldn't come I should know his history. They sent us a packet ahead of time with questions to fill out and general info about the practice. I had had CD3 bloodwork and an ultrasound done already by my OB/GYN. When we walked in the RE had clearly looked at the test results we already had and had a game plan. (I wasn't ovulating at all so the first step was clearly to get me to ovulate.) She went over our history and gave us her recommendations. We had time to ask questions. I had more bloodwork and another ultrasound that day. We also met with the RE nurse to discuss the medications I was going to start at the beginning of my next cycle. I brought my charts but she didn't look at them since she took my word that I wasn't ovulating which is all my charts showed anyway. She did say that we had to schedule HSG and SA within the next 2 cycles.

My H didn't come to our follow up appt after 3 failed cycles just because of work timing and I didn't feel it was necessary for him to go. He is willing to do whatever I want and doesn't understand most of the medical stuff anyway but I was glad he came to the very first appt. We have an IVF consult scheduled in a few weeks and the RE said he must come to that.

[sleepymonkey]

daisy818, I was wondering about whether they recommend having someone with you for the HSG. More than likely, I will have one in a few weeks and it is difficult for MH to take time off without causing problems.

[caer]

May 3, 2016 15:39:40 GMT -5 sleepymonkey said:

daisy818, I was wondering about whether they recommend having someone with you for the HSG. More than likely, I will have one in a few weeks and it is difficult for MH to take time off without causing problems.

FWIW, they didn't allow DH in the room with me for my HSG, so you might want to ask. He did come along but only because we had to drive 2 hours there and back.

[wannabmama]

May 3, 2016 15:48:27 GMT -5 caer said:

May 3, 2016 15:39:40 GMT -5 sleepymonkey said:

daisy818, I was wondering about whether they recommend having someone with you for the HSG. More than likely, I will have one in a few weeks and it is difficult for MH to take time off without causing problems.

FWIW, they didn't allow DH in the room with me for my HSG, so you might want to ask. He did come along but only because we had to drive 2 hours there and back.

MH did not come to mine and I don't think he would've been allowed in the room if he had been there (I saw other men waiting in the waiting room and at least one was there with his SO who was having an hsg.)

[kawaiikitsune]

MH came with me because his SA was scheduled the same day as my HSG, although not simultaneously. I wanted him to come back with me because I was really nervous but they did not allow it.

[daisy818]

sleepymonkey, so apparently worth checking about whether YH could be there with you during the HSG, because my experience seems to have been atypical. They let him come right on in there with me (maybe he had a face mask or something? I kind of remember that). It was also useful to have him there because the doctor had me take a Percocet and a Xanax before the procedure, so I was a bit loopy.

[wannabmama]

May 3, 2016 17:10:48 GMT -5 daisy818 said:

sleepymonkey, so apparently worth checking about whether YH could be there with you during the HSG, because my experience seems to have been atypical. They let him come right on in there with me (maybe he had a face mask or something? I kind of remember that). It was also useful to have him there because the doctor had me take a Percocet and a Xanax before the procedure, so I was a bit loopy.

I so wish my doc offered those meds...it was not a fun experience (very quick though!) I'd definitely opt for them even if he just had to sit in the waiting room to chauffeur me around

[thechickencoop]

Ooooh I'm glad you guys mentioned about your SOs not being allowed back for an HSG. I'm going to be scheduling mine for next cycle and I was hoping H could work out his schedule to be there, BUT, I guess I should ask if it's even allowed in the first place.

[thechickencoop]

{{hugs}} @irish,the worst part is the lead up to that first appointment, then you'll just wonder why you were so nervous! We just had our consult what...like, 2 weeks ago ish and I was a ball of nerves that day up until we got in the office, then it was just NBD haha.

Before the consult they sent a several page questionnaire which covered all of my cycle info and medical history, so I didn't print out my charts or anything like that.

H came for our consult, it was a bit of time talking with the RE, then a quick pelvic exam, then bloodwork. We are being evaluated for RPL as well as IF so I think some of our protocol is a bit different but she did the pelvic, a cervical culture, and we both had blood drawn. We are both having chromosomal testing done, and then I also had a bunch of other things tested. I will go this week for a progesterone level (and a repeat prolactin because that was abnormal last week), on Friday at 7 dpo, then for an endometrial biopsy at 10 dpo. Next cycle I will have CD3 bloodwork (my gyn did some but it was missing some things), an HSG, and then whatever follow up from those tests.

It's a lot, but it feels really good to be moving forward. Good luck lady!!

[Rama]

I find it very interesting that most of your SOs weren't allowed in the room during your HSGs. MrRama came to mine and got to stand near my head the whole time. Different practices!

[lgraceh]

I just had my first consult yesterday. DH came with me. He had previously done his SA, so that was already there. We talked for a while, going through our history and outlining options. Since it ended up being CD 1, they did the baseline US (which is internal) DH was in the room with me. I had blood work done as well. We did not do the genetic testing. HSG is scheduled for CD 12 and IUI #1 is hopefully after that. We met with finance after that so we had an idea of what we would be moving forward. She did write me a prescription for Femara if I wanted it, but suggested we try a cycle or 2 without. Assuming I don't O before my HSG, we are lucky to get to move forward pretty quickly.

[mikaela20]

Like most people my initial consultation was to go over medical history and discuss testing and next steps. I got information on treatments and also on things we could do ourselves to improve our fertility - specific vitamins, no smoking, etc. I also got information on our government medical coverage. The clinic asked that my husband be there but honestly he wasn't useful. I answered all questions. I went in with all my charts and she was mainly interested in my cycle lengths. She was confident that I ovulated on my own based on my charts, but that it was taking so long. She answered all my questions that I had which I stole from the 3T blog but most were answered before I asked. I even asked if saliva from oral was causing an issue- she was kind with her answer and said that would be an awful shame if that was the case. Ha!

[Deleted]

I'm so sorry I didn't mean to make this such a post and run! I got so busy and just finally sat down.

Oh my gosh thank you all so much for taking the time to share your experiences. I appreciate it so much bc I don't have anyone IRL to talk to about this.

teachermomtobe I didn't know about that blog, thank you so much I will definitely read it and write down questions!

As for HSG, is that pretty standard? I'm very scared about that. I'm a fainter. I have had cervical biopsies and cryosurgeries and I have fainted during them and ended up being put under the last time. Is being anesthetized and option? Lol.

This has all been so helpful! If no BFP in the next few days (which I don't expect) I will call and make an appt.

**trigger warning: LC mentioned**

I am familiar with the dildo am since I have children, but is it done sometimes while your still bleeding? I saw with some of your responses that it was done early in the cycle, has anyone experienced that? My only concern is that I bleed extremely heavy sometimes. Super plus tampon and super plus pad together. I can't imagine how embarrassing it will be if I am bleeding really heavy.

[Rama]

May 3, 2016 21:08:53 GMT -5 @irish said:

I'm so sorry I didn't mean to make this such a post and run! I got so busy and just finally sat down.

Oh my gosh thank you all so much for taking the time to share your experiences. I appreciate it so much bc I don't have anyone IRL to talk to about this.

teachermomtobe I didn't know about that blog, thank you so much I will definitely read it and write down questions!

As for HSG, is that pretty standard? I'm very scared about that. I'm a fainter. I have had cervical biopsies and cryosurgeries and I have fainted during them and ended up being put under the last time. Is being anesthetized and option? Lol.

This has all been so helpful! If no BFP in the next few days (which I don't expect) I will call and make an appt.

**trigger warning: LC mentioned**

I am familiar with the dildo am since I have children, but is it done sometimes while your still bleeding? I saw with some of your responses that it was done early in the cycle, has anyone experienced that? My only concern is that I bleed extremely heavy sometimes. Super plus tampon and super plus pad together. I can't imagine how embarrassing it will be if I am bleeding really heavy.

HSG is just to make sure your tubes are clear. You could ovulate a million eggs and not get pregnant of there's gunk in the way. :) It was very nbd to me, but I know I'm an odd case.

Yes, you will get an ultrasound while you are bleeding, most likely. It's definitely more awkward for you as a patient, but if you have to do treatment more than once, it gets easier/you give no shits. I can assure you, you're unlikely to surprise them with your flow. ;)

[kawaiikitsune]

I had my first dildo cam while bleeding. It was near the end of my period so it was significantly lighter than CD1-3 but I was still mortified. I believe I also apologized but the u/s tech was not very friendly and basically ignored me the whole time.

For my hsg, my cervix was numbed so the catheter insertion was painless. I did not feel the dye, even with a blocked tube, but some ladies say they do. It is pretty much identical to period cramps. I did cramp off & on the rest of the day but nothing ibuprofen couldn't handle. My one piece of advice is avoid Google at all costs. I did not and spiralled on horror stories so I was near hyperventilation in the waiting room. Anesthesia is not an option because sometimes you have to move around on the table. I had to turn on my side and stuff to try to get the dye through my tube but it didn't work. The test is really short, mine was less than 10 mins., so anesthesia would be a total waste.

[mikaela20]

@irish yes you will likely get an u/s during a bleed. Your ovaries are less active during this time so it's easier for them to count the eggs when doing an ovarian reserve test. It actually wasn't as bad as I expected. I was wearing a pad going in, brought a fresh one to use after going pee just before entering the room. They had cloths and wipes to freshen up in the washroom too. The table was covered in puppy pee pads (they looked and felt like them anyways lol) and it really wasn't too gross. The Dr doing it even apologized for going in at this time in my cycle and explained why they had to do it during AF which helps me feel less gross.

I had a saline sonogram with echovist/contrast instead of an hsg to check tubes and uterus. I was very freaked out. I had a specific abnormality so didn't have a good experience. The only advice I can give is to try to relax when going foe the test. I brought my mom. The test will likely be not great but being relaxed and breathing during the procedure will help get you through it.

[lgraceh]

May 3, 2016 21:08:53 GMT -5 @irish said:

I'm so sorry I didn't mean to make this such a post and run! I got so busy and just finally sat down.

Oh my gosh thank you all so much for taking the time to share your experiences. I appreciate it so much bc I don't have anyone IRL to talk to about this.

teachermomtobe I didn't know about that blog, thank you so much I will definitely read it and write down questions!

As for HSG, is that pretty standard? I'm very scared about that. I'm a fainter. I have had cervical biopsies and cryosurgeries and I have fainted during them and ended up being put under the last time. Is being anesthetized and option? Lol.

This has all been so helpful! If no BFP in the next few days (which I don't expect) I will call and make an appt.

**trigger warning: LC mentioned**

I am familiar with the dildo am since I have children, but is it done sometimes while your still bleeding? I saw with some of your responses that it was done early in the cycle, has anyone experienced that? My only concern is that I bleed extremely heavy sometimes. Super plus tampon and super plus pad together. I can't imagine how embarrassing it will be if I am bleeding really heavy.

AF literally showed as I was using the restroom before the dildo cam. I was so sure they would have to postpone. The nurse was like, nope, that's why we have the pad. And the doctor just said it was actually good timing. No worries!

[lvlyldybmp]

I'm glad you asked this, I just had my RE consultation Monday.
Lots of lots of talking, and I had a vaginal exam, they took swabs to check for an infection... She said this was standard.
I am lined up for CD3 bloodwork and an ultrasound, and also an HSG.
The nurse freaked me out by saying its "very very painful"... But then there are posts here where people say it's no big deal.
I don't know what to think.
Good luck!

[snakefisherbub]

Yeah mine was talking about our history and she thumbed through my chart but nothing more. I had a date with the dildo cam and had blood work done since it was all in the same building. My hsg my husband had to come they wouldn't do it unless I had someone to take me home but he wasn't allowed in the room. It was uncomfortable but manageable.